6 Points For Birth Partners to Consider When Hiring a Labor Doula

by Cynthya Dzialo, certified Hypnobabies hypno-doula and CBI birth doula, childbirth educator, and owner of The Happiest Doulas 

"HELP! My partner doesn't think we need to hire a doula."

Yikes! I've heard this before from clients and students of my classes. Sometimes, one partner REALLY wants to hire a birth doula and the other can't justify the expense or face the realities of the upcoming birthday. Evidence shows continuous support can significantly decrease the risk of cesareans, NICU admissions, Pitocin, and medications for pain relief, as well as increase satisfaction with the birth experience altogether.

Here are my suggested talking points for reserving the services of a doula and private childbirth classes:

1. Ask your partner how they plan to support your labor. Do they want to rub your back or squeeze your hips for 18 hours all by themself? Prior to labor, do they want to memorize optimal labor positions to facilitate progress and avoid a stall that can lead to medical interventions?
   

2. Have they prepared to be your SOLE source of emotional and physical comfort? Will they be able to provide you with informational support and advocate for alternatives to proposed medical interventions? Here is an article I wrote for preparing labor partners for the big event. It's generic but what everyone should know in the LEAST.
   

3. Who do they plan to have present on birthday to help THEM? Most partners want us to be present for them too, especially upon realizing the nurses won't be in the room but for an average of 10 minutes per hour prior to the second stage.
   

4. Yes, preparing for childbirth with a comprehensive prenatal class is VERY helpful, but on birthday, recalling pertinent info on little sleep while watching your partner run a marathon is stressful. Doulas remove the burden from the birth partner's shoulders, relieves their stress and helps them enjoy the birthday/night/weekend. Birthday can be a wonderful bonding experience for you two!
   

5. Is their hesitation due to financial reasons? Think about the cost of a c-section and an extended hospital stay. Since doula support is a PROVEN way to reduce the risk of c-section, hiring an experienced doula WILL SAVE YOU MONEY. Many of our clients use their HSA/FSA debit cards to pay for childbirth services such as classes and doula support. Our agency includes our NPI number and taxonomy code on our order confirmations so you may attempt reimbursement from your insurance company or HSA/FSA accounts.
   

6. The American College of Obstetricians and Gynecologists say doula support is NECESSARY in the prevention of the primary c-section! Here's an excerpt from my blog post with links to the research:

"Today, approximately 60% of all cesarean births are primary cesareans. Although cesarean birth can be life-saving for the baby and/or the mother, the rapid increase in cesarean birth rates raises significant concern that cesarean delivery is overused without clear evidence of improved maternal or newborn outcomes. Published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula. A Cochrane meta-analysis of 12 trials and more than 15,000 women demonstrated that the presence of continuous one-on-one support during labor and delivery was associated with improved patient satisfaction and a statistically significant reduction in the rate of cesarean delivery (111). Given that there are no associated measurable harms, this resource is probably underutilized."

The most important thing a woman needs during labor is continuous support.

Read (and share!) this article by Evidence Based Birth. Here's an excerpt: "Labor support also increases satisfaction and the chance of a spontaneous vaginal birth. Although continuous support can also be offered by birth partners, midwives, nurses, or even some physicians, research has shown that, with some outcomes, doulas have a stronger effect than other types of support persons. As such, doulas should be viewed by both parents and providers as a valuable, evidence-based member of the birth care team."

Prepare for the biggest day of your life!

You will most definitely need to be prepared for your baby's birthday if you plan to go without the professional assistance of a labor doula. Attend a prenatal birthing class. Our intensive prep - the 3 Hour Labor Lesson - helps your partner gain skills to help you on birthday effectively.

Related posts:
5 Reasons to Hire a Doula
Epidural, Please!

Probiotics + Pregnancy = Relieve Nausea, Reflux and Constipation

by Kristin Oja, DNP, FNP-C, PT-C

Improve vaginal flora for birth while strengthening your baby's immune system

Gut health has become quite a popular topic in functional and integrative medicine. You may have heard statements such as:

“The GUT is the GATEWAY to your health” or “Gut health is the KEY to overall HEALTH” – Kris Carr

“Heal your GUT, Heal your BODY” or “All disease begins in the GUT” – Hippocrates

“Anything that affects the GUT always affects the BRAIN” – Dr. Majors

These statements are all true. A healthy gut improves nutritional absorption, immune system function, hormone balance, mood, metabolism, and aids in detoxification. There are several variables that impact gut health, but one of the major drivers of a healthy gut is a diverse microbiome.

“Gut health is the KEY to overall HEALTH”

— Kris Carr

What is the microbiome?

The microbiome is simply a collection of live microorganisms that inhabit a specific area. According to The Gut Microbiota for Health, “our gut microbiota contains tens of trillions of microorganisms, including at least 1000 different species of known bacteria with more than 3 million genes (150 times more than human genes)”. Is that not amazing or what?

As a culture, our gut microbiomes are not as diverse and healthy as we would like because of antibiotic use, antimicrobial soaps, pesticides, and general cleanliness. Because of this, I encourage my clients to supplement with probiotics.

What are probiotics?

Probiotics are live organisms (both bacteria and fungi) that are good for our health, especially within the intestines. Probiotics can be found naturally in certain foods such as yogurt, kefir, kombucha, and cultured vegetables. Lactobaccilus and bifidobacterium are some of the most common beneficial bacteria found in probiotics and saccharomyces boulardii is one of the most common beneficial yeast found in probiotics. Probiotics help strengthen the immune system and help fight off pathogenic (disease causing) organisms from colonizing in our gut.

So why are probiotics important to supplement during pregnancy?

As you can see, probiotics are important during all phases of life; however, they are essential during pregnancy and postpartum. Scientists are starting to believe that by the age of 3 a child’s gut microbiome is similar to that of adults. Therefore, everything we do for our child from birth on can have a huge impact on their gut microbiome.

Your newborn’s intestines are quickly colonized with bacteria and yeast during and after delivery. As a baby passes through the vaginal canal, live microbes are transmitted to the baby through the nose, eyes, mouth, and skin. I have several of my patients and clients start using vaginal probiotics to make sure the vaginal flora is healthy for delivery. After delivery, breastfeeding is an excellent way to strengthen your infant's gut flora. We used to think that breast milk was sterile; however we are now finding breastfeeding is a great way to transmit probiotics to your little one. They are finding that infants who are breastfed have more bifidobacteria compared to formula fed infants.

It is never too early to start taking probiotics. I recommend taking probiotics throughout pregnancy because they may help with some of the common digestive complaints including nausea, reflux/heartburn, and constipation. Some of my favorite probiotics include: VSL 3, Prescript Assist, Dr. Formulated Probiotics for Women, and Orthobiotic.

More of my recommendations to prevent nausea and other pregnancy issues are reviewed in this free webinar, What Your OB Won’t Tell You. Be sure to check out STAT Wellness and follow me on Instagram to gain easy and healthy lifestyle tips.

In good health,
Kristin Oja, DNP, FNP-C, PT-C
 

Kristin Oja has her doctorate of nursing practice (DNP), is a board-certified family nurse practitioner, registered nurse, personal trainer, and group fitness instructor. Kristin is the Founder of STAT Wellness, which stands for Strength to Achieve Total Wellness. Through STAT Wellness, Kristin offers personal training, small group training, corporate wellness and wellbeing, and one on one consultations.

When she is not treating patients or working with STAT, Kristin is passionately serving the people of Honduras with the nonprofit HOI, where she serves on the medical board. Kristin was recently married and lives in Atlanta with her husband, Cameron. You may catch Kristin out for a run on the Beltline or enjoying the city’s food scene.

Related posts:
10 Benefits of Exercising During Pre

Prepare for a Mindful Birth with our NEW online childbirth classes

Unlock your potential with our quick and impactful collection of mini-courses, Mindful Preparation, designed for busy pregnant people. Take it at your own pace whenever you’d like! In just a couple of hours, each mini-course (chapters) gives you the essential knowledge and skills to enhance your childbirth experience.

Course Highlights:

• Evidence-Based Practices: Learn the latest research and techniques to support your birth plan.

• Labor Support Strategies: Discover effective methods to manage pain and navigate the labor process.

• Postpartum Preparation: Equip yourself with tools for recovery and newborn care to ensure a smooth transition into the “4th trimester”.

Why Choose Our Childbirth Courses?

• Expert Guidance: Created by seasoned doulas who understand the journey of childbirth.

• Inclusive Language: It’s our only way to speak. Not all pregnant people consider themselves expectant mothers. We’re a (queer) inclusive practice and welcome everybody including husbands and wives but you won’t read or hear those labels in our courses.

• Quick and Convenient: Designed to fit into your busy schedule. Works on mobile and desktop.

Our new collection of 4 childbirth mini-courses is available as 1 FULL class: Mindful Preparation at a special intro price.

