"Cynthya was our doula for the birth of our third child in April 2016. As this was my third birth, and I had been attended to by a doula at the first two, I knew that finding the right doula was crucial to a successful and satisfying birth." - Winter Wheeler-Young
5 Reasons to Hire a Birth Doula
It may be your first, it may be your fourth, but when you’re pregnant and considering your baby’s birth and delivery, having the proper support team is critical in ensuring you and your baby get off to the right start. Did you know a doula can help with that?
by Megan Ciampa, Birth Boot Camp Childbirth Instructor
It may be your first or your fourth, but when you’re pregnant and considering your baby’s birth and delivery, having the proper support team is critical in ensuring you and your baby get off to the right start. Did you know a birth doula can help with that?
When I was pregnant with my first child in 2009, I heard this new-to-me term thrown around, “doula.” I learned it was Greek for “mothering the mother” and it’s a professional birth worker trained in childbirth and labor who provides emotional, educational, and physical support to the pregnant woman before, during, and after labor. Generally that means she is not one of your friends or family members, or a part of the medical staff. While I thought that sounded nice, I couldn’t imagine anyone else in my birth environment other than my husband and our midwife/medical team. However, I was then exposed to the statistics of labor and birth for when a laboring mom has a doula present, and I was shocked. Doula? Hired.
Here’s why you want to hire a birth doula:
With birth doulas, the rate of cesarean section decreases 28%. I didn’t know much when I was pregnant with my first baby, but I knew that if I could avoid a c-section, that would be ideal! A labor doula’s continuous support throughout childbirth help a mom feel more at ease, reduce discomfort, and help her find different positions to move into to help baby down and out the birth canal. A c-section, while it can be a life-saving surgery, is major abdominal surgery and can put mom and baby at risk during and after birth. (Statistics from Cochrane Review)
With a labor doula, the use of Pitocin decreases 31%. Have you ever watched A Baby Story on TLC, or any other reality birth TV? If you have, then you may have seen what happens when a mom who is laboring naturally, on her own, is given Pitocin (which is a synthetic version of Oxytocin, a hormone our body naturally produces during labor, breastfeeding, and lovemaking, which assists in making the uterus contract). When a woman is given pitocin, the intensity and strength of her contractions increase significantly. And because it’s a synthetic hormone, the body cannot respond with its own stress release mechanisms the same way, and it’s extremely uncomfortable for the laboring mom. While labor can be done without an epidural, many a woman opts for an epidural after pitocin is administered to help cope with this incredible intensity. (Statistics from Cochrane Review)
With doulas, the likelihood of spontaneous vaginal birth increases 12%. Spontaneous vaginal birth is the simplest kind of delivery process. It just means vaginal delivery happens on its own, without doctors or midwives using any tools like forceps or a vacuum, to help pull the baby out. This is a good thing because while any of these tools may occasionally be used for emergency purposes, they also come at a risk to the mom and baby. Doulas can help the mom get into a better birthing position that applies the right amount of pressure to her cervix to allow baby to come out safely. (Statistics from Cochrane Review)
With doulas, the risk of being dissatisfied with the birth experience decreases 34%! With a labor doula present, you can know you have probably tried every option and resource possible to ensure you have as good a birth experience as possible. Because they have knowledge, tools and other resources available to them to assist you, it relieves pressure and anxiety on your partner or spouse, who may also be needing some emotional support during labor, and helps equip them to help you. All of this in turn? Drives higher satisfaction for you during your birth experience. (Statistics from Cochrane Review)
With birth doulas, the length of labor can decrease by 25%! I don’t know about you, but when I watched A Baby Story and saw the clock ticking and how long those moms were laboring to bring their babies to the world, my empathetic heart hurt for them. Those can be some long, hard hours. So, with a doula present, who helps you feel more safe, secure, and emotionally present, often labors are shorter. With my first birth, my highly experienced doula had me try several positions: squatting, walking, rocking, sitting on the toilet (it relaxes you in an unexpected way--trust me!) to help me get the baby further down the birth canal. I’m convinced that without her efforts, my approximately 12 hour labor, which is pretty great for a first-time mom, would’ve lasted hours longer! (Statistics from americanpregnancy.org)
Experts agree that Cesarean Sections or c-sections, particularly among low-risk, first-time mothers, may not be necessary and can be actually be risky for mother and baby. Various evidence-based strategies aimed at hospitals and health care 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.
