Pregnancy Update: 36 weeks!

I really have been in denial about this baby coming! Two nights ago, I had some serious feeling pre-birth pressure waves (Hypnobabies lingo for false labor), and I think that made me finally start to accept that this is really going to happen!

I have had two midwife appointments since I posted my last pregnancy update. At my 32 week appointment, I learned that the results of my glucose screen were excellent. I also learned that there had been a mistake with the tube the blood was drawn in for the CBC I had drawn at the same time. I decided to re-draw it because I really wanted to know what my iron level was. The midwife and I discussed the supplements I was taking, and she told me the vitamin D I was taking (2,000 IU) was probably not high enough. A recent study found that routine supplementation with 4,000 IU in pregnant women (ten times the current recommended daily intake) resulted in no harm and better outcomes. Considering that my level was very low in my prenatal blood work (and that was in the spring time), I need to be taking a much higher dose, so I have upped it to 10,000 IU a day.

A couple days later, my midwife let me know the results of my CBC--my iron was low. Not dangerously anemic low, but low enough for me to feel tired. I started taking Floradix, and feel so much better. I realized that the amount of sleep I was needing to function (about 9-10 hours in a 24 hour period) was not normal, and I have so much more energy now. I am keeping my house clean while busy with preschool and Hypnobabies and feel like I'm staying on top of things pretty well! I took it in my last pregnancy when my iron came back a little low at the same time and I thought it increased my energy level then, too. Why didn't I start taking Floradix earlier? Probably partly because Floradix is really expensive...

My 35 week appointment was a nice, long one. We talked about everything we need to do to set up for the birth. I asked about placenta encapsulation, and how I am interested in it but I'm not sure because there doesn't seem to be much definitive evidence out there. She said that everything she had seen about it is very positive. I have a friend who does encapsulation, so I might just have her do mine. The midwife said that they will make sure to take care of the placenta if I decide I want to have it encapsulated.

Somehow we got on the subject of cord clamping and I said that both of my prior two babies had their cords clamped earlier than I wanted. She said that they prefer to wait a long time, because even after all the blood has gone to the baby, there are stem cells that transfer from the placenta to the baby. I said that with my prior babies, they were taken away to be given oxygen, deep suctioning, etc. The midwife explained that it is possible to do those things in the mother's arms. She explained that at a recent neonatal resuscitation class she attended, she demonstrated, using the neonatal resuscitation doll, that the way that people instinctively hold newborns actually keeps their airways open.

The fee for my midwives is paid and the birth kit is ordered! My midwife will be giving me the birth pool next week, and I also ordered a liner to go in it along with my birth kit. I have a student doula who will be coming to the birth to help out with whatever we need--filming the birth, helping with the kids (who I plan to have present, as long as they want to be there and are not bothering me), helping with Hypnobabies tools, etc. I really want to capture this birth on film, which is something I didn't do with my others. I am really happy to give this opportunity to this student doula--I know I appreciate those who agreed to be my first few doula births! She is working on a nursing degree and hopes to eventually do a Masters in Midwifery at Bastyr, so I think seeing my birth will be great for her!

giveaway of book for birth workers

Sheridan at Enjoy Birth reviewed the book Keep the Fires Burning: Conquering Stress and Burnout as a Mother-Baby Professional by Mickey Jones, and she is giving a way a free copy! The life of a birth worker can be very demanding, and this book sounds like a great resource.

Click here to read the review and enter the giveaway!

New Website, Facebook Page, and Twitter Account!

I bought a domain name for my doula services website, and I decided to do away with "Peaceful Waves Birth." The new website for my Yakima area doula services is:

www.birthspecialist.com

The new website which will also be the location of information on the schedule of my Hypnobabies classes, and updates for my Dancing For Birth™ classes, when I get them started. I also made an accompanying facebook page, which you can find at The Birth Specialist. I also finally joined Twitter. Unfortunately @BirthSpecialist was taken (by someone who apparently created the account, but never used it), so I just went with my first and last name: @BrittanyCromar. So, now you can like and follow me if you are on Facebook and Twitter!

Doula Certification!

