Category: Birth Support

Checklist and Tips for Making a Birth Plan

Posted by on in Birth, Birth Prep, Birth Support, Pregnancy

Most people who give birth in a hospital are meeting their medical care team for the first time. Because of the circumstances, the staff do not have the time or bandwidth to get to know their patients in-depth.   

A good birth plan, which I prefer to call “Birth Preferences”, can build bridges with your medical team. It can help them get to know you and quickly understand what you’d like in your ideal birth. It’s also helpful to learn about the policies and practises at your birthplace, so you know what to put on your wish-list.

Your Birth Plan document should be only one page with lots of white space and an easy font – at least 12pt. Use respectful and positive, but firm language. “I prefer….” is wishy-washy for something that really matters to you. 

I recommend you use language that reflects who you are. If you have a great sense of humour, feel free to insert fun and levity in your plan. “If Jamie takes a nap, please kick him when he starts snoring.”

Checklist for an excellent Birth Preferences document

This section includes examples. Feel free to copy them or use your own language. 

  1. Start with an opening paragraph that includes:
  • An opening statement that encompasses your attitudes or overall vision e.g. “We’ve prepared for a natural birth” or “An epidural is part of my plan” or “We’re using Hypnobirthing as a tool.”
  • A statement about consent, such as “We’re open to changes after discussion with the medical staff so we can make informed choices.” or “I will ask questions whenever a procedure is recommended and then need a few minutes alone to think.”
  • A kindness to the staff. “Thank you for supporting us through our birth process” or “We appreciate the work you do.”
  1. An additional opening paragraph if there are special circumstances:
  • Medical conditions that need to be known urgently, such as “Lucy is allergic to penicillin”. 
  • Mobility issues or cognitive considerations.
  • Sensitive issues that may affect your birth, if it feels safe to share. (It’s been my experience that this level of personal sharing makes for better treatment.) “Due to previous trauma, no one is to touch me until I am aware of who they are, understand why and what’s involved, and have verbally agreed.”  Or “Robin faints at the sight of blood, even one drop.” Or “We’ve had a previous loss and do not want to discuss it. Please see the prenatal records.”
  1. Then a short list of points for your wishes. It could be titled, “These are our wishes”:
  • If anyone is joining you, name them. E.g. Your doula or “plus-one” such as a friend or mother.
  • The environment you’d like, such as quiet with dim lights, loud rocking music (bring your own), window blinds open for sunshine, privacy.
  • Continue this section with points that are unique to you. Here are a few of my favorite things from the hundreds of birth plans I’ve seen:
    • I must wear my purple socks at all times.
    • Do not offer pain medications; I’ll ask if I want anything.
    • Please run a bath and encourage me to get in.
    • Minimal cervical checks and only by experienced staff.
    • I will eat if I’m hungry; please provide a waiver.
    • Please provide the squatting bar and recommend positions to keep labour moving.
    • Please coach me through pushing. 
    • I will breathe my baby down and appreciate quiet during the bearing-down stage.
    • Essential staff only; no observers or learners. 
    • Students are welcome.

You get the idea!

  • Cord and placenta plans, if any. E.g. We’d like 3 minutes of delayed cord clamping. Or We’re keeping our placenta. Or Please show me the placenta before disposing of it.
  1. Some people add an “In case of Caesarean:” heading, with things that are important to them such as playing a certain song, delayed cord clamping, requesting someone to take photos if possible, keeping family together as long as possible in the OR.
  1. A closing sentence such as “Thank you for taking time to read this page” or “Thank you for being part of our big day!”

Do not include:

  • Disaster planning language e.g. “… unless something goes wrong.” or “… unless it’s needed”.  It’s a given. 
  • Things that aren’t issues. If your local hospital has a policy that all babies are held skin-to-skin by a parent immediately upon birth and for the first hour (that’s the policy in my local hospital), then there’s no need to ask for that. 
  • A shopping list of all the things you don’t want. You don’t have to tell your medical team that you don’t want an episiotomy or a caesarean – they know that. (Well, unless you’re in a place where episiotomies are routinely done – then add that to the list! In almost every Canadian hospital, episiotomies are not routinely done.)
  • The interventions that are only done after discussion, such as induction, which requires a conversation and signed consent form. 
  • Postpartum care of the maternal or newborn patient. “I will breastfeed” or “I will use formula” do not belong on the birth plan. 

Need help to make a birth plan that builds bridges instead of walls?

I can help you sort through your options and find the best wording. Check out my Birth Plan Prep Consultations which are available in person or on Zoom.

Summer pregnancies & hot births!!

Posted by on in Birth, Birth Prep, Birth Support, Comfort, Herbs, Labour, Nutrition, Postpartum, Pregnancy

Oh, the days are hot and even more so when we’re growing a baby or holding a newborn. If you don’t already know, profuse sweating is a normal part of postpartum recovery even during winter. 

Here are some tips for summer survival with a baby-bump that go beyond the obvious, typical lists – wear loose clothing, do things early in the day, stay hydrated, find AC. I think we all know that by now.  

Summer Pregnancy-Safe Drinks

Growing and/or feeding a baby both take a lot of energy and we burn through more electrolytes and minerals in the hot summer. Sugar drinks are not helpful. Pregnant and breastfeeding bodies are more susceptible to blood sugar shifts and the yeast / thrush infections that result from high sugar intake. I have 2 articles for you for healthy, refreshing and cooling drinks (other than plain old water which is of course, important every day). They’re all nutritive during pregnancy and postpartum recovery – actually any time. Kids and adults can consume these. 

