Friday, May 2, 2014
Emotional birth experience
Birth is emotional. That's no surprise right? What some may not prepare for is the after experience. The "life goes on" experience. Moms spend time thinking about what they hope for during delivery, when they get an experience that wasn't quite expected, there are many emotions that go along with that. What about the births that go perfectly? The moms that can't complain about a single thing during their delivery. Sounds ideal right?? You may be surprised to find out, those births can actually be a bit of a let down for moms. It's like that great vacation that you are planning and so excited for! It comes, and it goes and then, it's over. I remember when I had my babies, the pregnancy was typical, with monthly, biweekly and then weekly visits to the doctor. You get into a routine of appointments and preparations and then delivery day comes, and you are in the hospital for a few days, you have visitors and flowers and lot's of special treatment and all of the oohs and ahhs over the baby. You get home and you suddenly have no more weekly appointments, no more hospital room service, the visitors stop coming and life is "normal" again. I remember feeling sad as I adjusted to reality. I loved having the hospital experience, I loved the food, I loved the constant check ins (well, not so much in the middle of the night) but there were always people around me and I love being around people! My point today, your feelings and emotions are valid. Just because you had that perfect birth that others would love to experience, doesn't mean you can't feel let down or a bit bummed that it's all over and that it was for lack of a better word "uneventful".
What kind of birth to you want?
Simple question, that packs a punch! I meet many couples that have a clear vision of what they would like their birth experience to look like. As we discuss in more detail, my next question is usually do you plan to attend any childbirth classes? If so, which one?
I found a great handout that I give to expectant parents, it lists every choice you will be faced with for the childbirth process. Full list of birth options; by Preparing for Birth
For example, a few of those choices, in no particular order:
Own clothing vs. hospital gown
Monitoring options
Hydration options
Position options
Cord cutting options
Feeding options
Lot's of choices. You may be a person that would like to go into birth with an open mind and willing to fully listen to the staff at your birth and you may be a person that finds comfort planning every detail. You may be a person that will be disappointed if things don't go as planned, you may be a person that doesn't care if things go as planned, as long as things are OK in the end.
Birth is often compared to training for and running a marathon. The definition of marathon is as follows:
Interesting! "A long lasting or difficult task or operation of a specified kind". Can you think of a better way to describe birth? I don't know anyone that would enter a marathon without preparation and training. Do you think perhaps birth should be prepared for and trained for as well? What could you do to be ready for your child's birthday?
I found a great handout that I give to expectant parents, it lists every choice you will be faced with for the childbirth process. Full list of birth options; by Preparing for Birth
For example, a few of those choices, in no particular order:
Own clothing vs. hospital gown
Monitoring options
Hydration options
Position options
Cord cutting options
Feeding options
Lot's of choices. You may be a person that would like to go into birth with an open mind and willing to fully listen to the staff at your birth and you may be a person that finds comfort planning every detail. You may be a person that will be disappointed if things don't go as planned, you may be a person that doesn't care if things go as planned, as long as things are OK in the end.
Birth is often compared to training for and running a marathon. The definition of marathon is as follows:
mar·a·thon
ˈmarəˌTHän/
noun
- a long-distance running race, strictly one of 26 miles and 385 yards (42.195 km).
- a long-lasting or difficult task or operation of a specified kind.
Interesting! "A long lasting or difficult task or operation of a specified kind". Can you think of a better way to describe birth? I don't know anyone that would enter a marathon without preparation and training. Do you think perhaps birth should be prepared for and trained for as well? What could you do to be ready for your child's birthday?
Sunday, April 27, 2014
Circumcision
Circumcision;
The word packs quite a punch doesn't it? Unlike other blogs out there about circumcision, I am not going to share my opinion on whether it's OK or NOT OK to circumcise. No one other than you, the parent has the right to choose that for your child and furthermore, no one should make you feel bullied or guilty for your choice.
I have recently spent a lot of time doing research on circumcision. I am happy to say, I would make the same choice today, that I did when my son was born 6 years ago! And my husband agrees!
Circumcision is a hot button topic, there is a lot of heat when the word is said and it's simply impossible to have a conversation on a forum of any kind about circumcision without it getting really ugly, really fast.
So ugly infact, those that do circumcise I have found they simply stop talking and go silent. Not because they agree with what's being said but because no one likes to be ridiculed for their beliefs. I see it happen over and over and over again and it breaks my heart! No one should feel attacked for their choices about circumcision.
The one piece of advice I will give, look up objective reputable sources that weigh the pros and cons in a non emotional way. (You will find a few that I found helpful below) Medical advice is based on facts, not emotions. If you start reading an article, and you feel like perhaps there is a hidden agenda in the words you are reading, your instincts are probably right! Some of them can be pretty sneaky!! Once you have done a little bit of research, talk to your own doctor about the procedure, ask how it's done, ask if the area is numbed and if so, how? Ask about healing time, any other questions you would ask about any other medical procedure. Do not, I repeat, DO NOT go on a mother's forum and ask if you should or should not circumcise! This is a sure way to spark up controversy and you are looking for facts, not emotions.
Once you have done your research, think about what is best for your child. I hope beyond hope that when the day comes years down the road where you are faced with whether you would circumcise again or not, it's the same answer as you arrive at this time around.