I submitted all of my forms to complete my doula certification yesterday and was notified today that they have been received. It is official: I am a certified doula! I will be changing the image at the bottom of my blog to this:

How to get your partner on board with your birth plan

So, you want to change maternity care providers but your husband doesn't understand why you should go through the trouble? You want a natural birth, but your husband says, "why have pain when you don't have to?" You want to write a birth plan, but he thinks it is disrespectful to tell professionals how to do their jobs? You want to hire a doula but your husband doesn't see the benefit? Or maybe you want to give birth at home or in a birth center, but he thinks you should just go to the hospital like "everyone else"?

Here are a few ideas that might help him see why this matters to you:

• Get him to read a book, such as The Thinking Woman's Guide to a Better Birth or maybe a selected article or blog post, such as Dr. Sarah Buckley's Epidurals: risks and concerns for mother and baby or Navelgazing Midwife's Pointless Hospital "Rituals".
  
• If he is the kind of guy who doesn't like to read, have him watch a birth documentary with you. Some possibilities are The Business of Being Born and Pregnant in America.
  
• Set up a meeting for the two of you with the midwife or doula you would like to hire. She may be able to address some of his concerns.
• Get him to take a childbirth class with you. Choose a class that covers the benefits and risks of your various options, rather than one that only teaches what is standard practice at the hospital.
• Sit him down and have a heart-to-heart. Explain how much your baby's birth matters to you and why you want to be involved in the decisions about it.
  

I hope he becomes the supportive partner you want him to be. Or at the very least, he will decide to just leave the choices up to you and go along with it. Good luck!

Doulas and Cesareans

I have written about how a doula can help with different plans for hospital births and for homebirths. A post by Navelgazing Midwife made me realize that I left out yet another group of women. A follow-up guest post Doula-ing for Cesareans on Navelgazing Midwife's blog by Kristen French, of Central Washington's own Three Rivers Birth Services, (small world, huh?) addresses this much better than I ever could. A lot of people assume a doula can't really do anything for a woman having a cesarean, but Kristen's comprehensive post does a great job of explaining otherwise.

Here are a few key things a doula can help with for a cesarean:

• helping the mother understand the procedure and prepare emotionally for a cesarean
  
• helping the mother develop a birth plan that allows her cesarean to be a special birth for her and her baby in whatever ways he woman would like. Kristin's guest post contains a list of options, and some possibilities are shown in this amazing video:
  

• supporting the mother in the moments just before the surgery, where intense emotions are likely to arise
• helping the mother develop strategies for coping with the emotional intensity of the cesarean experience
  
• being present in the OR, if the hospital will allow it
• if the mother and baby must be separated, staying with the mother while the father stays with the baby
• helping with establishment of breastfeeding, which is often more difficult after a cesarean because the incision can make it necessary to use less common breastfeeding positions
  
• helping the mother process emotions from the birth to help her memories of it be as positive as possible
  

Blurry Lines

Focus by Tomasz Sienicki

A few months ago, I read the collection of midwife stories, Sisters on a Journey: Portraits of American Midwives by Penfield Chester. I mentioned it in a previous post. I wanted to go into a little more detail about the lessons I learned from this book, most specifically about the various roles that are all part of midwifery.

Midwife as Childbirth Educator

Ideally, the role of a midwife is not just to provide medical care that is less technological than the medical model, while still being the "birth expert." The role of a midwife is to foster independence in the woman. This is evidenced by the practice of showing the woman how to dip her own urine strips and read the results herself. The midwifery practice I went to for my first couple of appointments when pregnant with my son, before we moved here, used this method. Midwifery is supposed to be about teaching the woman how to take responsibility for her own health. A good midwife will help prepare her clients for childbirth. In some respects, a midwife is a childbirth educator.

As I have read blogs by midwives discussing unassisted birth, I find it interesting that some midwives feel that having a midwife teach a UCer how to perform assessments on herself makes it not "unassisted" anymore. But where is the line between "childbirth education" and "midwifery"? If a UC mom takes a childbirth class, that wouldn't be considered "having a midwife." What if a childbirth educator taught women how to do their own prenatal and birth health care?

Midwife as Doula

Midwifery care is holistic--midwives treat the entire patient, body and mind. They believe that a woman's emotions can have a direct impact on her body's processes, and works to help her feel emotionally supported during pregnancy and birth. A good midwife is skilled in natural pain relief techniques and helps her clients use them during labor. A doula's role is said to be "mothering the mother," but isn't this also what midwives do? A midwife is also a doula.

