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Postpartum Doula Support: Filling the Gaps in Healing After Birth

In January I began studying for a postpartum doula certification with Birth Arts International. This would allow me to continue supporting my clients as they transition to the next part of their journey. As expecting parents we tend to focus our time and energy on the pregnancy and birth process.  As a result, postpartum plans often get the short end of the stick. After coming home with their babies, many parents may feel as though they don’t have the support or resources to feel confident in what they are doing. We are questioning ourselves while trying to learn how to make our newborns happy and healthy, all while sleep deprived and often times neglecting our own needs. Frequently too, we have older children at home that are adjusting to the new baby and the change in household. We still have laundry. We still have to eat. We desperately need sleep, a real shower, and maybe a moment or two just for ourselves.

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That's where I come in.

Postpartum doula support fills in the gaps of what the family might need. These services include light errands, light house cleaning, meal prep, infant and sibling care, breast feeding support, postpartum healing guidance, debriefing support of your birth experience, and connecting families to local resources. Best of all is the emotional and mental support of another person who understands exactly where you are and what you are going through. This is someone who listens, knows birth intimately, and can help you process your experience of birth and new motherhood. When we are able to feel whole and have the details of our home taken care of, we have opportunities to heal faster, have improved breastfeeding success rates, and decreased severity of postpartum mood disorders.

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1 in 5 mothers experience a postpartum mood disorder, including anxiety and depression. 1 in 10 fathers will experience anxiety and depression as well. These feelings not only impact the individuals health, but the health of the family and community. Currently suicide is the second leading cause of death in perinatal women, with a rate of 1 in 5 postpartum deaths being contributed to suicide. The risk is increased through the first postpartum year. These statistics are a heart wrenching wake up call in how we treat parents, our postpartum care, mental health support, and often the ability of our village to see a struggling parent and know what to do. Having a knowledgeable professional help take off the weight of some of the daily burdens can create space for that family to heal.

It’s not about luxury.

It’s not about being demanding.

Postpartum doula support is about giving families and communities what they need to feel like better confident versions of themselves.

To learn more about how postpartum doula support, please contact me for a consultation at Living Heart Doula.

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Frederick Birth Center

Twenty years ago, Special Beginnings was opened in Arnold, Maryland, and has since been one of the only freestanding birth centers in the state. For families that live too far from Special Beginnings, there are two options: use your local hospital or birth at home. There’s a wide swing to that pendulum in consideration of care providers, cesarean rate, interventions , maternal and infant health, and financial cost. Having options is important, and families should be able to find a birthing place that best fits their family.

 

Fortunately for our Maryland families, there will be another option. Meet Mychal Pilia, CNM and owner of the Frederick Birth Center.

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Mychal holds a bachelors degrees in Nutrition, Nursing and a masters degree in Nurse-Midwifery. She has been serving the home birth community since 2014. Mychal has spent extensive amounts of time in both business research and seeking feedback from the community. You may remember seeing her at Baker park last summer completing surveys, and talking with families.

 

Her vision for the Frederick Birth Center includes a holistic and family centered approach to pregnancy and birth. Evidence based care is the mainstay of the practice, and means that parents are active participants in their prenatal care.

 

What makes a birthing center different?

 

The care at the birthing center is personal and is built on a relationship with Mychal and the midwives at the birth center throughout your pregnancy. You develop personal trusting relationships with your providers, because they spend more time with you.  Your appointments are typically a half hour long with the initial one being an hour. Discussions include everything from nutrition, options for prenatal testing, mental health and emotional health, and how your feeling physically. It’s a whole person approach.

 

Not only do they provide more one on one time and attention, but they also offer classes you can take with mothers due around the same time. These range from early pregnancy topics, sibling preparation, labor and birth, breastfeeding and new parenting classes.

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Rather than cycle through all the doctors and midwives at a large practice, your time is spent with your midwife and her nurse. When you come to the center in labor, your midwife is the one meeting you there. She’s the one evaluating your labor and overseeing the safety and comfort for both you and your baby. At a hospital, you are meeting with a group of strangers, wondering who’s on call, and only seeing that doctor for mere moments at a time, and often only at the glorious moment of when baby is crowning to its birth.

 

The birthing center facility is a beautifully designed home like atmosphere, with a real bed, shower, full immersion tubs for labor and birth, equipped with all the medical needs for mom and baby. This isn’t birthing in the hospital where it tries to not resemble a hospital. This is a home away from home.

 

When can you receive care at FBC?

The Frederick Birthing Center is now open and is currently taking patients. You can begin care before you even get pregnant or transfer care almost any time during your pregnancy.  After all this is a “service industry” and your health care providers work for you!

Boho room with creams, pops of color and texture.  

Boho room with creams, pops of color and texture.  

 

 

 

What does care include?

A midwife and nurse are on call if you have emergent or non-emergent needs during your pregnancy. Care includes 10-12 prenatal visits depending on when you begin services, and group classes are available. You will also have access to the lending library if your enjoy to prepare for your birth through reading.

 

You are fully supported during your birth, and families can leave for home as early as four hours after birth (upper limit is twelve).

 

Postpartum checks are completed with a 24-hour phone call, 1-2 day home visit, and a 1-2 week and 6 weeks office visits.

 

Well-woman care is also available at the center including pap smears, full range of family planning options, health screenings (cholesterol, blood sugar, thyroid, and anemia labs to say the least), and mental health counseling and screenings.

This 33" Japanese soaking tub is huge. I'm 5'5", and could easily submerge into this beauty. 

This 33" Japanese soaking tub is huge. I'm 5'5", and could easily submerge into this beauty. 

 

 

Cost of birthing at a Birth Center

Cost is $7,000 and includes the professional care and the facility fee. Check with your insurance provider for full understanding of benefits and what can be covered or reimbursed for your out-of-hospital birth.

 

Having your baby at a birthing center is a lower cost option, with lower interventions, high level of satisfaction and high safety standards proven with large national studies (check out the National Birth Center Study II to see the birth center difference!). The cesarean rate in Maryland is currently ~36% (higher than the national average (33%), where the rate for birth centers is only 6%. For healthy low-risk pregnancies, out-of-hospital births provide options that protect maternal and infant health, while lowering health care costs, and providing a memorable experience for your family for a lilfetime.