I will leave you with a few articles that I find to be fairly objective. I hope they help!
http://kidshealth.org/parent/system/surgical/circumcision.html
http://www.mayoclinic.org/tests-procedures/circumcision/basics/definition/prc-20013585
http://pediatrics.aappublications.org/content/130/3/e756.full?sid=bd9574fb-4575-4d35-a46e-a63394e68331
Parenthood is full of countless decisions that you as parent must make; some decisions we make are the right ones, and some are not, but often times, if you think logically about the pros and cons of each decision, you will come to the right choice for that moment in time.
The word packs quite a punch doesn't it? Unlike other blogs out there about circumcision, I am not going to share my opinion on whether it's OK or NOT OK to circumcise. No one other than you, the parent has the right to choose that for your child and furthermore, no one should make you feel bullied or guilty for your choice.
I have recently spent a lot of time doing research on circumcision. I am happy to say, I would make the same choice today, that I did when my son was born 6 years ago! And my husband agrees!
Circumcision is a hot button topic, there is a lot of heat when the word is said and it's simply impossible to have a conversation on a forum of any kind about circumcision without it getting really ugly, really fast.
So ugly infact, those that do circumcise I have found they simply stop talking and go silent. Not because they agree with what's being said but because no one likes to be ridiculed for their beliefs. I see it happen over and over and over again and it breaks my heart! No one should feel attacked for their choices about circumcision.
The one piece of advice I will give, look up objective reputable sources that weigh the pros and cons in a non emotional way. (You will find a few that I found helpful below) Medical advice is based on facts, not emotions. If you start reading an article, and you feel like perhaps there is a hidden agenda in the words you are reading, your instincts are probably right! Some of them can be pretty sneaky!! Once you have done a little bit of research, talk to your own doctor about the procedure, ask how it's done, ask if the area is numbed and if so, how? Ask about healing time, any other questions you would ask about any other medical procedure. Do not, I repeat, DO NOT go on a mother's forum and ask if you should or should not circumcise! This is a sure way to spark up controversy and you are looking for facts, not emotions.
Once you have done your research, think about what is best for your child. I hope beyond hope that when the day comes years down the road where you are faced with whether you would circumcise again or not, it's the same answer as you arrive at this time around.
I will leave you with a few articles that I find to be fairly objective. I hope they help!
http://kidshealth.org/parent/system/surgical/circumcision.html
http://www.mayoclinic.org/tests-procedures/circumcision/basics/definition/prc-20013585
http://pediatrics.aappublications.org/content/130/3/e756.full?sid=bd9574fb-4575-4d35-a46e-a63394e68331
Parenthood is full of countless decisions that you as parent must make; some decisions we make are the right ones, and some are not, but often times, if you think logically about the pros and cons of each decision, you will come to the right choice for that moment in time.
Sunday, March 2, 2014
So what is homebirth really like?
Thank you to fellow Chicago area doula, Lani who is my guest blogger today! Lani has experienced home births of her own and has worked with moms who have chosen this birth setting as well. I asked her to write an informative post about what home birth is really like. Enjoy!
There are so many
choices to make during pregnancy. Should I drink coffee? Color my
hair? Eat something other than organic kale? Do we test for genetic
anomalies, find out the gender, agree to the flu vaccine? These are
just during the “growing” period of pregnancy, a whole different
list appears for labor and delivery, and yet another for the few
hours after, and the next eighteen years. Choosing the best options
for us during our pregnancy gets us ready for the thousands, probably
millions of decisions we will make for and with our child(ren) in the
future. So we read, and listen to stories and hear doctors and
professionals speak about decision after decision.
Then we choose.
For better or worse our choices affect
us now and in the future. One of the choices is where to labor and
birth our babies. Hospitals, birth centers and homes are the most
common choices (the few “Fast and Furious” lovers come in cars…
but usually not by the choice of mom and dad.) So what makes a home
birth different, what is to be expected in a home birth and the
similarities between home births and hospital births?!
Preparation for a homebirth begins with
prenatal care. Although there may be a few OBs who attend
homebirths, the VAST majority are attended either by a Certified
Nurse Midwife (CNM), Certified Professional Midwife (CPM) or Licensed
Midwife (LM). Appointment times vary greatly between OB (or
midwifery) care through a hospital and midwife appointments for a
home (out of hospital) birth. Appointments times grow from 3-5
minutes per OB appointment to 45-60 minutes with a midwife
appointment. There is more discussing of how mom is feeling, fears,
excitements, preparation, etc. at midwifery appointments, they are
not held to the high patient to doctor ratio as their
liability/malpractice insurance is not that of an OB’s.
Something to also keep in mind is that
homebirth is not for everyone. People who have higher risk
pregnancies (multiples, uncontrolled gestational diabetes, breech
births) should research more closely the risks involved with birthing
outside of a medical institution. Low-risk mothers, who have a basic
understanding of the anatomy and physiology of how their body is
going to birth a baby are more than likely going to be the most
successful.
Another difference is probably the most
obvious. When the woman goes into labor, she stays home. There is
no packing a bag, preparing a birth plan as that has all been
discussed during prenatal appointments. So instead the new momma can
work on a baby blanket, go see a movie, take a walk, bake a birthday
cake- pretty much do whatever she wants to until she can’t
concentrate on anything except her labor.