When I wrote my post on Doulas and Hombirth, I realized that line between midwife and doula becomes blurry when you consider the possibility of a doula attending a UC. How is a doula-attended planned UC different from a planned homebirth with an unlicensed midwife? On paper, they are virtually the same thing.

Midwife as Healthcare Provider

The other role of a midwife is to observe the mother and baby for signs of problems and treat them if treatment is in her scope of practice or refer to another healthcare provider. This part of a midwife's role is similar to a physician, though her perspective on how to go about providing this healthcare is usually different than that of an obstetrician (though I would think a family practice physician might have a more midwife-like approach). And because midwives practice low intervention care and treat low-risk patients, the healthcare provider part of her role is a small part, though a very important one.

The professions of "childbirth educator" and "doula" are both relatively new because their roles were performed by midwives and their partners or apprentices before birth moved to the hospital and began being attended by physicians. The majority of physicians view the practice of medicine as dealing only with the body, not the mind, and those who are specialists like OB/GYNs are only concerned with the specific parts of the body they specialize in. Women have invented our own systems for filling the holes left in our healthcare by modern medicine, and have created the childbirth educator and the doula--and thus, the "team" of physician, childbirth educator, and doula together does all the jobs of midwifery.

Me, a Midwife?

I have recently been seriously considering the possibility of becoming a midwife someday. I have been considering the pros and cons of various paths to midwifery--ideally, I'd like to train as a midwife in another country, but I'm not sure that would work for my family. It won't happen until our own family is complete, and I feel that I won't know it is time for that until it happens. I want to be a midwife, but as I've said before, I'm quite intimidated by it. I realize, though, that what I am doing now allows women to have all aspects of their maternity care needs address (just not all by one person), so I am already helping women have care that is as close to midwifery care as they can get without actually having a midwife--to some extent, I might consider that being "part of midwifery."

Continuous Labor Support Reduces Risk of Cesarean Section and Other Adverse Outcomes in Women and Newborns

The following press release comes from Childbirth Connection, it is available in PDF here.


FOR IMMEDIATE RELEASE - 11 am ET, February 16, 2011

Continuous Labor Support Reduces Risk of Cesarean Section and Other Adverse Outcomes in Women and Newborns
Type of Caregiver Can Make a Big Difference in Labor Experience

New York City — Women who labor with a dedicated support companion are less likely than women without such support to experience a series of risky birth procedures, according to a review published in the current issue of The Cochrane Library. The comprehensive study of experiences of 15,061 women who participated in 21 randomized controlled trials confirms previously known benefits for maternal health, identifies an additional benefit for newborns, and finds no downsides. The study was carried out through the prestigious Cochrane Collaboration, an independent international organization that prepares and keeps up to date rigorous systematic reviews of evidence from the best available studies.

Overall, women who received supportive care from a companion throughout labor were less likely than women without such support to have a cesarean section, to use narcotics or any other pain medication, to use regional pain medication such as epidural analgesia, to give birth with vacuum extraction or forceps, and to rate their childbirth experience poorly. Having continuous support shortened labor and increased the likelihood of having a “spontaneous” birth with neither cesarean nor vacuum extraction nor forceps. These results confirm previous research. With the inclusion of six new randomized controlled trials, the present systematic review, identified another benefit of continuous labor support: reduced likelihood of a baby with a poor “Apgar score” rating of well being five minutes after birth. The authors conclude that all women should have continuous support while giving birth.
Ellen D. Hodnett, RN, PhD, Professor and Heather M. Reisman Chair of Perinatal Nursing Research, University of Toronto, and co-authors of “Continuous Support for Women During Childbirth” limited the study to randomized controlled trials. This type of research helps ensure that study groups are similar and that results are a true reflection of the effects of the care being studied — here, continuous labor support.

“Cesarean section, vacuum extraction and forceps, and pain medications are interventions that increase the likelihood of adverse short- and longer-term effects in women and babies. Continuous labor support is an important way for women to avoid overuse and harms of these practices, and to have a positive experience at this special time,” said Carol Sakala, PhD, MSPH, Director of Programs at Childbirth Connection. Dr. Sakala is a co-author of the report.

Supportive care during labor and birth does not involve clinical care, and may include:
• helping women with physical comfort
• providing emotional support
• offering information
• helping women communicate their wishes to caregivers
• engaging women’s husbands or partners, as desired by the couple.