A doula is a pretty great person to have around when you’re pregnant and giving birth, as well as afterwards in the postpartum period. While doulas weren’t so common about 10 years ago, they are sought after more than ever. Won’t you hire a birth doula today?
References:
https://evidencebasedbirth.com/the-evidence-for-doulas/
http://americanpregnancy.org/labor-and-birth/having-a-doula/
Postpartum Expectations and Must-have Items
To help you prepare for an easier postpartum time and a speedy recovery after birth, here are a dozen comfort suggestions and must-have items to have on hand following either a surgical or vaginal delivery.
In addition to filling your freezer with nutritious meals, lining up pet sitters, and daily help from family and friends, you'll want to stock up on postpartum supplies to have on hand upon your discharge from your birthing facility. Below are a dozen comfort suggestions to help you prepare for an easier postpartum time and a speedy recovery for both surgical and vaginal deliveries.
This post does NOT include any affiliate links for the below suggested items used for an easy postpartum recovery. We are sharing these links to help you prepare for parenthood. Also, here is our recommended gift registry for infant and breastfeeding gear that you may copy on Babylist to prepare for your baby showers. Happy Shopping!
After care items for a vaginal birth:
Epifoam
If you receive stitches on your perineum, you'll likely receive a numbing spray called Epifoam while in the hospital. If you need more after your return home, ask your doctor if Dermaplast (over the counter) is an acceptable alternative.Sitz baths
This plastic tub is placed directly on the toilet rim (seat up) and you sit on it as it circulates warm water on your bottom via a tube connected to a bag you fill from the sink. This helps clean your bottom, may encourage urination, and will help with healing. Many women find it very comforting. Follow this with an ice pack! (Insert sigh of relief!) Your hospital may offer you a sitz bath or you can find this at your local pharmacy.Peri-bottle
Following the birth of your baby, you will be given a small plastic bottle filled with warm water. Use it to squirt on your bottom as much as necessary to help encourage urination and dilute the sting caused from urine. Once your bladder is empty, squirt your bottom again gently with as much water as necessary to help clean your bottom. Then PAT your bottom dry with hospital wash cloths or toilet paper. Take your bottle home with you or buy a few to keep in each of your bathrooms.
For both type of deliveries:
Doughnut-shaped pillow or wedge (V-shaped) cushion
Called coccydynia or coccygodynia, tailbone pain usually goes away on its own within a few weeks or months after childbirth. To lessen pain while sitting, use a doughnut-shaped pillow or wedge (V-shaped) cushion. Try a dollar store pool tube!Witch hazel or Tuck's pads
Found at your local pharmacy, witch hazel is an over the counter astringent, which can be used to help shrink hemorrhoids. Most commercial bottles of witch hazel contain alcohol so it may sting with direct application. TJ Dickinson's is a brand that sells pure witch hazel. It may take you some time to locate TJ's unless you shop at Whole Foods. (You may want to try the wipes, Tuck's pads, or Preparation H.) If using the liquid, you can make a “padcicle” by soaking a pad with witch hazel and placing it in a clean Ziploc bag then freezing it. Once frozen, remove it and wear it as normal. Many women find this very comforting for their swollen, sore bottoms – especially after a vaginal delivery.Senokot
A gentle vegetable-based laxative called Senokot may be offered to you at the hospital. You can also find it over the counter at your local pharmacy. It is generally well-tolerated (doesn’t cause intestinal cramping) and takes effect within about 12 hours, so it’s usually taken in the evening.Colace
To help with those first few postpartum bowel movements, you may want to try Colace, a stool softener, during the first several days. Once you are eating/drinking somewhat “normally” and soreness has subsided, you may wish to stop taking these medications. Both can be taken on an as-needed basis in the future.Maxi Pads (overnight/heavy flow with wings)
