How to determine what matters most in birth.

What matters most in birth? A healthy baby? The experience? A healthy mom? Vaginal or Cesarean? Medicated or Natural? If you are reading this post now to find the answers I can tell you already that you are off to a VERY bad start.


What matters most in birth? Only you have the answer. So here is some advice: stop looking for it externally in blogs, threads on facebook, journals, and ANY other people and search internally. Ask yourself the question and answer honestly. Determine why you came up with answer and act accordingly.

Lastly, remember this; while it may be in the general nature of us human folk to seek validation in our choices, when we make them educated, fully aware, and from our hearts, validation becomes moot point.


Happy Birthing!

Doulas and Advocacy: Are they mutally exclusive?

I hear time and time again. I'm sitting in an interview with potential clients and they tell me that one of the reasons they want to hire a doula is to have someone advocate for them in the birthing room. I'm constantly explaining to clients that while I do consider myself an advocate of choices in birth, natural birth, and natural postpartum choices; I do not advocate for you during birth, but rather help you to advocate for yourself. I also explain that if they hire me as their doula, the process of how I help them to advocate for themselves starts prenatally.

I use to always wonder where these women and couples got the idea that doulas are advocates for them during birth. That is, until I started listening to my fellow doulas. Again, I'd hear over and over about stories of doulas who would get into heated conversations with doctors and nurses about hospital policy, clients wishes, evidence-based practices and more. I'd hear doulas brag about arguments they felt they won, shouting matching, standoffs, and more. The worst to me are the stories of doulas who unhooked IV's, stopped the pit machine, and spent time interpreting fetal monitor readouts. It was quite horrifying to me. Who was serving the mother at that time? How did this truly make her feel? Did these doulas really feel they served their clients best this way?

Now I understand there is a type of doula for everyone. Some women benefit from doulas with a more no nonsense attitude, the ones that don't sugar coat things or come off more "militant".  Other women prefer a lighter touch or a more "middle of the road" doula. I respect the differences and the need for them. However, I believe there should be a separation of doula and advocate. Politics, in particular your own personal politics, have no business at the birth of your client. Once a client is in labor, any personal agendas should be checked at the door. There is a more appropriate time and venue to try and change faulty birth practices.

I think the same thing goes for the myth that we empower women through these actions at her birth. A woman's power to advocate for herself and birth in the way she wants isn't ours to give. It's her birth and it has to be her job to find the power and be empowered. We can help, we can guide, we can even lead, but we can give that to anyone. Sadly though, through our actions, just like the hospital staff, we can take it away.



So people, what do you think? Do you think there should be  separation? Perhaps there is another side I am not seeing. Maybe you are a mother who benefited from a doula doing some of the things I mentioned above or a doula who felt there was no other way. Share your thoughts with me. I'm open to them.

Attitudes about birth do AFFECT birth!

This week I am going to let this little gem I found on Cafe Press speak for itself. I found this last year and was so riled up I sat on this blog post. In fact, when I decided to revisit it I got riled up again. So let me ask you this: Would consider this a harmless joke? Should I "get a sense of humor?" Or does it evoke other emotions in you? Please share. 

I'll be back next week with my well thought out, ever so tamed blog post about this fabulous T-shirt. By the way, in case you were wondering, the letters that are barely readable only say Cafe Press and it's website where you can purchase this shirt. It was in the OB section of site with other OB and birth related clothing for professionals.

Four Reason Why Moving in Labor is Best!

I want to start off by saying that I think most women who are allowed to find their own rhythm in birth will do just that! They will find a rhythm and ritual that works best for them as long as they have freedom of movement, are educated and informed of the birth process and well supported. Having said all that, I believe that one of the best things for a women to do in active and sometimes even in late labor is MOVE! Freedom of movement in labor is essential to the process and here are four reasons why:

1. IT MAKES YOU AN ACTIVE PARTICIPANT IN LABOR AND BIRTH: Labor and birth are active processes. Your baby and your body is working together to achieve birth. Waiting around for contractions can diminish your mental resolve. Many of my clients report feeling better when they have something to doing in birth. In the late stages of  labor, it's the pushing that gives them something to do. In active labor it's movement. By walking, rocking, "dancing", swaying, or other physical activities, you are working with your body to achieve the goal of birth. It can help to distract you in late phases of  early labor and in active labor, while also having great physical benefits.


