Can my mother/sister/husband/friend/midwife be my doula?

A laboring woman should be accompanied by whatever people as she chooses. However, the support of professional doula is different from – and complimentary to! – the support offered by loved ones, and that offered by medical professionals.

You wouldn’t expect your partner to stand in for the doctor, or the doctor to stand in for your partner, would you? Of course not! The primary role of the medical team – doctor/nurse/midwife – is to monitor and support the physical health of mother and baby. Doctors, nurses, and midwives typically endeavor to support the laboring woman emotionally as well, but when the birth room gets busy, that’s not their primary task.

So what about loved ones? Well, at my first birth I was assisted by two midwives, my husband, and my mother. My mother is an experienced nurse and nursing instructor. Although not an expert in labor and delivery, you’d likely imagine she’d be able to provide “emotional support, physical comfort measures and an objective viewpoint, as well as helping the woman get the information she needs to make informed decisions,” right? Well, she certainly provided emotional and physical support and gave my partner the breaks he needed, but so far as objective viewpoint goes: NOPE! This was her baby, in pain and bringing forth her grandbaby. In this moment, she was just – and wonderfully – Jackie’s Mommy.

For my second birth, I hired a doula. (I hired Rachel.) You can see her here, working together with my husband to support me through pushing. My midwives are present but out of the shot – because they are busy with the medical work of assisting delivery.Rachel assisting at the birth of Jackie's second child

This does not mean you should not invite your mother or other loved one as well as a professional doula! We strongly believe that women in labor should be attended by whomever they choose (though you may need to check in with your provider’s/birth location’s policies regarding number of attendants). Because just as your mother/sister/husband/friend/midwife isn’t a professional doula (and perhaps even if s/he is), a professional doula knows very well that her role is not the same as you mother/sister/husband/friend/midwife’s. Only the medical team is the medical team, and only your loved ones are your loved ones.

Indeed, although your doula’s primary duty is to you, the laboring mother, most medical professionals and loved ones wind up finding that the presence of a professional doula enhanced their own ability to support the laboring mother. The doula eases the pressure on the partner, and on the medical staff, to fill all the roles all the time. She helps hold the birthing room as a sacred space, in which every attendant is able to bring her or his particular skills and gifts.

Together, we support the mother and her birth memory.

Preparing and Packing for Birth

For many expectant mothers, labor is a big and scary looming event.  At the same time, you are excited to finally meet the little person growing inside you.  There are some things that can make your birth experience easier.

How to Prepare:

Go to a birth class.  Go to a good birth class that meets over the course of several weeks and covers breastfeeding initiation and coping techniques.  Yes, they take more time.  Yes, they sometimes cost more money.  But you will know a lot more about your own labor and the various tools midwives, doctors and doulas use to help your baby come into the world.

I’ve said this before, and I’ll say it again: hire a doula.  Even if you plan to get an epidural, even if you end up with a scheduled c-section.  Doulas do more than just help you cope with a natural labor—they can suggest positions that speed up progress with an epidural.  They can help you have a gentle c-section, and walk you through the process as it occurs.  And they can help you establish breastfeeding, which can sometimes be a challenging experience without lactation support.

If you plan on having a natural and intervention-free birth, then you really need a doula.  A doula can help you through each phase of labor with a wide range of knowledge about coping techniques, optimal baby positioning and pain management tools.

Packing your bag:

We packed wayyyyy too much for our son’s birth.  Here’s a list of what I felt we should have packed:

Your own clothes.

Slippers.

A list of restaurants that deliver.  Trust me on this one.

Something to relax/pass the time.

The basics: cash, your camera, toiletries, a going home outfit for you.

Breastfeeding Made Simple. 

Phone numbers for your lactation consultant and your placenta encapsulation specialist, if you choose to encapsulate.

Stuff for the baby: A few onesies and some non-toxic baby shampoo.