Bleeding for the first 6-8 weeks following delivery is normal. It is called Lochia (LOW-kee-uh). It will begin as very heavy, bright red bleeding that will gradually diminish to a dark red, brown and then to a more yellowish color. During this time period, nothing at all should be introduced to the vagina. Only wear pads, cloth/reusable or disposable, no douching, and no sexual intercourse until the lochia flow has stopped and you have been cleared by your provider."Granny" or Mesh Panties
At the hospital, you will use mesh panties to hold your pad and ice pack. Bring the mesh underwear home with you or have a pair or two at home. If you've had a c-section, try the C-Panty. Here’s a listing of postpartum panties to find the right type for you.Ibuprofen Pain Reliever (Motrin/Advil)
6-800mg of ibuprofen will be brought to you every 6 hours in the hospital, along with some crackers. This medicine will help with cramping, and will also help with inflammation “down below.” Most women find the ibuprofen is enough to manage their pain, but if you are still experiencing a lot of pain, ask your nurse for something else (usually taken in conjunction with the ibuprofen). You will be sent home with a prescription for the 800mg tabs of ibuprofen.Nursing Pads
When you nurse your baby, you will experience what is called a “let down”, which is simply the release of milk from your breasts at the same time. When you hear your baby cry, you may also leak milk and appreciate wearing nursing pads. Both reusable/washable and disposable pads are available for purchase. If you don't plan to breastfeed, you'll still need pads for a bit of time as well as a head of cabbage kept in your fridge.Nipple Cream
In the first few weeks breastfeeding, your nipples may get a bit sore. Nipple cream by Earth Mama Angel Baby or Motherlove will help soothe and heal the affected areas. Alternatively, you could try organic coconut oil.
It Takes A Village
You will need to build your village of support people. It’s important for BOTH parents to seek out support from other parents – not just friends, but other people who have kids and “get it.” Both men and women experience postpartum depression. Read this to be able to recognize the signs of postpartum anxiety and depression.
Find a support group NOW so you know who/where to turn to for help. You can always call your doula or care provider if you need suggestions. We're here for you.
Finally, you may wish to arrange a lesson with an infant care specialist for hands-on guidance on newborn care. Doing so will help ease your transition to parenthood. Best wishes!
How To Avoid a C-section Without Changing Hospitals For Less Than The Cost of a Latte A Day
Get dependable support for less than $5 per day of your pregnancy. Think about that. Then think about the cost of a c-section and an extended hospital stay. Hiring an experienced doula who works well with your care providers WILL SAVE YOU MONEY.
Do you know how to avoid the primary c-section? Hire a doula.
The American College of Obstetricians and Gynecologists (ACOG) backs this claim. An excerpt from their website:
"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."
Read ACOG's full article published March 2014: Safe Prevention of the Primary Cesarean Delivery, which discusses ways to decrease cesarean deliveries, including:
Allowing prolonged latent (early) phase labor.
Considering cervical dilation of 6 cm (instead of 4 cm) as the start of active phase labor.
Allowing more time for labor to progress in the active phase.
Allowing women to push for at least two hours if they have delivered before, three hours if it’s their first delivery, and even longer in some situations, for example, with an epidural.
Using techniques to assist with vaginal delivery, which is the preferred method when possible. This may include the use of forceps, for example.
Encouraging patients to avoid excessive weight gain during pregnancy.
One of the main points is to use continuous labor and delivery support:
"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."
“Approximately 60% of all cesarean births are primary cesareans.”
At the hospital, laboring families aren't truly supported during childbirth unless they have a doula present. Care providers are quite busy and frequently enter and exit the room leaving you unattended while they are busy with other patients. Our birth doulas stay by your side and provide support when you need it most!
Still wonder if doula support is necessary? Research your hospital's c-section rate - many metro hospitals are WELL ABOVE the national average of 32.2%. Afterwards, watch The Business of Being Born, a documentary "eye-opener" about birth in America.