 

For a look at hospital care cost, check out this article here:  http://www.scpr.org/blogs/health/2015/07/22/18049/pricecheck-how-much-does-it-cost-to-have-a-baby-at/

 

Future plans

Plans include two more Maryland freestanding birthing centers, located in Baltimore and Silver Spring.

 

For more information

You can reach Mychal Pilia at the Frederick Birth Center (frederickbirthcenter.com).

 

More about birthing centers:

https://www.mamanatural.com/birth-center/

http://www.birthcenters.org/?page=bce_what_is_a_bc

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Summer Pregnancy Survival: Beating the Heat While Feeling Your Best

*This post contains affiliate links. I receive a commission for any purchases from these links, at no additional cost to you. I only work with affiliates and recommend products I truly love, I am not paid for these reviews. 

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I had two summer pregnancies. With my first pregnancy it was the hottest summer on record here in Maryland. I was still working as a zookeeper in a hot humid building, and had to build up a repertoire of tools to feel okay. I was hot, sweaty and tired, but I avoided some big issues like dehydration and swelling. 

Let's get started enjoying the summer season, and keeping you pregnant mamas happy! Here's what helped:

1.  Get into the water! Whether it is your neighbors pool, the pool at the gym, the local city pool, local lake, or a blow up baby pool, get yourself in the water! Getting submerged not only cools you off, but blissfully relieves your joints from the weight of your growing belly. Swimming is excellent low impact cardio, and can be helpful with fetal positioning. 

2. Drink all the fluids. Make them fun!  Grab your favorite straw cup, and get sipping! Start with water everyday, and throw in some lemon, cucumber, mint, or berries to jazz it up. The lemon in water can be especially helpful with swelling, and provides a natural source of electrolytes. When the heat is on, making some fun blended mocktails is a delicious way to get through it. Check out some healthy smoothies and blended mocktails on the Living Heart Doula Summer Survival Pinterest board here

Earth Mama Organics also has some fun mocktail recipes, using teas. Pour over ice or blend for a cooling treat. 

Ginger Mint Mock-Tea-Ni with Morning Wellness Tea

 

3. Veg out and get your fruit on! When in doubt, eat your fluids. Watermelon, oranges, strawberries, and salads are excellent at keeping you cool and hydrated. A great option for when it is too warm to even turn on the stove, is to pull out the veggies in your crisper and grab some hummus and bean dip. This is also the time to utilize your instant pot and slow cooker. Set up dinner, spend the day at the pool, and come home to a ready meal without worrying about the heat or babysitting a grill.

4. Take advantage of the AC. Summertime here in Maryland is always a quandary; it's steamy hot outside, but you may need a sweater to get through grocery shopping due to the AC being kept at polar temperatures. However when you're pregnant during a swampy afternoon, you'll want all the AC you can get. Walk the mall, take older kids to story time and play at the library, catch a movie, even take a walk around your local Costco and soak up the air conditioning (grab some samples while you're there too). 

Unique, eco-friendly products chosen just for you and your little one!Earth Mama Angel Baby | Safe and Natural Products for Mama and Baby

5. Clothing options. The best fabrics for your growing belly are going to be lightweight and moisture wicking. Grab multiple dresses, maxi skirts, shirts and shorts in cotton, linen, and bamboo. Avoid heavy synthetic fabrics to avoid sweating and chaffing. Speaking of chaffing, to help prevent uncomfortable rubbing, try out these options: rub coconut oil on your thighs to prevent friction, baby powder or talcum powder to soak up sweat, wear cotton bicycle shorts under skirts, or apply antiperspirant to the area. You can find clean ingredient deodorant from Earth mama organics here . I've mentioned thighs several times, but these tricks should be helpful for multiple body areas.  

Think breezy light weight material for summer months. 

Think breezy light weight material for summer months. 

6. Ice, Ice Baby! During my hot sweaty pregnant zoo days, the most helpful item I had for staying comfortable was an ice pack. Put ice packs on the back of your neck, chest, and pulse points. For days out at the park with kids, pack an insulated tote bag with wash cloths and ice cubes. Apply them through the day, and dunk in the ice water to refresh. 

Fill an insulated tote bag with ice and wet cloths. Use the icy cold rags to cool off during summer outings. 

Fill an insulated tote bag with ice and wet cloths. Use the icy cold rags to cool off during summer outings. 

What helped you during the summer heat? Share your favorite tricks with us in the comments! 

 

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You Got This: What it should mean

“You’ve got this. Deep breath Mama!”

If you’ve ever been one of my clients, you’ve probably heard me say this. It’s something I say to remind my moms when labor begins to get tough, and it’s a matter of getting through one contraction at a time.

You got this. Now here are all the things I want to say... 

You got this. Now here are all the things I want to say... 

A simple phrase, a warm touch of reassurance, but it means a lot more to me when I really dig in to why I say it. When I'm trying to convey something stronger I often stumble over my words, trying to verbalize all the emotions that I cannot always express without getting tripped up and choked up.

All too often this phrase is getting used as a trite comforting gesture. It's become the proverbial knock on the shoulder, and "You stay chipper!" 

"You got this!" really means: 

  •        Let go of the nagging fears that are no longing serving you.
  •       You are so strong. I see it, and want you to feel it in your core.  
  •       This birthing thing… you’re rocking it!
  •       Dad, who is so unsure of what to do and think right now? Let her hold on to you. You’re a rock for her.
  •       Breastfeeding is hard sometimes, and it feels like you have a million new questions everyday. Ask them. Trust your gut if something feels off and you want another opinion.
  •       Parenthood is wild and hard. Don’t doubt your abilities to raise these little people. If you do, call a friend. Guaranteed they feel the same. Try again tomorrow.
  •        You may have only had two hours of sleep, and there’s a long day ahead of you. One step, one minute at a time.
  •       Sometimes postpartum hormones are really mean, and anxiety is a dirty rotten liar. Let's talk about how you're feeling. 
  • Going back to work after maternity/paternity leave is so hard. How are things going to be for our routine? How am I going to feel? Take it one day at a time, and bend when the wind blows. Be flexible where you can, and give yourself and your family all the grace you need during this season. 
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Deep breath.

