There were many things I learned from attending my first birth as a doula. I wanted to write them down so as not to forget them. What an incredible, fun, exhilarating, and beautiful experience it was!
The mama at my first birth ROCKED!! Baby was posterior and she had a rough labor. She was sick and in pain from the start (most likely from that posterior position) and was doing everything she could while running on low energy from being up all night. Her goal was to make it to 5 without an epidural. She did great!! She made it to a stretchy 6 and got the epi after being in labor for 15 hours. What a trooper!! After the epi she was able to relax a bit more and get minutes of sleep in between all the beeps of the monitors and interruptions that come with being monitored at the hospital. We were told the mom next door had a C-section after pushing for hours because she had a posterior baby. I think that the mama was a bit worried at first, but she did so awesome! She pushed for not even two hours and birthed her perfectly healthy posterior little boy after less than 24 hrs of labor and no pitocin. What an awesome experience. :)
So what I learned from this specific experience -
* Being a doula is more about the consistent presence and support than it is bringing something special to the table every moment of labor. I kept worrying about proving myself. I wanted the family to think I was worth having. I kept trying to think of great things that no one else could think of and was getting discouraged because between the nursing staff, a mom that's birthed 8 children, and a husband studying to be a nurse...I didn't have very many other "special skills" to offer. But when everyone was exhausted, I think it was just positive words and continuous support while she was awake that probably mattered the most.
* Taking turns is hard to do. It's so difficult to know when to back off and allow the other support people have their special moments being there for mom. I wanted to give them a break, but it was hard to know when they wanted one and if they wanted to be there the whole time or not. You really have to pay attention and try to pick up on cues. I desperately wanted to not overstep bounds and also not leave mom feeling abandoned. I realized I just have to do the best I can to watch everyone and use my intuition.
* Knowing what to do and how much of it is not easy. Mom is in p-a-i-n. She is hurting and her communication is limited. She is good at telling family when she's not enjoying something, but does she feel comfortable enough to tell me that? I was very worried that I was not helping but hindering a few times and never knew how long to do something for. It's a funny place to be in. Future labors I will definitely be telling moms to make sure they feel free to yell or grunt or do whatever they need to if they are not wanting that kind of specific massage or whatever at that moment.
* Birth is the most beautiful and awe-inspiring human event I've ever witnessed. It was an incredibly powerful thing to watch that little baby make his way into the world! I wonder if I will cry during every birth. :)
I know I have so much more to learn and am really looking forward to my next birth that is coming in the next week or so! I will hopefully continue to write what I'm learning so I don't forget it and can share with other doulas that are learning too.
In closing, I think the thing that I learned the most is that this is a difficult and incredibly rewarding job. Difficult because you will never know how valuable or invaluable you really were. You may never know what things really were helpful and what things were completely useless. Every mom and every birth is completely different and you will likely be effective at differing levels for each different birth. But all of them are beautiful. All of them are life-giving. And being apart of every single one will be a blessing.
Tuesday, April 5, 2011
Wednesday, February 9, 2011
Why a Midwife?
So, what is a midwife? - A midwife is a health care provider that provides a wide array of services. These can include but are not limited to: gynecological exams, prescriptions, prenatal care, labor and delivery, preconception counseling,the list goes on and on!
Deciding on a provider is a difficult choice to make. Many women do not even understand what a midwife does or why they would choose one over an OB. Here are some wonderful reasons why most regular and low-risk mommas should choose a midwife -
* Total care - A midwife focuses on her patient as a whole person. They focus on the patient emotionally as well as physically. They are ready to not only deliver your baby safely, but also to reassure you that your body is capable and was made to do this! A midwife believes in the natural birthing process and wants to support you!!
* Informed Decisions - Midwives promote and encourage informed decisions. Most will not simply follow a routine and hope that it fits you and your birth. They will encourage you to research and know what you want. Do you want medication, the cord cut immediately, etc. This sounds like more work (and it is, but a doula and your midwife can help make this process easier!) but, the work reaps multiple benefits. You will be sure that you know every risk and benefit that's attached to each procedure/intervention. This = a happy and healthy mom and baby.