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Related articles:
How to Get Support f
Postpartum Expectations
5 Reasons to Hire a Birth Doula

The Most Common Complications of Childbirth

by Jaime Filler, LMFT

1 out of 7 new moms experience a postpartum mood or anxiety disorder. In fact, perinatal depression and anxiety are the most common complications of childbirth. However, it's not being talked about with (or between) new moms, leaving these women to suffer in silence. It's time we learned about these conditions and the factors that can put a mom at a higher risk.

 

Prevalence

85% of childbearing women experience significant distress following pregnancy, yet as a society we often do not talk about perinatal distress.

Baby Blues

• 80% experience the “Baby Blues”

• Baby blues typically occurs a week after delivery and will self-resolve within 2-3 weeks.

• Common symptoms of the Blues are: tearfulness, irritability, anxiety, feeling overwhelmed.

Perinatal Mood and Anxiety Disorders

• 15-20% of moms experience Perinatal Mood and Anxiety Disorders

• Depression, Anxiety, OCD and PTSD are the most common

• Onset can be anytime within the first year

• Most common onset is 2-3 months after delivery

• Perinatal depression and anxiety are the most common complications of childbirth.

• 10% of DADS/Partners will experience anxiety or depression following the birth of a child. In fact, if a mom is experiencing depression or anxiety, the rate for dads/partners goes up to 50%.

Risk

Perinatal depression and anxiety can affect anyone, regardless of social class, race, and even gender.

Common Triggers: rapid weaning, hormonal birth control, increased family stress (going back to work, illness/hospitalization, loss/grief)

Risk Factor Check List:

1. It’s hard for me to ask for help.

2. I’ve had trouble with hormones and moods, especially before my period.

3. I was depressed or anxious after my last baby or during my pregnancy.

4. I’ve been depressed or anxious in the past.

5. My mother, sister, or aunt was depressed after her baby was born.

6. Sometimes it’s hard to slow down: I don’t need to sleep, have lots of new ideas, and feel very restless.

7. My family is far away and I don’t have many friends nearby.

8. I don’t have the money, food or housing I need.

If you have three or more risk factors, you are more likely to have depression or anxiety during pregnancy or postpartum. An additional risk factor is if you have experienced past sexual abuse or trauma. Often, those feelings will resurface during pregnancy or after child birth.

Symptoms

• Depression: Sad, crying, loss of appetite, insomnia, suicidal thoughts, loss of interest in enjoyable activities, anger or irritability

• Anxiety: Panic attacks, insomnia, fears, excessive worry, loss of appetite

• OCD: Intrusive thoughts or images (very disturbing to mother), hypervigilance, checking, avoiding harm or triggers (ex. hiding knives)

• PTSD: Often following a traumatic birth, or baby in the NICU. Re-experiencing traumatic event, increased anxiety, panic

• Psychosis: Occurs 1-2 in 1000 and usually starts 2-3 weeks after baby is born. Confusion, erratic behavior, rapid shifts in mood, delusions or hallucinations.

Prognosis

The quicker the symptoms are addressed, the quicker you will feel better.

With help, these conditions are treatable. Talk to your doctor or midwife, see a therapist who has specialized training in maternal mental health, and attend a support group. DO NOT SUFFER IN SILENCE! You are NOT ALONE!! Immediate help is available to you.

Related posts:   Nutrition Tips For Postpartum * Signs Of Postpartum Depression * 4 Things To Do Now For A Healthier Postpartum

Benefits of Upright and Spontaneous Pushing and How to Get Support For What You Want

No matter which birth option you choose - medicated or unmedicated - the key takeaway is to have the right support around you to optimize your birth outcome. Throughout the course of labor, including the pushing stage, women benefit from frequent position changes and ideally, should be free to select them at will.

Lamaze’s Healthy Birth Practice #5: Avoid Giving Birth on Your Back and Follow Your Urges to Push

In order to avoid giving birth on your back, following the Healthy Birth Practices of allowing labor to begin on its own, changing positions throughout labor, having continuous support, and avoiding unnecessary interventions really come into play.

First and foremost, allowing labor to begin on its own is a key ingredient of avoiding unnecessary interventions that in turn could cause you to have to give birth on your back because it avoids the use of synthetic drugs to get your labor started. Changing positions and having continuous support throughout your labor will also help you avoid interventions like medical pain management by easing the intensity of contractions.

Throughout history, women have been pictured giving birth in positions that are much more suitable for positive birth outcomes. Squatting, sitting, and standing all use the help of gravity to move the baby down and open the pelvis so the baby has more room to descend. Being able to freely change positions is much needed during labor, not only to ease discomfort but to promote the natural descent of the baby. Freedom of movement and working with your body will allow you to determine what position is optimal for you to push.

Many care providers prefer women to birth on their backs with their legs up in stirrups simply because it's easier access to see and catch the baby. Laboring on your back generally comes with directed pushing because it's likely that you've had an epidural which caused you to have to be on your back in the first place, otherwise you’d likely need/want to move during the pushing phase. (With an epidural, you may not feel the urge to push and need guidance on when and how to push effectively.)

Directed pushing is exhausting and according to the Lamaze website, “Goer and Romano (2012) found evidence to demonstrate that directed, forceful pushing had the potential to increase pressure on the baby and the umbilical cord, and the tissues of the perineum, resulting in more tears and a weaker pelvic floor musculature which can result in urinary incontinence."

To help ensure you can birth in the position you choose, follow these tips:

1. Talk to your care provider and choose one who fully supports any position for labor and birth.

2. Hire a doula or be sure to have continuous labor support available to help you avoid unnecessary pain medications. A doula is also very helpful with positioning if you do end up needing pain medication that limits mobility.

3. Get educated by taking a birth preparation class. The more you know about birth and what's normal, the more confidence you will have in the birth process and the more comfort measures you will learn.

4. Labor at home for as long as possible. The earlier you get to the hospital, the more likely you may be to use pain relief medication. Think of it like a kid in a candy store. If the "candy" is there, you may want to sample it!

When NOT lying on your back while giving birth, you oxygenate your body so you won't be lying on your aorta. Since the evidence is not strong enough at this point to recommend one specific birthing position over another, you should receive support to birth in whatever position feels right to you. However, flexible sacrum positions—those where you don’t put your weight on your tailbone—appear to be more helpful to normal vaginal birth.*

No matter what birth option you choose, medicated or unmedicated, the key takeaway is to have the support around you who will optimize your birth outcome. Throughout labor, including the second (pushing) stage, women benefit from frequent position changes and ideally, should be free to select them at will.

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This post is part 6 of a 7 part series written by our team of Lamaze Childbirth Educators. Stay tuned for our final post in this series, Keep Parent and Baby Together.

Part 1 can be read here.

Read part 2, Hormones and the Waiting Game
Read part 3, Make Labor Productive
Read part 4, When Childbirth Moved Into Hospitals
Read part 5, Avoid Routine Medical Interventions
Read part 6, Benefits of Upright and Spontaneous Pushing
Read part 7, Keep Parent and Baby Together

Resources cited:

https://www.lamaze.org/Connecting-the-Dots/book-review-optimal-care-in-childbirth-the-case-for-a-physiologic-approach-reviewed-through-a-childbirth-educators-eyes

https://www.lamaze.org/Portals/0/HBP%20%235%20Avoid%20Giving%20Birth%20on%20Your%20Back%20and%20Follow%20Your%20Body%27s%20Urges%20to%20Push.pdf

*Excerpt from Evidence Based Birth Handout, Evidence on Birthing Positions.
https://evidencebasedbirth.com/evidence-birthing-positions/

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Related articles:
5 Labor Tools for Pa
Postpartum Expectations
5 Reasons to Hire a Birth Doula

Make Labor Productive with Positivity, Positions and Personal Support

Part 3 of 7, written by Christina Thomson, Certified Birth Doula and Lamaze Childbirth Educator

 

Attribution: Lamaze International

Healthy Birth Practice 2: Walk, move around and change positions throughout labor

One key element to having an easier, faster and more productive labor is movement. In the past, moms were drugged and laid out flat on their backs to give birth and given very little opportunity to move around during labor. To this day, even a lot of media still portrays birth as a "lay on your back and push" method.

Movement during labor optimizes baby's positioning by using gravity to helps engage baby into the pelvis, naturally move baby down the birth canal, and can help relieve pain. It can also decrease the amount of intervention needed to help labor progress. Depending on your medical condition, fetal monitoring may be required intermittently or continuously during labor. Some hospitals have wireless fetal monitors that allow you to still walk around without restricting movement.

Follow these 3 major points to ensure you have freedom of movement during labor:
 

1. Your choice of a care provider is important. Be sure to choose someone with a natural mindset that supports movement in labor.

Women who are moving around and use upright positions during labor have shorter labors, less intervention, report less severe pain, and describe more satisfaction with their childbirth experience than women in recumbent positions. Changing positions frequently move the bones of the pelvis, helping the baby find the best fit to come down. Moving around can also help prevent c-section by reducing the chances of a stall of labor or shortening the amount of time a stall lasts; especially in early labor. A certified birth doula can help you with this…

 

2. Stay at home until you're in active labor (6cm). Contractions every five minutes lasting about a minute each for a steady hour or two is a good indicator that you’ll be approaching the active phase soon. Laboring at home is more relaxing because you're in your own environment and there’s less risk of an infection.