2. IT HELPS MOVE YOUR BABY INTO MORE OPTIMAL BIRTHING POSITIONS: While I've come to believe that most positions your baby is in during labor are variations of normal, there are more optimal positions for labor and birth. Most will agree that one of the more optimal positions is LOA (Left Occicput Anterior). There are many things you can do to encourage your baby to rotate into that position and lying down on your back is not one of them. Movement, in particular, pelvic tilts, rocking in the hands and knees positions, squats, and lunges are helpful.

3. IT CAN HELP SPEED UP LABOR: The process of labor and birth is greatly benefited by walking and the use of gravity. Gravity can help move the baby down in the birth canal, thus allowing the baby to press down the cervix more as it descends. This in turn helps to dilate the cervix with the pressure from the fetal head that also promotes more oxytocin to be released. Oxytocin is the hormone produced in the female body that causes contractions. The more efficient the contractions a woman has are, the better there are at effectively dilating the cervix. This is how  labor can be sped up by walking, standing, and squatting!  All movements that utilize the help of gravity!

 4. MOVEMENT CAN BE A COMFORT MEASURE FOR BIRTH: Movement, such as walking, rocking, swaying, bouncing on birthing ball, and squatting can all help to decrease the perception of pain, thus making it a comfort measure and labor coping technique. As a woman labors, any tension both during a contraction and after, increases her pain perception level. Effective relaxation techniques help greatly, but so does the use of movement. Through movement, a woman is effectively managing her pain, thus decreasing her stress and tension levels naturally and in turn her pain perception is lessened.



In the end, the goal of birth is always a healthy baby and healthy mom! The journey of birth should be distinct to every woman's ideals and birth vision. Your Journey belongs to you and your baby! Freedom of movement is one way to help you reach your optimal goal of a healthy baby and mom, while also giving you many options to use on that journey.  Happy Birthing to all!

Maternal positions and mobility during first stage labour. Cochrane database of systematic reviews (Online) (2) PMID: 19370591

Simkin, P., & Ancheta, R. (2005). The labor progress handbook (2nd ed.). Malden, MA: Blackwell Science.

Simkin, P., Whalley, J., & Keppler, A. (2001) Pregnancy, Childbirth and the Newborn (Expanded & Updated Edition). New York, NY: Simon & Schuster.

Three Postpartum Things No One Tells You While You're Pregnant!

Pregnant women always seem to bring out the inner expert in people. Everyone from your mother-in-law to the grocery store clerk has advice to give or a story to tell about pregnancy, childbirth, and beyond. However, rarely do we hear about certain things postpartum that could be useful to us if we had advice about it or even a heads up. I'd like to take some time to go over the top three things that occur postpartum I hear from clients, see on parenting/pregnancy boards, and have personal experience with, yet seemingly pregnant women rarely know anything about. I hope this list helps some of you ladies out there navigate through your first weeks postpartum with more knowledge and confidence that what you going through is normal and common.

#1 - HAIR LOSS

You read that right. Lots of women experience hair loss postpartum. It can be very daunting watching clumps of your once luxurious pregnancy-induced Pantene locks falling out suddenly, but fear not! It's perfectly normal and probably not premature female balding! Telogen Effluvium is the excessive shedding of hair that can occur anywhere from 1-6 months postpartum and you can blame those pesky hormones for it! Normally, about 90% of your hair is an active state and 10% is dormant. During pregnancy, the increase in hormone levels can keep your hair from entering the dormant phase, so hair you would shed normally stays put. When pregnancy ends and hormone levels return to normal, your hair that ceased to shed during pregnancy, then begins to fall out postpartum. It seems like you are losing more than normal, but in fact are losing hair you essentially should have lost before.

Here are few things you can do to help during this time:

*Eat a diet high in fruits and vegetables, which contain flavonoids and antioxidants.