*Midwives reduce the use of interventions like epidurals, episiotomies, forceps, and vacuum extraction. This is mostly proven to be true due to the fact that Midwives have many different pain options to try (TENS machines, hot water, birthing positions, etc) and believe in the natural birthing process. Most believe in having a mother push when SHE feels ready and in the position she feels is most effective. Pushing while lying down in a bed is not the most effective way to push for many, yet is considered routine almost everywhere in America. They also rarely put the strict timetables on the pushing stage (or the entire labor process in general) that others may, which leads to more natural deliveries.
* Your chance of cesarean drops significantly when you chose a midwife as your provider. It has been proven over and over that most midwives have a much lower cesarean rate than most OBs. Midwives are trained to help deliver babies vaginally! As mentioned before, they also can be much more patient and supportive to the natural birthing process.
* You can trust your midwife. You can trust her to have your best interest as well as your baby's at heart and in the forefront of her mind. You can also trust her to refer your care to an OB if something is concerning during pregnancy or delivery that she feels would need their care. Some midwives care so fully for their patients, that they will even stay for the entire labor and delivery to support them and ensure that they are comfortable and do not feel abandoned if this were to happen!
* Cost efficiency. This is last because I believe it is least important, but worth noting. Under the care of a midwife you will spend *about* a third of what an OB's care would cost. Remember, OBs are trained surgeons qualified and ready to perform the most common surgery in our country at a moment's notice. Midwives are trained delivery assistants with a passion for birth.
So, now you've decided, right? :) If a midwife is what you want, how do you go about finding one?
- First, you need to decide what kind of midwife you would like. There are many types and you will need to research and decide what is best for you. There are two main types of midwives in the states. There are Certified Nurse Midwives (more likely to work in a hospital-type setting) and Certified Professional Midwives (most likely midwives that specialize in home-birth settings). You will need to look closely and decide which you are most comfortable with. Here's a great article that may help you decide what type of birth setting is best for you and your family.
- Once you've decided what type of midwife you want and need, you can find the perfect midwife for you a few different ways. You can look through some websites to search for one in your area, you can talk to other women in your area to find one they would recommend, or if you live in Cottonwood (or in the surrounding areas) you can just go meet mine!
Stephanie Purinton (CNM)
Stephanie works in Dr. French's office and has privileges at VVMC here in town! You can find out more about her through her facebook page "Stephanie Purinton Certified Nurse Midwife" or by emailing her at stephanie@myazmidwife.com. You really should check her out, she's fabulous!
Deciding on a provider is a difficult choice to make. Many women do not even understand what a midwife does or why they would choose one over an OB. Here are some wonderful reasons why most regular and low-risk mommas should choose a midwife -
* Total care - A midwife focuses on her patient as a whole person. They focus on the patient emotionally as well as physically. They are ready to not only deliver your baby safely, but also to reassure you that your body is capable and was made to do this! A midwife believes in the natural birthing process and wants to support you!!
* Informed Decisions - Midwives promote and encourage informed decisions. Most will not simply follow a routine and hope that it fits you and your birth. They will encourage you to research and know what you want. Do you want medication, the cord cut immediately, etc. This sounds like more work (and it is, but a doula and your midwife can help make this process easier!) but, the work reaps multiple benefits. You will be sure that you know every risk and benefit that's attached to each procedure/intervention. This = a happy and healthy mom and baby.
*Midwives reduce the use of interventions like epidurals, episiotomies, forceps, and vacuum extraction. This is mostly proven to be true due to the fact that Midwives have many different pain options to try (TENS machines, hot water, birthing positions, etc) and believe in the natural birthing process. Most believe in having a mother push when SHE feels ready and in the position she feels is most effective. Pushing while lying down in a bed is not the most effective way to push for many, yet is considered routine almost everywhere in America. They also rarely put the strict timetables on the pushing stage (or the entire labor process in general) that others may, which leads to more natural deliveries.