 

You got this.

 

Earth Mama Organics

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Digging through the literature: Best New Baby Books (and available at your library!)

When I first thought about getting pregnant, I did what my nerd brain naturally gravitated toward: I went to the library and checked out a pile of books on every aspect of the topic.

Your local library can be a wealth of resources for your family. Plus, who doesn't love the smell of a good book?

Your local library can be a wealth of resources for your family. Plus, who doesn't love the smell of a good book?

 

I sifted through the old standby classics like What to Expect When You’re Expecting by Heidi Murkoff, some humorous ones like Belly Laughs by Jenny McCarthy or Girlfriends Guide to Pregnancy. Some I found really informative, others super dry, and a few became favorites.

 

As the years have passed, I was turned on to some great books by my doula while I was preparing for birth. Others I have come across during my training with Birth Arts International. I’m always dissecting birth and pregnancy books.

Is the language accessible and not just medical jargon? Is it up to date with evidence based practices? Which clients or friends will appreciate this particular book?

 

Know better, do better. 

Know better, do better. 

I’ve gathered my top 3 favorite birth and pregnancy books. The bonus: they are available for free at your local library! If it’s not available for some reason, ask your librarian. Often a book title can be requested from another library or they’ll purchase it for you. If you have a favorite birth book, consider donating a copy to your local library. It’s great to have a collection of birth literature available in your community.

1)The Mama Natural Week by Week Guide to Pregnancy and Childbirth by Genevieve Howland

Written by YouTuber and natural parenting blogger,  Genevieve Howland, this comprehensive book covers all aspects of fertility, pregnancy, and birth. It covers all the options with prenatal testing, providers, birthing locations, etc. Having these options laid out is the definition of informed consent, and can help with decision making. It offers great natural options and nutrition options without seeming too far out there. (I can honestly say that on a personal level, I laugh when I see tofu in a pregnancy nutrition book. Not happening. Pass me that giant bowl of pasta please.) 

This is my favorite new pregnancy book. It's modern, it's accessible, and it gives a fresh take on birth. Have your support, know your options, and have the best birth you can that day. 

2) nurture: A Modern Guide to Pregnancy, Birth, Early Motherhood- and Trusting Yourself and Your Body by Erica Chidi Cohen. 

Author Erica Chidi Cohen brings a new voice to the pregnancy and birth literature choir. Writing from the perspective of a birth and postpartum doula, she brings a compassionate conversation to the reader instead of the usual lecture you feel like you're getting (eat right, get your finances and all the things done, be happy, etc.). 

The book takes a deep dive into the emotions surrounding pregnancy and birth, and offers beautifully realistic ways of handling them. She has a strong focus on self care and mindfulness that often gets overlooked. It hits the full spectrum of care that's needed for mamas and families right on the head. 

Best part of this book: more than a third of nurture is dedicated to postpartum care of mom. Postpartum care often gets the short end of the stick. The focus is on labor and newborn care, often not bringing attention to the fact that moms get put through the ringer with birth. Moms need more than just a primer on how to use a peri bottle and nursing. Cohen helps to plan your household, and gives tips for healing and bonding with baby without chaos, but with a lot more grace. 

3) The Whole 9 Months: A Week-by-Week Pregnancy Nutrition Guide with Recipes for a Healthy Start by Jennifer Lang, MD. 

If you were like me during pregnancy, you spent the first several months trying decide what would stay down, or at least not be brutal if it came back up. It's survival mode. This title tackles the nutrition behind feeling better during those early weeks, and how to eat for wellness for the remainder of your pregnancy. 

Lang breaks down what to look for in a prenatal vitamin, as well as eating to tackle pregnancy issues (hello constipation) and alternatives for crazy pregnancy cravings. 

The best part are the recipes included in the book. They're easy, delicious and healthy, and several can be made while having a screaming toddler at your feet. I love a realistic take on nutrition! 

What was your favorite book when you were preparing for pregnancy and birth? Share with us below! 

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Holy Moly Where Has the Time Gone: A recap of 2017 and what's coming up for 2018

Hey friends! It's been several months since I've been able to update the blog with a new post, but it's been for some of the coolest reasons. October was the start of a very busy season for my doula business. I was honored to serve at several births in October and November, as well as represent Doulas of Central Maryland at the Frederick Birth and Baby Fair, teaching at newborn care workshops, and beginning to design a postpartum planning workshop (you guys know how much I care about the postpartum period, it's a doozy that needs way more attention than we give it.) 

While on call, my phone is always in hand. Especially at night!

While on call, my phone is always in hand. Especially at night!

It was a great season with a few, "Jesus Take the Wheel," moments. I learned something new at each birth, and was really stretched at some moments. So much growth happens in hard moments, and it reminds me why I LOVE this work so much. 

So back to why there hasn't been a post in three months. I typically do all my blogging late at night after my kids and husband are asleep. It means I get blissful uninterrupted silence, but I stay up well past midnight to get it done. Staying up so late while being on call for my families just wasn't smart. I needed to get proper sleep at night, be present for my kids during the day, and let some aspects of work take the back burner for a bit. 

Now I am back and ready for the new year! I wanted to recap what I learned this year, some changes, and what's going to happen for 2018. 

Earlier this year I injured my stomach, and got a crash course in Diastasis Recti, pelvic floor issues, and the red tape that goes along with insurance and some care providers, There are tons of resources out there friends! Don't get discouraged and keep looking for help! I can now share that my DR is down to a one finger gap, and I'll be seeking out pelvic floor therapy later in the season. I'll be writing about the experience, so you guys get all the information on it. Because no one should deal with peeing when they sneeze, painful sex, or just plain pelvic pain. 

Sleeping more has been a priority. Can't take care of mamas if my eyes can't stay open. 

Sleeping more has been a priority. Can't take care of mamas if my eyes can't stay open. 