Cooling Essential Oil Body Sprays / Mists

Even though every bottle says “don’t use during pregnancy”, there are a lot of oils that are safe. Consult a certified aromatherapist – that’s me, from way before it was cool (pun intended) to be into essential oils. You can make a spritzer with:

  • mint
  • lavender
  • cucumber
  • lemon – actually any citrus oil.

Add any combination of those to aloe, witch-hazel or a flower water such as rosewater.

If you prefer to buy a spray, check out the perineum sprays such as that made by Earth Mama Organics. They can be used all over, not just your bottom! 

Caution #1: Citrus oils can make your skin more sensitive to sun-burn; only use for an indoor spray.
Caution #2: Many commercial refreshers and cooling sprays contain Eucalyptus, which should never be used near babies and pets. Best to avoid it through pregnancy too. Some types are safe but the most commonly used ones are too strong. 

Angie’s Tips for a Cooler Birth:

  • Put a small wireless fan in your birth bag and/or birth place. Some of my clients use handheld fans and others use ones with a big clip. 
  • If you’re having a hospital birth, i.e. in a scent-free environment, then bring an empty squirt bottle and fill it with cold water for misting. 
  • Ice chips! They’re amazing during labour & birth. Suck on them, put them in a washcloth and use as a cold-pack all over the body, put them in a bowl of water and dip a washcloth in to apply on foreheads and necks, add them to juice and water. I rarely attend a birth without using at least a couple of cups of ice-chips. 
  • Temperature fluctuations are amplified during the birth process. This video has tips to regulate temperature during birth and what the partner / birth companions can do.  

C-19 Updates in Birth and Postpartum Care in Regina

Posted by on in Baby Care, Birth, Birth Prep, Birth Support, Dads, Homebirth, Induction, Labour, Pregnancy, Prenatal Classes, Safety

I’ve been keeping in touch with the good people managing the units at Regina General Hospital. Here are all of the recent updates of RGH Labour/Birth Unit and Mother/Baby Units here in Regina, Saskatchewan due to Covid-19. Please note that any of these may change on short notice due to the coronavirus pandemic.

Some additional tips for navigating your birth journey:

I lead RGH Tours live but online multiple times a month.

Article: How to Set Up your Birth Room (i.e. What Your Doula Would Normally Do!)

Easing Labour Pain: An online 2-hr class offered monthly that teaches partners how to provide hands-on birth-support, comfort, and decrease labour pain.

If anyone’s looking for online prenatal classes please contact me. I teach all the sessions live but online so you can ask questions.

*****

Hospital Update

ONGOING SUMMARY of Current Practises in the Labour & Birth Unit and the Mother-Baby Unit:

  • The health region is not on the same timeline of relaxing restrictions as the SK gov’t. Restrictions are still in place at health care facilities.
  • All maternal patients and their designated family members/support persons will be screened for COVID-19 upon arrival at RGH and be required to have a temperature check, wear a mask, participate in hand hygiene and follow physical distancing guidelines.
  • Support persons/visitors who are symptomatic for COVID-19 or who have other risk factors will not be permitted. 
  • Masks are mandatory for partners and support persons throughout the hospital, except for when there’s no staff present in the Mother-Baby Unit. Labouring patients who pass screening are asked to wear masks as long as they’re comfortable doing so. 
  • All waiting rooms are closed. One primary support person is allowed with each maternal patient through registration and the assessment areas. The second support person should wait at home or somewhere outside the hospital until the labouring person is officially admitted and moved to a birth room. 
  • Support people coming in on their own, i.e. not with the labouring patient, can be screened 24/7 at the main RGH doors (14th St entrance). Do not use the ER doors unless you are a patient or are with one.
  • All maternal patients will be offered an optional COVID-19 swab once their admitted to the Birth Unit. Family members/support persons will not be offered a COVID-19 swab.
  • If the maternal patient tested positive for Covid at any time during their pregnancy, then their placenta will be sent for testing. 
  • There are 2 support persons (aged 18+) of the maternal patients choosing, allowed in the BIRTH ROOM; no swapping. 
  • The MOTHER-BABY UNIT allows new families to have 2 additional visitors at a time (11am-8pm). The “no-swapping rule” has been lifted in this unit. Visitors must be aged 18 and over, except siblings of the newborn who are permitted to visit with an adult.
  • Nitrous Oxide / “laughing-gas”/ Entonox is available, “𝑡𝑜 𝑝𝑎𝑡𝑖𝑒𝑛𝑡𝑠 𝑤ℎ𝑜 𝑠𝑐𝑟𝑒𝑒𝑛 𝑡𝑜 𝑔𝑟𝑒𝑒𝑛 (𝑎𝑠𝑦𝑚𝑝𝑡𝑜𝑚𝑎𝑡𝑖𝑐 + 𝑛𝑒𝑔𝑎𝑡𝑖𝑣𝑒 𝑃𝑂𝐶 𝐶𝑂𝑉𝐼𝐷 𝑡𝑒𝑠𝑡) 𝑜𝑛 𝐿𝑎𝑏𝑜𝑢𝑟 & 𝐵𝑖𝑟𝑡ℎ 𝑎𝑡 𝑡ℎ𝑒 𝑅𝑒𝑔𝑖𝑛𝑎 𝐺𝑒𝑛𝑒𝑟𝑎𝑙 𝐻𝑜𝑠𝑝𝑖𝑡𝑎𝑙.” 
  • Waterbirth is no longer an option in the hospital, even for those under midwifery care. The installed bath-tub is available for comfort in labour.  Waterbirth is an option at homebirths when one is under midwifery care.
  • Breastfeeding is still being supported at RGH regardless of Covid-status. There are plans and protocols in place so that mother-baby can stay together if the birth-mom is at risk, has symptoms, or tests positive for C-19 in the immediate postpartum. 
  • All waiting rooms are closed. Food outlets have limited seating.
  • Galleys are closed to patients/visitors in both units. The nurses will get food for you in the birth unit but not in the mother-baby unit. Bring snacks! There is no access to the microwaves, kettles, food, water-ice machines. There is no access to the big fridges and freezers, but every room has a small mini-bar fridge.
  • The hospital does not provide warming tools other than blankets from the blanket warmer. If you like a hot-water bottle or heating pad, then bring your own. Staff are not allowed to take people’s heating devices to the microwave or kettle. You can use a plug-in device or fill a hot water bottle with hot tap water.
  • Bring what you would normally bring for your birth and hospital stay. Support people will be given a wristband so they can go to car later for extras and car-seat. You are still allowed to bring your pillow, clothing etc. – whatever you need for comfort.
  • Even though community restrictions are being lifted, great care should be taken with newborns once the family is home. Physical distancing and being only with members of the same household are still recommended. Anyone who enters the house can bring in pathogens/bugs.