Upon arrival at the hospital, be sure to request that IV use and continuous fetal monitoring is used as little as possible unless medically necessary.

Before choosing medication for pain management, be sure you're aware of how it could impact your ability to move. Most medications make it difficult to walk and stand during labor. An epidural will completely confine you to bed. A "walking epidural" generally refers to the ability to move your legs. The administration of pain medication generally requires the use of an IV and continuous fetal monitoring, which can restrict your movement quite a bit.

3. Prepare for labor and birth. Learn what to expect for childbirth and gain tools for staying comfortable throughout the process. Hire a doula or have a friend or family member join you during labor to help you with positioning techniques.

Positive positions for laboring:

• Hands and knees can relieve back pain and help baby rotate into optimal position.

• Sitting on the toilet uses gravity and relaxes the perineum.

• Sitting upright allows gravity to work and is a good position for resting. Sitting on a birth ball can be very soothing and allows for rocking your hips and bouncing.

• Squatting uses gravity and opens the pelvis to allow baby to descend. Request a squat bar to be attached to your hospital bed.

• Side-lying is another great position for resting, helps move oxygen to baby and is a good position if you have an epidural.

• Leaning or kneeling forward on the bed or wall allows baby to rotate into proper position, can relieve back pain and is great for pelvic rocking.

• Standing and walking use gravity to encourage baby's descent.

The key is to listen to your body and move in a way that feels natural to you. Throughout the duration of your labor you might find one position helpful, but then find it doesn't seem to work at a later time. It's important to remember that with each position change, sometimes that first contraction or two in the new position may seem very uncomfortable. Give the new position a try with a few contractions before deciding that it's not comfortable for you. A birth doula can help you stay comfortable and focused throughout active labor and the transition stage to delivery.

Be sure to surround yourself with positivity and only have people in the room that you are comfortable with. The more relaxed and mobile you can be during your labor, the easier it will be! Consider hiring a doula to help you throughout the process of labor and childbirth. Our doula group can help you in both Tampa and Atlanta. Learn more about our Doula Support options here.
 

Attribution: Lamaze International

The Institute of Medicine says it takes on average 17 YEARS after new research is published for medical professionals to change the way they practice. Don't get stuck with outdated practices for your baby's birthday! With our private prenatal lesson or "intensive" ONE DAY childbirth class, you'll learn how to get evidence-based care to optimize your birth outcome. In both Atlanta and Tampa, we teach an "intensive" preparation for childbirth with our "ONE DAY" group class. 

If you cannot attend an in-person birthing class with us, we suggest you schedule a private prenatal lesson. Registration for either the Intensive class or a private, in-home lesson includes access to our online Learning Center where you may watch videos, read further research and download sample birth plans. Both these class options are an excellent opportunity for you and your birth partner to gain current evidence based birth practices that can help you have the safest birth for you and your baby. Sign up today.

This post is part 3 of a 7 part series written by our team of Lamaze Childbirth Educators. Stay tuned for upcoming posts in our series, How To Alleviate Fears and Manage Labor Pain.

Part 1 can be read here.

Read part 2, Hormones and the Waiting Game
Read part 3, Make Labor Productive
Read part 4, When Childbirth Moved Into Hospitals
Read part 5, Avoid Routine Medical Interventions
Read part 6, Benefits of Upright and Spontaneous Pushing
Read part 7, Keep Parent and Baby Together

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Related posts: 
5 Reasons Your Labor Nurse Cannot Be Your Doula
Episiotomy and C-section Rates at Atlanta Hospitals
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Benefits of Keeping Parent and Baby Together Following Birth

Kangaroo care, also known as skin-to-skin contact, is more than just the start of cultivating the bond between you and your baby. In this post, we list the health benefits of uninterrupted skin contact between baby and parent as well as tips to advocate for yourself on this healthy birth practice.

Healthy Birth Practice #6: Keep Parent and Baby Together

According to Lamaze International, “mothers and babies have a physiologic need to be together during the moments, hours, and days following birth, and this time together significantly improves maternal and newborn outcomes.” The World Health Organization and UNICEF recommend that all healthy babies and mothers, regardless of feeding preference and method of birth, have uninterrupted skin-to- skin care beginning immediately after birth for at least an hour.

As midwife Ina May Gaskin says, you’re entitled to "keep your prize,” and during those first moments after birth, the mother and baby “are doing something more important than just lying together. They are falling in love.” Every relationship needs time to grow. The same is true for the relationship between a mom and a new baby. That “Golden Hour” after a baby is born is when they are the most alert and learning about their new world. Your baby is taking in your smell, your voice, your face, and the nutrition you provide. Their new world is you, and that's all your baby needs.

Studies show that there are also health benefits to doing skin to skin with your baby. That contact regulates your baby's heart rate and body temperature. It also helps establish regular breathing patterns and sustains stable blood sugar levels. There are also health benefits for mom! That feeling of “falling in love” with your baby is caused by the high levels of Oxytocin that occur as your baby moves through your birth canal and when you first touch and look at each other. The high levels of Oxytocin are responsible for keeping your uterus contracted to reduce bleeding and helping you and your baby feel calm and responsive. When our bodies work hard, we have a rush of endorphins, which have been shown to help a mother’s ability to bond with her baby. Endorphin levels are especially high within the first 20 minutes of birth, and they are strongly present in breast milk! This is the ideal time to initiate breastfeeding!

How can you make sure you and your baby are given this time?

• Request that your baby is placed on your bare abdomen or chest right after birth, with a warmed blanket laid over you both.

• If baby is healthy, you can also ask that any examinations be done while the baby is in your arms.

• If you plan to do certain vaccinations at birth, you can ask that they be delayed until after you've had that special time together.

• If you aren't able to do skin-to-skin immediately, your baby will still benefit from doing skin-to- skin with your partner or support person.

• In the event of a Cesarean birth, ask your provider about doing a family-centered Cesarean in which the lights are dimmed and your baby is placed on your chest after surgery.
  
  

The first moments after birth are so important in cultivating the bond between you and your baby. Take that time. Rest with your baby. This is just the beginning of an amazing foundation of love, trust, and understanding. But also remember that forming a strong attachment to your baby is not done only during the first few hours. It is a lifelong process.

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This post is the final chapter of our 7 part series, How To Alleviate Fears and Manage Labor Pain.

Part 1 can be read here.

Read part 2, Hormones and the Waiting Game
Read part 3, Make Labor Productive
Read part 4, When Childbirth Moved Into Hospitals
Read part 5, Avoid Routine Medical Interventions
Read part 6, Benefits of Upright and Spontaneous Pushing
Read part 7, Keep Parent and Baby Together

Supported by research studies that examine the benefits and risks of maternity care practices, these 6 birth practices are the foundation of Lamaze childbirth classes taught around the world. These healthy practices are designed to simplify the birth process to alleviate fear and manage discomfort. No matter what type of labor, the length of your labor, or your confidence level, these practices are key to keeping you and your baby as safe and healthy as possible.

To learn more, schedule a private lesson here. Our team will help you get evidence-based care and self-advocate for what you want on your baby’s birthday and beyond.

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Related posts:
How Taking a Childbirth Class May Prevent Birth Trauma
9 Questions To Ask Yourself: Signs Of Postpartum Depression
Episiotomy, Tears, and Perineal Support

These 6 Healthy Practices Alleviate Childbirth Fears and Help Manage Labor Pain

Attribution: Lamaze International

Supported by research studies that examine the benefits and risks of maternity care practices, these six birth practices are the foundation of Lamaze childbirth classes taught around the world. These healthy practices are designed to simplify the birth process in order to alleviate fear and manage discomfort. No matter what type of labor, the length of your labor, or your confidence level, these practices are key to keeping you and your baby as safe and healthy as possible.

What are the Six Lamaze Healthy Birth Practices?

1) Let Labor Begin On Its Own

2) Walk, Move, Change Positions
 
3) Continuous Labor Support

4) Avoid Routine Interventions

5) Avoid Giving Birth on Your Back and Follow Your Urges to Push 

6) Keep Parent and Baby Together

In both Atlanta and Tampa, we teach an intensive preparation for childbirth with our Labor Lesson. We suggest you schedule a private prenatal lesson to take place around 34-35 weeks gestation.

Registration for this private, in-home lesson includes access to our online Learning Center where you may watch videos, read further research, and download sample birth plans. This is an excellent opportunity for you and your birth partner to gain current evidence-based birth practices to help you have the safest birth experience.

Read part 2, Hormones and the Waiting Game
Read part 3, Make Labor Productive
Read part 4, When Childbirth Moved Into Hospitals
Read part 5, Avoid Routine Medical Interventions
Read part 6, Benefits of Upright and Spontaneous Pushing
Read part 7, Keep Parent and Baby Together
 

Related posts:
Prevent Birth Trauma
5 Labor Tools for Partners
Epidural, Please!

