Five Activities for the Final Weeks (or days) of Your Pregnancy

The last weeks of pregnancy can be filled with anxiety, excitement and frustration waiting for labor to start and to meet your baby.  For first time moms especially, waiting it out can be a challenge because they might not have the distraction of other children.  As a doula, I've learned that supporting a mama through her last few weeks and days of being pregnant can be as challenging as supporting her through the labor itself because your mental state leading up to birth affects how prepared and calm you will be during labor. 

I encourage my clients to keep busy and perform activities that will be helpful during her postpartum period, as well as things they enjoy that will help them relax.  Here are a few things that are "must dos" for the final weeks:

1.  Walk the dog.  Walking is great for opening the pelvis and encouraging the baby to engage.  Fresh air never hurt anyone, and it is an enjoyable way to pass time.

2.  Make lots of meals and freeze them.  It is always lovely when neighbors and friends bring you delicious homemade meals, but it will be nice to have familiar, comforting food you love.  You will be glad you made six quarts of butternut squash soup or your favorite chili!

3.  Craft your own postpartum padsicles.  YOU WILL BE SO HAPPY YOU DID THIS!  My favorite recipe is here:  postpartum padsicles.

4.  Go to prenatal yoga.  What better way to prepare for birth, spend time with other expectant mamas and send labor love (or a friendly eviction notice) to your baby?

5.  Take a bath.  Relaxing in the tub is a wonderful way to soothe aching muscles and cherish your last few weeks or days of "me" time.  Practice relaxing your inner thighs and pelvic floor... and it doesn't hurt to throw in a few kegels!

Meet the Doulas

Come visit us tonight from 6-7 at the Ellwood's community room!

For Parents: How to Write a Birth Plan

If you have been to a childbirth education class, more than likely you have heard talk of the importance of writing your birth plan.  You've probably learned the pros and cons of various interventions and spent time thinking about what's right for you.  The place where you sum it all up is your birth plan, or on a document more softly titled, Birth Wishes, which I prefer because it acknowledges that everything may not go according to plan.

It should be simple.  This is the document for the busy nursing staff and care providers that describes how you would like to be cared for during labor and birth, and subsequently how you would like your baby to be cared for after he or she is born. 

When helping my clients structure their birth preferences, I encourage them to think of it in three parts:

1.  Introduction
This part sets the tone of your birth preferences.  It is important to introduce yourself and state the general feel of how you would like your birth. For example, it could start something like this:

Hello, we are Jess and John Doe and are so happy to be giving birth today at XYZ Birth Place.  We understand that our birth wishes may not go according to plan, however, we appreciate your support to help us achieve a positive and happy birth experience.

2.  State your wishes
I suggest using bullet points because they are simple, clear and effective for communicating your desires.

• I would like to labor naturally.
• We would like to delay cord clamping.
• We wish to have immediate skin-to-skin with baby.

The list can go on and on!  Get to know your provider's and birth place's policies to that you aren't listing things they will already be doing, which will help your birth wish list be short and sweet.  It is important for the staff to know how you'd like to be cared for, but if the document is five pages long, you run the risk of the staff not remembering or not reading it.  I suggest keeping your wishes to one page for simplicity.

3.  Thank the staff for caring for you and your loved ones
An awesome birth team is an essential part of having a positive birth experience, so thank them in advance for supporting your wishes.   It also helps to remind them of the mood you'd like to have in your birthing room:

We hope to have a peaceful, quiet birth and are thankful for your kindness and support.

Ending with a thank you helps create a positive tone to your preferences so that they will be more willing to support you in having the birth that you desire.

Lastly, talk over you birth preferences with your provider to make sure he or she is on board!

For Parents: A Guide to Interviewing Doulas

Finding, interviewing and choosing the perfect doula can be time consuming and tricky!  To all parents, and especially first-time parents, the process can seem overwhelming because who you choose to be present at your child's birth can literally make-or-break the situation.  Having the perfect team: a loving partner, a midwife or doctor you trust, and a doula who provides unconditional comfort and support is key to having a satisfying birth experience.

If you decide to go the doula route (and I might be biased, but everyone should!) you have find, interview and hire a stranger to provide you comfort during a beautiful but vulnerable period of you and your partner's lives.  Finding the right person is paramount, and during a short interview, it can be hard to get to know someone well enough to make an informed decision.  Here are a few talking points  and tips to help open conversation so that you can really get to know your potential doulas and find your perfect doula match!