* Your chance of cesarean drops significantly when you chose a midwife as your provider. It has been proven over and over that most midwives have a much lower cesarean rate than most OBs. Midwives are trained to help deliver babies vaginally! As mentioned before, they also can be much more patient and supportive to the natural birthing process.
* You can trust your midwife. You can trust her to have your best interest as well as your baby's at heart and in the forefront of her mind. You can also trust her to refer your care to an OB if something is concerning during pregnancy or delivery that she feels would need their care. Some midwives care so fully for their patients, that they will even stay for the entire labor and delivery to support them and ensure that they are comfortable and do not feel abandoned if this were to happen!
* Cost efficiency. This is last because I believe it is least important, but worth noting. Under the care of a midwife you will spend *about* a third of what an OB's care would cost. Remember, OBs are trained surgeons qualified and ready to perform the most common surgery in our country at a moment's notice. Midwives are trained delivery assistants with a passion for birth.
So, now you've decided, right? :) If a midwife is what you want, how do you go about finding one?
- First, you need to decide what kind of midwife you would like. There are many types and you will need to research and decide what is best for you. There are two main types of midwives in the states. There are Certified Nurse Midwives (more likely to work in a hospital-type setting) and Certified Professional Midwives (most likely midwives that specialize in home-birth settings). You will need to look closely and decide which you are most comfortable with. Here's a great article that may help you decide what type of birth setting is best for you and your family.
- Once you've decided what type of midwife you want and need, you can find the perfect midwife for you a few different ways. You can look through some websites to search for one in your area, you can talk to other women in your area to find one they would recommend, or if you live in Cottonwood (or in the surrounding areas) you can just go meet mine!
Stephanie Purinton (CNM)
Stephanie works in Dr. French's office and has privileges at VVMC here in town! You can find out more about her through her facebook page "Stephanie Purinton Certified Nurse Midwife" or by emailing her at stephanie@myazmidwife.com. You really should check her out, she's fabulous!
Saturday, January 29, 2011
C-sections
(All of this information is from the WHO and Childbirth international and is research-based information)
Did you know??
*The World Health Organization states that a Cesarean level above 15% cannot be justified. The rate in the US is 30% + and steadily climbing
* The US alone performs between 400,00 and 500,000 unnecessary cesareans each year.
* True CPD ( a mismatch in size between the baby's size and mother's pelvis) is incredibly rare. Generally only occurring in women with a previously shattered pelvis or rickets disease.
* As many as 44% of inductions fail and result in C-sections.
* Infants are FIVE times more likely to need help breathing and or be admitted to the NICU.
* Mothers are 27 times more likely to need a hysterectomy after 1 c-section than women who delivered vaginally....27!
* Chances of Placenta Previa increase by 25% for EACH cesarean a mother has. Placenta previa doubles the chances of infant death and increases the premature birth rate by up to 6 times.
* If the cesarean rate in the US were to decrease by just 1% that would be a savings of $900,000 each year! Imagine what would happen is it decreased 15%+ to fit into the national WHO guidelines!
*** Cesareans can be a life-saving procedure for both mother and baby when medically necessary! They are also often a down-played surgery made by mom's who are un- or misinformed about the truths and dangers it possesses, especially when used unnecessarily.***
Did you know??
*The World Health Organization states that a Cesarean level above 15% cannot be justified. The rate in the US is 30% + and steadily climbing
* The US alone performs between 400,00 and 500,000 unnecessary cesareans each year.
* True CPD ( a mismatch in size between the baby's size and mother's pelvis) is incredibly rare. Generally only occurring in women with a previously shattered pelvis or rickets disease.
* As many as 44% of inductions fail and result in C-sections.
* Infants are FIVE times more likely to need help breathing and or be admitted to the NICU.
* Mothers are 27 times more likely to need a hysterectomy after 1 c-section than women who delivered vaginally....27!
* Chances of Placenta Previa increase by 25% for EACH cesarean a mother has. Placenta previa doubles the chances of infant death and increases the premature birth rate by up to 6 times.
* If the cesarean rate in the US were to decrease by just 1% that would be a savings of $900,000 each year! Imagine what would happen is it decreased 15%+ to fit into the national WHO guidelines!