*Avoid hair styles that place stress on your hair such as ponytails, braids, and weaves.

*Use shampoos and conditioners containing biotin and silica

If for some reason you still feel your hair loss is exceptionally excessive, consult with your physician.


#2 - NIGHT SWEATS

I know some of you pregnant women out there are probably thinking big deal! I sweat already. To that I would say, not like this. Postpartum night sweats are a completely different beast. I've had clients who reported waking up with sheets soaked so bad they felt they'd been doused with a bucket of water. Although it may seem like a very strange post-pregnancy symptom, it's actually quite understandable considering all the extra fluid retention a pregnant woman takes on. After birth your hormones (yes, hormones again) adjust and signal to the body that it’s time to eliminate the extra fluid. Like many postpartum symptoms, this too shall pass. Usually in about 2-4 weeks. In the meantime, here are a few things you can do to make yourself more comfortable:

*Drink plenty of fluids. It may seem counter-intuitive, but drinking extra fluids will keep you hydrated (all that sweating can dehydrate you afterall) and help your body reestablish a normal water balance more quickly.

*Put a soft towel or a pad over your pillow and under your sheets to absorb some of the moisture.

*Wear loose, lightweight clothing and sleepwear made of cotton, or even sleep in the nude.

As always, if you have other accompanying symptoms with the night sweats such as fever or dizziness consultant with a physician.


#3 - DISCOMFORT AND UNCERTAINTY WITH BREASTFEEDING

Many pregnant women read up on the benefits of breastfeeding, hear about the magical bonding of mother and child, and may even witness a mother, sitting on a park bench, breastfeeding her baby with ease and grace. A real pro. Then you birth your wonderful baby, settle in to breastfeed the little angel and realize not only do you not know what the heck you are doing, but it hurts as well. Yes, it's a perfectly natural thing, breastfeeding, but it doesn't come without it's challenges, i.e., pain and discomfort. Especially those first few days postpartum. Now I completely understand words like pain and discomfort are subjective. One woman's mild discomfort is another woman's severe pain. Keep in mind though, that my point here isn't about those cases of bleeding cracked nipples, mastitis or severe engorgement, but the run-of-the mill discomfort caused by a hungry baby vigorously sucking (and at times tugging and pulling) on your virgin nipples.

You may have heard or even read before that old saying If you are doing it right it shouldn't hurt. Let me interject my first (and only) swear word in this post by saying that is utter bullshit. Well meaning women say this without realizing how condescending and hurtful those nine words can be. It's also wrong. Breast-feeding is a learned skill, and you'll need time, along with practice, and patience to make it a comfortable, successful experience. While many issues that come about during breastfeeding can be attributed to malpositioning of the baby and a poor latch, there is still that initial discomfort you can feel without experiencing those aforementioned issues. You may also feel unsure you baby is getting enough milk that exacerbates you concerns. These feelings are all within the range of normal and there are measures you can take to help you along with breastfeeding:

*Nurse on demand. During the first 12-24 hours after your milk comes in, by letting the baby nurse almost continuously, you may be able to avoid the initial engorgement (and accompanying pain) that normally occurs when the milk comes in.

*Even though fear of pain and discomfort may make you shy away from it; always begin feeding the baby on the sorest breast or the one that seems to be the fullest.

*Expose your nipples to air whenever possible to help toughen them up and to prevent continuous contact with moisture, which can cause nipple irritation, soreness, and damage.

*Lastly, you want to make sure you latch is correct. If you need further help you can contact breastfeeding consultants at Le Leche League International . Also consult a physician if you have severe bleeding cracked nipples and/or fever accompanying swollen painful breast.

As a passionate advocate of breastfeeding I urge any mothers going through this to allow for yourself and your baby the time patience to hang in there if you experience this rough patch! There are many reasons that make it worth it and a few weeks postpartum you'll mostly like be that mother looking that old breastfeeding pro in the park.

What does Choice mean to you? An open thread.

I am truly curious about women who advocate for choices but have no problem removing the ones from women that they don't agree with. This post comes about after many conversations I've had and read regarding an article that reported one hospital banning elective cesarean sections and inductions.