03A47318

 

A TIMELINE OF PREVIOUS UPDATES

…. just in case you’re curious about what’s been coming and going and happening through the pandemic.  Note that several of these restrictions have been lifted. The list above is current.

June 08, 2022 – Good news! Nitrous Oxide / “laughing-gas”/ Entonox is available again in Regina, “𝑡𝑜 𝑝𝑎𝑡𝑖𝑒𝑛𝑡𝑠 𝑤ℎ𝑜 𝑠𝑐𝑟𝑒𝑒𝑛 𝑡𝑜 𝑔𝑟𝑒𝑒𝑛 (𝑎𝑠𝑦𝑚𝑝𝑡𝑜𝑚𝑎𝑡𝑖𝑐 + 𝑛𝑒𝑔𝑎𝑡𝑖𝑣𝑒 𝑃𝑂𝐶 𝐶𝑂𝑉𝐼𝐷 𝑡𝑒𝑠𝑡) 𝑜𝑛 𝐿𝑎𝑏𝑜𝑢𝑟 & 𝐵𝑖𝑟𝑡ℎ 𝑎𝑡 𝑡ℎ𝑒 𝑅𝑒𝑔𝑖𝑛𝑎 𝐺𝑒𝑛𝑒𝑟𝑎𝑙 𝐻𝑜𝑠𝑝𝑖𝑡𝑎𝑙.” All maternal patients are screened on the way in (answer the usual questions re travel & symptoms) and then offered a swab-test once they’re admitted to the unit.

March 2022

  • Due to Covid, the Nitrous Oxide (“laughing gas”) is not available. It may be available again, depending on some supply issues. 
  • The Mother Baby Unit now allows new families to have 2 visitors at a time (11am-8pm) and they can be anyone you want. (The “no-swapping rule” has been lifted.)
    That said, postpartum hospital stays are usually short – only 1-2 days. There are many benefits to just resting with your new baby and saving the visitors for once you return home.
  • Note: The Labour & Birth Unit remains as is – 2 support persons per maternal patient, no swapping.

Feb 2022. The proof of vaccination / negative test requirements have been lifted.  Support persons no longer have to show proof of anything. 

Nov 8, 2021, partners, visitors, doulas, support persons, everyone EXCEPT the patient being admitted, must show proof of double Covid vaccine or a negative test within the past 72 hours from an SHA approved tester in order to enter SHA hospitals. Anyone who is not double vaxxed and wants to attend the birth might consider serial testing every 72 hours in order to be ready anytime.  

There are 2 support persons allowed in the BIRTH ROOM. From Saskatchewan Health Authority:

“Effective immediately, expectant mothers and families across Saskatchewan will now be permitted to have two designated family members/support persons present during their birthing experience. Designated family members/support persons are chosen by the mother and family and may include but are not limited to partners, family members, coaches, doulas or cultural support persons.

All maternal patients and their designated family members/support persons will be screened for COVID-19 upon arrival and be required to have a temperature check, wear a mask, participate in hand hygiene and follow physical distancing guidelines. Designated family members/support persons who are symptomatic for COVID-19 or who have other risk factors will not be permitted. The designated family members/support persons must be consistent during the duration of the patient’s stay. They may leave the facility but cannot be switched out for another family member or support person. Only designated family members/support persons will be permitted at this time, other visitors, including siblings, will not be allowed.

All maternal patients will be offered an optional COVID-19 swab upon admission. Family members/support persons will not be offered a COVID-19 swab.

Summer 2020

◆ Support people coming in on their own, i.e. not with the labouring patient, can be screened 24/7 at the main RGH doors (14th St entrance). They do not have to go to the ER doors.
◆A 24-hr support person who’s joining a birth or going to MBU for a maternal patient that has already been admitted can enter through the main 14th St doors at any time, 24/7. No need to go through the ER.
◆ A support person entering the hospital with a maternal patient will be screenedwith the maternal patient.