Homebirths happen differently every
time. Women are given the space, time and environment that they want
and create for their birth. The laboring momma is able and
encouraged to move freely, eat and drink as much as she wants. Labor
is hard work, and your body needs fuel to keep going! Position
changes are encouraged, the more a momma moves, the more her baby
moves twisting, turning and descending in preparation for birth!
If an emergency were to occur during a
homebirth 911 would be called, unless the laboring woman was so close
to a hospital a husband or partner driving would be faster (and
feasible). Something to keep in mind though, which will be discussed
later, is that because the midwife is looking for “red flags”
serious emergencies are rare. There are no drugs available for the
mother so labor is not unnaturally slowed causing the need for
Pitocin and stronger labor augmentation measures, cervical checks
which can increase the chance of infection are done rarely, the
baby’s heart beat is checked every fifteen minutes and continue
doppler can be used if deemed necessary for a time.
Usually as a woman begins her labor she will relax, call her midwife, let her know something might be changing (contractions are beginning, bag of water broke, more discharge, etc.). Normally the midwife will instruct the mother to rest as long as possible, take a nap, shower, eat a good meal, drink lots of water and conserve her energy.
As labor progresses an assistant will
come out, another nurse (at least an RN, some homebirth practices
employ CPMs or LMs) will come to assess the mom. A cervical check
will occur to determine where the woman is in her labor unless
otherwise discussed. If mom is in active labor, around five
centimeters or more, then the head midwife will come out.
When the head midwife comes out, she
will greet the laboring woman, the assistant will inform her of how
the mom is progressing, and she will chart progression, letting mom
labor as long as she needs to safely. The midwives primary job is
the guardian of safety for both the mother and the baby. She is the
person who, watches for “red flags” during labor that could lead
to possible complications (unsafe fluctuations in baby’s heart
rate, mother getting too dehydrated, tired, etc.), and suggests
transfer to a hospital if need be.
Labor will progress, someone will come
and check the baby’s heartbeat about every 15-20 minutes. About
every 4 hours (more or less depending on the woman) a midwife will
perform a cervical check. This is to assure progression of labor as
well as determine possible position of the baby. If the baby’s
head is cocked a certain way, or isn’t quite lined up the way it
needs to be for the birth the midwives may suggest a position change
or two to help facilitate that head and body rotation of the little
one. Eventually the woman will be pushing out her baby. The midwife
will assist in coaching with pushing if needed, allow mom the space
she needs to birth her baby, time the amount of time baby’s head is
out of the birth canal as the shoulders are delivered and correct any
complications that can come up during the second stage of labor such
as shoulder dystocia (where the shoulders of the baby get caught
behind the mother’s pelvic bones. After baby is delivered the
child will be placed on the mother's chest (if she didn’t catch the
baby when he/she came out.) The midwife will make sure baby is doing
well, breathing, checking APGAR scores, monitor the mother for signs
of extreme blood loss (hemorrhage), blood pressure, and general
well-being of both mom and baby. Again, she is paying attention for
“red flags” that may need to be addressed at a hospital. She
will help the new mom deliver her placenta, and check and repair any
tears (within reason, most midwives will transfer to a hospital for
anything deeper than a mid-third degree tear.) She will stay with
the mother until they have successfully breastfed a full session.
There are obviously many differences
between homebirths and hospital births, but there are many
similarities as well. Doctors and midwives share the same role in
birth. They are the guardians of safety for the mothers. They look
out for her best interests and those of her child. They are not
emotional support. This may be more obvious in a hospital setting,
but it is also true in a homebirth setting. That is what a doula is
for. Doulas are the witnesses of a new mother’s journey. They are
the servant, support, cheerleader for the mother. The power is the
woman’s in both the hospital and the home birth. No hospital can
force unwanted medication, a cesarean (non-emergent), and unnecessary
intervention. The choice, the power, the decisions are all the
mother’s. The birth that she desires can be hers whether in a
hospital or in her bedroom. Where a woman births her baby can be a
major decision. This choice is just one of a million choices that a
mother will make for her child. All she needs to do is trust
herself, the choice will be the right one.
Wednesday, February 19, 2014
Why didn't my doula hold my baby at the hospital?
Have you ever wondered why doulas don't often offer to take that sweet new little bundle of joy out of your hands for a snuggle at the hospital? I would *love* to hold that new baby of yours! I love babies, especially brand new ones that are still all curled up because they haven't even realized they have room to stretch in their new world! As a doula, I am there for you, mom and dad. My focus is on what is best for your family. Though I would love to hold your baby, the benefit is a selfish one for me, not a benefit for that newborn of yours.
Baby was just born.
Baby is adjusting to this crazy new life that was just thrust upon her (or him).
Baby is bonding with mom and dad.
Baby instinctively knows the love and comfort and warmth of mom's arms and mom's smells and mom's heartbeat.
Baby thrives in mom's arms.