I also signed as a contractor with Deborah Bailey's doula agency, Doulas of Central Maryland (check us out here: www.doulasofcentralmaryland.com). Having a team behind me, has given new life to my doula practice. The wisdom, support, and back up of these three women have helped me to hone my skills. So what does this mean for clients coming to Living Heart Doula? You can still have me as your doula with all my support, but with the agency we can offer you more services including placenta encapsulation, belly binding, photography, and postpartum doula support. 

For the coming year, I am looking at the ways I can serve my readers and clients better. I will be adding an email newsletter to share more information, new blog posts, and find new products and services that serve pregnancy and parenting. I love the local businesses in our area, and want to share their offerings with you guys. (Who doesn't love awesome service with a friendly discount!) In these newsletters, I may  be polling and asking for feedback. What services are you looking for? What would you like from your doula services (aromatherapy vs massage)?

I am hoping to design and host more workshops this year. Postpartum planning is near and dear to my heart, so that is my starting focus for the new year.

I want to do lots and lots of blogging.  

Most of all, I want to serve my growing families and support their births. Loving on families and babies is the best. 

So tell me friends, what do you want to see from LHD this year? What are  you learning about? What are your plans for 2018? 

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Jacob's Birth Story: A fast breech vaginal birth

Before I begin my most recent birth story, I need to give some background information about myself. I am a Neonatal Nurse Practitioner and work at the same hospital that I receive my OB care; therefore, I have a close professional relationship with my OB providers. I also have a uterine anomaly called a bicornuate uterus. This means that my uterus is divided into two sections. This was discovered at my 13 week nuchal transluceny ultrasound with my first pregnancy. The complications associated with this anomaly are cervical insufficiency, preterm labor, preterm delivery, growth restriction, and breech presentation. The risk of breech presentation is due to the limited space for the baby to turn. Because of this anomaly, I was followed very closely by the high risk OB and had approximately 13 ultrasounds with my first pregnancy. My son was born by vaginal delivery after spontaneous labor at 37 weeks and 2 days. At every ultrasound he was head down.

With my second pregnancy, my son was in breech presentation at every ultrasound. I really became concerned about this around 26-28 weeks, given the limited uterine space and that my first son was always head down and this time my son was always breech. Everyone (both medical and non-medical) tried to reassure me that “there’s plenty of time for him to flip.” It was at this point that I began my research on getting a baby to turn. I googled, youtubed, and read a lot of articles and blogs. I tried anything and everything to get my baby to turn, with no avail. At 34 weeks I had a discussion with my OB about attempting an external cephalic version (ECV); however, I am not a candidate for this procedure given my uterine anomaly. It finally started to sink in that I was going to have a c-section. My OB decided not to schedule me for a c-section, rather we would wait until I went into labor in order to give me every opportunity for the baby to flip.

Breech presentations include:

  • Frank Breech (Bottom down, feet are up by the head)
  • Footling breech (One or both feet are by down)
  • Complete breech (Bottom is down and legs are crossed. Imagine baby sitting Indian style.)

During a casual conversation one day at work with the high risk OB director, I expressed my concern for having a c-section and how much I did not want to have one. He agreed that I was not a candidate for an ECV and what I thought was jokingly, he said,“Well you could always do a breech vaginal, the only problem is I would have to be at your delivery, and that might be uncomfortable for you.” My response was that I would not have a breech vaginal because of the risks associated with it. That was the extent of our conversation. I did not have any conversation with my primary OB about a breech vaginal delivery.

So what are the risks with breech birth?
- Placenta being compressed
- Head getting stuck
- Some incidence of large limb fractures
Biggest issue currently is finding a provider who is experienced and educated in delivering a breech!

At 37 weeks I went to my routine OB appointment, and again had a discussion with my OB about a C-section, and again expressed my feelings and anxiety about it. She was very empathetic, but tried to reassure me that it wouldn’t be as bad as I thought and also gently brought me to reality that this baby would most likely not flip at this point. I was 1 cm dilated and 50% effaced at this appointment and not having any significant contractions.

The next morning, at 37 weeks and 1 day, I woke up with some intermittent cramping back pain. It wasn’t very painful, but it was certainly noticeable. Shortly thereafter I began to have some lower abdominal cramping similar to that of a period. I didn’t time the cramping but thought something might be happening given that it was intermittent and not a consistent discomfort. At this point I didn’t want to call my OB, because I knew she would want me to come in right away given the breech presentation and I didn’t want to have my husband come home from work and call my childcare if this wasn’t, “the real thing.” But, I did get my (almost) 2 year old set up with breakfast and hopped in the shower, did my hair and makeup, and got myself all ready “just in case” this was it. I packed the car with our bags before heading out with my son. Throughout the pregnancy I constantly thought about the, “last day” that it would be just, “us.” My son loves ice cream, so I wanted to take him out on an ice cream date. We got to the ice cream parlor a little before noon just to find out they didn’t open until noon. We went next door to the grocery store to kill a little time. By this point the cramping was occurring more frequently, but not necessarily with more intensity. I stopped in the bathroom on our way out and that’s when I had my bloody mucousy show. It finally sunk in at that time that I was in early labor. We got our ice cream and I just sat and enjoyed those last minutes with my son before my attention was going to have to be shared.

Megan the morning of Jacob's birth.

Megan the morning of Jacob's birth.

We got out to the car around 12:15 and I called my OB to report my symptoms. As I expected, she told me to come to the hospital to get evaluated. I called my husband who was working an hour away and my sister who was going to watch my son. By the time my husband got home and we got out the door it was around 1:30. We weren’t in the car more than 5 minutes when the intensity of my contractions increased and I was unable to talk during them. The ride to where we were meeting my sister was about 25 minutes. Just as we pulled up my water broke. I called my OB again to give her an update and that we were about 20 minutes away. By the time we arrived to the hospital I could barely think or talk due to the pain of the contractions which were now about a minute apart.