Impact Depends on Type of Caregiver
The study provides new knowledge about effects of continuous labor support under different conditions. A major finding is that the impact of this care appears to differ, according to the type of person providing the care. Effects were strongest when the caregiver was neither a member of the hospital staff nor a person in the woman’s social network, and was present solely to provide one-to-one supportive care, such as a doula. Compared with women who had no continuous support, women with companions who were neither on the hospital staff nor in the woman’s social network were:

• 28% less likely to have a cesarean section
• 31% less likely to use synthetic oxytocin to speed labor
• 9% less likely to use any pain medication
• 34% less like to rate their childbirth experience negatively.

When compared with no continuous support, continuous support by members of the hospital staff did not appear to reduce the likelihood of having a cesarean section or improve ratings of the childbirth experience and may have increased the likelihood of using synthetic oxytocin. These results may reflect the fact that hospital staff can experience divided loyalties, additional duties, and constraints of institutional policies when providing continuous support. Continuous support from a person in the mother’s social network (for example, her partner, husband, other relative, or friend) appeared to increase the mother’s satisfaction with her childbirth experience, but did not seem to impact her likelihood of undergoing a series of labor and birth interventions.

Background
Historically, laboring women routinely received support from female companions. However, more recently in hospitals worldwide, continuous labor support has become the exception rather than the norm. “There is concern about widespread dehumanization of women’s birth experiences,” said Dr. Hodnett. “Concern about institutional routines, high rates of intervention in healthy women and newborns, limits on women’s autonomy and control, unfamiliar personnel, and lack of privacy is leading to calls for making continuous labor support widely available to childbearing women.”

Leading options for continuous labor support in the United States include trained labor support companions known as doulas and — for satisfaction with the childbirth experience — the help of a friend or family member who is invited to be present when a woman gives birth. Childbirth Connection’s second national Listening to Mothers survey found that just 3% of women who gave birth in U.S. hospitals in 2005 experienced the most beneficial type of labor support, in the form of doula care. Although insurance coverage of doula services is limited, trained doulas are available in many communities throughout the United States. Typically, a woman (and her partner, if she has one) selects a doula during pregnancy, and they discuss the woman’s goals, preferences, and concerns. Some hospitals sponsor doula programs to increase access to continuous labor support. In addition to continuous presence during labor, birth doulas may provide some support in the days after birth.

“Hiring a doula was one of the best decisions my husband and I made during pregnancy,” said new mom Jenny McElroy. “Though we prepared by reading books, taking childbirth classes, and practicing comfort techniques, we were inexperienced with childbirth. Our doula knew exactly how to help my husband support me, help me cope with the pain, and help us stay calm and have the birth experience we wanted.”

Effective Strategy for Improving Maternity Care Quality and Value
Medicaid programs and taxpayers cover about 42% of the nation’s births, and private insurers and employers cover about half. The review authors encourage policy makers to provide coverage and hospitals to provide programs for continuous labor support. “The benefits of continuous labor support for mothers and babies are numerous, well established, and compelling, and warrant economic analyses of the relative costs and benefits,” said Maureen Corry, MPH, Executive Director of Childbirth Connection. “Medicaid programs and others seeking ways to improve maternity care quality and value and women’s experiences of care should consider continuous labor support as a key component of a high-quality, high-value maternity care system.”

Resources for Childbearing Women, Health Professionals and Policy Makers
Childbirth Connection’s website includes an in-depth evidence-based section to help childbearing women understand the benefits of continuous labor support, decide whether to have a continuous labor support companion, and arrange for such care (see www.childbirthconnection.org/laborsupport/). The professional area of the website includes a summary of results of the updated review and provides access to the full review, at www.childbirthconnection.org/laborsupportreview/.

Doulas and Homebirth

In a previous post, I discussed how doulas can benefit women with various different birth plans and support scenarios, but a commenter notified me that I left one out...

How can a doula benefit me if I'm having a homebirth?

Part of the answer to this question relates closely to another post I started a long time ago but haven't finished yet about the similarities and differences in the roles of doulas and midwives. I will try to get that finished soon so that it can complement this post. I believe that the role of a midwife is meant to encompass the role of the doula, but it doesn't always happen that way.

