Nurturing Hands Birth Doula

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I absolutely LOVE talking about pregnancy, birth and babies!  I am by no means an expert, but I do have a wealth of knowledge and am so excited to share it with you all!  Please feel free to comment and ask questions or if you have a topic you want discussed, let me know!

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What to Look for When Hiring A Doula

31 May 2021

A lot of women wonder what they should be looking for when they’re hiring a doula. Some expectant parents come to the initial consultation with a list of questions, others come with none at all. Both are completely perfect approaches. The thing is, there is no one perfect doula, and so, no one perfect checklist to look for!


Things like experience and training are usually one of the first things expectant parents look at. Which isn’t bad, experience and training is typically what tells us if someone is qualified to do a job. So asking a doula what training she has taken and how many births she’s attended are very valid questions. No doula knows everything. Every single birth is different, sort of like snowflakes, lots of them have similar qualities but in the end, they are all very unique. I for one, aim to learn something from each birth I attend, with over 50 births under my belt I still feel so brand new and honestly, I hope that feeling never goes away. I truly think that the day I walk into a birthing space feeling like I know everything is the day I need to find a new career. I want to always be learning and expanding my knowledge. All that being said, just because a doula is newer or hasn’t attended many births does not mean she won’t be an amazing support for you. An amazing doula is one who sees a need and finds a way to support it.


Availability is a very important thing to look at. You can find the absolute perfect doula for you but if she is booked solid and doesn’t have space in her schedule for your birth then she may not actually make it to your birth. Lots of doulas only take a limited number of clients per month. Birth is so unpredictable, so we never know when we’ll be called to a birth, and it is always so heart breaking when you have to miss a birth for any reason. So, asking your doula how many births she has scheduled for your birth month is always a good idea.

Lots of doulas are also trained or certified in different fields as well so ask about any other services they offer. Lots of doula offer massage therapy, photography, lactation consultations, placenta encapsulation, the list really does go on and on and on!

Fees … the fees that doulas charge varies from area to area and from doula to doula. Fees will also depend on what other services are being offered. So don’t be afraid to ask about fees, we all understand that money does not grow on trees, and we all know that not everyone can afford everything. So, you want to find a doula that fits into your budget. Keep in mind that most doulas offer payment arrangements, and lots offer different packages.

In my humble opinion this next point is the most important one. How do you feel in the doula’s presence? Birth is such an intimate experience and one that you will remember for the rest of your life. You are inviting someone to join you in an incredibly precious moment and you want to make sure that you are completely comfortable with them. If you feel judged, watched, on edge at all sitting across a table from them, then that is probably not the right doula for you. You want it to feel like you’re talking to a close friend, someone you can open up too, someone you can imagine guiding you. I find often the clients I click with the most we’ve both known in the first couple minutes that I would be their doula … keep looking until you find that!

Optimal Fetal Positioning 

20 February 2021

 Fetal Positioning, in my opinion, is one of the most important factors when it comes to birthing your baby. When a baby is in an ideal position the crown of the head is the first part of baby to emerge, this is great because it is the smallest diameter, so it is typically the easiest way out. When a baby is facing forward or has their head tilted, it makes the decent a longer process and usually requires much more effort on the mama’s part to push baby out.

Ideally, we want baby to be head down, facing mama’s back and have the chin tucked to the chest. Back at the beginning of time our daily lives facilitated getting baby into an ideal position, we did a lot of walking, squatting, leaning forward type of work so we were using gravity and movement to encourage baby into that head down chin tucked position. However, the majority of us are no longer working outside, squatting and leaning forward growing and picking our own food, we are sitting at desks, reclining on sofas, and driving in vehicles so it’s becoming increasingly more difficult for baby to naturally settle into an ideal position.

In order for baby to settle into this ideal position we need three things: balance in the pelvis, movement, and gravity. Movement and gravity are the easy ones, it’s balancing the pelvis that is a bit trickier. There are many ways to help balance the pelvis but there are three exercises I ask my Mama’s to do daily once they reach about 36 weeks. The first is a forward leaning inversion. For this one, you kneel on your couch and move until your knees are at the very edge of the couch. Then you carefully lower your hands and then your elbows to the floor. You allow your head to hang freely while you take 3 nice slow deep breaths. Then slowly, and with the help of a partner, raise yourself back up to a kneeling position on the couch. This creates a stretch in the ligaments supporting the uterus, often times they tighten up and this allows them to release, it also allows baby to lift just ever so slightly out of the pelvis to readjust the head if needed.