You see, it's not about what I want at that moment. Doulas work to keep emotions of a new birth at bay, and focus on being fully present to the needs of the new family. That is what sets us apart from family members that are eagerly awaiting their invitation into the room at the hospital! Inside, I am overjoyed for you! I enjoy your baby from afar, I sneak longing looks at the baby, my heart swells for you, parents, who have endured the marathon of labor and delivery and I am thrilled at the moments after birth where all of the hard work pays off and you have your baby in your arms. The baby you have been waiting for is here, in the flesh and you are all soaking each other in! It's a beautiful and precious experience to watch from the outside. That is why your doula doesn't hold your baby at the hospital. Trust me, she wants to. But what she loves more, is watching you interact with your new precious bundle in this time of newness.
Baby was just born.
Baby is adjusting to this crazy new life that was just thrust upon her (or him).
Baby is bonding with mom and dad.
Baby instinctively knows the love and comfort and warmth of mom's arms and mom's smells and mom's heartbeat.
Baby thrives in mom's arms.
You see, it's not about what I want at that moment. Doulas work to keep emotions of a new birth at bay, and focus on being fully present to the needs of the new family. That is what sets us apart from family members that are eagerly awaiting their invitation into the room at the hospital! Inside, I am overjoyed for you! I enjoy your baby from afar, I sneak longing looks at the baby, my heart swells for you, parents, who have endured the marathon of labor and delivery and I am thrilled at the moments after birth where all of the hard work pays off and you have your baby in your arms. The baby you have been waiting for is here, in the flesh and you are all soaking each other in! It's a beautiful and precious experience to watch from the outside. That is why your doula doesn't hold your baby at the hospital. Trust me, she wants to. But what she loves more, is watching you interact with your new precious bundle in this time of newness.
| Courtesy of Google search |
Monday, January 6, 2014
What does a hospital birth look like?
If this is your first pregnancy, you may have some questions about what a hospital birth looks like. I am going to try to paint a clear picture for you and offer some questions you may want to consider.
Many couples prefer hospital births and I will admit that many hospitals have taken large strides in the right direction to be more family friendly, there are still many hospitals that have a long way to go, so don't take choosing your birth location lightly. Some hospitals have a better track record than others, ask around in your area to find out where the best places are to give birth and why they feel that way. Your doula can help by recommending her favorite places to go, afterall, we tend to have our favorites to work with.
I often tell clients how important it is to have a care provider that you can trust. There are many OB's and many midwives that offer supreme care. There are also both OB's and Midwives that perhaps are not in the best professional field. You spend a lot of time with these people prior to your birth, *most* of them will show their true colors at your prenatal visits. You *should* be able to get a clear picture of the type of care they are going to provide once delivery day comes. With that said, it's best to get your questions answered well before you even step foot into the hospital or birth center. There are significant differences between hospital births and home births, today the focus is on what a hospital birth looks like.
Triage:
Unless your care provider has called you in, you can expect to spend some time in triage. This is the time of "in between". The hospital is monitoring you, doing some of the admission tests, such as blood work, urine samples, etc. They will check you and your baby, they will ask lot's of questions. If you have a birth plan, this is a great time to hand one out to those caring for you. You will be managing your contractions, this is a time that you will want to plan for while preparing for birth. If you are planning a medication free birth, you will have practiced contraction management methods, so it's best to stay focused on keeping yourself comfortable. That will help keep labor moving. If you are planning to have an epidural, you will still need to have some methods of handling your contractions, and staying calm and allowing the contractions to do their job. I know moms who say triage was the hardest part because the last thing you want to be dealing with is a bunch of questions and feeling unsettled. You may want to have some ideas of how to handle this part of your hospital experience. If it means having your doula with you, then ask her to attend with you. If it means you and your birth partner are armed with techniques like having your music readily available or bringing some lavender oil to keep your mood relaxed. It helps to know what keeps you calm in stressful situations. This is one of the reasons why many parents choose to stay home as long as possible once labor starts. Ask yourself the question, do I want to labor in the comfort of my own home? Or do I want to labor in the hospital? That's a question only you can answer. Some feel better at home, others feel better knowing they won't be delivering in the car, if they wait too long to head in. Repeat after me, triage and transition don't mix :) However, be fully prepared to be sent home if you show up too early. And that's good news if you think about it! More time at home is never a bad thing!
Labor room:
You will be assigned a room and a nurse once it is determined you are far enough along on the delivery path. It will be wise to get acquainted with your new surroundings! There will be blood pressure cuffs, baby monitors, contraction monitors. The monitors can make or break the mood! It's incredibly frustrating to have to have the nurse come in every time you move because the monitors have stopped doing their job, when you plan to be moving a lot, because that's what gets baby OUT! I highly recommend you take special care to consider options as far as monitoring is concerned. Perhaps you can bribe the nurse to come in every twenty minutes with a doppler instead of the continuous monitoring? In all seriousness, I've seen traveling monitors that help a little bit, however, there is still a lot of readjusting. So be prepared for this. Thankfully most nurses are incredibly patient with moms that have a need to move around a lot! So don't let it keep you from moving, even if you are told to stay near the bed, don't underestimate the power of positioning while close to the bed!