Please note that while the 14th Ave entrance is open 24/7 with a security guard that can screen and let people in, the registration desk is only open from 6am-6pm. Support people can enter this door 24/7 because they are not patients (don’t need to go through the registration process).
 
If you’re in labour and going to RGH as a patient, then you’ll have to go to an entrance that has an open registration desk. On weekends, holidays and evenings/overnights, that will be the ER.

If you have to step outside and get back in, here’s how:

◆ 14th St main entry has a security person around the clock. If you have your proof of screening and are wearing a band it’s easy to get back in 24/7. If you’ve not been screened yet, I recommend you start at this door. If they are unable to screen you, they will send you through the ER doors instead.
◆ The ER can screen 24/7 but please save the ER capacity for people who need it.
◆ 15th St admitting doors are locked overnight. The doors below MBU at 15th St parking lot are locked 24/7. You can not enter the 15th St side of RGH overnight. If you go out those doors, you’ll have to walk around to the 14th St entry.

If your 2nd support person is not at the birth but is invited to MBU, they will be screened on their way into the hospital. They must be named when you are admitted to LBU so remember to tell your nurse. You must get a coloured bracelet for them. I expect someone has to meet them outside the unit to give them the band that will grant them access to the MBU, but ask your MBU nurse about this.

◆ “If the patient fails screening, she becomes a Person Under Investigation (PUI), therefore the support person now becomes a PUI as they have been in ‘close, prolonged contact with a PUI.’ The support will be sent home, however, the patient may have an alternative support person or people who pass screening. ” That means anyone who has been with the labouring person for more than 2 hours will not be allowed in if they are suspected of C-19/exposure.

Folks – you need to plan for this. Plan C. New support people who have not been with you for more than 2 hours AND who pass screening may be allowed into isolation. They will be gowned, masked, gloved throughout and will not be allowed to leave the isolation room. Food will be brought in.

◆ Again, it’s up to you to ensure that a 2nd support person has been named so they can enter the unit. Ask your nurse about this.
◆ Supports must be 19 years and older. (No, I’m not sure what happens in the case of teen pregnancy, young doulas and so on. This is just what I was told.)
◆ The health region is not on the same timeline of relaxing restrictions as the SK gov’t. Restrictions are still in place at health care facilities.
◆ You’ll see staff wearing masks throughout your stay.
◆ Bring what you would normally bring for your birth and hospital stay. Support people will be given a wristband so they can go to car later for extras and car-seat. You are still allowed to bring your pillow, clothing etc – whatever you need for comfort.

Doctor

◆ Labouring women are asked to wear the mask as long as they can stand to do so. Postpartum patients are asked to wear their masks when staff are in the room.

◆ Masks are mandatory for partners and support persons throughout the hospital, except for when there’s no staff present in the Mother-Baby Unit.

◆ People can wear whatever mask they want to enter the building. Public Health does have recommendations on personal masks (on the SHA site). However, once inside the building, people will go through screening and will be given medical masks to wear in the building (the blue ones with folds). The blue medical masks must be worn in all public spaces and the assessment area.

◆ Nitrous-oxide (“laughing”) gas is available for pain management. If a tank is being used (instead of the tubes that go directly into the wall), then the maternal patient must have a negative Covid swab done prior to use. 
◆ If you or baby are at high-risk for birth complications, you may be asked to use an epidural during labour to avoid the need for a general anaesthetic in case of an urgent/stat caesarean. Best to discuss this with your OB ahead of time so you can learn your options and make a plan.
◆ Waterbirth is currently not an option in the hospital. Midwives are not lending pools out for home birth. If you have your own then waterbirth at home is still an option (contact me for info on where to get one).
◆ The installed bath-tub is available for comfort in labour.
◆ Breastfeeding is still being supported at RGH.
◆ There are plans and protocols in place so that mother-baby can stay together if mom is at risk or has symptoms of C-19 in the immediate postpartum.
◆ Even though some community restrictions are being lifted, great care should be taken with newborns once the family is home. Physical distancing and being only with members of the same household are still recommended. Anyone who enters the house can bring in pathogens/bugs.

◆I always tell people to bring their own hot water bottle or Magic Bag to the hospital. That’s because the hospital does not provide any warm tools other than blankets from the blanket warmer. They are lovely but they are not the same as a hot water bottle. The new update is that the staff are not allowed to take people heating devices to the microwave or kettle. Therefore if people want to use heat it will have to be a plug-in device or they can fill the hot water bottle with hot tap water in their own room. Stay warm and stay well during your visit!

◆ Paid parking has resumed in the RGH parking lots. You will need cash for the main lot. Also, the 15th street parking is reserved only for people who have appointments or are being admitted to the hospital. Vehicles are being ticketed again on the streets around the hospital so no more free parking that way.

◆ There is nowhere for the second support person to wait as all waiting rooms are closed. The second support person should wait at home or somewhere outside the hospital until the labouring person is officially admitted and moved to a birth room.

◆ Partners/support persons will be provided with a mask at the entry doors. (Bring a big paperclip or string if you want to save sore ears.) Check out these tips for saving your ears from mask-pain.  Everyone must wear masks in the hallways. Labouring people do not have to wear a mask once they’re in their patient rooms in the birth unit and the mother-baby unit.

◆ Food outlets now allow people to sit in.