*** Cesareans can be a life-saving procedure for both mother and baby when medically necessary! They are also often a down-played surgery made by mom's who are un- or misinformed about the truths and dangers it possesses, especially when used unnecessarily.***
Saturday, January 22, 2011
Doula = more successful births?
When I was pregnant, a woman from my church called and offered to be our doula for FREE. I turned her down because I thought that doula's were only for women who wanted to have a natural birth (SO not true) and I thought it would be weird to have someone I knew in the room with me (looking back I wouldn't have cared and I ended up knowing my nurse that was there!). I didn't understand what a doula did or why I would need to have one. Currently doulas attend 3% of births in the United States and 1 out of every 3 births results in a C-Section. Here are some stats I wish I would've known before birth!
Numerous clinical studies have proven that when a laboring mother has a doula by her side:
- tends to result in shorter labors with fewer complications
- reduces negative feelings about one’s childbirth experience
- reduces the need for pitocin (a labor-inducing drug), forceps or vacuum extraction and cesareans
- reduces the mother’s request for pain medication and/or epidurals
(From the DONA website)
Stats were taken from Childbirth.org. Having a doula present results in:
- 50% reduction in the cesarean rate
- 25% shorter labor
- 60% reduction in epidural requests
- 40% reduction in oxytocin use
- 30% reduction in analgesia use
- 40% reduction in forceps delivery
Sunday, January 16, 2011
Helpful things to bring...
I'm making a list of things to bring to the hospital/birthing center or to have readily available if you are having a home birth as well as my list of things to bring for you! This is not the typical "to pack" list with clothing and toiletries etc. This is a list to make you comfortable while in labor (which, for most, is a longer period of time than the time they spend there postpartum!)
Things for you to have ready:
Your favorite pillow from home if you have one
A robe and comfy slippers for walking the halls. Hospital gowns are open in the back and those floors are cold!!
An ipod with a few different playlists for labor and birth. I suggest a soothing one, one with favorites that's mixed (both upbeat and low), and then an energetic and inspiring one for pushing, bouncing on the birthing ball, etc.
Some things I will try to have readily available for you in labor:
Calming mist scents - like essential oils to help make your birthing room a calm and tranquil place
Lotions and oils - for massages and acupressure techniques
Massage items - such as (wooden rollers, textured massage balls, cold cans of soda/frozen water bottle)
Hard sucking candy like suckers and honey sticks - they really help stabilize blood sugar and give a kick of energy They really can help with nausea too.
Gum and protein bars - for birth partners present and mom if she decides that she needs to eat too
Straws - it's so much easier to stay well hydrated during labor to just be able to take a quick sip, especially if you are in an odd position that is finally providing relief
A small notebook - so that we can write down details for the birth story later
A rice sock - the heat can be a great break and help ease discomfort with back pain and contractions
A change of cloths - for me since birth is messy!
A toothbrush and toothpaste - since births can easily go many many hours!
Hair ties - they can be tricky to find in your bag and easy to forget
Emergen- C packets - for an energizing and electrolyte-filled drink
Ipod speaker - I will always keep these and extra batteries to keep those playlists flowing (I can bring my ipod with my own generic playlists too if you don't have one or don't have time to make the lists)
Camera - Just in case yours is lost or forgotten or runs out of batteries.
These are items that I think will help in a pinch and really better prepare everyone in the birthing room for the long-haul.
Are there items that you loved having at your birth??
Things for you to have ready:
Your favorite pillow from home if you have one
A robe and comfy slippers for walking the halls. Hospital gowns are open in the back and those floors are cold!!
An ipod with a few different playlists for labor and birth. I suggest a soothing one, one with favorites that's mixed (both upbeat and low), and then an energetic and inspiring one for pushing, bouncing on the birthing ball, etc.
Some things I will try to have readily available for you in labor:
Calming mist scents - like essential oils to help make your birthing room a calm and tranquil place
Lotions and oils - for massages and acupressure techniques
Massage items - such as (wooden rollers, textured massage balls, cold cans of soda/frozen water bottle)
Hard sucking candy like suckers and honey sticks - they really help stabilize blood sugar and give a kick of energy They really can help with nausea too.