What the hospital provides:

Really, you don’t have to bring anything.  Most hospitals have gowns, mesh undies, baby clothes, diapers, toiletry products and baby care products.  When you leave, I highly advise you to grab, um, a few free samples on your way out.  Extra mesh undies, extra gigantor pads for postpartum lochia, and most importantly, AT LEAST TWO BULB SYRINGES.  The bulb syringes from the hospital are far better at sucking out snot than any bulb syringe you will find in the store.  Your insurance is going to pay for that stuff anyways, might as well milk as much as you can out of it.

Navigating the First Trimester

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Congratulations, you are pregnant!  The first trimester can be a very exciting time as you relish in the thought that you will soon be bringing a child into the world.  The hardest decisions for you right now likely will be choosing a care provider and deciding when to tell your family.  Pregnancy monitoring during the first trimester is pretty laid back; you generally only go in about once a month for checkups at this point.  At 8 weeks, most expectant mothers will have an ultrasound to check the fetus for viability and determine a more accurate due date.

Choose your provider

When you choose your care provider, take your time.  You want to make sure that you will be on the same page throughout your pregnancy and during the birth process.  You will also need to have a good idea of what kind of birth you want; many OB’s will not attend home births and most states have rather specific laws about what midwives can and can’t do in hospitals.  If you want a natural birth, ask your care provider how he or she feels about letting you labor at home, the necessity of common interventions like breaking your water and also check his or her C-Section rate.  High cesarean rates don’t necessarily mean that your care provider won’t support a natural birth, but they do mean that your care provider’s experience and training are more geared in that direction.

Planning ahead

You don’t have to be ready for birth right now, but you will probably want to consider what type of birth and postpartum experience are important to you.  You can consult pregnancy books to learn a little bit about different birth plans.  For your postpartum, you may want to start thinking about how you will find the support you need to breastfeed (a doula is a great choice!) and make it through those first sleep-deprived weeks.

Tips, tricks, and favorite products:

Morning sickness

For morning sickness, nothing really worked for me.  Everyone suggested I eat saltines, but they only made me more sick.  What worked for me?  Ginger beer (with real ginger bits), sour patch kids and Preggie Pops.  Apparently sour things (and cheese) were the only things that agreed with me. I also was a big fan of tea, and Earth Mama Angel Baby makes a great Morning Wellness tea if you are into that.  And remember that your body is pre-programmed to feed your baby first, so he or she will be fine even if you have days where the eating is at a minimum.

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Fitness

It is important to keep exercising while you are pregnant.  In fact, if you are currently running or cycling regularly, you don’t even have to stop with your normal routine. You’ll probably not be up to a brisk jog in your final month, but for now, keep it up.  The exercise will help your baby grow and keep morning sickness and exhaustion to a minimum.  You might be tired, but make a point to get up off the couch once a day to take care of your changing body.

Books

For starters, let me state that I never got into entire line of “What to Expect” books.  They aren’t bad, but they aren’t really the best resource you can have at your fingertips.  When you go to select your pregnancy book, take some time to look at the entire shelf.  I have personally found that the Dr. Sears pregnancy book and the Great Expectations pregnancy book are my two favorites: they present all of the information you need in a balanced way that makes you feel empowered during your pregnancy.

Your body

You may not look pregnant yet, but your body is already starting to change, and you need to start preparing now.  First, invest in a large stainless steel or BPA-free plastic water bottle.  Trust me, you will be dying of thirst until the day you stop nursing, so just invest in the prettiest, coolest water bottle you can so that you always have plenty to drink no matter where you are.  Second, find a way to unwind–whether that is through a daily yoga DVD or a monthly prenatal massage, it’s time to relax and prepare your mind and body to support this baby!

Finally, now is the time to start moisturizing that belly so your stretch marks don’t stick around for the rest of your life.  Let me clarify: every woman gets stretch marks.  But good moisturization and hydration during and after pregnancy will help them disappear to practically nothing. Personally, I loved the Mama Bee Belly Cream, made by Burt’s Bees and the Earth Mama Angel Baby belly oil.