◆ Galleys are still closed to patients in both units. The nurses will get food for you in the birth unit but not in the mother-baby unit so people have to bring their own snacks. There is no access to the microwaves, kettles, food, water-ice machines. There is no access to the big fridges and freezers, but every room has a small mini-bar fridge.

Birth Room

𝐏𝐫𝐞𝐧𝐚𝐭𝐚𝐥 𝐂𝐚𝐫𝐞

● Attend appointments, diagnostics (ultrasound, lab) solo. Routine appointments might be done over the phone or spaced out. High-risk and special circumstances will still get the extra care they need.
● Midwifery offices are doing the discussion part of the consult by phone and then a quick in-person appointment for the hands-on part. They prefer pregnant patients attend alone but will allow partners. No other family members/friends/support are allowed.
● Anyone under midwifery or GP care who tests positive for C-19 at any point in their pregnant, birth or postpartum will be immediately transferred to OB care.
● If you’re an early-bird you may be asked to wait in your car until your appointment time.

𝐀𝐧𝐭𝐞𝐧𝐚𝐭𝐚𝐥 𝐂𝐚𝐫𝐞 (𝐋𝐚𝐛𝐨𝐮𝐫 & 𝐁𝐢𝐫𝐭𝐡)

● Early discharge is being offered as an option for those that are healthy and feel comfortable with newborn care. That means to go home a few hours after your birth instead of staying 24-36 hours.
● Anyone getting a cervidil induction will be monitored and then sent home to wait for labour to start, as per usual, then rescreened at RGH doors and LBU doors upon return.
● Support people are allowed at homebirths but must be screened. If anyone in the home (residents or support people) doesn’t pass screening, then the birth must be transferred to RGH. In that case, the one support person rule applies. Home birthers – screen your people before they come over!

𝐏𝐨𝐬𝐭𝐩𝐚𝐫𝐭𝐮𝐦 𝐂𝐚𝐫𝐞

● Doors that don’t have an admitting desk are locked tight; security will not let anyone in. That includes the convenient door just below the MBU.
● Families are being asked to stay in their room as much as possible.
● Support people may not visit any other patient areas.
● Food trays are being provided for new moms in the MBU.
● Breastfeeding class in the unit is still running but only birth mother and baby attend, and only up to 3 participants. If there are less than 3 maternal patients, then partners may be allowed to attend.
● Midwives and public health nurses are still providing postpartum home-visits. Some may be done by phone or video, depending on your needs.

Please contact me if you have any questions about this information or any of my services.

5 Ways Labour Pain is Different than Broken-Bone Pain

Posted by on in Birth, Birth Prep, Birth Support, Comfort, Labour, Pain

Some people compare labour pain to that of breaking bones. Besides scaring pregnant people, that’s not an accurate comparison. On the other hand, some women share stories of pain-free birth. Here are 5 ways the sensations felt in labour are different than “broken-bone pain”.

  1. Broken-bone pain is unrelenting and doesn’t go away without strong pain meds; labour pain comes and goes in a rhythmical manner. In fact, throughout labour, much more time is spent in the rest between contractions. Even in advanced labour, most contractions last between 60-75 seconds but can sometimes get to 90 seconds. Then there’s a rest before the next once. In active labour that rest will generally be between 1-3 minutes. In earlier labour that rest will be up to 10 minutes. There is no rest with broken-bone pain. It’s constant.
  2. Broken-bone pain is all encompassing, resulting in the release of stress hormones and injury responses in our body. Labour pain is accompanied by powerful pain-killing hormones such as endorphins. The female body is equipped for labour with strong, naturally occurring hormones that are released as labour progresses. The effect of these hormones has been compared to morphine by physiologists. (However those hormones are not as concentrated and isolated like morphine. Still, that’s a powerful comparison!) Stress makes pain worse.
  3. Broken bones are a terrible injury; labour is a normal human process.
  4. Broken bones are due to an accident; labour is a known and sometimes planned event. Therefore we can prepare for the intensity of labour. There are many helpful tools and strategies for comfort measures that can be done by the labouring person or their birth companions. We teach many of these in our How to Ease Labour Pain Class.
  5. Doulas! Birth doulas can make a significant difference in how labour is experienced and felt. There’s ample research showing the benefits of doula support through birth, including shorter labours, half the rate of Caesareans, significantly fewer requests for epidurals. To my knowledge, there’s no such thing as “broken-bone doulas”. Everyone around someone with broken bones is providing medical care – good thing too. Ideally, labouring people will have someone knowledgeable with them whose only job is to provide comfort and support.
  6. Broken bone pain is measured in weeks and months; labour is measured in hours.

* It’s interesting to note that I’ve only heard men make this comparison. Many pregnant women fear this will be the case but I’ve never heard anyone who’s gone through labour and had a past experience of broken bones say they were the same thing. I’m one of them. A couple of years before being pregnant, I broke my pelvis. There is absolutely no comparison between the two events.

Doulas and Dads

Posted by on in Birth Prep, Birth Support, Dads, Doula, Labour

Although the information here will reassure any partner, this article intentionally addresses dads-to-be. All the quotes, links and videos are made by dads for dads-to-be, about their most common concerns about birth support:  1) Value; why should we pay for a doula if I’m going to be there?  2) Why do we even need a doula; what does she have that I don’t?  3) How will I be included if a doula attends?