How To Avoid Routine Medical Interventions

Medical interventions are frequently used in the birthing process, however, they usually have unintended effects that lead to more and more interventions. They tend to be done based on convenience rather than a medical reason and are quite often overused. However, there are instances in which they may be beneficial. Interventions should be thought of as tools to help guide you through labor if certain situations arise.

Before deciding to disrupt your body’s natural response to labor talk to your care provider about benefits, risks, and alternatives to the proposed intervention. It is important you know that ultimately it is your labor and your choice of how you want to birth your baby.

Healthy Birth Practice #4: Avoid Routine Procedures, Interventions

Intervention 1: Intravenous Fluids

Intravenous fluids are one of the most common routine interventions used throughout labor and delivery. IV fluids may be used concurrently with medications such as antibiotics or pain medication. IV fluids may seem harmless but they carry risks just like any other intervention. For example, having continuous fluids may cause:

• Restricted movement -> increased pain -> epidural

• Areolar swelling -> hard to latch baby to successfully breastfeed -> supplement with formula

• An increase in baby’s weight -> baby loses 10% or more of birth weight -> supplement with formula

Alternative: Talk with your care provider about drinking clear fluids.

The World Health Organization urges against the use of routine IV fluids during normal labor and birth (WHO, 1997). They caution that restricting oral intake can lead to dehydration and exhaustion, and propose instead that people at low risk of requiring general anesthesia be offered drinks and light meals during labor.
 

Intervention 2: Episiotomy

An episiotomy is sometimes used when a baby is very large or is in a suboptimal position while pushing. For many years, episiotomies were performed regularly on practically all birthing women. It was once thought that repairing a surgical cut was easier than repairing a jagged tear. Unfortunately, once an episiotomy is done, women have a tendency to continue tearing. Research has since proven that routine episiotomies are not any more effective nor healthier than naturally tearing.

Alternative: Have your care provider use a warm compress on your perineum during pushing.

Intervention 3: Pitocin

Pitocin is a drug used to mimic the body’s natural hormone responsible for labor - oxytocin. Pitocin can be used during labor to speed up and strengthen contractions. It can also be used after delivery to stop bleeding and shrink the uterus. While they do work alike, oxytocin provides more benefit to mother and baby.

Below is a comparison of how the two differ; Oxytocin (O) vs. Pitocin (P):

• O: released in pulsing action intermittently

• P: given continuously through IV = longer and stronger contractions

• O: body responds with endorphins = natural pain relief

• P: body does not know to release endorphins

• O: spikes at birth to promote healing/bonding with your baby

• P: does not spike - interferes with natural release of oxytocin

Alternative: Use nipple stimulation to promote natural oxytocin release.

Intervention 4: Continuous Electronic Fetal Monitoring

Upon arrival at the hospital it is common to be placed on electronic fetal monitors to read your baby’s heart rate. This is done to confirm that your baby is tolerating labor well. However, oftentimes the mother is continually hooked up to these monitors without reason. There has been no proven benefit of continuous monitoring for babies. In fact, the World Health Organization states continuous monitoring is often used inappropriately. The American College of Obstetricians and Gynecologists suggests intermittent monitoring every 30 minutes during labor and every 15 minutes while pushing.

Alternative: Ask your care provider for intermittent monitoring.

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These are just a few examples of how medical interventions are used routinely during labor and delivery. One way to avoid many of the routine interventions is to labor at home as long as possible. Early labor can last up to 24 hours. Be sure to communicate with your care provider on when to head to the hospital.

It is also important to have a general understanding of birth. Taking a childbirth class and writing out a birth plan that includes your wishes for how you want your labor to look is a great idea as well. Most importantly, carefully choose your care provider - choose one that is understanding of your birth preferences. Also consider hiring a doula to help support you physically and emotionally throughout your labor and postpartum period!

Credit: Lamaze International

The Institute of Medicine says it takes on average 17 YEARS after new research is published for medical professionals to change the way they practice. Don't get stuck with outdated practices for your baby's birthday! With our private prenatal lesson you'll learn how to get evidence-based care to optimize your birth outcome. In both Atlanta and Tampa, we teach an "intensive" preparation for childbirth with our private in-home Labor Lesson. You can reserve your spot here.

Registration includes access to our online Learning Center where you may watch videos, read further research, and download sample birth plans. Both these class options are an excellent opportunity for you and your birth partner to gain current evidence-based birth practices that can help you have the safest birth for you and your baby.

This post is part 5 of a 7 part series written by our team of Lamaze Childbirth Educators. Stay tuned for upcoming posts in our series, How To Alleviate Fears and Manage Labor Pain.

Part 1 can be read here.

Read part 2, Hormones and the Waiting Game
Read part 3, Make Labor Productive
Read part 4, When Childbirth Moved Into Hospitals
Read part 5, Avoid Routine Medical Interventions
Read part 6, Benefits of Upright and Spontaneous Pushing
Read part 7, Keep Parent and Baby Together

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Related posts:
Episiotomy and C-section Rates
Prevent Birth Trauma
Signs Of Postpartum Depression
Make Breastfeeding E

Hormones and the Waiting Game: Letting Labor Begin on its Own, Weighing Benefits v Risks of Induction

Part 2 of 7, a series written by our team of Lamaze Childbirth Educators.
 

If you’ve been pregnant before, or had friends or family who have been pregnant, then you have likely either heard or been asked, “Is the baby here yet?” or “Have you had the baby yet?” Strangers who feel they possess the ability to gauge exactly how pregnant you are simply by glancing at your belly, and say something along the lines of, "Oh, you must be about to pop!”

Healthy Birth Practice #1: Let Labor Begin on its Own

Once a "due date" is assigned, people start to view that date like the finish line. You finish the marathon of pregnancy, and hit 39 - 40 weeks and you're done. The turkey timer has popped up, and everyone you know (and some you don’t) wait with pregnant anticipation for you to announce you are headed to the hospital, or for you to share a picture of your new little bundle the second he/she is born. However, the due date comes and goes. Still no baby. You just ran a marathon and crossed the finish line, you shouldn't have to run around the block a few more times before you get your medal, right? You’ve got impatient family members, people wanting to make plans to visit, your favorite midwife or doctor is only on call certain days, not to mention you are feeling so ready to be done. If you’ve paid your dues, and grew and carried that sweet baby for at least 39 weeks; what is so wrong with inducing labor or giving it a little push to help make schedules fit, or so you can have your favorite provider for delivery, etc.? 

Every day of the last weeks of pregnancy is vital to your body's (and your baby's) preparation for birth. Should you choose for labor to be induced, it becomes a medical event and proceeds quite differently from spontaneous labor. Keep reading to better understand why this is so.

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In pregnancy, labor will start only when all the players—your baby, your uterus, your hormones, and your placenta—are ready. There are hormones that play a part in labor (oxytocin, endorphins, catecholamines, and prolactin) are important. Here's why:

Oxytocin causes labor contractions and helps create feelings of love, calmness, and connection to others.

There is a natural occurring oxytocin surge in the mother’s body that precedes spontaneous labor. This is thought to have a neuroprotective effect on the baby, reducing oxygen requirements of the fetal brain. Also worth noting, when higher levels of the synthetic version of oxytocin was used (pitocin), it produced the opposite effect on the fetal brain in animal studies. In english: The surge in the naturally occurring oxytocin in your body before spontaneous labor, can actually help protect your baby’s brain during parts of labor when oxygen is not as readily available. 
 

Endorphins help relieve stress and pain around the time of birth.

Oxytocin and oxytocin receptors increase in the final days before spontaneous labor. Endorphin levels and endorphin receptors also gradually increase as well. Women who exercise regularly have higher levels of endorphins when they go into labor and report less labor pain than women who do not exercise regularly. Letting labor begin on its own and exercising regularly throughout pregnancy will allow women to begin labor with optimal levels of endorphins.
 

Catecholamines help you and your baby feel alert and ready for birth, and they help protect your baby’s heart and brain during strong labor contractions.

Catecholamines are vital to readying the baby’s lungs for air breathing after birth, and fetal catecholamines increase a few days before spontaneous labor. Knowing that due dates are rarely exact (and even if they are, some babies need more time), inducing at 40 weeks can still lead to issues if the baby is not ready.
 

Prolactin is called the “mothering hormone.” It has many roles including helping your breasts make milk.

However, its not just for breastfeeding! There are studies that show that like its cohorts oxytocin, endorphins, and catecholamines, prolactin levels increase throughout pregnancy, increasing shortly before the onset of spontaneous labor. It is also thought that prolactin in late-gestation plays a part in helping fetal lungs to mature as well as helping with temperature regulation of the baby after birth.