The labor room has lot's of lights and mostly they can be dimmed so you can enjoy your dark room, nurses visit constantly, even if you want a quiet birth there will be many many MANY distractions. The beeping monitors (your support team gets rather good at jumping up to mute the beeping) you can have music or TV on, you can walk around the room or even the halls. You are going to be wanting to drink at the very least to stay hydrated, and hopefully have some snacks on hand too. Crackers with honey are a great snack! Popsicles can be great, some hospitals will allow you to keep them in their freezer. Great option! With the eating and drinking comes the bathroom breaks. This is something moms often need to be reminded of. It's a good idea to try to go every 20-30 minutes, especially as things progress. Sometimes baby's head can get stopped up by a full bladder, so you want to keep that bladder empty so baby can keep moving down, down, down.
If you have a doula (I sure hope you do!) this doula will most likely join you once management of contractions gets a little more intense. Some moms choose to have their doula with them every step of the way, some doulas love to do that, however, some don't come until birth is more active and contractions are a little less pleasant. This is great because mom and dad get some alone time to perhaps keep that oxytocin flowing, if you know what I mean! :) (I will note however, if your water has broken by now, there shall be nothing more than touchy feely business!) If doula is there, she will be encouraging you to keep up with your bathroom breaks and drinking and snacking, she will offer to get you whatever you need, she will be walking with you, massaging you while you rest on the birth ball, she will be doing some acupressure to stimulate relaxation or contractions if they are stalling out. This is a period of time that can take hours and hours and hours and hours, but it can also go rather quickly. You just never know. Try to mentally prepare for both a long labor (24 hours +) and a really short labor (6 hours or less). There are challenges that you face with both types of births. The longer labors tend to discourage moms because all of those hours with the hospital staff breathing down your neck is not a picnic, it's like being asked to pee on demand, sometimes it just doesn't happen! Think of ways to mentally allow yourself to relax and open up that pelvis. This is a great time for using visualization. Another thing your doula can help you with, perhaps while dad tries to get some rest! Another great way to try to keep contractions moving is using a breast pump. This is something you will want either your doula or a nurse to help with. The shorter labors are a bit of a whirlwind too. You will have to make decisions quickly and sometimes the hospital staff just starts doing things you haven't consented to because they haven't had time to soak up your birth plan. Think of things that are high priority and have those in bold print or readily available if needed, share those with your husband, because your doula can't speak for you, but your husband sure can!
How often will you see your care provider?
Care providers are rarely seen a lot throughout labor. They are often close by and check in with you and with the nurses, but they are not going to stay in the room until baby is practically crowning. This is something that surprises some parents, what you will want to do is get along with your nurses, if not, it's acceptable to respectfully ask for someone else. They are going to be the constant presence and even they pop in and out of your room because they have other patients, but you will want to get along with them. Are you delivering with a group or are you delivering with a midwife? Will your OB be the one at your delivery? If not, have you met all of the on call care providers?
The "time clock":
The truth is, you are on a time clock the minute you walk through the hospital doors. More so if your water has already broken. There are some care providers that try to be patient, but if your baby is not tolerating labor, or you start to show signs of infection such as fever, etc, they are ready to act. These are the times that you have to consider realistically. This is when it really helps to have a care provider that you trust. You need to trust they are doing what they think is best for you and though there is still some room for consent, a lot of times there are few options at that point other than to get baby out. This is the gray area of hospital births. I would like to believe they want what's best for mom and baby, but there is the blaring fact that they are trying to avoid lawsuits. It's a double edged sword.
Pushing stage:
This can happen two ways, if you have not had any medication, you should be able to feel when your body is pushing baby out. A lot of moms say they can't control the pushing because their bodies do it without any coaching. There is something to be said about allowing your body to tell you when it's time to push. A lot of times that happens around the same time that you are fully dilated, however sometimes it takes a little time. Let your body lead. Nurses are not used to seeing this happen, their instincts are to coach you to push once you hit 10 cms, just remember most of them mean well! It's exciting for everyone to see a baby emerge, even those of us that have seen it many times before!
The other side of pushing is with an epidural. There are positions your doula can recommend with an epidural in place, and most of the time there is the option turn the epidural down or off, so you can feel the sensation to push. These are great options to be able to push effectively. Otherwise, you will most likely be coached and they will do the whole count to ten in one breath thing and it can move quickly or it can go on for a few hours. Consider what this looks like to you.
After birth:
If you have not had any pitocin up until this time, don't be surprised if the hospital tries to push a round of it after the baby is born. There are studies that show it's effectiveness, and there are studies that look down on this practice. The theory of the hospitals is that it will reduce the risk of hemorrhaging. Read up on it and make your decision as to whether you will allow it or not. It's one of those "sneak in's" that they try to do while your guard is down and you are busy with baby. Also, if you have had no medication and you need to be stitched up from tearing, be sure to let your OB know more than once that you would like to be sure you are numb down there before they start stitching. Nothing worse than having those blissful moments skin to skin with baby after delivery and flinching and grimacing because you are feeling the stitch work down below! Ouch!
Thankfully most hospitals have adapted to allowing mom and baby to have skin to skin and some even do the delayed cord clamp routinely, as long as baby is doing well, you can expect to spend the first 30-60 minutes soaking your baby in while he/she rests on your bare chest. (You will want to make sure these are standard procedures at your birth place, if not, be sure to add it to your birth plan and talk to your care provider about your intentions) The staff or doula will find a blanket to cover you to keep you both warm. This is a really sweet and special time. Your doula is probably snapping pictures by now and keeping you company when the baby needs to go for weight and apgar checks. You can expect this to occur in the same room as you, but it doesn't hurt to ask while on the hospital tour just to make sure.