Read More “Doulas and Dads”

𝗗𝗼𝘂𝗹𝗮𝘀 𝗮𝗻𝗱 𝗣𝗮𝗿𝘁𝗻𝗲𝗿𝘀: 𝗪𝗼𝗿𝗸𝗶𝗻𝗴 𝗧𝗼𝗴𝗲𝘁𝗵𝗲𝗿. Top 3 𝗠𝘆𝘁𝗵𝘀 & 𝗥𝗲𝗮𝗹𝗶𝘁𝗶𝗲𝘀

Posted by on in Birth, Birth Support, Dads, Doula, Labour, Partners

Some couples worry that the partner will be relegated to a minor role if a doula attends the birth. On the other hand, some pregnant women worry that their partners will not be very helpful but are hesitant to suggest a doula for fear of hurting the partner’s feelings. Many partners want to help but feel insecure about their ability to meet all of their loved one’s needs.

𝗠𝘆𝘁𝗵 #1: Partners can do all the labour support on their own.

𝗥𝗲𝗮𝗹𝗶𝘁𝘆: While this may be true for a minority of couples, many partners are not equipped to be the primary birth support. Doulas are specifically trained in emotional and physical support such as comfort measures. They understand the birth process and what to do at various stages and situations. Besides, partners are going through their own birthing journey and need support too.

𝗠𝘆𝘁𝗵 #2: Doulas displace partners and interfere with the couple’s intimate experience.

𝗥𝗲𝗮𝗹𝗶𝘁𝘆: Research shows more eye-contact and physical touch between couples when a doula is present; they usually work more closely together. Doulas help couples clarify their expectations of each other and then make space for partners to participate at their comfort level. When the partner chooses to be the primary emotional support, the doula can supplement their efforts by running errands, making suggestions for comfort measures, etc. During a long tiring labor, she can give the partner a break. While the doula probably knows more than the partner about birth, hospitals and maternity care, the partner knows more about the woman’s personality, likes and dislikes, and needs. Moreover, they love the birthing woman!

𝗠𝘆𝘁𝗵 #3: Doulas are there only for the birthing client.

𝗥𝗲𝗮𝗹𝗶𝘁𝘆: Of course the labouring woman is the priority but doulas support partners too! Medical staff have other priorities that may compete with the emotional care of their patient; e.g. breaks, shift changes, clinical responsibilities, office hours and hospital policies. Client care is the doula’s priority. She is not just another stranger with the couple. They’ve met prenatally until they know each other and feel ready as a team. Doulas understand the dreams, wishes, goals of the birthing person and the partner. By making sure that the partner’s needs are met (e.g. food, drink, reassurance, and maybe even rest), the birthing woman and partner can work more closely together.

As one partner said, “I heaved a big sigh of relief when she (the doula) walked in. I hadn’t realized how much pressure I had been feeling. She not only calmed my wife, she calmed me down. I was able to support my partner MORE when the doula was with us!”

Birth Support on a Budget

Posted by on in Birth Support, Doula, Education, Fees, Prenatal Classes

If rates for full doula care seem too high, please read on.  There are many ways I can contribute to you being prepared and supported through your birth. I offer prenatal classes, birth prep consultations, a lower-priced doula package, birth-plan prep sessions, and creative ideas for paying your doula.  Details for all of this are below.

My current fees of $1400-1600 for full doula support are a fair reflection of my extensive experience, skills and knowledge.  Besides the often long and unpredictable hours, there are costs associated with being a professional doula. Some of these are monetary such as training, missing other work-shifts, association fees, parking and all the normal expenses related to self-employment.  Other costs are not measurable, such as missed family events, being on-call (700+ hours per client), and recovery time from long births.  Experienced doulas are worth the expense and in fact are the first to fill their client list.

I also offer a couple of lower-priced doula support packages starting at $900. They are described below and as a doula support packages comparison chart.  

If you wish to benefit from my expertise but the cost is out of your range, then you might be interested in attending prenatal classes or accessing other services such as Birth Plan Preparation, or working with me and one of the doulas I’m mentoring.

Birth Preparation and Support Packages (please see the doula support packages comparison chart for details of what’s included in each)

  • Lower-cost doula mentorship package:  Work with me and one of the newer doulas I’m mentoring for $900. Prenatal preparation is vital for having your ideal birth. Therefore you’ll have all prenatal consultations, including creating a birth-plan and any questions answered along the way, with me and the new doula, who is fully and professionally trained, and meets the requirements of mentorship with me. She’s a professional doula who is building her birth experience. The newer doula will be your primary doula for your labour and birth. We both attend the postpartum visit. (I train Birth and Postpartum Doulas of excellence through Birth Ways International.) Many happy clients have chosen this option.
  • Dial-a-Doula Prep & Birth Support for local or far away clients. Includes everything in the full birth doula support package but with virtual instead of in-person support. I’ve supported people in my own town and as far away as Singapore in this manner! $1000.
  • Birth Prep Package without birth doula support:  I educate and set up clients with the same care my doula clients get. It’s up to you to arrange for another doula or perhaps you are not working with a doula at all.  This involves 3 meetings prenatally to go over options, unpack previous births (if applicable), and create a vision of their ideal birth, and extensive educational support (e-mails, client hand-outs, referrals to local health practitioners, help with birth-plans and sibling-prep), a Directory for the Childbearing Year, a Roadmap to Optimal Birth Prep, and a Postpartum Prep list.  These clients have access to the “client-only” section of my site and lots of great info, and we prepare a birth plan together.  They can also ask me questions via e-mail any time through their pregnancy – to pick my brain or get answers to things that come up along their pregnancy. This is currently $500.