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Each of these hormones are important is helping your labor progress as smoothly as safely as possible. Each one is an important piece and plays an important role in the entire birth process. Your body has its own instructions and these hormones respond to each instruction, helping you to reach you goal. If you interrupt that process through a non-medically necessary intervention or try and get your body to start the process through induction or “natural induction”, it may throw your body, baby, and birth, off a bit.

There are clear medical reasons for induction of labor, and an appropriate induction can save the life of the baby, the mother or even both! While an induction of labor has a higher percent of cesarean rate associated with it, having clear dialogue with care providers about benefits v. risks, and the right path for YOU is the key takeaway here. So while a cesarean is not definitive with an induction, ask yourself if the potential benefit truly outweighs the risks. 

“In pregnancy, labor will start only when all the players—your baby, your uterus, your hormones, and your placenta—are ready.”

Just as little humans grow at different rates, some babies never get the memo that they are supposed to be ready to come out on the day a provider or ultrasound estimated. However, when they are ready, your body knows, and will begin the process of evicting its tiny tenant in the most beneficial way possible. With the cascade of hormones - one signaling another in perfect harmony, your body helps itself and your baby to birth in the safest way possible.

 

Attribution: Lamaze International

The Institute of Medicine says it takes on average 17 years after new research is published for medical professionals to change the way they practice. Don't get stuck with outdated practices for your baby's birthday! With our private prenatal lesson / childbirth class, you'll learn how to get evidence-based care to optimize your birth outcome.

If you cannot attend an in-person birthing class with us, we suggest you reserve a private Labor Lesson. Our intensive class is held as a private, in-home lesson, which includes access to our online Learning Center.

The Center is where you may watch videos, read further research on childbirth and postpartum topics, and download sample birth plans. Both these class options are an excellent opportunity for you and your birth partner to gain current evidence-based birth practices that can help you have the safest birth for you and your baby.

This post is part 2 of a 7-part series written by our team of Lamaze Childbirth Educators. Stay tuned for upcoming posts in our series, How To Alleviate Fears and Manage Labor Pain.

Part 1 can be read here.

Read part 2, Hormones and the Waiting Game
Read part 3, Make Labor Productive
Read part 4, When Childbirth Moved Into Hospitals
Read part 5, Avoid Routine Medical Interventions
Read part 6, Benefits of Upright and Spontaneous Pushing
Read part 7, Keep Parent and Baby Together

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Related posts:
Make Labor Productive with Positivity, Positions and Personal Support
Labor Tips For Birth Partners
6 Practices To Help Manage Labor Pain
How Taking a Childbirth Class May Prevent Birth Trauma

Treatment of Depression During Pregnancy and the Postpartum Period

"Several adverse obstetric complications have been reported with untreated prenatal stress and depression, including pre-eclampsia, preterm delivery, low birth weight, miscarriage, small-for-gestational-age babies, low Apgar scores, and neonatal complications.7,8 In addition to being debilitating for the mother, postpartum depression affects maternal-infant interactions and some measures of infant development."

This is an excerpt from this article titled Treatment of Depression During Pregnancy and the Postpartum Period, published by the US Department of Health and Human Services.

While there is a fine line between normal hormonal changes and clinical depression and anxiety, any symptomatic woman in the perinatal period should seek clinical evaluation and possibly treatment.

Won't the Medications Cause Harm to Baby? 

It is a common concern for women with known depression to be wary of taking medication during pregnancy and/or breastfeeding. Quite frankly, for most pregnant women, there is some sense of fear of putting anything in their bodies. However, more and more is being published about the much GREATER risks of untreated depression in pregnant women. I spoke to an OB and a Pediatrician personally and asked for their opinion on the subject. To paraphrase, each physician emphasized how grateful they are when women come forward with these concerns so that they can be appropriately taken care of. Both of the doctors reiterated the vast research on the damage that untreated chemical imbalances can cause the mother AND the child. There are many safe antidepressant medications for pregnancy and breastfeeding.

There are Facebook support groups for women struggling with pregnancy and postpartum depression/anxiety with literally THOUSANDS of members. This is an epidemic that deserves more attention and less judgment. We are afraid to seek help for fear of looking weak or unfit as a parent.

As a society, we need to remove the stigma of mood disorders and mental illness. A mother who feels out of control of her emotions or feelings should not feel ashamed or like a bad mother. She should feel empowered to do the right thing for herself and her baby and seek the best treatment, as decided by her provider and herself.

Related articles:
Know The Symptoms Of Postpartum Anxiety And Depression
Embracing The Roller Coaster Of Motherhood
Nutrition Tips For Thriving During Postpartum
6 Comfort Tips For NOT Breastfeeding

Essential Items for Baby and Which to Ditch

by Cynthya Dzialo, certified Hypnobabies hypno-doula and CBI birth doula, childbirth educator, and owner of The Happiest Doulas

Having a baby is such an exciting time but we know it can also be overwhelming with so many choices to make during pregnancy. When considering which items to add to your gift registry, the baby aisles may seem enormous and have you wondering which items are really necessary to get. Check out our list of must-have essential items to get your nursery stocked and ready for your little bundle(s) of joy! For a more detailed list of "less major" items, check out our BabyList Registry.
 

4 Things You Can Do Without

1. Wipes warmer. Having your baby get used to warm wipes at home won’t do much good when you're out and about and all you have are cold wipes.

2. Bottle sterilizer. Hot soap and water or running the bottles through the dishwasher kills the germs just as well.

3. Portable swing. Unless you travel a lot and want an easy swing to take along, this really isn’t necessary.

4. Stuffed animal with womb sounds. These are much too quiet for baby.
   

12 Must-Have Baby Items

1. Travel System (Infant Carset and Stroller combo)

2. Pack n Play / Crib / Bassinet or rent or buy a SNOO (they have cribs too)

3. Diaper pail

4. Rocking chair

5. Baby swing

6. Swaddle blankets or Swaddle Me wraps; Halo and Sleepea are good choices too. Get a variety of brands/kinds to try out.

7. Conair white noise sound machine; read why here

8. Tommee Tippee bottles or try biomimetic bottles (and pump adapters) from Emulait

9. MAM pacifiers or ones from Emulait

10. Breast pump

11. Baby monitor

We recommend creating only ONE online gift registry to include all the items you wish to receive. Add our Gift Card link to be gifted any dollar amount toward the purchase of doula services and childbirth classes. How cool is that?!

You can review our listing of suggested items that may aid your postpartum recovery.
 

Related articles:
Shhh! A Baby’s Language Of Love
6 Ways to Survive a Colicky Baby
Postpartum Expectations and Must-have Items
Symphysis Pubis Dysfunction (SPD) 

When Childbirth Moved Into Hospitals Labor Support Was Left Behind

Part 4 of 7, written by Christina Thomson, Certified Birth Doula and Lamaze Childbirth Educator
 

Healthy Birth Practice #3: Bring a loved one, friend, or Doula for continuous support.

As humans, we do better when we’re surrounded by those we love and trust, with people who are positive and encouraging. Historically, women were helping other women as they labored and gave birth. Since most births were happening in the home with a local midwife delivering the baby, the laboring mother took comfort and support from her female relatives or close friends.

As we moved away from home births and into hospitals, this tradition wasn't as common. Your support person became your doctor or nurse. In modern hospitals, however, it is difficult for staff to offer the continuous support that you need during labor and delivery. According to the Journal of Obstetric, Gynecologic, and Neonatal Nursing, women expect their labor nurses to provide information, comfort, and support, but research shows less than 5 percent of a nurse's time is spent doing that.

 

Credit Lamaze International

What does good labor support look like?

According to The Official Lamaze Guide, it's “making sure you are not disturbed, respecting the time that labor takes, and reminding you that you know how to birth your baby.” Your support person “should spin a cocoon around you while you're in labor – create a space where you feel safe and secure and do the hard work of labor without worry.” Good labor support might include: helping you change positions or move around, offering words of encouragement, reminding you to eat or drink, and offering you cold cloths if you are hot. “Good labor support tries to respond to all your physical and emotional needs throughout labor.”

The 2013 Cochrane Review finds that women who received continuous labor support had the following positive outcomes: more spontaneous vaginal births, fewer cesarean surgeries or instrumental vaginal births, less use of epidurals and other pain medications, slightly shorter labors, and greater satisfaction with their birth experiences. Babies of these mothers were less likely to have low Apgar scores at birth. They conclude that all women should have continuous support during labor, and further state that the services of a person, such as a doula, with some training, who is experienced in providing labor support, is the most beneficial.

“The doula’s presence allows your birth partner to participate in the birth in a way that is meaningful to them.”

In Penny Simkin's book, The Birth Partner, a birth doula “guides and supports women and their partners continuously through labor and birth.” According to Lamaze International, a doula is “trained to provide continuous physical, emotional, and informational support to a mother before, during, and just after she gives birth.” A doula isn't going to replace your birth partner.