The second exercise is sifting. You need a partner for this one and a long scarf or Rebozo, a top sheet from your bed also works. You get into a hands and knees position on the floor, I also encourage mamas to rest their upper body on a birth ball or a couch and put some cushions under the knees. Then you’re going to wrap your long scarf around your belly so that it completely encases the belly. Your partner is going to stand above you, holding onto the ends of the scarf. Then gently but firmly lift the ends of the scarf and wiggle the belly for 5 minutes. This usually feels quite nice for the mama!

The last exercise is a side lying release. You’ll need a couch or bed high enough that your foot won’t hit the floor when lowered. You’ll start by lying on your side as close to the edge of the bed as you can get without falling off. You want your shoulders and your hips to be directly on top of each other, you don’t want to be leaning forward or backwards, it helps if you have something to hold onto like a lamp or bedside table. You’re then going to straighten your legs; the bottom foot will be flexed as if you’re standing on the ground. Your partner is going to stand at your hips to ensure you don’t fall off the bed and place two hands on your top hip applying a little bit of downward pressure to stabilize your hip and keep it from rolling forwards. Then you’ll take your top leg, flex at the hip and allow your foot to lower towards the ground. You’ll hold this position for 5 minutes and then your partner will lift your leg up and back onto the bed for you. Then you repeat this on the other side!

Once you’ve done all three exercises, you can go for a walk, do hoola-hoops on your birth ball, go swimming, anything that has you upright and moving. It’s also important to be aware of your body positioning. When you’re sitting try to adopt a more forward position rather than a reclined one. When we recline gravity is going to take the heavies part of baby … the head and spine … and pull it down causing baby to be facing your belly instead of your back. So, having nice wide knees and allowing your belly to hang down between your knees is a great position to sit in. A birth ball also makes a wonderful chair since it’s difficult to recline while sitting on a birth ball! Have you tried any of these exercises? What position was your baby born in?

Induction

12 February 2021

Something I hear very frequently from my Mama’s is “my doctor said he’ll let me go to 40 weeks”. I have an issue with the language used, it’s the word LET that really gets me, in situations like this the doctor is telling the expectant mother what she is allowed to do … um … she’s not a child, she’s not a prisoner, she’s not incapable of making decisions … so … why is she being treated as such? A doctor does not decide what is best for an expectant mother, a doctor gives his or her professional advice, give’s evidence-based information and the expectant mother then decides what is best for her and her unborn baby!


We have created a society where we don’t question doctors, they tell us to do something and we do it. And this works fine when you have a heart attack, you get to the hospital and the doctor saves your life. The difference between birth and a heart attack is that birth is not a medical procedure, being pregnant does not make you sick, or broken, or in need of saving. Birth is a natural biological process; pregnant women do not need to be saved or fixed. They need to be given evidence-based information so that they can make a decision that is best for her and her unborn baby. 


The two biggest reasons I hear for being induced are my baby is too big and I’m past my due date. Both of these reasons make me roll my eyes a little bit. Big babies are not automatically a bad thing, I know the thought of pushing out a 10 lb baby can be scary but keep in mind that your body is designed to open up, the bones in your pelvis shift to allow more room for baby to descend and the tissue of the vaginal canal is very stretchy! It’s actually very uncommon for a woman to grow a baby that is too big to fit through her birth canal! In my experience it’s not so much the size of the baby but the position of the baby – this is something we’ll chat about next week! Also, estimating an unborn baby’s size is very inaccurate and is just that, an estimate!

Now, the “past my due date” reason. First of all, the calculation of a due date is based on a study of 100 women in 1744, the calculation was a little unclear and over the years led to interpretation by a few different professors. So, we were calculating an estimated due date based on very outdated information, not any current scientific evidence. In the 1970’s doctors started using ultrasounds to verify gestational age. Through various studies we determined that dating ultrasounds became less accurate after 20 weeks. Second, full term is defined as 39 weeks to 40 weeks plus 6 days. So, to induce at 40 weeks isn’t even allowing for the complete “full term”. In 2001 a study was conducted on 1514 women resulting in 75% of first-time mothers giving birth at 41 weeks plus 2 days. Research has told us that there is no such thing as an exact due date, 40 weeks’ gestation is not an accurate number.