Gum and protein bars - for birth partners present and mom if she decides that she needs to eat too
Straws - it's so much easier to stay well hydrated during labor to just be able to take a quick sip, especially if you are in an odd position that is finally providing relief
A small notebook - so that we can write down details for the birth story later
A rice sock - the heat can be a great break and help ease discomfort with back pain and contractions
A change of cloths - for me since birth is messy!
A toothbrush and toothpaste - since births can easily go many many hours!
Hair ties - they can be tricky to find in your bag and easy to forget
Emergen- C packets - for an energizing and electrolyte-filled drink
Ipod speaker - I will always keep these and extra batteries to keep those playlists flowing (I can bring my ipod with my own generic playlists too if you don't have one or don't have time to make the lists)
Camera - Just in case yours is lost or forgotten or runs out of batteries.
These are items that I think will help in a pinch and really better prepare everyone in the birthing room for the long-haul.
Are there items that you loved having at your birth??
Thursday, January 13, 2011
The Doula/Dad Relationship
One of the most frequently asked questions is - does a doula replace the Dad's position in labor?
My answer - Absolutely not! So I wanted to take a moment to explain the differing roles of a dad and a doula.
1. Doula's have experience and training that tells them what the mom needs. They will recognize when it's time for a new position or time for new breathing techniques. Rather than taking over and butting dad out, the doula shows dad what and to do and ensures that he is doing it effectively.If dad is uncomfortable, then doula is more than happy to take over that specific aspect (like the hip squeeze) just when mom wants that move.
2. Doula's provide relief for a Dad who is helping the mom progress. When dad's hands get tired, doula is right there to step in. She understands that closeness is vital for most women in labor and preserves that relationship with dad above all else, and is quietly there to support during that time. Then, if dad needs a break, doula is there to fill in the gaps. Let dad sleep a bit or grab a bit to eat and then come back refreshed and ready for the long-haul.
3. Doula's know many massage/acupressure/relaxation techniques that she can teach dad so that he can not only be there, but be effective while he is in that support role. Or if dad would rather, he can be talking to and with mom and supporting her other ways while the doula supports mom physically.
I see a doula as a support of the birthing couple, not just the mother. If she is good, she will only empower the couple and encourage them together!
I found this blog post incredibly informative. It is a dad writing about his birth experience with their doula. Check it out! http://bringbirthhome.com/bbh-dad/dad-doula-relationship/
My answer - Absolutely not! So I wanted to take a moment to explain the differing roles of a dad and a doula.
1. Doula's have experience and training that tells them what the mom needs. They will recognize when it's time for a new position or time for new breathing techniques. Rather than taking over and butting dad out, the doula shows dad what and to do and ensures that he is doing it effectively.If dad is uncomfortable, then doula is more than happy to take over that specific aspect (like the hip squeeze) just when mom wants that move.
2. Doula's provide relief for a Dad who is helping the mom progress. When dad's hands get tired, doula is right there to step in. She understands that closeness is vital for most women in labor and preserves that relationship with dad above all else, and is quietly there to support during that time. Then, if dad needs a break, doula is there to fill in the gaps. Let dad sleep a bit or grab a bit to eat and then come back refreshed and ready for the long-haul.
3. Doula's know many massage/acupressure/relaxation techniques that she can teach dad so that he can not only be there, but be effective while he is in that support role. Or if dad would rather, he can be talking to and with mom and supporting her other ways while the doula supports mom physically.
I see a doula as a support of the birthing couple, not just the mother. If she is good, she will only empower the couple and encourage them together!