In fact, the doula’s presence allows your birth partner to participate in the birth in a way that is meaningful to them. If your partner wants to be more active in supporting you, your doula can gently remind them about techniques they learned in your childbirth class, assist them in physically supporting you, and model ways to provide emotional support. If partners prefer to let the doula be the primary support person, the doula can take the lead and help partners to participate in the birth to their level of comfort, while ensuring that the mother’s needs are met. The doula may even give the partner a break to go to the bathroom or to get something to eat.

The true value of having a doula is that a doula knows birth. She brings a quiet confidence in the process of birth, which allows you and your support team to relax and find strength as you do the hard work of meeting your baby. Research has shown doulas to be so effective that neonatologist and researcher John Kennell says, “If a doula were a drug, it would be unethical not to use it.”

Continuous labor support is an essential component of safe, healthy care during labor and birth. All women should be allowed and encouraged to bring a loved one, friend, or doula to their birth.

In both Atlanta and Tampa, we teach an "intensive" preparation for childbirth - the 3 Hour Labor Lesson. You can schedule a private prenatal lesson here. Registration includes weekly follow-up emails to further learning, and access to our online Learning Center where you may watch videos, review current evidence, and download sample birth plans. This is an excellent opportunity for you and your birth partner to gain knowledge on healthy birth practices to help you have the safest birth for you and your baby.
 

This post is part 4 of a 7 part series written by our team of Lamaze Childbirth Educators. Stay tuned for upcoming posts in our series, How To Alleviate Fears and Manage Labor Pain.

Part 1 can be read here.

Read part 2, Hormones and the Waiting Game
Read part 3, Make Labor Productive
Read part 4, When Childbirth Moved Into Hospitals
Read part 5, Avoid Routine Medical Interventions
Read part 6, Benefits of Upright and Spontaneous Pushing
Read part 7, Keep Parent and Baby Together

 

Related posts:
How Taking a Childbirth Class May Prevent Birth Trauma
5 Reasons to Hire a Birth Doula
6 Points For Birth Partners to Consider When Hiring a Labor Doula
5 Reasons Your Labor Nurse Cannot Be Your Doula

Nursery Product Safety Standards and SIDS Prevention

by Cynthya Dzialo, Doula, Educator and Owner of The Happiest Doulas

For the first two months of your baby’s life, they will sleep between feedings for about 30 minutes to 3 hours at a time.

Having your baby sleep in the same room as you can lower their SIDS (sudden infant death syndrome) risk by 50%. Use a separate sleeping area near your bed for at least the first six months. You can use a sidecar / co-sleeper, bassinet, or crib to make feeding easier.

Be sure your crib meets all current safety standards. It should have fixed sides (not a drop-down type), narrow slats (no more than 2 3/8 inches apart), and a firm and well-fitting mattress. You should only be able to fit 2 finger widths between the crib mattress and the frame.

Babies should not sleep in car seats, strollers, bouncy seats, swings, etc. Babies who sleep upright are at higher risk of suffocation if their heads tip over. The majority of sitting-device-related infant deaths occur in nontraveling situations under the supervision of a parent or guardian. If the baby falls asleep in a sitting device, move them to their crib as soon as possible and place them flat on their back to sleep.

A note on swing use to soothe a fussy baby: generally, swings can be used at birth and until baby weighs about 25-35 pounds. For babies younger than 4 months, use the most reclined swing position to prevent suffocation.

There are gaps in public knowledge on safe sleep-environment practices. Educate your child care providers such as baby-sitters and non-parental family members too.

Crib and SIeep Safety

• Don’t place anything in the crib but your baby and a fitted crib sheet.

• Place the crib away from windows and furniture that could pose a risk if the baby attempts to climb out.

• Mobiles can cause strangulation. These shouldn’t have any small parts, ribbons or strings. Big-box retail stores likely meet current safety standards - use caution if DIY or shopping Etsy - and remove the mobile when baby can push up on their hands and knees.

• Never hang anything on the walls above the crib.

• Many cribs have adjustable heights so you can lower the mattress as your baby gets taller, making it more difficult for them to climb out. Lower the mattress level down one notch when baby can sit upright and again when he learns to stand. Once your toddler reaches 35 inches in height, it's time to move out of the crib.

• Install a ceiling fan to help prevent SIDS.
  

Nursery Safety 

• To avoid tipping over, secure furniture to the wall studs using dry-wall screws.

• Do not use furniture with glass doors.

• Keep all furniture away from windows to prevent toddlers from wanting to crawl toward the window.

• Be sure all cords from blinds are high enough that your baby cannot reach them.

• Do not use curtains with fancy beaded or decorative pieces that could pose a choking hazard. Get first aid instruction: an illustrated guide to choking for children ages 1 to 12, and infant CPR and first aid for choking.

• Avoid floor lamps. Hide or secure cords for table lamps (and baby monitors).

• Use plastic outlet covers on all unused outlets.

• Use a baby gate at the doorway to prevent crawling or toddling out of the bedroom.

• Use child-proof drawer locks to prevent toddlers from crawling into open drawers.

• Be careful with toy chests! REMOVE THE LID COMPLETELY or make sure they have spring-loaded hinges, are ventilated, and can be opened from the inside to prevent suffocation if your toddler crawls inside.

• Install a smoke detector and test it regularly.

Childproofing the Rest of Your Home

There are many actions you can take to protect your baby now and later when they are mobile. By installing safety devices, following safety standards, and checking for product recalls, you can prevent an injury or accidental death. Babies rely on adults to keep them safe. Sign up for recall notifications from the Consumer Product Safety Commission at CPSC.gov.

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Related articles:
5 Easy Steps to Stop Your Baby's Crying
Diapering 101: Creams, Cloths, and Changing Stations
4 Tips For Designing a Practical Nursery

Diapering 101: Creams, Cloths, and Changing Stations

by Cynthya Dzialo, Doula, Educator and Owner of The Happiest Doulas

We know you’re gearing up to welcome your little one soon and wondering which items are really needed. Don’t let the many options overwhelm you! Below, you’ll find our recommendations for must-have baby items, newborn care, diapering guidance, and when to call your doctor for medical advice.

Caring For Diaper Rash

• Change baby often - at least more often than you were on the days leading up to the rash’s appearance.

• Instead of diaper wipes, use a plain washcloth with water. Make sure baby’s bottom is dry before re-diapering. 

• Apply a diaper rash cream before diapering. A half-and-half mixture of Aquaphor and Palmer’s cocoa butter lotion works wonders. Vitamin A&D and Triple Paste are also recommended.

• Make tummy time diaper-free and place baby on a waterproof mat.

• If the rash lasts longer than a week, call your pediatrician.
  
  

Caring For Males

• Keep the penis area clean. If stool gets on the penis, wipe it off gently with a wet washcloth.

• While changing the baby, hold a wipe over the penis to avoid getting sprayed!

• Some pediatricians recommend keeping a clean dressing over the circumcised penis until it’s fully healed, while others advise leaving it off. For 6 to 7 days post-circumcision put a nickel-sized amount of Vaseline on some gauze and place it over the penis before diapering.

• If uncircumcised, don’t draw the foreskin back!

• Point the baby’s penis down inside the diaper to prevent leaks.
  
  

Caring For Females

• Wipe front to back (top to bottom) and take care not to use a soiled area of cloth/wipe to clean the vaginal area.

• Vaginal discharge is normal during the first 2-3 weeks and can look a bit bloody due to hormone regulation/balance.

• During the first 2-3 weeks following birthday, urate crystals may cause urine to appear red, pink, or orange-colored. This is normal and caused by the baby passing highly concentrated urine.  

Bowel Movements (BMs)

• Meconium is baby’s first BM and is black and sticky like tar. It may turn greenish-brown after a few days.

• By day 4-5 of life, breastfed babies will have semi-solid yellow, seedy BMs. Formula-fed babies will have yellow-brown-greenish BMs with peanut butter consistency. Read more on baby’s first BMs.

• You may see small streaks of blood in the baby’s stool caused by tiny tears in the baby’s anus or as a result of feeding on mom’s bleeding or cracked nipples.

• A bloody BM could be a cause for medical concern. Call your pediatrician to rule out the previous point.

• Mucus in the stool may be a sign of an allergy.

• Use an app to keep a record of baby’s diapers (and feedings) for the first few weeks. Baby should have at least 6 wet diapers per day after the first week of life.
  
  

Cloth vs. Disposable Diapers

• Cloth Pros:

• Cloth diapers are reusable even with multiple children. 

• According to Consumer Reports, cloth diapers can be slightly cheaper than disposable diapers.

• Cloth diapers are marginally better for the environment than disposable diapers.

• Cloth Cons:

  • Inconvenient when away from home (transporting the necessary pieces and soiled diapers to wash later).

  • Cloth diapers aren’t as absorbent as disposable ones, so they must be changed more frequently to prevent diaper rash.
    
    

• Disposable Pros:

• Convenient when out and about.

• Because they are super-absorbant, it isn’t necessary to frequently change baby and carry many supplies.

• Disposable Cons:

  • Landfill / environmental impact

  • The gels used to absorb moisture could cause a reaction with the baby’s skin.