Simply put, our team helps you obtain your true childbirth options so you can have a great labor and birth experience.
For less money than you'd spend on a latte a day, you can hire an experienced labor doula.
Get dependable support for less than $5 per day of your pregnancy. Think about that. Then think about the cost of a c-section and an extended hospital stay. Hiring an experienced doula who works well with your care providers 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.
You should also note that we offer eGiftCards. If you receive a gift card after to you after you've paid, you'll be refunded the amount to the credit card used to reserve services through our website.
“For less money than you’d spend on a latte a day, you can hire help from an experienced labor doula.”
You'll remember your birthing experience forever. I wish you and your family a healthy and happy birthday.
Be well,
Cynthya
Click to visit http://www.lamaze.org/p/cm/ld/fid=160
Reference: Safe Prevention of the Primary Cesarean Delivery http://www.acog.org/Resources-And-Publications/Obstetric-Care-Consensus-Series/Safe-Prevention-of-the-Primary-Cesarean-Delivery
2 More Reasons You Don’t Need an Induction
No two pregnancies are the same (even within the same body), no two labors are the same; there are so many factors that play into a pregnancy and her subsequent labor and birth.
by Lauren King, Registered Nurse, Certified Lamaze Educator, and DONA Labor Doula
What is the average size of a baby born in America? Would you guess 7 pounds? Maybe 7 and a half? Eight pounds. Eight pounds is the average size of babies born in America. That means some (lots!) of babies are bigger than that – and many babies are smaller than that. Genetics and mom’s lifestyle, among other things, play a huge role in how big you grow your babies. I’ve seen babies born vaginally that weighed over 10 pounds! I’ve heard stories of babies just as large born vaginally with no pain medication! It’s certainly not impossible. (Maybe not necessarily the most pleasant thought… but not impossible!) Do you know how much amniotic fluid is adding to your weight? Well, not much honestly, but if you’re around 34 weeks, you have now reached the peak amount of amniotic fluid at about 800 mL. From 34 weeks on, amniotic fluid levels will gradually decline. Read on to learn why this matters.
Some doctors suggest an induction for “big baby” because they believe it decreases the chance of a shoulder dystocia (difficulty delivering the shoulders) or the need for a cesarean due to the baby being too large to fit through the pelvis. However, research shows this is simply not true. The risk of shoulder dystocia is relatively small – and it’s impossible to predict who will have a shoulder dystocia. Furthermore, for a doctor to suggest a woman to induce for this reason, the doctor must assume the ultrasound is accurately assessing the size of the baby. Next time a late-pregnancy ultrasound is recommended to you to assess fetal size during your pregnancy, ask your doctor or the sonographer how accurate it is. If they tell you the baby “might” weigh about 8 pounds, please know they can be off by as much as 2 pounds either direction. There is a HUGE difference between a 6 pound baby, an 8 pound baby, and a 10 pound baby. I have seen elective c-sections performed on first-time mothers due to “possible macrosomia” (big baby), only to discover the baby weighed LESS than 8 pounds.
I often tell people that things in labor and delivery can be very dynamic. The more I think about it, the more I realize how true that statement is in so many ways. No two pregnancies are the same (even within the same body), no two labors are the same; there are so many factors that play into a pregnancy and her subsequent labor and birth. Another dynamic aspect of pregnancy? Amniotic fluid. As I mentioned above, the amount of amniotic fluid peaks at about 34 weeks, reaching around 800 mL, and gradually declines to around 600 mL by 40 weeks. However, there are many factors that can play into these numbers. The baby, the mother, and the sonographer measuring the amniotic fluid can all affect the actual or perceived level of fluid.
The baby constantly circulates the fluid by inhaling it, swallowing it, and then releasing it through the urinary tract. Near term, the baby swallows more and urinates less often, thereby holding more fluid at any given time. Other baby-driven factors include: post-term (past 42-weeks), birth defect, or problems with the kidneys or urinary tract.
