So What's In The Bag...?

During consultations about doula services, some common questions include things like:

• What do you actually *do* at the birth?...
• When do we call you?...
• What is your relationship like with the hospital staff?...

Those are all good questions, and we’ll answer them in a separate blog post.  But another common one is “What do you bring with you?” Although there are a couple of things that will be unique to each doula, our team prides itself on having a variety of tools in our toolbox – I mean, doula bag – for conquering labor and birth!

TENS Unit

Have you experienced or heard of “back labor”? If you have had it, you know how terrible it can be. Back labor is caused when the baby is in a posterior position and their head is putting pressure on the tailbone. Unlike contractions, the discomfort of back labor doesn’t come and go. It’s constant. And in some cases can be excruciating. This is where a TENS Unit comes into play….A TENS Unit is a small electronic device that runs off a single 9-volt battery with 4 wires that attach to leads that are placed on the lower back, in a square around the area of discomfort. Small electronic pulses are sent through the device and in essence, they “disrupt” the pain signals going up the spine to the brain. While it doesn’t take away all of the discomfort, it can make it manageable enough that your doula can work with you to get into positions that may encourage the baby into a better position within the pelvis and alleviate the issue altogether. The intensity of the current is controlled by the laboring woman, so you can turn it up or down to your liking. All of our doulas are trained in the use of TENS and we carry them with us to all births. As part of our paperwork process, we ask that you obtain consent from your physician or midwife for the use of the TENS, as there are some contraindications to its use.

Scents

Smell has a powerful impact to incite a physical and emotional response. Typical fragrances like lavender can be soothing and relaxing, while others like sweet orange and lemongrass can be energizing. Scents help set the stage for the environment and mood you are looking to achieve. Most of our doulas carry a minimum of 5-6 different scents that can be used in a variety of ways including being massaged into pressure points or diffused into the room.

Robozo

A what? Robozo refers to a type of cloth as well as the technique they are used for. Essentially, it’s a long scarf that can be used to reduce the pressure the baby is causing in a certain area, encourage a better position from baby, alleviate hip and lower back pain, hold the weight of the laboring woman, for counter force during pushing, and many other options. While any cloth can work with these techniques, a slightly stretchy yet sturdy material tends to work best.

The Birth Vision

The Birth Vision, or Birth Plan are all of the preferences the family has identified as important to them during labor, the birth and postpartum period. We always bring record of those plans as well as your basic health history and any notes we’ve taken during our prenatal visits together. We can share them with the birth team if necessary, but most often, we refer to them on the way to the birth and a couple of times during the birth to ensure that everything is on track.

Music

Similar to the olfactory benefits of scents, music or sounds can also help create an auditory environment that supports your vision for your labor. While we encourage all families to prepare some music that they prefer, we also have subscriptions to music services so we can put on some tunes to affect the mood. Sometimes it’s soothing nature sounds to help you relax, sometimes it’s 80’s cardio jams to energize the room and keep your spirits up. It’s not uncommon for a mom to completely escape into the music which improves relaxation, connection to baby, reduces muscle tension and mentally prepares her for the birth. About 5 years ago, I was with a mother who was slightly apprehensive about the pushing phase, causing her to lose focus on her labor. We put on some music that really speaks to her that let her focus her energy and settle her mind. Literally within minutes, she was holding her baby with tears of joy streaming down her face.

Tennis Ball

A tennis ball or stress ball is a very simple tool that we use in labor. You can squeeze it, roll it on mom’s back, have her roll her feet across it, bounce it to relieve nervous energy…They are such a simple device that can have a soothing or distracting effect. You’ll never catch me without several different stress balls in my bag!

Mints and Gum

If mom’s feeling nauseous or has had an upset stomach, sometimes a mint can help calm her stomach. Likewise, gum can be a pleasant distraction and way to relieve nervous energy.

Hand Sanitizer

This one's pretty self explanatory.

Absorbent Pads

We tuck a couple of these in our bags in case mom’s water has broken before we all leave for the hospital or to place in the car on the way to the hospital to avoid messy clean ups later.

Snacks

Labors can be long – sustenance is key! Simple, easy to eat snacks like almonds, dried fruit, fresh fruit and crackers can usually be found in my bag. I always have extras in case the other individuals supporting mom need some. In a case where the laboring woman is refraining from eating out of choice or by request of her medical providers, I will take a small break to use the restroom and have a quick snack so I can continue to support mom at 100%.