  • You’ll want/need a diaper pail!

Changing Station Must-Have Items

• Changing table (or use a dresser) and put a changing pad on top; get at least 2 pad/pillow covers.

• Diapers, wipes, and washcloths

• Baby lotion or coconut oil

• Diaper rash creams: Aquaphor, Palmer’s cocoa butter, Vitamin A&D, and Triple Paste (extreme cases).

• Store these items to grab easily with one hand.

Clothing Must-Haves (for the first few months)

• 10 onesies - your baby will wear these when swaddled.

• 10 sleepers / sacks to include fleece ones (as a top coat for going out in cold weather) and if your home is cool.

• To see which ones you and baby like best, get multiple types of sleeper sacks that have velcro “wings” to wrap baby’s arms down or use swaddle blankets that are square and stretchy. Swaddle Me wraps; Halo and Sleepea are good choices.

• Many, many socks! Store these in a small basket or box to keep track of them all. They often disappear.

Must-Have Nursery Items

• Crib

• Dresser

• Glider or rocking chair with a footstool

• Baby monitor

• White noise sound machine

• Swing (Weight and age limits vary by model - check the manufacturer’s guide. Generally, swings can be used at birth and until baby weighs about 25 - 35 pounds. For babies younger than 4 months, use the most reclined swing position to prevent suffocation.
  

Nursery Organization Tips

• Roll all clothing to easily see what you have stored in the dresser drawers.

• Use the dresser for baby's current size and the next size up.

• Use the closet to store clothing that is 2 sizes up from what they are currently wearing.

• Hang a bag in the closet to collect too-small clothes for donation.

• Wash baby's clothing separately from the rest of the household laundry to save time putting it away.

• Use Oxiclean to soak bad stains overnight.

We recommend creating only ONE online gift registry to include all the items you wish to receive. Add our Gift Card link to be gifted any dollar amount toward the purchase of doula services and childbirth classes.

For more ideas on which items to have at the ready and which products we recommend, read our Essential Items post and start shopping!

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Related articles:
Nursery Product Safety Standards and SIDS Prevention
4 Tips For Designing a Practical Nursery
Skin Elasticity During Pregnancy and Beyond

9 Questions to Ask Yourself: Signs of Postpartum Anxiety and Depression

by Cynthya Dzialo, certified Hypnobabies hypno-doula and CBI birth doula, owner of The Happiest Doulas

Symptoms of postpartum depression can appear any time during pregnancy and the first 12 months after childbirth. If you recognize that help is needed, call your doctor or midwife for a referral to a trained therapist. Also, like this Facebook page for peer support and further guidance. Don't wait to get help!! 
 

Below are 9 questions to help you determine if help is needed.

1. Are you feeling sad or depressed?

2. Do you feel more irritable or angry with those around you?

3. Are you having difficulty bonding with your baby?

4. Do you feel anxious or panicky?

5. Are you having problems with eating or sleeping?

6. Are you having upsetting thoughts that you can’t get out of your mind?

7. Do you feel as if you are “out of control” or “going crazy”?

8. Do you feel like you never should have become a mother?

9. Are you worried that you might hurt your baby or yourself?

Get Help Now

Postpartum Support International hosts free, live phone sessions every week, including Wednesday chats for parents who have given birth, and on the first Monday of each month, a chat is held to support partners. You can also join online meetings and groups for peer support.

Your doula can help you to identify the important people in your village, and how they can help you once your baby is here.
 

I strongly believe in a proactive, preventative approach to help you build up your resources and help you develop a postpartum plan for wellness before your baby arrives. Your plan should include realistic ways to make sure you are getting physical activity, that your nutritional needs are being met, that you have a plan to make sure you are getting some sleep and rest.

Set aside some time soon so you and your partner can talk about expectations for yourselves and each other in your new roles as parents. Identify ways that you can continue to connect as a couple and find time to make sure your relationship is getting the attention it needs. And, if despite your efforts, you do experience significant distress postpartum, our team can provide you with local resources for help.

If you find this post helpful, please share this post with your friends to help raise awareness of postpartum depression and anxiety. Spreading the message helps to destigmatize mental health issues and the desire to seek care.

Related articles:
The Most Common Complications of Childbirth
How Taking a Childbirth Class May Prevent Birth Trauma
Nutrition Tips For Postpartum

Capture the Magic of Parenthood with a Birth Doula Photographer

Are you looking for a way to preserve the precious moments of your birthing experience forever? Look no further than The Happiest Doulas! The owner, Cynthya, combines the skills of a doula and a professional photographer to provide you with an unparalleled experience, capturing the raw emotions, tender moments, and joyous milestones of your journey into parenthood.

Why Hire a Birth Doula-Photographer?

1. Memories to Treasure: Your birthing experience is a one-of-a-kind event, filled with intense emotions and unforgettable moments. Cynthya is a birth doula-photographer trained to expertly capture these breathtaking moments, allowing you to relive them for years to come. From those first cries to the first bonding moments, every detail will be beautifully documented.

2. Personalized Support: Cynthya is an experienced and compassionate professional who understands the unique needs and desires of expectant families - she’s been doing this work for over 15 years! By hiring her as your birth doula-photographer, you not only gain a skilled photographer but also an incredible support system. She’ll be there to provide comfort, guidance, and encouragement throughout your birth, ensuring a positive experience while capturing stunning, authentic images.

3. Professional Expertise: Cynthya is specially trained in documenting birth stories. She understands the intricacies and challenges of childbirth, ensuring that they are in the right place at the right time to capture those irreplaceable moments. With a keen eye for detail and artistic composition, she creates images that are both breathtaking and emotionally resonant.

4. Soothing Presence: The presence of a birth doula photographer can bring a sense of calm and reassurance during the birthing process. Having someone dedicated to capturing these moments allows you to fully focus on the miracle of bringing your baby into the world, knowing that you don't have to worry about missing a single precious second.

5. A Lasting Legacy: Nothing compares to the emotional impact of looking back at the photographs that encapsulate the journey of bringing your child into the world. Having these cherished memories shared with your child as they grow creates a powerful bond and a beautiful legacy for generations to come.

Booking a birth photographer is an important step in preparing for your birth experience. Here are key tips to consider when making your decision:

• Research: Start by researching local birth photographers. Look at their portfolios to ensure their style aligns with your vision for capturing this moment.

• Reviews and Recommendations: Read reviews from previous clients and seek recommendations from friends or childbirth professionals.

• Availability: Check the photographer's availability around your due date. Birth can be unpredictable, so make sure they have a flexible schedule.

• Meeting and Consultation: Schedule a meeting or phone call to discuss your preferences, ask questions, and gauge if you feel comfortable with the photographer.

• Packages and Pricing: Inquire about their packages, including what is offered (e.g., prenatal sessions, delivery coverage, postpartum sessions) and the associated costs.

• Contract and Payment: Review the contract carefully before signing. Pay attention to details about deposits, cancellation policies, and rights to the images.

• Discuss Your Preferences: Communicate your preferences for the birth, including any specific moments you want to be captured and your comfort levels concerning photography during labor.

• Backup Plan: Ask about their backup plans in case they are unable to attend the birth due to unforeseen circumstances.

• Follow-Up: After booking, keep in touch with your photographer leading up to your due date to ensure they are updated on your preferences.

Taking the time to choose the right birth photographer will help you capture the unique experience of your birth story. Book a consultation call today with Cynthya.

9 Suggestions to Try When Your Baby Won't Take a Bottle During the Day

by Cynthya Dzialo, certified Hypnobabies hypno-doula and CBI birth doula, childbirth educator, and owner of The Happiest Doulas 

So you've been a champion breastfeeder for months, your baby has a great sleep routine, and now it's time for you to return to work. No problem, right? You've got the perfect daycare lined up and you're excited for this new change. You drop your baby off at daycare and with a somewhat heavy heart, full of mixed feelings, you head off to work. After a successful workday, you go to pick up your little bundle of joy. The daycare teacher said he was terrific, except that he wouldn't drink more than a few ounces from his bottle the whole day. What now? Your baby begs to nurse and acts ravenous the rest of the evening and into the night, waking every couple of hours to nurse. You're exhausted and have to function at your job the next day. Sound familiar?

Helpful tips for bottle feeding a breastfed baby

Follow these tips to transition your baby from the breast to the bottle when your baby refuses to feed from a bottle.
 

• Establish an early bedtime for your baby. Being around other babies at daycare can cause shorter naps, which leads to an overtired baby by the end of the day. Putting your baby down to sleep between 7pm and 8pm is best. Be sure any feedings throughout the rest of the night are done with the least amount of stimulation and in as much darkness as possible to keep your little one in sleep mode.
  

• If your baby is 6 months or older, try feeding your baby breastmilk from a sippy cup. Sometimes this option appeals more to a baby. Try a few different kinds of sippy cups with various types of nipples.
  