I found this blog post incredibly informative. It is a dad writing about his birth experience with their doula. Check it out! http://bringbirthhome.com/bbh-dad/dad-doula-relationship/
Sunday, January 9, 2011
Why I chose to be a doula
SOOOO I'm going to become a CBI certified Doula this year! I am so so excited! This may seem random to some of you so I'm going to explain why I want to become a Doula and what it is exactly. :)
The moment I was being rolled down the hall to the OR for my C-Section I was praying and crying and promised God that I would do things HIS way next time. No inductions, no scare tactics, just a firm and calm belief that my body really can do what it was created to. So my VBAC journey began. A VBAC is a vaginal birth after cesarean. I began to look into it mostly because my doctor told me that our family could be medically limited to 2-3 babies if things did not go absolutely perfect each time. That terrified me. How can someone else decide that for us?! So I knew that I needed to do things differently. I cannot have a VBAC in Cottonwood, so I have to travel to Phx in order to do this. As I looked further and further I found that I have about a 75-80% chance of success at Phoenix Baptist in Phx!! I also found that studies have overwhelmingly proved that having a doula present decreases your need for c-sections, pain medication, an episiotomy, vacuum/forcep extraction, etc. That sounded fantastic to me! I also LOVE that if I want an epidural, that's totally OK! My doula is there as I will be there for others to support them in whatever decision they make!!
So what is a doula?? * this information is from the DONA international web page*
The word "doula" comes from the ancient Greek meaning "a woman who serves" and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.
Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily.
A Birth Doula
* Recognizes birth as a key experience the mother will remember all her life
* Understands the physiology of birth and the emotional needs of a woman in labor
* Assists the woman in preparing for and carrying out her plans for birth
* Stays with the woman throughout the labor
* Provides emotional support, physical comfort measures and an objective viewpoint, as well as helping the woman get the information she needs to make informed decision
* Facilitates communication between the laboring woman, her partner and her clinical care providers
* Perceives her role as nurturing and protecting the woman's memory of the birth experience
* Allows the woman's partner to participate at his/her comfort level
Research evidence shows that the quality services of a postpartum doula can ease the transition that comes with the addition of a baby to a family, improve parental satisfaction and reduce the risk of mood disorders.
I am so passionate now about empowering women to make informed decisions about their births and help them avoid any intervention that they are not open or welcoming to. I cannot wait to get started! I have 2 births lined up currently and hope to have many many more!! :)
The moment I was being rolled down the hall to the OR for my C-Section I was praying and crying and promised God that I would do things HIS way next time. No inductions, no scare tactics, just a firm and calm belief that my body really can do what it was created to. So my VBAC journey began. A VBAC is a vaginal birth after cesarean. I began to look into it mostly because my doctor told me that our family could be medically limited to 2-3 babies if things did not go absolutely perfect each time. That terrified me. How can someone else decide that for us?! So I knew that I needed to do things differently. I cannot have a VBAC in Cottonwood, so I have to travel to Phx in order to do this. As I looked further and further I found that I have about a 75-80% chance of success at Phoenix Baptist in Phx!! I also found that studies have overwhelmingly proved that having a doula present decreases your need for c-sections, pain medication, an episiotomy, vacuum/forcep extraction, etc. That sounded fantastic to me! I also LOVE that if I want an epidural, that's totally OK! My doula is there as I will be there for others to support them in whatever decision they make!!
So what is a doula?? * this information is from the DONA international web page*
The word "doula" comes from the ancient Greek meaning "a woman who serves" and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.
Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily.
A Birth Doula
* Recognizes birth as a key experience the mother will remember all her life
* Understands the physiology of birth and the emotional needs of a woman in labor
* Assists the woman in preparing for and carrying out her plans for birth
* Stays with the woman throughout the labor
* Provides emotional support, physical comfort measures and an objective viewpoint, as well as helping the woman get the information she needs to make informed decision
* Facilitates communication between the laboring woman, her partner and her clinical care providers
* Perceives her role as nurturing and protecting the woman's memory of the birth experience
* Allows the woman's partner to participate at his/her comfort level
Research evidence shows that the quality services of a postpartum doula can ease the transition that comes with the addition of a baby to a family, improve parental satisfaction and reduce the risk of mood disorders.
I am so passionate now about empowering women to make informed decisions about their births and help them avoid any intervention that they are not open or welcoming to. I cannot wait to get started! I have 2 births lined up currently and hope to have many many more!! :)
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