I was immediately taken into a room (the PACU was full) and my OB checked me and said I was 6 cms. There were so many medical professionals in my room working diligently to get me prepared for my c-section since I had progressed into labor so quickly and was continuing to have very strong contractions every minute. That was when my OB told me that the hospitalist was on service and she has experience with breech vaginal deliveries and asked if that was something I wanted to consider. I could barely focus on her words so she decided to get me my epidural and get me comfortable before we had any further conversation. As soon as I got my epidural she checked me again and I was 9 cms (that was about 30 minutes after the first time she checked me). I had to make my decision very quickly after having a brief but serious conversation with the hospitalist. I knew in my heart that this was the right decision for me. My husband was against it, but said he trusted me and my OB and knew that I was very aware of the risks associated with this type of delivery given my medical background.

So we moved into the OR, which is where I had to deliver in case they had to do an emergency c-section. As was explained to me before making my decision, I labored down for about an hour before I started pushing in order for the baby to optimally move into the birth canal vs pushing him into position. I pushed for 18 minutes until I heard the most beautiful sound in the world which was that of my baby crying. He was placed skin to skin with me and I just cried tears of joy and relief. He weighed exactly the same as my first son, which was 6 lbs 13 oz. I had no tears and felt so wonderful during my recovery. Every day I thought about how different my recovery would have been if I had a c-section.

On the way to the hospital when I was contracting so painfully I thought to myself, “Why did I wait so long to call my OB? I should have called this morning! This pain is so unbearable I could have avoided this if I hadn’t waited!” Afterwards, I was so thankful that I did wait to call, because my delivery experience would have been so different. Everything happened to just fall into place to make this all possible. The OB that I had such extensive conversations with was on service at the hospital so she knew my anxiety about having a c-section, the hospitalist who will do the breech vaginal delivery was on service, I was in spontaneous labor with contractions every minute with very fast cervical dilation, and my baby was tolerating the labor. Had any one of these factors been missing or different, I would have had a c-section. I absolutely love my birth story and I hope you enjoyed reading it!

Jacob meets his big brother.

Jacob meets his big brother.

 

 

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So What's a Doula? Answers to the top three questions about birth work

Often when someone hears that I am a doula, the first questions about my field are:

Is that like a midwife?

That's for home births, right?

But then what does the dad do?

 

Let me address these questions, then I'll share exactly what a doula does for her clients.

 

Is that like a midwife?

Nope. A midwife is a medical professional that oversees your and baby's medical care through pregnancy and birth. Midwives are typically low intervention, and are great advocates for natural birth. A midwife can practice in a hospital, birthing center, or private home birth practice depending on the state.

Midwife checking on baby. Midwives can serve births at hospitals, birth centers, and at home. If you are having a low risk, healthy pregnancy, midwifery care may be for you.

Midwife checking on baby. Midwives can serve births at hospitals, birth centers, and at home. If you are having a low risk, healthy pregnancy, midwifery care may be for you.

 

A doula does not dispense medical advice, and it's out of their scope of practice to perform any medical procedures (temperature, cervical checks, manually feeling your belly for fetal position, etc.) Instead, a doula is a wealth of resources and knowledge. If you are faced with a procedure during your pregnancy and you are unsure of your options, a doula can help you to research the procedure and suggest questions to bring to your provider. We don't want to make decisions for you, but help to empower you in your decisions. We offer resources and support both prenatally and during birth.

 

When you begin to labor, you can call your doula to be with you whenever you want her. A doula can help you to labor at home longer and more comfortably (A well trained doula knows the signs in labor to transfer to the birthing location. However, whenever mama wants to go, is when we head in. We can also make transferring more comfortable too!) We are equipped with birth balls, rebozos, essential oils, and massage techniques. We can help with positioning, counter pressure for back labor, grabbing snacks, and making suggestions for other coping strategies. We are also there to support you emotionally, and can help with any mental blocks. Labor can be a crazy, emotional, messy time, and we are there to protect that space and see you through it. I reassure clients that she can release on me in a way that maybe she couldn’t with her mother-in-law around.

Airlia is sitting on the birth ball while I help keep heat and pressure on her lower back. Even while being monitored, there are ways to keep moms comfortable and not just in bed.

Airlia is sitting on the birth ball while I help keep heat and pressure on her lower back. Even while being monitored, there are ways to keep moms comfortable and not just in bed.

 

A midwife will usually come as you are heading in to active labor if you are birthing at home. If you are at a hospital or birthing center, they will be around to check in with you, but won’t likely be with you the entire time. They will be with you during pushing, and can aide with protecting your perineum with stretching or counter pressure. Your midwife is the other half of the equation to your birth team.  Midwife + doula + partner = Fully Supported Mama

 

That’s for home births, right?

You may be hearing about doulas from your crunchier mamas. While I do support mamas that choose to birth at home, I also happily support families that birth at the hospital or birthing center. If you are planning a natural birth, opting for medication, or scheduled cesarean, I fully support you in your best birth. That looks different to different families, and no mama is the same in what she needs to birth with confidence. What matters to me is that you have options, and are fully supported in your choices.

 

But then what does the Dad do?

Doulas do not replace partners. Dads, partners, and other support people all have a role to play in supporting the mama. As a doula, I care about their needs as well. I can offer tons of support to Dad who may be nervous about how the labor is progressing, and pull him in with tips on how to offer counter pressure on a sore back, show him how to use a rebozo on mama’s belly to help a posterior baby turn, and I can be the one running to reheating the rice pack so he can be with you. It’s a team effort, and I am here for both of you! 

 

Here’s the nitty gritty on what a doula does for you:

  •          Meets with you in the weeks before your due. Meetings are usually to go over any health issues, any problems from previous births, and any lingering anxieties or fears about the labor. This allows us to develop strategies to help you cope during labor, and to develop your birth plan. We want to get to know you, so we can better support you.
  •           Having your doula present can:

o   decrease pain

o    decrease the need for epidural or pain meds

o   Shorten labor

o   Improve parent-baby bonding

o   Lower rate of postpartum depression

o   Lower caesarian rate 

 

  • While we aren't birth photographers, we will happily snap photos and video of the birth if you'd like us to.
  •  Doulas can help with the first breastfeeding session, and can help support you in the early days as well. If you choose to bottle feed, we are happy to support you with that too!
  •  Once you are home from the hospital, your doula will check in with a postpartum visit. This visit is usually to go over the birth, discuss how you and baby are doing, and help with any issues you may be facing. Having a baby is life changing, and no one understands this more than your doula. Birth is beautiful, hard, emotional, transforming work.