If you are dehydrated, such as in the coming summer months especially, if your water is broken, or if the placenta is no longer functioning properly, you may be diagnosed with low amniotic fluid. Some things you may try to increase amniotic fluid levels include drinking more water (at least 2-3 liters a day) and laying on your left side during an ultrasound when measuring fluid levels. Other factors that can play into an inaccurate reading include too much pressure on the ultrasound transducer, floating particles in the fluid, and an obese mother. Yes, “low amniotic fluid” could be a sign of a health issue and can be a medical reason for induction, but ask your doctor what their specific concern is before agreeing to induction simply for “low amniotic fluid.” Furthermore, you may wish to have a reevaluation in a couple days. Drink lots and lots of water, and when you return for another ultrasound (hopefully by the same sonographer!), if the fluid level is still low, or has decreased further, then you may wish to discuss the next step with your provider. If it has increased, then you might have saved yourself from an unnecessary induction! For a brand new diagnosis of “low fluid” without any other known cause, you may be better off to wait.
"What I have heard, and what I suspect it ultimately boils down to, is for one thing, doctors are human." - tweet this!
So, knowing all of this, why do doctors recommend things that are not backed by research or ACOG? My honest answer is: I don’t know. What I have heard, and what I suspect it ultimately boils down to, is that for one thing, doctors are human. Meaning: doctors want convenience and easy and predictable and good ratings. What? Good ratings? Exactly. Doctors and hospitals have a business to run. They have to keep their patients happy to keep them coming back for subsequent care! And businesses are consumer-driven. How many times have you heard that you can’t treat a viral infection with antibiotics? And yet, when a patient goes into a doctor’s office, demanding something to be done about their illness, they just might walk out with an antibiotic prescription in hand. Same thing with inductions. When a patient begs, pleads, whines, and complains about all the aches and pains, and difficulties of pregnancy, their doctor wants to appease them. No, not all doctors act this way, but the ones that do are the ones contributing to the problem and making it “okay” for other doctors to do the same. Although, I have to say – it’s not ALL the doctors’ faults. We, as women, as mothers, as consumers are just as much to blame. If I walk into my doctor’s office, demanding an induction – all the while, knowing all the risks of doing such – my doctor doesn’t want to lose me as a customer, so he agrees.
You Have More Power Than You Know
On the flip side, if more women – more consumers – are asking their doctors to allow their bodies to go into labor naturally, they will stop suggesting and allowing for non-medical inductions. If more women are getting educated on their options and on the pros and cons of such procedures, and refusing inductions for the sake of convenience, doctors will follow suit. Ultimately, they want to make their customers happy.
For more information on inductions, please visit MedLine Plus, American Pregnancy Association, and the Adventures of a Labor Nurse.
"Amniotic fluid peaks at 34 weeks, reaching around 800 mL, and gradually declines to around 600 mL by 40 weeks." - tweet this!
Related articles:
Knowing Your Options Is Vital To Your Labor And Birth
How To Avoid a C-section Without Changing Hospitals
6 Comfort Tips For NOT Breastfeeding
So You Need An Induction, Eh?
So You Need An Induction, eh?
I believe women (actually any person) should be able to whole-heartedly trust their doctors. We want to believe our doctor is doing what is in our best interest – and they should be.
by Lauren King, Registered Nurse, Certified Lamaze Educator, and DONA Labor Doula
Photo By BirthYearBook
I feel the need to provide a disclaimer before I delve into this topic. I am not saying all doctors, midwives, or other medical staff are bad. There are definitely a lot of really great medical personnel out there. But just like anything in life, there are always a few bad apples.
I believe everyone should be able to whole-heartedly trust their doctors. We want to believe our doctor is doing what is in our best interest – and they should be. But I don’t think it’s a secret that there are doctors that sometimes do things in their own best interest. The question is: how do you know? As a non-medical person, how does one know their doctor is top-notch, and not suggesting every intervention, hoping for another nickel in their pocket, or hoping to be out on the golf course in an hour?