To understand doula fees, please see http://www.cordmama.com/blog/2015/3/23/why-doulas-are-expensive-and-why-youre-glad-they-are

If you have a partner who doesn’t understand paying for extra support, please see http://goodmenproject.com/families/new-dads-advice-just-hire-a-damn-doula-jrmk/

Other Options:

  • We can set up a payment plan.
  • Gift certificates for my services.
  • Raise funds e.g. a collection-box at your baby-shower or Mother-Blessing, or ask people to contribute to your doula rather than buying other gifts.
  • Find a less experienced doula, as they usually have lower fees. See The Doulas of Regina for a listing of local doulas.
  • If there’s no way you can pay for birth support, check out the Doulas of Regina  Relief Fund.  They pay for doulas to attend the births of women who qualify based on financial need.

Angie The Doula – Tips and Recipes for Labour-Aid Drinks

Posted by on in Birth Support, Labour, Nutrition1 Comment

Here are some alternatives to store-bought sport drinks, which are usually full of chemicals and unhealthy ingredients. High quality coconut water is full of electrolytes. Any bone broth works too for Labour-Aid.

Labour-Aid and broths are excellent for hydration, energy and electrolytes.  They help keep the powerful forces of labour progressing.  Stock the ingredients at home and prepare at the first sign of labour.  Or make ahead (this is a great task for someone who wishes to help out) and freeze as cubes, popsicles, or in a bottle, to be thawed and consumed as labour progresses.

Most labouring women prefer their labour-aid chilled and their broths warm.

LABOUR-AID DRINK – basic (recipe shared by many midwives and natural birth books)
1 L  water or Pregnancy Tea
1/3 C  raw honey or real maple syrup
1/3 C  juice, fresh-squeezed from a real lemon
1/2 t  salt, preferably Celtic or Himalayan
1/4 t  baking soda
2 crushed calcium tablets

LABOUR-AID DRINK – easiest (recipe by Head to Heal Wellness)
1L water (for hydration)
1 Tbsp honey (to give us fuel while being active)
1/4 Tsp salt (to replace the loss of electrolytes)
1/4 Tsp baking soda (to replace electrolytes lost)
1/2 a lemon
Combine all the ingredients into a glass container and stir. You can tweak the amounts based on your personal preference and needs. Squeeze as much lemon as you like until you find your favourite ratio. Voila!

These next two versions are from Mommypotamus.  See the website for details of ingredients.

LABOUR-AID DRINK – Lemon Labor Aide
4 C  water
1/2 C  freshly squeezed lemon juice
1/4 t  salt, preferably Celtic or Himalayan
1/4 C  raw honey (or more to taste)
a few drops concentrated minerals (available at health stores, optional)
a few drops Rescue Remedy (optional)

LABOUR-AID DRINK – Coconut & Lime Labor Aide
3 C  coconut water
1 C  water (or more)
1/2 C  freshly squeezed lime juice
1/4 t  salt, preferably Celtic or Himalayan
2 T  raw honey or maple syrup
a few drops concentrated minerals (available at health stores, optional)
a few drops Rescue Remedy (optional)

VEGGIE BROTH
Add fresh or dried veggies (e.g. carrots, celery, onion, garlic – anything) to boiling water
Simmer for 20-30 min
Add 1 T  apple-cider vinegar
Season with any herbs or spices you like
Add salt to taste, preferably Himilayan or Celtic (kelp powder can be used instead)
Blend to smooth consistency or strain veggie chunks out

BONE BROTH
Put bones and any left-over bits, including meat on bones in pot and cover with water.
Add 1-2 T  apple cider vinegar
Bring to boil then simmer (large bones such as beef for up to 24 hours; small animal bones such as chicken only need 3-4 hours)
Strain
Add salt to taste, preferably Himilayan or Celtic (kelp powder can be used instead)
Optional:  Add dried or finely chopped fresh veggies, herbs or spices and simmer for another 30min

Updated RGH policies for maternal patients and what doulas can do for you

Posted by on in Birth, Birth Prep, Birth Support, Labour

As of April 2, 2021, RGH and all Sask hospitals are now closed to visitors and are restricting support to only ONE person in the Labour & Birth Unit and the Mother-Baby Unit. Each labouring woman can have one person with her throughout her stay; the same one person, no swapping or changing. The restrictions also affect patients in pretty much every unit throughout all hospitals.

The Sask Health Authority will re-evaluate weekly and get back to 2 support persons as soon as they deem it safe to do so. My fingers and toes are crossed that this happens before your birth! If it doesn’t, doulas are still here to help you.

I have been down this road a year ago for about 2 months with several clients and can still be immensely helpful to you. Here’s what doulas can do to help you prepare for your birth during this time:

  • Extra planning and education for your birth, given this new situation.
  • Answer your questions through pregnancy, birth and postpartum. You still have someone you can call anytime.
  • Early labour support in your home, while wearing masks.
  • Help you make the decision about when to go to hospital. We can do this by phone or in person.
  • Ensure you know which door to use, where to park, what you need to go through registration and admitting.
  • Be your back-up for support in case one of you “fails screening”. 
  • Be the primary support person if wanted or needed.
  • Phone and/or video support throughout your labour and birth. This works best if you resist the urge to “be polite and let your doula sleep”. If I have updates throughout your journey, I can advise you on questions to ask, positions to try, things to do for comfort, things to do to keep labour progressing as well as possible. I can watch for “cross roads” and help you towards what is your version of an ideal birth. I can still help you navigate detours. I supported 7 couples in this manner in 2020 and they were grateful for the guidance, even though it looked differently than we had originally planned.
  • Postpartum support will be offered as usual – at your home, by phone or video call – your choice. 