Now, it’s your turn: What worked for you in the first trimester??????

See also:

Navigating the Second Trimester

Navigating the Third Trimester

Trimester Tuesdays: The “Try”-mester

 
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This post is a little bit about TTC, or Trying to Conceive.  For some couples, this comes easily, while other couples struggle with infertility and pregnancy loss.  I am not a medical professional, so it is hard for me to get into the ins and outs of trying to conceive, but I will pass along the few things I DO know in the hopes that you can discuss them with your care provider and set up a plan that works for you.
To wait or not to wait?
This week, 47-year-old Halle Berry gave birth to a beautiful baby boy.  With stories like this common in the media, you might think that you don’t have to worry about getting pregnant until you are well established in your career and personal life.  For many people, this plan will work, but for many others you may be missing a window.  I don’t want to get into the whole “biological clock” debate, but it is true that it starts to get harder to conceive between the ages of 30 and 40.  It is important to make sure you are emotionally ready to care for a child before you try, but it is also important to remember that if you wait until you have enough money, job success, etc to have a child, you may never be ready to have one. No matter what you decide, make sure you talk it over with your partner and make the decision together.
Understand your body
You already probably know that you ovulate and you menstruate, but fertility is a little more complex than that.  One method of trying to conceive is known as the “maybe baby,” where you simply stop using contraceptive tools and see what happens.  For many people, this will result in a pregnancy, but for many others it may not be the best way to take advantage of your fertility window.  What is your fertility window?  You may have heard that you ovulate on day 14, but this actually varies from woman to woman, so you really need to know the ins and outs of your personal fertility cycle. Basal body temperature, cervical fluid and cervical position can all help give you a clue when you are in a fertile time period.  I highly recommend the book Taking Charge of your Fertility by Toni Weschler as a great guide to your cycle.  Plus, the book includes digital help and a collection of charts to help you with conception and even pregnancy prevention.
Be patient
It can take up to 6 months or longer for many couples to conceive.  Because unexpected pregnancies are quite common, most people assume that it is an easy process.  However, many factors must line up right for a child to come into being.  Age, diet and environment can be big factors in how easily you will get pregnant.  Remember also that it can take a long time for your body to kick back into gear after quitting long-term birth control. If you have been trying for a year with no success, it may be time to talk to your care provider about possible issues and solutions.
Check your environment
It is suspected that household chemicals and products may have some effect on conception abilities.  Try to avoid harsh cleaners and chemicals, as well as any plastics that contain BPA.  You may also want to avoid products containing hormones, such as traditional dairy foods or perfumes with pheromones.  Take a look at this article to find some common household hormone disrupters and get them out of your home: http://pregnant.thebump.com/getting-pregnant/fertility-ovulation/articles/10-ways-home-making-you-infertile.aspx?MsdVisit=1
Relax and be healthy
Stress can make baby making not so fun.  Relax and let chance be your guide. Keep eating a healthy diet full of whole grains, fruits and vegetables and remember to exercise at least three times a week.  If your body is happy and healthy and stress-free, you are increasing your chances of conception just by making a safe and stress-free home for your babe.
Dealing with infertility
If you are having trouble conceiving, I am going to add a few comments from a friend who was diagnosed with PCOS and struggled with infertility.  I found her advice very helpful and hope you do too.
“I wanted to share just a few things we had hoped we knew beforehand. One is that when you go to the doctor for infertility, DONT say that is what you’re there for because typically infertility is not covered by insurance companies. We learned that the hard way. If you simply say you’re there for PCOS or whatever other health condition you have that may be limiting your chances of getting pregnant, then you shouldn’t end up with crazy bills to pay afterwards. Also, when you are diagnosed with a health condition, say ‘I’ve been diagnosed with …’ Rather than ‘I have …’ Because when you say ‘I have PCOS’, then you own it, it is yours. It’s really a mental thing. Just a matter of it not taking control of you.”
For the record, she did eventually get pregnant, so there is often hope out there if you seek out help and support!
I hope this was a good launching point for your TTC journey.  The best thing you can do is get involved in the process.  Reach out to other women and get on some boards for tips, tricks and people to help you through on your journey to create a baby!