I think that the degree of necessity for a doula in a homebirth is going to vary depending on several factors. The following are some situations where it would be to your advantage to have a doula at your homebirth:

busy midwife: If your midwife is at another birth when your labor begins, she may send a partner to be with you. You should be given an opportunity to meet any partner your midwife works with before your birth, but you may not have the same relationship with her you you have with your own midwife, but you will have that relationship with your doula.

absent partner: If you are a single mom or there is a chance your partner may not be present for the birth, a doula can act as your primary birth partner. This may also apply if you have a husband who is uncomfortable with playing an active role in the birth, disturbed by blood, etc.

sometimes even homebirthers need to be protected from trauma: Unfortunately, not all midwives are as gentle and respectful as what most homebirthing moms are looking for. I recently came across some birth stories of women (the blogger at Mandala Mom and Dy at Complete Beginnings) who hexperienced trauma because of the way they were treated by their homebirth midwives. I will give the founder of the midwifery method implicated in these posts the benefit of the doubt, and say that I don't think she intended for her ideas to be used this way, but I think it is important to understand that things like this can happen, and would like to propose that a good doula can help you find your voice when a provider (even a midwife) is trying to do something to you that you do not want. The women in the stories above both said that they had no indication of their midwives having anything in their philosophy that they disagreed with. All birthing women need to watch out for themselves, and a doula can be your watchdog.

What if I want an unassisted birth?

I am by no means an expert on UC. I imagine that for some women, hiring a doula may not align with their reasons for choosing an unassisted birth. Others may see a benefit to having an extra person around who knows about unmedicated birth is experienced in birth support in case you need an another pair of hands for something.

Giveaways for moms and birth workers

Sheridan at Enjoybirth is doing two giveaways on her blog. One is for birth workers and one is for moms. (Since I am both, I'm entering both giveaways).

For Moms: Tag*a*Long Giveaway

The Tag*a*Long is a handle you can attach to a stroller for a child to hold on to while you push the stroller. I think this is a great idea. We don't own a double stroller because when my son was smaller, I'd wear him in my wrap and my daughter would ride in the stroller. Now that they are bigger, I like to put my son in the stroller and have my daughter walk, but she needs something to hold on to so she doesn't wander and the Tag*a*Long would be perfect because if she holds onto the stroller itself she is in my way.

For Birth Workers: $25 Injoy Gift Certificate Giveaway

Injoy supplies birth and parenting educational materials, including videos and web-enhanced booklets. Many of the materials would be a great supplement to any childbirth education program or could be used as an informative resource for doulas or for healthcare providers.

If you are interested in either giveaway, check them out today!

How a Doula can Benefit You (yes, YOU)

This is a post I started a while ago and left it unfinished. When I found out about the Support Doulas Giveaway at Birth a Miracle Services, I decided to take the opportunity to finish it so I could enter. Today is the last day to enter the giveaway, so check it out if you are interested in winning some homemade natural hand cream!

What are the benefits of having a doula?
I am becoming a doula because I want more women to have all the benefits of doula support. Scientific studies have found clear benefits to having a professionally trained doula with you during childbirth. These include:

* 26% reduction in cesarean sections,
* 41% reduction in use of vacuum extraction or forceps,
* 28% reduction in need for pain medications, and
* 33% reduction in dissatisfaction with the birth experience
(Hodnett and colleagues 2004).

What benefits does having a doula offer over just having my husband as my birth support person?
It is wonderful that the "father pacing in the waiting room" has become a thing of the past, and fathers are now able to participate in the births of their children, to whatever degree they are willing and comfortable. The support that a loving, in-tune partner can provide a woman is of great value. However, it's important to recognize that the birth of your child is a highly significant experience in the life of your partner as well. Expecting the father, for whom the experience is extremely emotional, to meet all the emotional and physical needs of the laboring woman is a lot to ask. He may be worried about you and the baby and may find it difficult to watch you struggling with the obstacle of labor. He may not know or remember what he needs to do to help you. Doulas can be great for reminding or teaching the partner ways to better support the birthing mother. Having a doula also may allow the partner to take breaks if labor is long, without you having to be left without emotional and physical support.

How is a having doula different from having a female friend or family member at my birth?
Having an extra support person can be beneficial, and I recommend this if having a doula is not an option for you. A professional doula does offer unique benefits. She has more knowledge about the birth process, the medical procedures that may be offered, and pain reduction or coping techniques. She may be better equipped to support your plans than a friend or family member may not understand the choices you make. A friend or family member may also find it scary to watch you go through labor, while a doula is more objective and more familiar with labor and what is normal and not normal for women.