It’s important to be aware that any intervention carries risks, and because of these risks the door is opened for needing more interventions … we call it the Cascade of Interventions! As with all interventions, induction carries risks which include:

  • Failed Induction – 25% of first-time mothers have a failed induction meaning the methods used to force labor to progress did not work which then requires a c-section.
  • Low Fetal Heart Rate – sometimes the drugs used to induce labor cause excessive or abnormal contractions leading to less oxygen to baby and a decrease in heart rate. This can sometimes be fixed with adjusting the amount of drugs given or changing positions but if it does not resolve then a c-section is needed.
  • Infection – some induction methods (rupture of membranes, membrane sweep) increase the chance of infection in the uterus and for baby.
  • Uterine Rupture – this is a rarer complication of induction, if you’ve had a previous c-section the risk is a little higher, but it can still happen in a first-time mother which then leads to an emergency c-section.
  • Bleeding after Delivery – induction can cause your uterine muscles to be overworked so that by the time baby is born the muscles can-not properly contract which leads to excessive bleeding.
  • Pre-term Delivery – due to an inaccurate estimate of the due date, induction can lead to delivery of a preterm baby with risks of underdeveloped lungs and the possibility of needing NICU support.

Induction is not always bad, just like every other birth intervention it has its time and place. For the most part birth is very safe but there are those odd situations where it does need a little bit of help. There are some very valid reasons for being induced. If your doctor brings up induction, it’s important to ask questions. I encourage all my Mama’s to use the BRAIN method. Look at the Benefits, the Risks, any Alternatives, what does your Intuition say, and what happens if you do Nothing? Then considering all this information, you can then make the decision that is best for you. It’s always a great idea to do a little bit of your own research as well, Evidence Based Birth is an amazing website with current evidence-based information on a massive range of pregnancy topics! 


I just want to leave you with a quote ... "When we insist that pregnancy length is fixed and not fluid, when we force women to follow due dates defined by machines and not their own bodies, when we constantly prioritize medical definitions over women's own instincts, we undermine a vital source of information and a well of trust."  - Dr. Sara Wickham 

Informed Consent

28 January 2021

Informed Consent is what my philosophy is based on. Let me start by saying that doctors are amazing, I love them, they save countless lives, they are brilliant and talented and so needed. We have created a society where we don’t question our doctors, especially when it comes to pregnancy and labor. We take the recommendations of doctors as gospel, we put our complete trust in them. The issue with this is that doctors are trained to save lives in emergency situations, they’re trained to prevent problems and birth is not an emergency! Very rarely do doctors see natural physiological birth, they are not trained to sit and wait and watch, they are trained to intervene, speed things up, take pain away. They often see birth as something that needs to be managed. They also come from a place of protocols and worst-case scenarios, but birth can’t be looked at as a worst-case scenario, birth needs to be left alone unless there is a reason to intervene.


This is where Informed Consent comes into play. By definition Informed Consent is “the process by which a patient learns about and understands the purpose, benefits, and potential risks of a medical or surgical intervention … and then agrees to receive the treatment”. Quite often a doctor will decide that they need to do something, they need to speed things up, they need to check you, they need to intervene and before any of that happens Informed Consent needs to be given.

During labor, when a doctor decides he/she needs to intervene, things tend to happen quickly. It’s not uncommon for a doctor to tell a laboring woman what they want to do and if the woman does not say no, or ask any questions, the doctor goes ahead and performs the task they deemed necessary. This is not Informed Consent! What needs to happen is the doctor needs to explain three things; first, the reason he/she wants to perform the intervention, second the risks, and third the benefits. Once that is done, the laboring woman should ask any questions she may have. Then, and only then, if she decides the intervention is something that is right for her, she can tell her doctor that she consents. This is Informed Consent.


I want to share a little secret … it’s a very important secret … once given, consent can be taken away AT ANY POINT!   Here’s a little example; a woman is laboring; her doctor comes into the room and says that he/she would like to perform a vaginal exam to see how far dilated she is. The doctor explains the reason, risk, and benefits and the laboring woman decides to consent to the vaginal exam. During the exam, a contraction starts, and the laboring woman no longer wants the doctor’s fingers inside her, she begins to protest “Stop, please, it hurts, stop”. This is a woman withdrawing her consent. This is her right. And it is the responsibility of the doctor to listen and immediately stop the exam.


The last thing I want to leave you with is this … you are the boss! You are the boss of your body!   You and only you decide what happens to your body and your baby!  

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