Here’s what you can do to make your birth as empowering as possible for both of you:

  • Extra planning and education, with a doula’s help.
  • Have a good solid birth plan.
  • RGH Tour with me
  • Easing Labour Pain class, which teaches partners how to do hands-on support. It also covers informed choice and many options for comfort and labour progress.
  • Print, read and bring to your birth Hospital Set-up 101. There’s a link to a YT video if you prefer that.
  • Check out my article, When to go to Hospital. 
  • Lots of communication with your doula!

My mantra lately, even with this latest development, is “everyone is doing the best they can”. The new restrictions are certainly frustrating (to say the least) and inconvenient but our health care providers are working hard to find the balance of patient safety and patient experience.  My fingers are crossed that this phase passes quickly and we can get back to our regular routines of attending hospital births in person. That said, I’m so sorry about the effect this has on your birth plans. Even if things change before you go into labour and we can be together in person, it does mean extra preparation and stress for you.

Please let me know if you have any questions. I am here to help.

I teach a variety of Child Birth Education classes and prenatal workshops online for people all over.  I have been a birth doula since 2002, and have helped over 300 clients with their births and over 1000 through prenatal classes. Learn more about my birth doula services, and contact me with any questions you may have.

Angie The Doula – Guide on When To Go To The Hospital

Posted by on in Birth, Birth Prep, Birth Support, Labour

If you’re planning a hospital birth then you have to figure out when to go. This guide will help you make that important decision.

Most people don’t know that the majority of naturally-starting labours are usually done at home. Some people want to get to the hospital later in the birth process. They know the longer they’re in the hospital, the more likely they are to have interventions as part of their birth. Other birth mothers simply enjoy being at home more. 

One of the benefits of working with a doula is that we help clients decide when to go. We will let you know that you won’t be officially admitted if you aren’t “far enough along” in labour. Most first time birthers without professional guidance go far too early, often by many hours. This leads to the disappointment of being sent back home. 

Please note that this is a general guide. At your prenatal appointments, ask your medical care provider if there are any specific recommendations for when you should go in. Some pre-existing conditions or medical issues lead to different recommendations from those below.

Photo by Paula O. Licensed under Attribution 2.0 Generic (CC BY 2.0)

When to go to hospital

Unless you’ve been told otherwise by HCP…

  • Pattern of sensations or contractions (explained below): 311 for a first birth or 411 for subsequent births; even sooner in labour if you have a history of fast birthing.
  • Can’t walk or talk through sensations that fall into the pattern above
  • Tip: If you feel like eating, then it’s likely too early, based on labour pattern alone
  • Lots of pressure and contractions end with a grunt, the urge to poop, bear down or “push”. 
  • Signs of labour or waters releasing before 37 weeks
  • Any health concerns (some “warning signs” are below)
  • Decreased fetal movement that isn’t remedied by eating and resting
  • When waters release? Maybe, maybe not.
  • If there’s a colour (yellow, brown, green) or foul odour when waters release
  • Want pharmaceutical help coping with pain
  • Feel safer at the hospital or want reassurance about your own or baby’s health (will be sent home if not in ‘active labour’)

Before heading in:

  • Have some juice or snack (unless you’ve been instructed to not eat e.g. schedule c/s)
  • Pee before heading out the door
  • Bring:
    • Health Card
    • Envelope with your prenatal records & birth-plan
    • Any prescription medications
  • Bonus: lip-balm and a hair-tie
  • Be ready to answer these 3 questions:

1.    What’s the labour pattern

2.    Have waters released? If so was there a colour? 

3.    Is the baby moving normally?

Warning Signs

This is a partial list. Warning signs are covered in detail in prenatal classes and health region documents.

Seek medical attention (do not sleep on these signs or wait in hopes that they pass):

  • Decreased fetal movement
  • Visual disturbances
  • Sudden and severe headache
  • Pain in upper abdomen that doesn’t pass
  • Maternal fever

911 call:

  • Red, flowing bleeding or clots
  • Sudden, severe / intense / sharp pain that brings you to your knees and doesn’t pass
  • Cord prolapse when waters release

A note about “being sent home”: It’s OK. Perhaps it’s inconvenient but it can be reassuring to get checked out, be found healthy, and then be sent home. I’ve met a lot of nice staff at various hospitals who will tell you it’s better to come in for nothing than to miss a problem.  

Note about the contraction pattern: 

  • 311 means 3 minutes between the start of one contraction and the start of the next; 1 minute from start to end of the contraction; at least 1 hour of that pattern consistently. (411 is the same except 4 min between contractions.) 
  • Use 411 as your guide if you wish to get there soon into active labour, and likely stay but maybe sent home . 
  • Use 311 as your guide if you want to be more certain of being admitted and have no need or desire to go earlier in the process

I teach a variety of Child Birth Education classes and prenatal workshops online for people all over.  I have been a birth doula since 2002, and have helped over 300 clients with their births and over 1000 through prenatal classes. Learn more about my birth doula services, and contact me with any questions you may have.