1. Describe your birth doula philosophy.

Understanding a doula's birth philosophy will help you understand how she will care for you.  A good doula understands it is her job to support you and your partner's decisions whether they are in line with the decisions she would make herself.  

 

2.  How would you describe your relationship with local providers?

This cues you in on how she sees her role as a doula.  If a doula has positive relationships with care providers, then the chances of having a peaceful birthing room are greater.  A good doula has mastered the art of facilitating communication between you, your partner and your provider, and should add ease to the situation, not tension.  

 

4.  Tell me about a challenging birth you have experienced and what you did to better the situation?

As a doula, challenging births have been points of professional growth.  Knowing how she has supported families through challenging situations may inform you how she will support you and your partner if something complicated or unexpected arises.

5.  How long have you been a doula and what certifications do you hold?

This one is pretty straight forward.  Many doulas base their fees on experience, and it is helpful to know how long someone has been in the industry.

6.  What special services set you apart from other doulas?

Every doula has a unique outlook and skill set to offer her families.  Some offer Reiki, yoga, birth photography and other services, so find out what is included or can be added on to their birth doula services.

Facts aside, it is most important to find the doula you love.  Kind of cheesy, I know, but with every one of my clients, I have felt a genuine sense of comfort and natural ease.  We just worked well together. I truly believe that there is the right doula for every mother and father-to-be, and that you just have to interview a good number of candidates and trust your intuition to find your perfect doula match.

To find doulas in your area check out www.dona.org, www.doulamatch.net, or search for local doula groups.

Looking for a doula?

Prenatal Yoga in Richmond, Virginia

In this class, mothers will join together for a 90 minute practice to prepare them for labor and birth.  The class focuses on strengthening and stretching key muscles, relaxation techniques that are helpful during labor, and yoga poses that promote optimal fetal positioning. We will also focus on poses to alleviate common ailments during pregnancy for healthier, happier mamas and babies.
Fridays from 6-730 pm
(October 11, 18 & 25)
Restore PT, 411 N. 23rd Street

Email reservation is suggested & donations warmly accepted.

 

Email for artwork credit. 

 

Five Benefits of Family Yoga

The benefits of practicing yoga seem endless, whether you have a relaxed home practice, a regular class you enjoy attending, or pop into class once in a while to strengthen and relieve stress. Introducing your children to yoga at an early age will help them to develop many positive skills while everyone has a little fun together.

from Parenting Magazine

Five  Benefits of Practicing Family Yoga

Stress relieving. 
Children face an untold amount of stress in their daily lives.  Sure, they don't have to worry about a mortgage or government shut down, but their small worlds are filled with school politics and stress from change.  Yoga gives them a foundation for finding peace within themselves.

Teaches focus.
Daily life contains so much distracting technology that putting aside an hour for your child to practice fun yoga poses like lion or to grow their branches in tree pose will help them build better study and testing skills for school.

Increases self-esteem.
Yoga gives growing children a chance to learn to navigate their constantly changing bodies. It also helps them grow up fit and strong in a world where childhood obesity is on the rise.

Makes bedtime easier.
Enough said.

Grows bonds between family members.
Yoga is a fun activity that encourages positive relationships between you and your children.  I don't know anyone who has left a yoga class more stressed than they came, and sharing the feeling of contentment amongst family is one of the best things you can do together.

The Long Prodromal Labor

Supporting a mother through a long early labor can be tricky and challenging.  It may be especially frustrating for first time mamas because it makes them begin to wonder if their bodies can really are capable of birthing their babies.  As a doula, it is our job to remind them what deep down they probably already know, yes, they can.

Although birth may be a long way out, to a first time mama, prodromal labor may feel like the real thing. And in a way, it is the real thing because her body is working to prepare for the birth of her baby.  

I find the 5 Rs helpful in reminding me how to best help during a long early labor:

• Remind her of reasons why early labor may be so long (positioning problems, braxton hicks, baby isn't quite engaged).
• Redefine progress: sometimes it is difficult to think of progress outside of dilation, but I find it is helpful to get mama's mind off of her "number" and to break labor down contraction by contraction.  Focusing on the smaller victories helps her realize she really can do it.
• Rest: assure her that she will hold her baby soon, and that she should use now to rest as much as possible to prepare for her later labor and birth.  If her labor plateaus or stops, which can sometimes happen, assure her that her body is giving her time to rest, and that can be just the thing she needs.  
• Reposition: lots of long early labors happen because the body is working to reposition a poorly positioned baby.  I always consult Spinning Babies for positioning ideas and tips.
• Reset: sometimes a nice bath will help reset mama so she can relax and gain perspective on her labor as a whole. Eventually she will have that baby!