What is the benefit of having a doula in addition to the medical staff who will be there?
Most doctors are only able to be with their patients at the very end of labor to catch the baby. A midwife will typically spend more time with you, though in some situations, she will have to care for more than one laboring woman at once. In a hospital, you will have never met the nurses and they may also not be able to stay with you continuously. Some nurses are much better than others at support techniques, and you may not know in advance how good yours will be, though sometimes your choice of hospital plays a role. A doula is a person you choose, who you can get to know in advance, and who will be with you constantly during your labor and birth. Also, the primary responsibility of your medical care providers is to be concerned with the safety of you and your baby. A doula is primarily responsible for your emotional and comfort needs. The medical staff also has to worry about regulation by the hospital and their malpractice insurers. A doula works for you, not your doctor or hospital, and can often offer a more balanced perspective on your options.

Doulas sound great for women who are planning unmedicated birth, but I'm planning on having pain medication. Do I still need a doula?
Many women do choose to hire a doula to support them in their choice for an unmedicated birth, as such support can be difficult to find. However, having a doula can benefit all women, regardless of what kind of births they have. Most women will have to cope with some labor before they receive pain medication, and a doula's support can be beneficial to help the woman get through while she waits for it to be administered. Also, pain medication does not take away a woman's needs for emotional support and unbiased information. Even if a woman needs to have a cesarean, a doula can help keep her calm before and during the procedure and stay with her while the partner stays with the baby. A good doula will support the woman completely in whatever she chooses.

A woman's birth experience matters!
Research conducted by doula, childbirth educator, and author Penny Simkin indicates that women remember accurate details about their births 20 years later. Simkin's research also found that the most significant factor in the satisfaction rating a woman gave for her birth experience 15-20 years down the road was not the length of labor, whether there were complications, or whether or not she had pain medication, but how she was treated by those who cared for her. All women deserve the loving, continuous emotional and physical support of a knowledgeable professional while giving birth. (from Simkin, The Birth Partner: A Complete Guide to Childbirth for Dads, Doulas, and All Other Labor Companions, Third Edition, pg xi-xii)

First birth as a doula!

Please forgive the detour from the schedule of posts I had planned. I just have to share that I had my first birth as a doula early this morning. The timing was perfect for me because my family was all sleeping the whole time I was gone. Everything went very well. It was a really fast birth, so I didn't have much time to provide support, but I feel lucky to have gotten to be there. And I got to cut the cord!

Doula mini-documentary

This video, created by the doula credential organization DONA International, explains what a doula is and how having a doula can benefit you. Every birthing family can benefit from a doula, no matter what kind of birth they are planning. It includes interviews with researchers who did some of the original studies on continuous labor support. Although I am certifying with Childbirth International, I think DONA did a great job with this 15 minute documentary and it describes the role of the doula very well.

Traditional Birth Secrets: The Rebozo

What is a Rebozo?

A rebozo (pronounciation) is a woven piece of fabric used by Mexican women as a shawl, a baby carrier (similar to the way I use a wrap, but the fabric is not as long), and a comfort and positioning tool for pregnancy and childbirth.

Photo by Luis Marquez
Courtesy of Special Collections, University of Houston Libraries

Rebozo Use during Childbirth

Techniques for the Rebozo in childbirth include:

• "sifting" the mother
  
• to aid in the double hip squeeze
• rocking or dangling the mother
• covering the mother's eyes and ears to block distractions
  
• for the mother to pull on, especially during pushing
  

The "sifting" technique is the most well-known uses of the rebozo in birth. It is a method jiggle a woman, similar to what Ina May Gaskin calls "shaking the apples." The motion promotes relaxation of the birthing muscles, which can aid in rotation and decent of the baby. Here is a demonstration of the "sifting" technique from a doula training:



Here is the above technique being used in at the hospital during a pitocin induction:



The technique used in the above two videos are explained more in-depth at the Spinning Babies website.