You will stay in labor and delivery until you are showing signs that you are ready to "graduate" to Mother/baby. Mother/baby is the room you will live in until you are discharged from the hospital. You may or not be surprised that during this time, there has been some rough "mashing" of your belly. This is not pleasant, but it is something they do to ensure your uterus is clamping down and shrinking. It's also a way to monitor your post partum bleeding. Some nurses are more gentle than others, most of them hate doing this to their patients. Along with the bleeding, you will be given some "mesh panties" to wear. They are really stretchy and I can say they are pretty comfortable, though not everyone will agree! You are free to make your own judgement :)
Mother/Baby:
This is a time baby usually gets to room in with mom. There are times that baby can go to the nursery, if it's requested or if there are routine procedures that need to be performed. If parents really push to not be separated from baby, they usually attempt to satisfy these requests. You will see a lot of medical staff faces while in this room. The OB checks in, the nurses are in and out, the Lactation consultant, the pediatrician, food staff...it might be wise to take notes of who visits and when, so you can keep it all straight if you have any questions. You are usually left to your own devices while in this room. You have all of the supplies needed to change baby's diaper and feed, nurses will be available to assist when needed and they will be coming in to do vitals and check for bleeding, check to ensure your uterus is shrinking, etc. You will just work on feeling good and ready to head home to start your new life!
Many couples prefer hospital births and I will admit that many hospitals have taken large strides in the right direction to be more family friendly, there are still many hospitals that have a long way to go, so don't take choosing your birth location lightly. Some hospitals have a better track record than others, ask around in your area to find out where the best places are to give birth and why they feel that way. Your doula can help by recommending her favorite places to go, afterall, we tend to have our favorites to work with.
I often tell clients how important it is to have a care provider that you can trust. There are many OB's and many midwives that offer supreme care. There are also both OB's and Midwives that perhaps are not in the best professional field. You spend a lot of time with these people prior to your birth, *most* of them will show their true colors at your prenatal visits. You *should* be able to get a clear picture of the type of care they are going to provide once delivery day comes. With that said, it's best to get your questions answered well before you even step foot into the hospital or birth center. There are significant differences between hospital births and home births, today the focus is on what a hospital birth looks like.
Triage:
Unless your care provider has called you in, you can expect to spend some time in triage. This is the time of "in between". The hospital is monitoring you, doing some of the admission tests, such as blood work, urine samples, etc. They will check you and your baby, they will ask lot's of questions. If you have a birth plan, this is a great time to hand one out to those caring for you. You will be managing your contractions, this is a time that you will want to plan for while preparing for birth. If you are planning a medication free birth, you will have practiced contraction management methods, so it's best to stay focused on keeping yourself comfortable. That will help keep labor moving. If you are planning to have an epidural, you will still need to have some methods of handling your contractions, and staying calm and allowing the contractions to do their job. I know moms who say triage was the hardest part because the last thing you want to be dealing with is a bunch of questions and feeling unsettled. You may want to have some ideas of how to handle this part of your hospital experience. If it means having your doula with you, then ask her to attend with you. If it means you and your birth partner are armed with techniques like having your music readily available or bringing some lavender oil to keep your mood relaxed. It helps to know what keeps you calm in stressful situations. This is one of the reasons why many parents choose to stay home as long as possible once labor starts. Ask yourself the question, do I want to labor in the comfort of my own home? Or do I want to labor in the hospital? That's a question only you can answer. Some feel better at home, others feel better knowing they won't be delivering in the car, if they wait too long to head in. Repeat after me, triage and transition don't mix :) However, be fully prepared to be sent home if you show up too early. And that's good news if you think about it! More time at home is never a bad thing!
Labor room:
You will be assigned a room and a nurse once it is determined you are far enough along on the delivery path. It will be wise to get acquainted with your new surroundings! There will be blood pressure cuffs, baby monitors, contraction monitors. The monitors can make or break the mood! It's incredibly frustrating to have to have the nurse come in every time you move because the monitors have stopped doing their job, when you plan to be moving a lot, because that's what gets baby OUT! I highly recommend you take special care to consider options as far as monitoring is concerned. Perhaps you can bribe the nurse to come in every twenty minutes with a doppler instead of the continuous monitoring? In all seriousness, I've seen traveling monitors that help a little bit, however, there is still a lot of readjusting. So be prepared for this. Thankfully most nurses are incredibly patient with moms that have a need to move around a lot! So don't let it keep you from moving, even if you are told to stay near the bed, don't underestimate the power of positioning while close to the bed!
The labor room has lot's of lights and mostly they can be dimmed so you can enjoy your dark room, nurses visit constantly, even if you want a quiet birth there will be many many MANY distractions. The beeping monitors (your support team gets rather good at jumping up to mute the beeping) you can have music or TV on, you can walk around the room or even the halls. You are going to be wanting to drink at the very least to stay hydrated, and hopefully have some snacks on hand too. Crackers with honey are a great snack! Popsicles can be great, some hospitals will allow you to keep them in their freezer. Great option! With the eating and drinking comes the bathroom breaks. This is something moms often need to be reminded of. It's a good idea to try to go every 20-30 minutes, especially as things progress. Sometimes baby's head can get stopped up by a full bladder, so you want to keep that bladder empty so baby can keep moving down, down, down.