 

So to recap, doulas offer non-medical support for birthing families, offering education and physical and emotional support through the birthing process. We support all kinds of birth, and can act as guide through the experience.

 

 I am honored I get to witness it. I am honored to serve the growing families in my community.

 

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A Postpartum Checklist: Planning Ahead for a Better Recovery

There's a thing about birth that other moms don't tell you about. Recovery can be hard. You're sore and possibly torn in your most sensitive spots, your organs are rearranging themselves after pregnancy, and odds are pretty good that you haven't had more than a few hours sleep at a time for days. Not to mention nursing, trying to maintain your household and take care of any older siblings too. This period can be really hard, and we don't always have family and friends around to help out.

Planning and preparing for post postpartum in the last months of pregnancy can make a huge difference in the time spent resting and healing versus stressing over the to do list.

Here are my favorite tips:

Food:

  • Stock your freezer with extra meals that can be thrown in the crock pot or oven. (Ask friends to set up a meal train or have people bring freezer meals as a part of your baby shower!)
  • Stock snacks that are shelf stable and nutritious. (Trail mix, protein bars, granola bars, muffins.) Bonus points if it can be eaten with one hand.
  • Bottles of water or good cups with straws for easy access during nursing. Keep them stashed around the house!

Healing items for mama:

  •  Rice bag or heating pad for after pains. (And its true what they say, after pains get stronger after each baby!)
  • Witch hazel (Add to your Peri bottle to soothe angry tissue and stitches. You can use to make your own cooling pads, or you can purchase Tucks.)
  • Lavender essential oil. Add to the Peri bottle when you rinse, and the oil will help to heal any tears and help prevent infection.
  • Aloe, straight from an aloe plant! Will help sooth stitches. (Can you tell I've dealt with some nasty tearing?)
  • A boppy  pillow or hemorrhoid ring, because sitting on your sore bottom can be torture. As often as you can, lay down. Nurse on your side lying down or reclined. If you need to sit up for visits, don't be afraid to keep them short.
  • Earth Mama Angel Baby has a great line of products, including Happy Bottom spray, Postpartum Bath Herbs, and nipple cream. I loved them with my second baby! The bottom spray was heaven on stitches, and  the bath herbs can pull double duty. Save the liquid for your Peri bottle and use the herbal pack as a warm or cold compress, or use as a typical sitz bath.
  •  Padsicles! Ice packs feel awesome in those first swollen days and a padsicle can help with both swelling and irritation. Check out this recipe here: http://just-making-noise.com/pregnancy-notes-soothing-postpartum-pads-recipe/
  • If you had your placenta encapsulated, break those babies out! They'll start to help with healing and replacing lost nutrients.
  • Have extra large granny panties, in dark colors, because leaks are bound to happen. I suggest having a larger size to accommodate the large pads and ice packs in the early days after birth.
  • Have super comfy jammies. I had no shame and bought extra large sweat pants. I just needed comfort and room to heal; I really didn't care about being cute. (I may still have some of these in my drawer. A girl has to hold on to some things for a Maryland winter.)

Nursing:

  • Have some nursing tanks on hand, but in my humble opinion hold off on buying nursing bras until baby is born and nursing is established. I was shocked by how much my breasts changed. We are talking three cup sizes! Wait and see what your milk does before you go to the trouble of buying bras.
  • Have a good breast pump and parts ready to roll. You don't want to be sterilizing parts while engorged. (Ask me how I know.) if you're using a pump from a previous baby, ask for new parts from your hospital. My lactation consultant gave me a bag with new tubing, flanges, etc. for free! This is also a good time to make sure bottles, nipples and pacifiers are cleaned and ready for use.
  • This is where all the food prep will come in handy! Eat and a drink a ton, more than you think you might need to. Your body is doing a lot of work in repairing and also making milk for baby.

For Baby:

  • Besides all the usual items for baby, I suggest having a carrier or wrap for those newborn days. I love the maya wrap or a ring sling to help keep them snuggled while you keep your hands free.
  • Sleeping arrangements for baby to be close by, whether in a co-sleeper, bassinet, or pack n play, keep baby in the room with you. Everyone will sleep easier.

For the home:

  • Netflix. If you don't have it already, do it. There will be days where you will be nursing the baby non-stop on the couch. Binge watch and rest!
  •  Set up baby station baskets around the house. Any where you'll be spending time with baby, but also in places like your bedroom. Include a change of clothes, diapers, wipes, easy open  snacks, bottle of water, breast pads, toy/book to entertain an older sibling, and a magazine or book for you. I often found myself, “stuck”, under a nursing and napping baby while starving and thirsty. Having these in reach made things very easy. I felt like I had anything I could need within easy reach, without having to go up and down stairs for items. I seriously just used whatever baskets I had on hand around the house.

What was helpful for your family in the weeks following birth?

 

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Using Water During Labor and Birth

          Humans have an integral relationship with the element of water.  It runs through our veins, we are born of it, and it is necessary for our survival. We are drawn to it for escape, adventure, release, and cleansing. As a woman is preparing to give birth, water is a means of release from the weight of her growing belly, and the means to ease her aching muscles. Water is a great coping tool in labor, whether through a shower or tub. (For the sake of this paper we will only be mentioning the use of a tub.) The use of water in labor can aide in pain management by increasing relaxation, decreasing strain on muscles, and creating freedom of movement.

 

         The mother’s ability to relax her muscles during labor can affect the length of labor and the intensity of contractions. The more a mother fights and tenses her muscles the worse contractions may feel. Especially in active labor, the mother may need as many coping strategies as possible. The birthing tub offers a great respite, and a simple way to relax. The birthing tub is often called, "The midwife’s epidural”, for its effectiveness (Drichta, Owen p. 257). The warmth of the water helps to ease the pain felt from contractions, relaxing muscles of the pelvic floor and back, and creates a mental space that creates privacy (Drichta p. 258). It is recommended to maintain water temperature at 96-98 degrees. Using higher temperatures could cause increased blood pressure, dehydration and lethargy (Drichta p. 258). The bath is also deeply engrained as a place of mental release in daily routines. Our bathtubs are typically places of retreat to relax, and the mental association during labor holds true.