In my doula training, I learned how to do a technique called a "double hip squeeze" with my hands to open the pelvis. This video explains how to use the Rebozo to make the double hip squeeze easier:



More articles and pictures:

• The Rebozo: a transcript of a rebozo workshop given by Doña Irene Sotelo and Naolí Vinaver, published in Midwifery Today (more pictures can be seen by following the link below the photo shown)
• "Comfort Measures for Childbirth: Let's do it with a Rebozo"--a collection of images by Patti Ramos taken at a rebozo workshop with Guadalupe Trueba, including images of the rebozo used for rocking , putting it over the eyes to block out distractions, to pull on while pushing, and other uses
  
• The Many Uses of a Rebozo at Birthing Essentials--short explanations with pictures of many of the techniques
  

For more information on traditional baby carriers and rebozos, visit www.rebozoway.org.

Birth and Death: "to mourn with those that mourn"

Today, Navelgazing Midwife wrote a beautiful post comparing the transition phase of childbirth to the transition of death. It related so much to so many other things I've been thinking about, studying, and experiencing, and inspired me to finally get those thoughts down in writing.

I have been reading my second book for the Childbirth International book review assignment (the first one inspired me to write posts on progesterone and celebrating fertility). My local library had a book that was on the list called, Sisters on a Journey: Portraits of American Midwives by Penfield Chester. Chester interviewed 27 midwives for the book, and each chapter tells one of their stories, each in that midwife's own words. I am really enjoying reading all the different perspectives. I find it inspiring, for any future midwifery aspirations I may have, but also for doula work, as it has taught me that doula-ing is actually a very large part of midwifery.

One of the common themes in the interviews is dealing with the responsibility of life-or-death situations and the possibility of death being so close. Honestly, this is something that terrifies me about the idea of becoming a midwife. I don't want the pressure to have to make such important decisions and have to act quickly and skillfully in a crisis. This book has taught me that my feelings are normal and has helped me learn how midwives may deal with that responsibility. I also learned that birth and death have a lot in common. Here is one example that stood out to me, from the interview with renowned midwife, Ina May Gaskin.

In our community, although we had never read anything about this, it was the midwives that naturally gravitated toward being with families who were dealing with death. Everyone noticed that death felt much like birth, that there was the same sort of energy--a very heightened awareness. Things and people looked dear to you; you had the sense of life being precious, of the need to be good to each other, of the need to be thankful for life, of the need to be attentive to what you had to say, of the need to mix sadness and laughter, to tell stories, to come together and be very human with each other. Not to think about money, not to think about what would anybody think.

My own baby was the first one in our community that died. I was in the first few months of my midwifery practice, exhausted and anemic, and he was born very premature and lived for twelve hours. I knew that he couldn't have been saved a the time, so we didn't go to the hospital. We did what we could, but I knew from losing him, I learned a lot. I think if it had happened to somebody else I wouldn't be a midwife now. But because I had the support of the community, I learned about grieving. I also knew that in some what that happened to teach me something important as a midwife and so I tell that story. I've learned about healing, and I learned about how you treat somebody when they've lost a baby.

(Chester, Sisters on A Journey, 1997, pg. 132-133)

That's all I am going to quote here, but Ina May also explained more about how midwives are like "gatekeepers" of birth and death, and also told the story of her daughter's death at a young age.

I recently saw the film The Curious Case of Benjamin Button, and though I found the film very long and the ending, sad, I learned the lesson I think it was trying to teach--growing up and getting old are really the same, just in opposite order, and life is really more of a circle than a line. Based on this perspective, birth and death are basically the same.

October 15th was Pregnancy and Infant Loss Remembrance Day. As I lit my candle that evening, I thought of my friend who lost her baby in her second trimester recently. I was very affected by the loss, since we had discussed her preparations for the birth and I had offered to serve as her doula. I found I needed to cry alone about it, and I don't think I would have anticipated that happening.

Last week I learned that my high school U.S. History A.P. teacher, now retired, was killed in a car accident while traveling in Greece. She was my favorite teacher, an entertaining storyteller whose love of history really shined in her teaching. She was an inspiration, the kind of educator I aspire to be. Any time such a vibrant person leaves this world, it kind of brings you face-to-face with your own mortality.