Now to be fair, there is part of me that wants to give in and celebrate this a victory for natural birth advocates, for women, for babies, but then there is another part that first and foremost terrified of the word ban and choice being in the same sentence when it comes to how women birth their babies. So before I get up on my high horse and tell you all why, I want to hear from you. I am hoping to learn something and have meaningful dialogue, not discredit anyone's point of view or argue. So let's try not do that in the comments, passionate as you all may be! Let's open it up to all choices in childbirth, not just this one. Do you feel there are other things that should be banned? If so, why, and again, why do you think it's not a dangerous thing to do, banning any choice in childbirth. So it's open to you ladies (and gentlemen if you are out there).

Woman! You ain' t nothing special!

Birth is nothing special. Any mammal can do it. Just because you got knocked up doesn't make you a goddess and it certainly doesn't matter that you were crazy enough to have the kid without medication.

That quote speaks volumes to me. It's not exactly verbatim, meaning I actually left out the more offensive stuff (if you can believe that), but that's the gist of it. It's an attitude that I keep running into and the really disturbing part is that like the quote above, a lot of it is coming from women. Aside from the fact that some woman would have the audacity to tell me (or any other woman), that my birth experiences are nothing special, I find it tremendously sad that she would feel that way about her own.

It seems to me that this push to devalue birth has reached a fever pitch and is part of a greater problem. There are misogynistic undertones to almost every debate made against natural birth, even when the debater is female. There is a scene in Business of Being Born where one of the doctors interviewed equated natural birth to "feminist machoism" (whatever the hell that means)and that he "frankly, didn't see the need for it". I can not tell how incredibly offended I was by that statement, not to mention shocked that it's not referenced more in the more "feminist" circles as the exact reason many men have NO BUSINESS in the realm of birth. But of course I shouldn't be shocked because like I said, many women feel the same way he does.

Where does these attitudes come from? Is the disregard for the process and act of birth a direct correlation to the disregard of women in this culture? When we are told our choices in birth don't matter and our accomplishments in birth aren't special, the underlying message is, we as women don't matter and we are not special. When you think back on the way obstetrics was practiced long ago and even now it's quite hard not to see a correlation. Misogyny, gender inequality, sexism are deeply ingrained in our culture, and so how can it not take root in one of the most powerful thing that sets us apart from men?

It saddens me to see these attitudes in women. It reminds me how effectively we've been pitted against each other. We are constantly seeking to invalidate each others choices, especially when it comes to birth. Whether it be vaginal or surgical. Pain-med free or epidural. VBAC or Repeat Cesarean. Each time we argue and belittle these choices, we forget the very meaning of choice and we devalue our sisters as a whole. Nothing, however, is worst than telling a woman that birth in and of itself is not special. Though it's been liken to any other physiological function (like shitting - an analogy I've really come to detested), it's not. It's by far one of the most complex and still in many ways mysterious physiological functions. We should all marvel at the fact that any conception is made and once made "sticks". The odds are usually against us. Then when it comes time to birth our babies, an even bigger miracle happens. We still do not know everything about why labor is started, but we do know that mother and child work together to achieve the goal of birth. When left alone and barring complications, it's a very harmonious dance between mother and child. It matters, how a woman is treated during this time. It matters how the child (both unborn and born) is treated.

Think about this: Without birth, our species can not survive. How we view birth is very telling about how we view life itself. Do you feel each life is special? If you are pro-life, then birth and how it unfolds should be special to you. If you are pro-choice, then choices in birth should be important to you. If you are against the death penalty because you value life, then how it's treated in the beginning should be of value and special. If you are a feminist, choice is one of the most holiest of words. How can you devalue another woman's? Birth is a very powerful thing and that makes it special. Women are the only one's capable of birthing a human child and so that is one of the many things makes us special. However, even if you choose not to birth or can not birth a child, birth is still special too you, because you were once born. If you've adopted, that child was once born. Let's stop denying our power as women and the importance birth. How our species thrives and survives depends on it.