Extra Clothes

Births can be messy. I learned my lesson several years back when I was sitting on a bed, comforting a laboring woman when her water broke. I was grateful to have had a spare pair of pants in my car….now I have a full change of clothes in my bag!

Personal Items

We like to keep a little pack of personal items in our bags so we can stay fresh and focused during a labor. Some of my favorites include Whisps toothbrushes (small disposable toothbrushes pre-filled with toothpaste), hair ties, a comb/brush, deodorant, contact solution and backup glasses, tissues.

Reference Cards

Most times, births go pretty "text book", but sometimes there's a unique scenario that we may not encounter as often. For these situations, we often have some note cards, books or other reference materials that may give us some less-often used techniques to employ during your labor. They can also be a good tool when we seem to have tried *everything* and need some new ideas to help a stalled labor or a stubbornly malpositioned baby.

Hopefully this gives you an idea of what you can expect from our birth bags. They are always evolving, though, as we frequently add new tricks and tools based on new techniques that we've learned or trade secrets our doula friends share with us! 

Ooops, I Missed Your Birth, My Bad!

     Hiring a labor doula, while very beneficial, is a luxury not a necessity. You are paying for a service to enhance your birth experience and you expect a professional to provide this service. So what happens when your doula doesn't make it in time? Babies are unpredictable and can come without warning, so choosing a doula that is in close proximity to where you plan on birthing is vital to ensuring you receive the support you expect. Even in cases where baby is born rapidly and mom may have not needed hours of labor support a birth doula will be there to help ease the anxiety of a fast labor.  Birth doulas will come to you ASAP at whatever location baby was delivered, either it be at your desired location or a different location like your home,  another hospital or someplace even more unexpected.  They will keep you and your family informed and engaged with your medical staff during that time of confusion and fear.   

            The labor doulas of The Growing Place all live right here in the Lehigh Valley. It’s our goal to never have a doula farther than 15 minutes from any hospital in the Leigh Valley. Labor can go from 0 to “WOW this is intense where is my doula?” in a matter of minutes.  Your doula team stays in constant contact with you as you labor and when you decide you are ready for hands on support, we can be there quickly.

            Many doulas may travel up to 2 hours to support a mom in labor, but not The Growing Place. When you call, we are prepared and ready to support you, regardless of where you are in the Lehigh Valley. We match you with the labor doula team that will not only be able to connect with you professionally but who are close to your birthing facility, geographically. If your doula does not live within 30 minutes of your home or birthing facility, you may want to rethink hiring them, it could mean not being fully supported during your labor and birth.

Did you hear who is encapsulating their placenta?

            Placenta encapsulating celebrity mommas are making headlines left and right these days. But what about us normal folks? Who of us is taking placenta capsules? You may be surprised at the “types” of mothers that are choosing placenta encapsulation for their postpartum wellbeing.

            The preconceptions about placenta encapsulation are that it is only for granola making, hippie earth mothers. And the person preparing the placenta must be just as crunchy and out there! Well I am here to debunk those myths. I am a dental hygienist turned doula and placenta specialist. I've always loved science and appreciate modern medicine. I also believe our bodies have the ability to heal themselves with very minimal intervention.

            If I have a head ache, I'm going to drink water and eat something before I go running for the ibuprofen. If you can correct small imbalances in your body by taking a capsule of your own powdered placenta instead of a prescription drug that may affect your new baby, would you?

            In my experience as a placenta specialist, I've served moms who do fit the above stereotype, however most of them don't fall into that category at all. Many are either trying to avoid an issue they've had in a previous postpartum period, such as low milk supply, iron deficiency or baby blues. Others are thinking long term and what something to help with PMS symptoms when their cycle returns or to help balance hormones when menopause hits. I’ve encapsulated for families that really run the gamut – marathon runners, lawyers, stay at home moms, nurses, teachers – there really isn’t one specific category that all of them fall in to!

         Whatever your reasons are for considering placenta encapsulation, just remember: there are plenty of moms just like you doing it and raving about the results!

         In the comments section, tell us what your number 1 reason is for considering encapsulation!

Did your dog lick my placenta?

Are you the type of person who is extra sweet to your waitress because you fear what will happen if you aren't?! Have you considered having your placenta encapsulated but you're hesitant to commit because you can't ensure the process is up to your standards? Then, my dear, you are in the right place!