This is one of my favorite resources (again, Spinning Babies) for prodromal labor and I encourage you to read and share: Is This Labor or Not?

Also, remember this is your time to rest, too.  Doula support is most important during the active phases of labor, but it is still necessary for you to emotionally support during this early time, especially if she is frustrated and disappointed if her labor isn't progressing as quickly as she'd hoped.

NO PRENATAL CLASS TONIGHT

Sorry for any inconvenience, but Prenatal I is canceled tonight due to unexpected (but lovely) birth work.  We hope to see you next Friday for the next session!

Prenatal Yoga in Church Hill

Come one, come all! Join together with other mothers-to-be (or send your clients) to prepare your body for labor and birth. Donations will be graciously accepted! 

The Baby Led Latch

This past weekend, I attended a breastfeeding workshop led by DONA trainer, Sally Riley of the Academy of Certified Birth Educators.  She showed us some great videos and techniques for supporting our clients during the immediate post-partum period.  I came away from the workshop really believing that if we allow babies to lead in breastfeeding, we may see more successful feeding, which leads to happier, more confident babies and mothers.

It is interesting to see how instinctively the babies will crawl and nuzzle at the breast, and how once they are close to the nipple, with a little guidance from their mothers, may instinctively latch. I'm not saying that every mother and baby are destined to have a magical time breastfeeding.  The experience is different for every woman and child. However, I think that if we give mother and baby that skin-to-skin for the first hour or so after birth, we are setting them up to have the best relationship with breastfeeding possible.

Here is a clip I found that shows the beauty of the breast crawl and baby led latch:

 

URL:  http://www.youtube.com/watch?v=lEjM2TkVmK8&feature=share&list=PLcJcnxkZNqPrJfupk36Ll7VOoDyuzOVfN

So You're Meeting With a Potential Client...

In the early days of doulahood, meeting with new clients can be nerve-wracking! You have to take all the things you've learned and articulate professionally to a mother-to-be (and potentially a dad-to-be) why having a skilled labor companion is of value to them during labor and birth. So, I thought it might be helpful to share some of the guidelines I found work for me.

• Listen.  When meeting with a client, it is more important to listen than to fill the space asking questions. More than likely they will answer the questions you would ask anyway in natural conversation.  If you are doing most of the talking, you won't be able to sense how they feel, after all, the meeting serves for you both to become more acquainted with each other and for you to learn how you can be of service to her during a very vulnerable but beautiful process of her life.
• Be present for the meeting. This seems like an obvious one, but you would be surprised how many mothers-to-be have brought up the fact that a potential doula's use of technology (texting, etc.) changed their mind about hiring said doula.  If you aren't present during the meeting, how can they expect you to be fully present during birth?
• Ask key questions.  Asking key questions works to facilitate conversation.  Remember, even though some things seem obvious, it is better to ask and talk about them so everyone is on the same page.  It is better than being blindsided during labor!  A few questions I return to are:

Who are you delivering with and what is your estimated due date?

How do you envision your birth?

What are you most afraid of in terms of your birth?

How do you feel about interventions, and how strong are those feelings?

When you are feeling sick/anxious/tired what helps you feel better?

What are your pet peeves?

What do you think I can do to help you have your best birth?



• And remember, these questions are points of conversation.  Sometimes moms are still figuring out exactly what their hopes and wishes are for labor and birth. Some moms work out the details of their birth best by talking through different options with their doula and partner.
• Include her partner. When asking questions, it is really important to include her partner in on the conversation since they will be able to offer a different perspective.  Remember, a father's fears during labor can transfer to the mother, so it is vital to understand what everyone's fears and hopes are for their baby's entrance to the world.

I hope this helps other doulas work out their client meeting process!  I find that it works well for me to have two meetings prior to birth.  One to get to know one another and become familiar with their birth hopes and another to talk more specific comfort measures and how her partner and I can be of service throughout the different stages of labor.  If this first meeting is also serving as an informal interview, I find it handy to keep a copy of my birth agreement tucked away so that if they ask for details on fees and services they are able to see exactly what I am able to provide for them, and sometimes if you're lucky they want to sign right away to block off the space in your calendar!



What's in My Doula Bag?