If you have a doula (I sure hope you do!) this doula will most likely join you once management of contractions gets a little more intense. Some moms choose to have their doula with them every step of the way, some doulas love to do that, however, some don't come until birth is more active and contractions are a little less pleasant. This is great because mom and dad get some alone time to perhaps keep that oxytocin flowing, if you know what I mean! :) (I will note however, if your water has broken by now, there shall be nothing more than touchy feely business!) If doula is there, she will be encouraging you to keep up with your bathroom breaks and drinking and snacking, she will offer to get you whatever you need, she will be walking with you, massaging you while you rest on the birth ball, she will be doing some acupressure to stimulate relaxation or contractions if they are stalling out. This is a period of time that can take hours and hours and hours and hours, but it can also go rather quickly. You just never know. Try to mentally prepare for both a long labor (24 hours +) and a really short labor (6 hours or less). There are challenges that you face with both types of births. The longer labors tend to discourage moms because all of those hours with the hospital staff breathing down your neck is not a picnic, it's like being asked to pee on demand, sometimes it just doesn't happen! Think of ways to mentally allow yourself to relax and open up that pelvis. This is a great time for using visualization. Another thing your doula can help you with, perhaps while dad tries to get some rest! Another great way to try to keep contractions moving is using a breast pump. This is something you will want either your doula or a nurse to help with. The shorter labors are a bit of a whirlwind too. You will have to make decisions quickly and sometimes the hospital staff just starts doing things you haven't consented to because they haven't had time to soak up your birth plan. Think of things that are high priority and have those in bold print or readily available if needed, share those with your husband, because your doula can't speak for you, but your husband sure can!
How often will you see your care provider?
Care providers are rarely seen a lot throughout labor. They are often close by and check in with you and with the nurses, but they are not going to stay in the room until baby is practically crowning. This is something that surprises some parents, what you will want to do is get along with your nurses, if not, it's acceptable to respectfully ask for someone else. They are going to be the constant presence and even they pop in and out of your room because they have other patients, but you will want to get along with them. Are you delivering with a group or are you delivering with a midwife? Will your OB be the one at your delivery? If not, have you met all of the on call care providers?
The "time clock":
The truth is, you are on a time clock the minute you walk through the hospital doors. More so if your water has already broken. There are some care providers that try to be patient, but if your baby is not tolerating labor, or you start to show signs of infection such as fever, etc, they are ready to act. These are the times that you have to consider realistically. This is when it really helps to have a care provider that you trust. You need to trust they are doing what they think is best for you and though there is still some room for consent, a lot of times there are few options at that point other than to get baby out. This is the gray area of hospital births. I would like to believe they want what's best for mom and baby, but there is the blaring fact that they are trying to avoid lawsuits. It's a double edged sword.
Pushing stage:
This can happen two ways, if you have not had any medication, you should be able to feel when your body is pushing baby out. A lot of moms say they can't control the pushing because their bodies do it without any coaching. There is something to be said about allowing your body to tell you when it's time to push. A lot of times that happens around the same time that you are fully dilated, however sometimes it takes a little time. Let your body lead. Nurses are not used to seeing this happen, their instincts are to coach you to push once you hit 10 cms, just remember most of them mean well! It's exciting for everyone to see a baby emerge, even those of us that have seen it many times before!
The other side of pushing is with an epidural. There are positions your doula can recommend with an epidural in place, and most of the time there is the option turn the epidural down or off, so you can feel the sensation to push. These are great options to be able to push effectively. Otherwise, you will most likely be coached and they will do the whole count to ten in one breath thing and it can move quickly or it can go on for a few hours. Consider what this looks like to you.
After birth:
If you have not had any pitocin up until this time, don't be surprised if the hospital tries to push a round of it after the baby is born. There are studies that show it's effectiveness, and there are studies that look down on this practice. The theory of the hospitals is that it will reduce the risk of hemorrhaging. Read up on it and make your decision as to whether you will allow it or not. It's one of those "sneak in's" that they try to do while your guard is down and you are busy with baby. Also, if you have had no medication and you need to be stitched up from tearing, be sure to let your OB know more than once that you would like to be sure you are numb down there before they start stitching. Nothing worse than having those blissful moments skin to skin with baby after delivery and flinching and grimacing because you are feeling the stitch work down below! Ouch!
Thankfully most hospitals have adapted to allowing mom and baby to have skin to skin and some even do the delayed cord clamp routinely, as long as baby is doing well, you can expect to spend the first 30-60 minutes soaking your baby in while he/she rests on your bare chest. (You will want to make sure these are standard procedures at your birth place, if not, be sure to add it to your birth plan and talk to your care provider about your intentions) The staff or doula will find a blanket to cover you to keep you both warm. This is a really sweet and special time. Your doula is probably snapping pictures by now and keeping you company when the baby needs to go for weight and apgar checks. You can expect this to occur in the same room as you, but it doesn't hurt to ask while on the hospital tour just to make sure.