 

          Labor is a physically demanding process. From hours of walking, lunging, squatting, intense contractions, and the possibility of little sleep can make for a grueling marathon on the mother’s muscles. The warmth of the tub eases both the pain of the contractions and the work of her remaining muscles (Drichta p. 257). Being in a large tub that covers her belly, the mother is buoyant and freed from the gravity of dry land. Her pelvic muscles are relaxed and her cervix will continue to dilate, often with more ease as she relaxes. A mother that is able to relax and mentally release her tension, will have an easier time laboring than a mother that is fighting each contraction.

 

        Being weightless allows the mom to assume positions that could be too taxing on land, such as deep squats using the side of the pool, that will help baby to descend and turn. She's able to easily move from one position to the next in response to her labor, while remaining warm and relaxed. The ease of movement allows the mother to find her own rhythm and coping responses that she would not have had if she was limited to a bed. Her ability to move through labor gives the mother more control and autonomy during the birth. She's able to push in the position that suits her, catch her own baby, and bring baby to chest without outside help or others manipulating her body. She has full confidence and control.

 

          Relaxation, decreased strain on muscles and freedom of movement are gained for the birthing mother with the use of water during labor. The three work together as a pain management strategy, addressing both mental and physical tension that could hinder a birth. The birthing tub is used at its greatest advantage during late stage active labor throughtransition. It is recommended that for every hour spent in the tub, the mother spends at least thirty minutes out of the tub. This is to ensure that contractions do not slow down, as can sometimes happen. Often contractions may just feel less intense, but are still actively working. According to Water BirthInternational, “Getting back in the water after thirty minutes will reactivate the chemical and hormonal process, including a sudden and often marked increase in oxytocin.” (Harper p. 2) As with other labors, hydration is of the utmost importance. Keep a drink with a straw nearby so the mother can drink at will. The birth can be completed in the water as well, depending on location (some hospitals only allow laboring in the tub) and as long as the labor is not having any complications (ex:meconium, shoulder dystocia).

           

 

                                                     Works Cited

Drichta, Jane E., CPM and Owen, Jodilyn, CPM. The Essential Homebirth Guide for Families Planning or Considering Birthing at Home. 2003. Simon and Schuster.

 

Harper, Barbara. "Guidelines for Safe Waterbirth.”Waterbirth International. p. 2

https://www.youtube.com/watch?v=aQVM36r1rvw#action=share

https://www.youtube.com/watch?v=U6KHW7TNiCk#action=share

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Birth Balls, Best thing ever

Birth balls, commonly recognized as exercise balls, have been used for many purposes over the last ten years, including physical therapy, abdominal exercise, and most recently to aid pregnancy and labor. Its shape and durability allow it to be used by a variety of weights and heights, and in multiple positions. Birth balls can aide in pregnancy and labor to improve fetal positioning, fetal descent and maternal comfort.

Fetal positioning can make a huge difference in how labor develops. A baby facing in the posterior position in the womb may have a slow descent, and can also cause painful back labor (Spinning Babies). Poor fetal position can also cause very slow dilation, often resulting in unnecessary interventions. In some cases, the baby may have a difficult time turning and become stuck, requiring surgery or forceps delivery (Spinning Babies). Fetal positioning can be improved by having good posture. Often pregnant women are sitting on cushy couches or less than ergonomic driver seats, causing poor posture (Spinning Babies). By sitting and resting on the ball, the posture is upright and forward leaning, engaging abdominal muscles while relaxing the pelvis area. The back is comforted and strengthened by ball use, supporting the pelvis. With proper alignment and a relaxed pelvic area, the baby will have room to position properly, and begin to drop into the pelvis (Spinning Babies). It also encourages the baby to settle into an anterior position that is optimal for labor (Spinning Babies). Often a posterior baby can be encouraged to turn during labor by sitting on the ball.

Fetal descent is defined as entrance of the presenting portion (usually the head) into the birth canal. Descending takes time and hard work from both mom and baby.The use of gravity and squatting positions are helpful in this process, but can be taxing on the mother’s muscles over a long labor. The birth ball is a great tool in this scenario, as it allows mom to sit in a squatting position, allowing the use of gravity and an open pelvis to bring the baby down, but also allows for rest. The mother can also lean forward while sitting, and receive a massage or counter pressure. The ball can also be hugged while deeply squatting on the floor. It allows mom a greater balance and ease in the position, one that can be utilized in the pushing stage.

The birth ball is a great comfort tool for mothers in labor. It allows the mother to rest while still engaging an open pelvis. The birth ball can be a great break from walking, while still remaining active (Birth Arts Handbook p.187). It allows the mother to do pelvic circles and rhythmic movements that help her ease the pain of contractions. These movements often help the baby to navigate the turns in the pelvis before crowning (Birth Arts International p.187).  The birth ball also creates a counter pressure against the perineum and buttocks that can ease the sensations of early transition, which can be a difficult time for the mother. Having the birth ball as a comfort tool the mother can find a coping mechanism and rhythm through her contractions. By having support and a rhythm to help her cope, the mother can navigate her labor and have a mental place to return to when labor gets hard.

By utilizing the versatility of the birth ball, a mother can improve fetal position, while encouraging fetal descent and increasing comfort during labor. By improving these aspects of birth, unnecessary intervention can be avoided, as well as the use for drugs. This can greatly improve outcomes for mothers and babies, especially in a hospital setting where the mother is out of her comfort zone.

Works Cited

Birth Arts International, Certified Doula Education Program. Demetria Clark. 2000-2015. P.187

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Why You Should Hire an Encapsulator

After my first birth my body felt like it was hit by a truck. My muscles were achy, my belly was rubbery, and I was nursing a pretty bad tear. The baby blues were strong. I cried at the drop of a hat; looking at my beautiful Elena, thinking about how hard the birth was, how much I loved my husband for helping. I was overwhelmed with it all. Time went on, my body recovered and we managed to survive our first stent as parents.