How the YMCA and the Village People can help your Breastfeeding Relationship

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I don’t know anyone who has breastfed; how will I get the support I need?

You will have to build your own support network, but don’t worry there is help out there!  There are many online communities like kellymom.com as well as local support groups like La Leche League that can help you connect with other nursing mothers.  I like to use the acronym YMCA to help other moms find some village people to help establish the support they need:

Y-Your family (your husband and mom can be very influential cheerleaders)

M-Medical professionals (find a lactation consultant and a good pediatrician)

C-Community groups for breastfeeding (La Leche League, Breastfeeding USA)

A-Any breastfeeding moms you know (new mom’s groups, church, high school friends, etc)

My breastfeeding story

To illustrate, I’d like to share my breastfeeding journey, and how the Village People and my YMCA saved my breastfeeding relationship. You might have a baby who is an expert nursling, but you might also need all the help you can get!

3rd Trimester

The Road Block: Lack of Knowledge

The Village People: Birth Class

The Support:  My husband and I signed up for a birth class that offered a FULL CLASS of breastfeeding education, and an introduction to the concept of a doula, who was essential to our birth and breastfeeding support.

The birth

The Road Block: A broken tailbone and a baby who wouldn’t latch

The Village People: A doula and my husband

The Support: Our doula went above and beyond, stayed for FOUR HOURS after our birth and called her mentor for instructions on how to teach my husband to hand express colostrum while I was out of commission.

The first few days

The Road Block: A refusal to latch, jaundice, weight loss, painful engorgement

The Village People: my mom, 2 IBCLC’s, a lactation counselor, and our pediatrician

The Support:  The hospital lactation consultants worked tirelessly to help us out, and my mother supported me through tearful phone calls at all hours of the day. At our first Ped appointment, our pediatrician could have just handed us a can of formula, but instead she rushed us into see a lactation counselor, who taught me how to use a breast pump to relieve engorgement and how to feed my son a bottle until we could get a latch.

Six weeks

The Road Block: Pain, and lots of it

The Village People: My husband, our childbirth educator, an IBCLC, and a cranial-sacral therapist

The Support:  Thanks to the pump and bottle, our son was gaining weight, but the latch was still wrong.  I thought about giving up, but my husband encouraged me to speak to our childbirth educator, who referred me to an IBCLC.  She diagnosed an upper lip tie and taught me how to adjust my son’s latch.  It helped a little, and combined with a referral to a cranial-sacral therapist, our son was finally latching pain-free within a month.

2 months

The Road Block: Colic and later, projectile vomit after every feeding

The Village People: A lactation consultant, a pediatrician and a mommy friend

The Support: The lactation consultant was able to diagnose an oversupply issue and the pediatrician suggested my son might have a dairy allergy.  A mommy friend helped me adjust to the new diet, and within days the hours of endless screaming had stopped.

4 months

The Road Block: Teething and biting

The Village People: Nurse and Chat

The support: Within a few minutes at Nurse and Chat, a lactation consultant gave me several tips to help me nurse a teething baby who was using me as a teething ring. It was that easy, but imagine if I had never gone in!

8 Months:

The road block: A lack of sleep from a babe who wanted to nurse all night

The Village People: La Leche League, New Mom’s Group, and our pediatrician

The support: Old friends from my New Mom’s Group suggested I read the No Cry Sleep Solution, and my local La Leche League had it to borrow from their lending library.  Our pediatrician gave us words of encouragement at our son’s nine-month appointment, and it really helped to lift our spirits.

And beyond:

I know that as my son approaches toddlerhood, our nursing relationship will change again.  Because I have my own personal YMCA, I will know whom to call to get my answers so that I can have true success feeding my child.  For all you expectant and nursing mothers out there, I hope that you can also build a network to support you through your breastfeeding years