You will stay in labor and delivery until you are showing signs that you are ready to "graduate" to Mother/baby. Mother/baby is the room you will live in until you are discharged from the hospital. You may or not be surprised that during this time, there has been some rough "mashing" of your belly. This is not pleasant, but it is something they do to ensure your uterus is clamping down and shrinking. It's also a way to monitor your post partum bleeding. Some nurses are more gentle than others, most of them hate doing this to their patients. Along with the bleeding, you will be given some "mesh panties" to wear. They are really stretchy and I can say they are pretty comfortable, though not everyone will agree! You are free to make your own judgement :)
Mother/Baby:
This is a time baby usually gets to room in with mom. There are times that baby can go to the nursery, if it's requested or if there are routine procedures that need to be performed. If parents really push to not be separated from baby, they usually attempt to satisfy these requests. You will see a lot of medical staff faces while in this room. The OB checks in, the nurses are in and out, the Lactation consultant, the pediatrician, food staff...it might be wise to take notes of who visits and when, so you can keep it all straight if you have any questions. You are usually left to your own devices while in this room. You have all of the supplies needed to change baby's diaper and feed, nurses will be available to assist when needed and they will be coming in to do vitals and check for bleeding, check to ensure your uterus is shrinking, etc. You will just work on feeling good and ready to head home to start your new life!
Saturday, January 4, 2014
Dads and Doulas
Pregnancy is a journey for everyone involved. It affects dads and moms differently and that is something that should be noticed and tended to. It's a very intimate experience, it will bond you in a way that hasn't yet been achieved. Dad, you will have a chance to be there for your wife in a way that is a treasure. My best piece of advice for you dads, is to educate yourself on how to be a great birth partner! (There are many books and articles that you can find that will teach you and that, linked with your best instincts will be a great pair) Just like a mother can't truly prepare for what birth is like, the same is true for dads. You can read and you can prepare and then you have to trust that you are ready.
Surprises are common, things you didn't think of will happen, even for the best prepared couple, it won't be exactly as you imagined. That's where a doula comes in. Doulas are trained to be there with you and for you. Doulas have seen many different situations and they are experienced enough to stay level headed for you, to be that objective person that is rooting for you and has no agenda other than that. Doulas are ready and willing to tend to every need of the mother, as well as the father. Doulas are that extra set of hands. Imagine having a personal assistant that can and will do backbends if they believe it will help you progress :)
There are some doulas that will be with you every second from the start of your first contraction until well after the baby is born, because they believe that is their role. There are other doulas that are really good at giving a couple space and allowing them to lead the way with what they need. (I've had couples not call me until almost the actual birth itself and then I am racing against the clock to get there in time, and I am ok with that, because I know that by the time you are in labor, you are prepared and you are ready for me "when you need me") That's a good thing to ask the doulas you interview. They should be able to tell you when they normally join you and if they think it's their duty to attend to your wife while she is in the bathroom, or if she believes she best serves you both by waiting nearby. Each couple is different and has different needs and it's our job to tap into that and tend to your individual needs. This is not a one size fits all job!
Generally speaking, doulas are not dads and dads are not doulas. Dads serve a role that no one can fulfill. Dads are intimate with their wives, they love their wives and want to protect their wives in a primal way and that can not be matched. Doulas also serve a role that no one else can fulfill, not the nurses, or the OB's/Midwives, not even dads, even though some try. A person becomes a doula because they have something in their heart that says they are called to serve others. That heart is what births a doula and the training and expertise just add to that. Doulas are a valid and important part of your birth team.
*Dad is my generic name for birth partner. I know there are many variations of couples, but I find addressing each one makes my writing confusing.*
Surprises are common, things you didn't think of will happen, even for the best prepared couple, it won't be exactly as you imagined. That's where a doula comes in. Doulas are trained to be there with you and for you. Doulas have seen many different situations and they are experienced enough to stay level headed for you, to be that objective person that is rooting for you and has no agenda other than that. Doulas are ready and willing to tend to every need of the mother, as well as the father. Doulas are that extra set of hands. Imagine having a personal assistant that can and will do backbends if they believe it will help you progress :)
There are some doulas that will be with you every second from the start of your first contraction until well after the baby is born, because they believe that is their role. There are other doulas that are really good at giving a couple space and allowing them to lead the way with what they need. (I've had couples not call me until almost the actual birth itself and then I am racing against the clock to get there in time, and I am ok with that, because I know that by the time you are in labor, you are prepared and you are ready for me "when you need me") That's a good thing to ask the doulas you interview. They should be able to tell you when they normally join you and if they think it's their duty to attend to your wife while she is in the bathroom, or if she believes she best serves you both by waiting nearby. Each couple is different and has different needs and it's our job to tap into that and tend to your individual needs. This is not a one size fits all job!
Generally speaking, doulas are not dads and dads are not doulas. Dads serve a role that no one can fulfill. Dads are intimate with their wives, they love their wives and want to protect their wives in a primal way and that can not be matched. Doulas also serve a role that no one else can fulfill, not the nurses, or the OB's/Midwives, not even dads, even though some try. A person becomes a doula because they have something in their heart that says they are called to serve others. That heart is what births a doula and the training and expertise just add to that. Doulas are a valid and important part of your birth team.
*Dad is my generic name for birth partner. I know there are many variations of couples, but I find addressing each one makes my writing confusing.*
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