Through all of these experiences and learning, the following passage from the Book of Mormon has been on my mind:

...and now, as ye are desirous to come into the fold of God, and to be called his people, and are willing to bear one another’s burdens, that they may be light;

Yea, and are willing to mourn with those that mourn; yea, and comfort those that stand in need of comfort, and to stand as witnesses of God at all times and in all things, and in all places...(Mosiah 18: 8-9)

These verses represent the covenant one makes when joining our faith. Interestingly, the last part of it is quoted in the document I wrote about in my Guest Post at the Gift of Giving Life. It is the part before that which I have been thinking about, especially "to mourn with those that mourn." If we have charity and love others as God loves them, we will have the desire to support others through their journeys in life. This includes things like crying with someone who is in the middle of grief. I have been thinking that maybe working with pregnant and birthing women, in the fragile time of newly developing life, who will sometimes not keep that life as long as we all would want them to, will be my personal way to fulfill my promise "to mourn with those that mourn."

I'm in!

It's official! I got the e-mail today saying I've been accepted into the Hypnobabies Instructor training program! Now I have to register, do book reviews, and do the Introduction to Hypnosis Course, as well as finish my doula training. If all goes according to my plans, in about 10 months, I will have both CD(CBI) and HCHI after my name.

Introducing my new doula services website

Peaceful Waves Birth Services: Birth Doula Services in Yakima, WA.

It's a free website with Weebly right now, but I hope to upgrade to my own domain in the future. I will also add more services (childbirth education, in particular) when I am ready to offer them. Check it out and pass the link on if you know anyone in my area.

Updated 9/2/10: I realized the link was incorrect! It's fixed now!

ABC's Rookie Blue spreads stereotypes of doulas and homebirth

Last night, my husband and I caught a re-run of Episode 7 of ABC's summer series Rookie Blue. This was our first time seeing the show. It follows the lives of five fresh out of The Academy cops.

Episode 7 featured a power outage during a heat wave. One of the story lines involved Officers Gail Peck (Charlotte Sullivan) and Dov Epstein (Gregory Smith) stumbling upon a pregnant woman in her apartment who appears to be in labor, characterized by her grabbing her belly and screaming bloody murder every few minutes. She says she is not due for another month. Her water breaks, and after she is shown on the phone, she tells the cops that she is planning a homebirth and has just spoken to her midwife and is calling her doula next. Gail turns to Dov and asks him "What is a doula?" to which he responds, "A birth coach for hippies." Peck replies "I thought a birth coach was a birth coach for hippies." I was so offended by this characterization of doulas, I almost demanded my husband change the channel right then. Doulas are for everybody, and it is not only hippies who desire natural birth or homebirth. I wanted to see how this scenario played out, so I kept watching.

Dov eventually realizes that the woman is agoraphobic and she tells them she has not left her house since she went off her meds when she started trying to get pregnant. While a woman going off her meds for the sake of her baby is highly commendable, this show seems to suggest that women who choose homebirth must be psychologically unstable or at least have irrational fears. So, now the message I'm getting is that women would have to either be a hippie or psychotic to want a homebirth, and this is far from the truth.

Despite Gail's insistence that the woman's baby is in danger and that they should just arrest the woman and take her to the hospital (really?), Dov sees that the baby is coming fast (as is typical of television births) and he is going to have to "deliver" it himself. Dov catches a very large baby for being "preterm" and which has no vernix on it, and Gail cuts the cord the second the baby emerges, with no mention of clamps (the myth that it is necessary to cut the cord immediately has GOT to stop!) Dov convinces the woman to go with her baby to the hospital to get it checked out (a good example of a woman willing to do anything for her baby), and Dov and Gail grin at each other over the experience.


Gail even later tells her boyfriend that how great she did (what did she do besides bring negativity to the room and prematurely cut an unclamped cord?) On the other hand, perhaps Dov should leave the Force in favor of becoming a male midwife?

If you want to watch the episode yourself, you can view it here.

Doula! The Ultimate Birth Companion: Film Trailer

Below is the trailer for the 65 minute documentary, Doula! The Ultimate Birth Companion, which was launched in London on June 7, 2010. It looks really good.



The film's director/producer, Toni Harman, is hoping to get the word out about this film so that the more people who learn about doulas, the more people will hire one and have a better birth experience. If you would like to see this film, you can purchase it on Amazon, or you can visit the film's website to learn about hosting a public screening.

I am now officially a student doula!

I signed up for Childbirth International's doula training course this morning! From what I've seen on the student website so far, I really like the way everything is set up. They make it easy for you to find other students in your area, too, which I love. I love that their course is all homestudy and at-your-own-pace, and I especially like that they don't require yearly membership fees to maintain certification.