 

I learned how consuming placenta can help in postpartum recovery, it can lessen the hormonal baby blues, help with milk production, help replace the nutrients lost in birth, and help the body to heal any trauma/injury. I was determined that with my next birth, I’d make the postpartum period better. I'd rest more instead of entertaining visitors, I'd make awesome witch hazel pads for healing, and I'd get my placenta encapsulated.

 

Fast forward two more years. I'm pregnant with my second baby and getting close to my due date. I was getting things in line for the birth. Cloth diapers prepped? Check. Doula set up and birth plan ready? Check. Postpartum supplies? Check. Placenta encapsulation? Oops! Somehow it fell to the bottom of my prepping list to check out my local encapsulators and get everything lined up. When I finally got around to it, we were a few weeks out from the birth, and our budget was looking tight. I felt like it was out of reach to hire out, but I'd heard of other crunchy mamas doing it themselves. How hard could it be right?

 

I did a little digging around (thank you google and Pinterest), and had my instructions pretty well laid out. I could totally handle cleaning my placenta and drying it out. Putting it in the capsules was going to be time consuming, but no huge deal right? Positive attitude all around! My hubs did tell me I was on my own on this one. Handling bodily organs isn't his thing. I felt totally confident I could handle it.

 

Sophia was born September 7, 2015, Labor Day. You can read her birth story below. Her birth was awesome, super peaceful and empowering. But I tore really badly. Yet again. I was in a lot of pain coming home from the hospital, and was looking for relief.  I was super excited to sleep in my own bed, and snuggle with my newborn.

Sophie is here!

Sophie is here!

 

But I had to deal with my placenta.

 

So in the fog of newborn haze, with a broken yoni, I stood at my kitchen counter with my placenta and supplies. It was the last thing on earth I wanted to do. I had a huge placenta too, that baby would have made a year’s worth of happy placenta pills. I started cleaning it and getting it into slivers. And it was taking me forever.

(Photos Courtesy of The Nurturing Root, Carmen Calvo)

I wish I could say I powered through and got it done. But I didn't. Instead I took a handful of my placenta slivers and saved them in the freezer and buried the rest of my placenta under a mulberry tree out back. Instead of encapsulating, I just used a small sliver of placenta in a berry smoothie. I had to tell myself it was going to help me, and I chugged it down. I couldn't taste it! Nothing gross, and I can happily report it helped with my baby blues. Not nearly as bad as the first round. I only used the slivers a few more times, and just kept the rest in the freezer on standby.

 

So what did I learn?

 

Take the time to hire someone to do this job for you! It's a big job, time consuming and needing attention to detail. Save your energy for the squishy newborn and wild toddler.

 

Photo Courtesy of The Nurturing Root, Carmen Calvo

Photo Courtesy of The Nurturing Root, Carmen Calvo

I'd like to share the business information of our local encapsulators, so you can encapsulate your next placenta:

 

Eimile Hannes

Helping Hannes Doula

http://www.helpinghannesdoula.com/

 

Brittany Hotem

Northern Maryland Doulas

http://www.northernmarylanddoulas.com/

 

Deborah Bailey

Doulas of Central Maryland

http://doulasofcentralmaryland

 

Carmen calvo

The Nurturing Root

Http://www.thenurturingroot.com

 

 

And for more in depth information on placenta consumption:

http://placentabenefits.info/articles.asp

http://www.mamanatural.com/why-eat-your-own-placenta/

http://www.placentawise.com/

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Hypnobirthing

With my second birth, I used hypnobirthing during my labor. You can read more about my birth story in the post below. I had heard a bit about hypnobirthing on some group forums, but was really introduced to it by a nurse I had during my hospital stay after the birth of my first daughter, Elena. The nurse and I were comparing notes on natural child birth, and she mentioned that she used hypnobirthing with her fifth baby.

"It was the most peaceful, painless birth. I'd think it was a crock if I hadn't done it myself."

Intriguing to say the least! Something that could make child birth painless without an epidural sounded amazing. So here's what I learned:

There are two schools of hypnobirthing; Hypnobabies and Mongan method hypnobirthing.  Instruction is typically done in a class with certified instructors, with subtle differences in what is taught. For instance, a Hypnobabies class may teach specific hypnosis techniques for analgesia/pain relief where hypnobirthing may teach guided meditations for deep relaxation (helping to avoid the tension that leads to pain). Either way, here is the point of hypnobirthing: release your mind of fear and tension, and your body will use its natural ability to birth without excess pain. The more you tense, the more you feel pain, and the longer your body takes to birth. By relaxing your mind and body, the cervix can open much more easily. We are mammals after all. If we feel fearful, our mind tells the body, "I can't birth here, it's not safe."

The best way to utilize the practice, is to do just that. Practice. It does take repetitive practice to train your mind and body to relax. In our busy lifestyles of constant running, it can be difficult to turn ourselves off. To go to a quiet place and just be still. The more you can do this, the more effective the tracks will be in aiding relaxation during labor. I visualized a quiet place that I stumbled upon on Pinterest. (I know. Pinterest is so good at that, great pieces to inspire labor and bathroom redecorating.)

This was my safe place during transition. Who wouldn't want to be here?

This was my safe place during transition. Who wouldn't want to be here?

 

 

 

I used this as my safe place when labor got hard, and I could retreat to somewhere else mentally.

 

So did hypnobirthing give me a pain free birth? No. I had labor pain like any other birthing mammal, but my mind and body were relaxed the whole time. I was wonderfully prepared for my birth, and didn't feel the same kind of pain I had with my first. I would describe it as intense, but I was able to cope. Sophia's birth was peaceful, and I can't wait to do it again.

 

Other perks of practicing hypnobirthing:

1)I slept amazingly well. I slept like a rock when I did the tracks right before bed. Goodbye insomnia!

2) I noticed a decrease in freaky pregnancy dreams. Could be a coincidence, but it's worth trying.

3) The tracks were a great break during a stressful day. I ended a recording feeling calm and focused. Something I needed when my three year old was losing her mind daily in the last weeks of my pregnancy.

4) Others have reported less anxiety and being able to better cope with anxiety using the techniques.

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