Most encapsulation specialists have a dedicated work space within their own home for preparation, but not me. I don't ever bring another persons internal organs into my home. What if I turn my back and my dog chews on it or my husband thinks its dinner and digs in? NO WAY! I only prepare placentas in your home.

Let me tell you why:

• You (or a family member) bring your placenta home from the hospital-- you have peace of mind that you won't be ingesting anyone else's placenta mistakenly!
• You have the option to watch and ask questions during the process
• Although my sanitation practices meet all food handlers safety guidelines, your body is used to the microorganisms living in your home. Therefore, it is less risk of contamination when the placenta is being prepared in your space. This ensures your safety!

My favorite part of preparing your placenta in your home is the interaction. Even the most uninterested, squeamish dads/family members inevitably end up in the kitchen with me at some point, asking questions and taking it all in! If this level on control appeals to you, then give us a call!

reflections of a VBAC mom

Before I even begin typing all of the things that are running through my head, I have to acknowledge a couple of things:

-I was lucky enough to have the complete support of my family as VBAC hopefuls.

-I was lucky enough to have access to a care provider and birth location that were supportive of our goals to VBAC.

-I was lucky enough to avoid conditions that would risk me out of TOLAC.

I recognize that these are not givens for every family and that many of the cards were stacked in our favor here. But this post is just a couple of reflections on my experience and maybe how it’s shaped my view as a mom and doula.

1.      I was scared….really scared. But of what? I wasn't scared that my uterus would blow up. I wasn't scared that my baby would die. I wasn't scared that my care provider would bait and switch me. I was scared that for whatever reason, my VBAC wouldn't be successful and that I would have to face family, friends and colleagues. While everyone was outright supportive, I knew there were some people who thought we were a little nuts and I didn't want to have to hear any “I told you so’s”.  It’s probably the silliest thing in the world to be afraid of, but it’s true…this was my hang up…

2.      I was determined. Really determined. Not in a bullheaded way, just in an “I’m doing this!” kind of way. Knowing that I was open to the idea of more kids in the future, I viewed this as a critical turning point in our reproductive future.  For anyone who may not be familiar with the research on the complications associated with cesarean sections, the most important thing to know is that the risk of many obstetrical complications increases with every cesarean. For example, the risk of placenta accreta in a first cesarean is about 0.24%, or one in 417 women; in a second cesarean, this increases to 0.31% or one in every 323 women; but by the 4th cesarean, the risk jumps to 2.13% or one in every 47 women! ICAN, the International Cesarean Network, is a fantastic resource for this kind of information, as is VBACFacts.

3.      I was confident. Maybe a little overly confident? I didn't see any reason why I couldn't do it. It just seemed logical to me that humans can birth humans without surgical intervention.  To be honest, I didn't even say I was having a VBAC, I was just planning a vaginal birth- no qualification of “after cesarean” even entered my mind.

4.      I wasn't ready for a battle. I didn't know every statistic, every study. I don’t even think I knew that I should stay away from Pitocin. There is no way I could have engaged in an intellectual discussion with my care provider about these things. Luckily, I didn't need to. But if I had to do it again, I’d be better armed to speak intelligently about my reservations and to propose alternatives that may help us compromise on care that we are both comfortable with.

5.      I didn't have any labor support. I’m a professional doula, so this isn't easy for me to say, but you don’t *need* anyone there to achieve your VBAC. To say that you must have someone there to advocate for you takes power away from you. Don’t make anyone else’s presence a prerequisite for VBAC success. (As a side note, our doula practice has a 97% VBAC success rate across the last 5 years, which is significantly ahead of the national and even local average!)

6.      A little help is ok. Some people think that the only way to achieve VBAC is to go completely natural with absolutely no medical intervention. That’s a great way to do it, but it’s not the only way. A little help can remain just that…a little help. Having fetal monitoring or a little pitocin or even an epidural aren't going to completely kibosh your VBAC dreams. All things in moderation, though. Be careful of the “cascade of interventions”, but recognize your needs in the moment and be kind to yourself.

7.      It was as awesome as I thought it would be. No, I don’t think that a woman should be defined by any biological process…we don’t take joys in any other of them…but there is something to be said for making a plan, working hard to accomplish it, and achieving it!