A while ago I began gathering supplies for my doula bag, and I thought it would be nice to share its contents for other new doulas.  A few of these might even be nice for dads to bring along in the birth bag to help keep mom comfy.

 

 

So, here is the break down:

 

A few things I include for myself

•  lip balm (it is nice to bring an additional sealed one for mom)
• deodorant
• a business card or two to give to the midwife or OB if we are meeting for the first time

 

 

 

For mom it is nice to have

• mints
• travel size mouthwash to freshen up if she is nauseated  (I always bring a few extra for myself and dad in case of a long birth)

 

• bendy straws help to keep mom drink in various laboring positions
• energy bars are a great, compact snack for mom (if she is allowed to eat) and it helps doula and dad keep their energy up without leaving mom alone
• (not pictured) honey straws are a quick energy boost for when mom is getting tired

 

 

• Dr. Bronner's Magic Castille Soap in lavender and peppermint are great for drawing up a bath and for scenting cool compress towels for mom's forehead during harder parts of labor.  Lavender is really calming and peppermint is great to bring energy.
• Weleda body oils are awesome for massage.  I especially love the Arnica one since it is helpful to soothe mama's working muscles.
• Jojoba oil is a lovely for massage and is unscented incase mom is sensitive to scents. 

 

 

• combs are helpful for mom to squeeze with the teeth facing her palms during difficult contractions.
• rebozo is great tool for relaxing during labor.  I always refer to www.spinningbabies.com.
• hot pack or rice sacks are perfect for using heat therapy during labor.
• (not pictured) hand held fan to keep mom refreshed and cool.

 

 

 

extra references/guides

• birth plan which I usually keep on my phone, but it is handy to have a hard copy
• birth partner comfort guide which I like to print out in case dad forgets his copy
• Ina May's Guide to Childbirth
• Spinning Babies readily on hand through my phone
• contraction timer app really helpful rather than writing everything down since you only have to press the start/stop button so you can focus more on the laboring mother-to-be.

 

My doula bag contents all in one place!  I keep all the snack type things in a gallon sized plastic bag and the massage oils and soaps in another so that they don't leak and cause a huge mess!  It is also nice to bring a peanut ball and birth/exercise ball if the hospital doesn't provide them. 
 

 

 

 

 

 All packed and ready!

 

Birth Partner Comfort Guide

In a recent client meeting, the husband expressed his desire to help the mama through her labor, but said that he was nervous because of his lack of experience since this is their first child.  Basically, he wanted to help at his comfort level but didn't know what to expect or how he could be of service.  I made this chart because I wanted to give him something simple that he could keep with the birth plan to refer back to during the big event!  I referred to Ina May's Guide to Childbirth,  Penny Simkin's The Birth Partner, and various Bradley Method handouts as a guide.


Birth Partner and Comfort Guide

Early First Stage
• Emotionally exciting.
• Contractions are generally 10 minutes apart and last 45-60 seconds. They become progressively stronger and closer together. Strong contractions peak at 30 seconds.
• Help keep mom busy.
• Walk together to help open the pelvis.
• Eat if hungry, drink often, rest!

First Stage
• Confident and committed, acceptance of labor.
• This is a great time to have labor stations at home so that mom can be in different positions.
• Walking is still very important.
• Many changes are happening, but her body is settling into a pattern.
• Contractions are becoming stronger, generally 5 minutes apart and lasting around 60 seconds.
• Increased pressure, fullness in pelvis, backache, cramping.
• Pelvic rock, double hip squeeze, back massage are key!

Late First Stage (Hard Labor)
• Somber stage.
• Lying down may help (stack pillows or a peanut ball between knees to help open pelvis).
• May like privacy.
• Intense contractions that generally follow a pattern and last 60 seconds or more.
• Help mom relax completely between contractions with visualization, massage, cool towels, etc.
• Dim the lights and create a peaceful environment to allow her to let the labor take over.
• If anything, help mom relax through this stage.

Transition
• This is the most challenging part! Help her break it down one contraction at a time.
• Validate her feelings.
• Contractions may become irregular or may come on top of each other.
• Baby is shifting into alignment, which can cause a lot of pressure.
• Reassure her—the hard part is almost over.
• Whenever things get difficult, change something.

Second Stage
• Renewed energy, calm, determined.
• Urge to push.
• Might sleep between contractions, and there is usually more time between them to allow rest.
• Burning feeling that releases as the baby is born.
• Encourage her and allow her to choose the best position. Do as she asks!

Please feel free to use and share this with any doulas, dads and any other birth partners.