• Try sneaking in some extra nursing sessions throughout the day. Try to nurse as soon as your baby wakes up in the morning and before arriving at daycare. If your job allows you some extra time during your lunch break, visit your baby and nurse, or if possible, have someone bring your baby to you during your lunch break. When you get home from work in the evening, try cluster feeding until bedtime. Cluster feeding means to hold several feeding sessions close together within just a few hours.
  

• Use loud white noise throughout the night to help keep your baby calm and in a deeper sleep.

• Feed your baby a bottle in a quiet, non-distracting place. Take your baby to a quiet area for a few minutes and rock or sing softly to get your baby comfortable with the area. Then gently offer the bottle.
  

• Don't try to offer a bottle when your baby is starving. You would think offering a bottle when your baby is very hungry would cause him to eat out of desperation, but this sometimes backfires on you. Experiment with trying to find your baby's midpoint between acting not too interested in feeding and being quite hungry. It will take some trial and error.
  

• When bottle feeding, hold baby in a different position than when you breastfeed. Babies often do better with a bottle if they are not cradled similar to when breastfeeding. Face your baby away from your body, somewhat reclined, with their back to your stomach.
  

• Experiment with the nipple flow. Some babies like a slow flow and others like a faster flowing nipple. If you choose a faster flow, be aware some babies can't handle it and may choke easily.
  

• Try different bottle types. Some babies prefer a wider mouthed nipple that resembles the breast, while others prefer a smaller size. Don't go out and spend a fortune on different types, though. Two or three different kinds should be enough with which to experiment.
  

Important newborn tip: During this time, be sure to have your daycare keep track of wet diapers. To avoid dehydration, you want to make sure your baby has 6-7 wet diapers per day.

This can be a very frustrating time for parents. Between sleep deprivation and the transition to working again, it can seem like your world is upside down. Have patience. All babies are very different and many take time to get used to a new routine. Stick with it and he'll soon accept the new feeding routine.

For more info on how to jump the hurdles of breastfeeding, see if this affiliate online course and other resources (some are free!) by Lactation Link are right for you.

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Make Breastfeeding Easier 
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Diapering 101
Mini-course: Online Childbirth Class

5 Tools For Birth Partners: From “Helpless” to “Hero” During Labor and Delivery

by Megan Ciampa, Birth Boot Camp Childbirth Instructor

Have you ever seen a woman in labor? If you have, then you may know that the intensity of what a laboring woman is experiencing can be so great that her support team can fumble and in fact, be the ones in need of support. Sometimes, sitting with someone in their pain is harder than trying “all the things” to reduce it or wish it away! (A doula can help…) And sometimes, it may be what leads mom to an early epidural in labor when she may not have really needed it.
 

Photography provided by Birth Boot Camp

But what if you could legitimately provide support and help a laboring woman achieve the birth she desires? The good news is that you can.

Here are the 5 tools for a birth partner to help during labor:

1. Muscle observation. Take a look at mom’s face. Is it tight, clenched? Notice her jaw and throat. If it’s tightly closed or clenched, this will directly impact how tight and clenched the rest of her body is, particularly her cervix, which needs to open and soften in order for baby to come down through the birth canal and be born. Gently encourage her to relax her jaw. If she’s not in a mood to be talked to, gently place your hand or fingers on the area that is tense to help remind her to relax.

2. Sound out contractions with her. Women can make interesting sounds during labor. However, sometimes moms go silent in labor as they internally work through labor, and need reminding to feel the freedom to sound out their labor. This can be unnerving for women who “don’t want to make others feel uncomfortable,” so help open the door for her by sounding out the labor sounds with her. Low moaning, groaning, or “ohmmm” noises may really help her relax and let go.

3. Get her in the water. Often called the “aqua-dural,” the water has a unique way of helping a woman cope with the intensities of labor. Whether it’s a shower with focused pressure at various points on her back or belly, or the bathtub, the water really helps a woman relax, and may help you relax too.

4. Keep things interesting. Just like in your relationship, variety is a good thing and it’s the same with labor. Every 30 or so minutes, suggest mom makes a position change. If she’s been leaning against the wall or the bed, suggest she walk or take low squats. If she’s been in the water, suggest she lean backwards against the toilet. These subtle shifts in her movement help her from getting stuck in labor and bring baby closer to delivery.

5. Maybe most importantly, be aware of the environment and people in the room. Is the room too cold? Too bright? Are the people in there supporting and providing relief, or bringing tension and doubtfulness? It’s totally within your prerogative to act as a bouncer and tell others to leave or give mom some privacy for a few minutes. Even better--send them out get snacks or treats for the birth center or hospital staff--always a nice touch!
    

And the best way to help someone in labor is to learn more about childbirth. Not only will this ease any insecurities or questions you have, but it will also be a bonding experience as you prepare for a new baby. And of course, we recommend having a birth doula by your side for labor and delivery.
 

Related posts:
5 Reasons to Hire a Birth Doula
Make Labor Productive
When Childbirth Moved Into Hospitals

2023 Update: Episiotomy and C-section Rates at Atlanta and St Pete Hospitals

by Cynthya Dzialo, Birth Doula-Photographer, Lactation Counselor, and Owner of The Happiest Doulas

Experts agree that Cesarean Sections or c-sections, particularly among low-risk, first-time mothers, may not be necessary and can actually be risky for mother and baby. C-sections are linked to an increased risk of infections and blood clots, and many women who aren’t at higher risk for delivery complications get unnecessary c-sections.*

Various evidence-based strategies aimed at hospitals and healthcare providers can help reduce c-sections in low-risk women. Evidence shows that doula support improves birth outcomes, including a vaginal delivery with lowered risk of episiotomy and other interventions. Benefits described in randomized trials include shortened labor, decreased need for analgesia, fewer operative deliveries, and increased satisfaction with the experience of labor. Read ACOG’s approach to preventing the primary c-section here.

According to the Healthy People 2030 initiative by the U.S. Department of Health and Human Services, and Leapfrog Group’s Maternity Care Expert Panel, a hospital’s rate of first-time pregnancy (nulliparous/NTSV) c- c-section delivery should be measured against a national target of 23.6%. The World Health Organization states the international healthcare community has considered the ideal rate for c-sections to be between 10-15%.

Experts agree that episiotomies - an incision made in the perineum during childbirth - should not be done routinely and can result in worse perineal tears, loss of bladder or bowel control, and pelvic floor defects. According to Leapfrog Group, the national episiotomy rate should be 1% for all hospitals. Hospitals report on their episiotomy rate in vaginal deliveries.

To decrease perineal trauma during the second stage of labor, studies show it may be beneficial for nulliparous people to perform perineal massage in the weeks before labor begins; however, evidence is limited on the benefits and there’s no consensus on frequency or duration. Some studies showed that more frequent massage had less benefit than less frequent massage. As an alternative, there may be a benefit to applying warm compresses to the perineum during the crowning phase. More on that here.

For Leapfrog Group’s Hospital Survey, hospitals report on their rate of c-sections for first-time mothers giving birth to a single baby, at full-term, in the head-down position as well as their overall rate of episiotomy.

Reporting Period: Summer 2023

The following hospitals in metro Atlanta have reported their numbers to the Leapfrog Group. Northside Hospital in Atlanta DID NOT DISCLOSE their numbers.

• Emory Decatur averages 56 babies delivered per week, with an annual c-section rate of 31.5% and an episiotomy rate of 2.4%.

• Emory Midtown: annual 30.1% c-section, episiotomy 1.9%, averaged 106 weekly births

• Piedmont: annual 26.5% c-section, episiotomy 3.4%, averaged 56 weekly births

• North Fulton: 23.6% c-section, episiotomy 1.2%, averaged 25 weekly births

The following hospitals in St Pete / Tampa Bay region have reported their numbers to the Leapfrog Group. HCA Florida St. Petersburg Hospital has DECLINED TO RESPOND

• Bayfront Health “Baby Place” averages 63 live births per week, an annual 28.8% c-section rate, and an episiotomy rate of 1.7%.

• Morton Plant: annual 26.5% c-section, episiotomy 4.8%, averaged 45 weekly births.

• Tampa General Hospital: annual 26.6% c-section, episiotomy 1.5%, averaged 131 weekly births.

• Manatee Memorial Hospital: annual 36.7% c-section, episiotomy 4.5%, averaged 35 weekly births.

If your doctor or midwife can tell you their personal rates or the collective rate of their group, that’s great! It likely means they care about improving their patient outcomes by measuring their practice. Ask your provider.

Resources referenced:

*Text excerpts from Leap Frog Group: https://ratings.leapfroggroup.org/sites/default/files/inline-files/2021%20Maternity%20Care%20Fact%20Sheet_2.pdf

https://health.gov/healthypeople/objectives-and-data/browse-objectives/pregnancy-and-childbirth/reduce-cesarean-births-among-low-risk-women-no-prior-births-mich-06

https://www.who.int/reproductivehealth/publications/maternal_perinatal_health/cs-statement/en/

https://icea.org/wp-content/uploads/2020/01/ICEA-Position-Paper-Episiotomy-PP.pdf

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