8.      I understand completely why some families chose a repeat cesarean. The decision was really easy for us, but I can see why it might not be such a clear cut choice for every family. There’s politics, there’s conflicting information about the safety, there’s “policy wars”, insurance concerns, the hunt for a supportive provider, fears about the unknown… And all of this when you’re literally trying to grow a human.

9.      No amount of preparation can guarantee VBAC success. Just like cesareans are sometimes 100% indicated in a first birth, the same holds true in a second or later birth. You can read every book on child birth, have all the research under your belt for preparing a safe VBAC, have an awesomely supportive provider, be accompanied by a fantastic doula, have the baby’s father on your side 100% of the way, (insert all the other things you think are necessary to achieve a vaginal birth), and things still may not work out as planned.  Refresh your knowledge of when a cesarean is indicated. Know which ones are immediate emergencies, and which ones you may be able to work to reverse or manage. This will help you to feel comfortable in the event that it is no longer safe to continue a trial of labor.

I have absolutely no regrets about my VBAC - well, except for the tragic song he had to be born to. It wasn't a short or easy labor; early labor began on Monday and didn't end until just after Wednesday turned into Thursday. After 50+ hours of intense but tolerable labor, my sister finally convinced me to go to the hospital as I was throwing up on my bathroom floor. I had been denying it was time to have the baby, despite his being many days (dare I say "weeks") past his estimated due date. From the time I got to the hospital to baby napping in my arms was 3 hours, and my Thanksgiving baby and I have been inseparable since. 

End note: For those of your reading from Eastern PA, we are also lucky to be living in an area that is becoming more supportive of VBAC, even VBA2C, VBAmC and special scar situations. When I had my VBAC, this wasn't the case and I was simply lucky to have had a care provider that was one of the few really supportive people in the area.  If you need information on VBAC supportive providers, we are happy to point you in the right direction!

Early Labor: A Waiting Game

Something that every mom seems to remember about their birth is how long they were in labor. It’s a number that rolls off the tongue as easily as the baby’s birth day or what color his eyes are. But knowing when your labor started is not an exact science, and it usually has something to do with when it became obvious to you, whether that was because your water broke or contractions became harder to manage, or even the time you entered the hospital. In my experience as a doula, one of the biggest mistakes that moms make is paying attention to labor too soon – at the first sign of contractions (even if they are 15-20 minutes apart) or perhaps if your amniotic fluid starts to leak, even without other signs of labor.  It is also common for labor to go in spurts- starting and stopping; preparing the labor and the mother for when things gear up; allowing her to get some rest. The challenge with telling yourself you’re in labor at this point is that it can be hours, even days (yikes!) until the baby actually arrives. And as the hours tick by, a mother’s confidence can start to wane and she can tire of the idea of being in labor, even if she is not physically tired.

So how can you avoid getting stuck in the “I’ve been in labor forever" trap? Here are some ideas to help you get through early labor!

1.   Take a nap. If labor really is starting, you’ll be glad you got some extra rest.

2.      Read a book. It’s relaxing, it might take your mind off things, and if you’re close to the end of the book, you can keep encouraging yourself to go just.one.more.page.

3.      Go for a walk. Get your blood pumping, see the neighborhood sights for one last time in a way that you may not have the opportunity to in the future….After all, the next time you take that walk could be pushing a stroller or carrying a baby and may not have time to appreciate the little things like weeds growing in the sidewalk cracks, pavement pushed up by tree roots or little birds’ nests.

4.      Go shopping! Who doesn’t love to browse the racks, flip through the pages of books you’ll probably never buy, or people watch?!

5.      Have lunch with a friend. A supportive friend who won’t freak out when you stop to take a deep breath or close your eyes through a contraction. Bonus if the friend won’t make jokes about you potentially breaking your water.

6.      Call your mom, or better yet, your grandmother. If they are still around and won’t worry you to death with stories of a friend’s sister’s neighbor’s long lost cousin’s terrible labor, have a little chat, knowing it may be a couple weeks (months?) until you may have an uninterrupted moment.

7.      Daytime TV! Game shows! Lifetime movies! Trashy “he cheated on me” talk shows! Re-runs! Infomercials! So much good TV, so little time!

8.      Plant a garden. How cool would it be years down the road to tell your child about the garden – or tree! – you planted as you waited impatiently patiently for their arrival?

9.      Play a game with your older child/children. If you have older children, they may feel a little forgotten about or lonely after the new baby comes. Spend a little time with them, making them feel special and reassuring them how much you care for them.