Of course, the obvious response here is: talk about your options with your doula from The Happiest Doulas, and we will do everything we can to help you achieve the beautiful birth you want and deserve. But equally as important is to be educated. You don’t need a nursing degree or a medical license to make important medical decisions, but you do need at least a pretty basic understanding of some of the top decision areas. And for everything else, ask lots of questions. Specifically, discuss the B-A-R with your provider: benefits, alternatives, and risks. When discussing pros and cons about procedures (especially induction) a great question for your provider is, “What research do you have about that topic?” or, “Where can we get more research-based information about that to help us make a decision?”
I’ve written before about inductions, but this is a topic that comes up a LOT in my classes. Plus, it’s the topic that really gets me started, gets me up on my high horse, my soap box… and it is hhhaarrrddd for me to get off it! “My doctor wants me to have another ultrasound next week because the baby is measuring big,” – and as a bonus to that one, “And if I don’t deliver by my due date, the doctor wants to induce me.” “My doctor said my amniotic fluid level is low.” “My doctor told me I need an induction because I conceived through IVF.” Ok, well, I don’t actually know what the literature says specifically about IVF, but just in my personal OPINION, it doesn’t make sense to me.
"I whole-heartedly believe in inductions for medical reasons for mom or baby’s health." - tweet this!
Let’s talk about the reasons for induction, though. There are actual medical reasons for induction, and I whole-heartedly believe in inductions for medical reasons for mom or baby’s health. What I don’t believe in is disguising a convenient induction in medical terminology. Here are some medical reasons for induction, according to ACOG: pregnancy that continues 1-2 weeks past the estimated due date, high blood pressure, uncontrolled gestational diabetes, an infection in the uterus, or a baby who is not growing properly (IUGR). This list is not completely exhaustive, but “big baby” and even “low amniotic fluid” (by itself) are not included in the list of medical reasons for induction.
I’ll discuss those two things in a later post, but for now, let’s discuss induction for postdates (going past your due date). Do you know what “EDC” or “EDD” stands for? Both start with E for estimated. (EDC stands for “estimated date of confinement”, in case you didn’t know.) A point I made in one of my classes recently was this: do you always have a 28-day cycle? Do you know, for a fact, that you ovulated on day 14 when you got pregnant? Do you know, for a fact, the exact date you conceived? (Ok, so some can truthfully say ‘yes’ here.) So, I went on to say: Did you all walk at 12 months? Did you all crawl at 7 months? Did you all roll over at 3 months? My point is that just as we all grow and develop at different rates Earth-side, so too do our babies grow and develop at different rates in the womb.
Due dates are calculated based on an archaic formula, called Naegele’s Rule, which assumes every woman has a 28-day cycle. Even then, the man behind Naegele’s Rule, Frederich Naegele, was not the original “inventor” of “how to estimate the length of human gestation.” It was an 18th-century professor of botany and medicine, Hermann Boerhaave, who developed the formula. Am I the only person who thinks this whole business of calculating a due date deserves a little more visitation by the research and medical community?!
Many Are Mislabeled as "Post-Term"
I do a lot of reading to keep up with the newest information. One of my favorite places to get information is from Evidence Based Birth. Rebecca Dekker, the author, just published a very extensive article on the evidence for inducing for going past your due date. She touches on Naegele’s Rule as well, but one thing she wrote really struck me. She wrote, “using the LMP [last menstrual period] to estimate your due date makes it more likely that you will be mislabeled as “post-term” and experience an unnecessary induction.” The reason for this is just as I stated above: not everyone’s cycles are cookie-cutter perfect! Even if a woman does ovulate on day 14, if she conceives that month, the embryo may not implant for several days! I was so thrilled for this article to come out, I wish everyone could take the time to read it word-for-word; however, I realize it is lengthy. I encourage you to skim it, and if nothing else, read the section “What’s the bottom line?” found at the end of the article.
"If a woman ovulates on day 14, and conceives that month, the embryo may not implant for several days." - tweet this!
So that you have more time to read that very important article, I’ll go ahead and end now. I hope this has given you some valuable information and resources. Next up, I’ll discuss why doctors induce for “big baby” and low amniotic fluid, so come back soon!