10.  Bake some bread. Chances are, if you’re in early labor, you’re going to have some time on your hands, so baking bread may be a perfect, timely distraction! 

11.  Get creative! Grab a paint brush, charcoal, watercolors, whatever you have handy. Express your emotions through art. Paint your birth vision. Make a little memorial of your early labor that you can share with you babe in years to come. Lat that brush sway with you as you move your body in response to the contractions.

12.   Get lovey. Did you know that intimacy is a great way to get labor moving? Some people may not be up to full-fledged romance, but that’s ok – physical closeness in any form helps prepare the body (and mind!) for labor. Enjoy lying together, maybe some smoochin’ or whatever you’re up to (unless you’re on pelvic rest, and then you’ll have to go for a hard stop before things get too serious!).

13.  Clean. Having some anxiety about all the visitors you’ll likely be hosting after the little one arrives? Get ahead of it by doing a little tidying up. Already have a spotless house? Eh, move things around- rearrange, organize, toss some stuff out. “Nesting” is common as mothers take one last opportunity to get everything ready to the baby to arrive.

14.  Prepare the baby’s clothes. Have a superstition that prevents you from doing too much preparing too far in advance? Or are you just plain good at procrastinating? Either way….now that baby is almost here, maybe it’s a good time to get some of those adorable onesies scrubbied up.

15.  Soak up some sun. Everyone knows that a little splash of sun can lighten any mood, so get some rays to boost your spirit...

16.  What? It’s 3am? Well grab your baby daddy and go for a moonlit stroll. Gaze at those stars, breathe some cool crisp air and enjoy the sound of silence.

17.  Make lasagna. You’re going to need lots of yummy nutrition to help recover from birth, and to sustain your energy to care for your little one. Even more so if you’re breastfeeding. So grab some grub and cook up some meals that freeze well so you’ll have plenty to choose from in the coming weeks.

18.  Car Seat time. If you haven’t already installed the car seat, now may be a good time to do that. And if you really want to pass the time, read the manual cover to cover. It’s a good idea to do that anyway (tons of safety information that is too easily overlooked!)

19.  Journal. For the same reasons mentioned in number eleven. Every day that you move further away from an event, the less of the detail you will remember. Get all the details down on paper – your hopes and fears for your little bean sprout – so you’ll always remember how you’re feeling right now. You’ll thank yourself a year – or even 10 years – down the road.

20.  Angry birds. I was going to include this one as a joke, but then I got to thinking….a game as addictive as this could be a great way to pass the hours!

21.  Nosh. You’ll need lots of energy over the next couple of hours and days. Pack in some protein, some high energy carbs and some refreshing fruits and veggies. Having a hard time keeping things down? Go for a small bite every couple of minutes or go for liquids. And remember to hydrate, too.

22.  Wash the car. Feeling a little hot and flush? Get outside, turn on the hose and suds up the car. The up and down motion of sponging off the car will force you to squat and help engage the baby’s head against the cervix. Too cold out? Windexing the patio doors and shower doors will accomplish the same thing. And as a bonus, you’ll have something shiny to admire your glowing self in! (Yeah, I said it, you’ll look like a rock star in labor!)

23.  Cat! Cow! Pigeon! Warrior! That’s right, get your yoga on. Not only can going back to your tried and true poses in early labor take you to the same calm, meditative place you always get to when you’re practicing yoga, those that rotate and open up the pelvis can also help engage the baby.

24.  Go swimming. It’s refreshing, relaxing and can help keep your joints feeling nice and loose. Pools are also a great place to do some hip-opening stretches like lunges and squats since there’s less pressure on the knees and ankles. (Check with your care provider if your waters have already broken, as pools can be a breeding ground for less-than-pleasant germs.)

25.  Take some pictures! You’re embarking on a brand new journey, one whose beginning marks the distinct end of another (pregnancy!) Take this opportunity to snap some last minute memories of your beautiful belly and your family before baby comes. You may feel less than gorgeous, but everyone else thinks you’re stunning and radiant and you’ll love looking back at those photos later.

If you’re reading this because you are in early labor: Congratulations. We hope you have an awesome birth experience and that you’re little bundle of joy is as perfect as can be! If you’re with us remembering back to your labor, what were ways you kept distracted during early labor? 

Image courtesy of adamr, FreeDigitaPhotos.net