Category: Education

Birth Doula FAQs

Posted by on in Birth Prep, Birth Support, Doula, Education, Labour, Postpartum2 Comments

What’s a doula?
A doula is a professional part of the birth care team. Birth Doulas provide continuous physical, emotional and informational support to their clients through pregnancy, birth & early postpartum. In much of the world today and throughout history, women support women through labour & birth.

What’s the difference between a midwife and a doula?
Doulas work as part of a team with doctors or midwives, but not instead of. They provide non-medical support and comfort measures (e.g. encouragement, massage, positioning suggestions). They do not perform clinical tasks such as heart rate, blood pressure, or internal exams.

Midwives are medical providers, highly trained in the medical aspects of birth. The carry oxygen, medicines, resuscitation equipment and other gear, and are known as primary care-givers during birth. In North America primary/medical birth care is offered by either a midwife or a physician.

Why choose a doula over simply using a friend or family member as support?
Doulas are trained and experienced in childbirth support. They know the sounds and behaviors of laboring women, and what that may indicate about progress. Doulas are trained in pain-reducing comfort measures, natural methods to keep labor progressing, and to support the laboring people and partners / birth companions. Doulas are familiar with local hospital policies & practices and have often built a rapport with the doctors, nurses and midwives. See http://evidencebasedbirth.com/2012/06/26/why-wouldnt-you-hire-a-doula/

In most Canadian hospitals, maternal patients are allowed 2 support persons – usually that’s a partner and a support person. Some hospitals accommodate a 3rd support person. Homebirths and birth centers encourage women to have all the support they wish.

How does the doula fit in with nursing staff?
Doulas do not replace nurses or other medical staff, but rather work as part of the team. Doulas provide comfort and support while nursing staff take care of medical needs and charting (often in a supportive manner of course). Nurses change shifts; doulas stay.

How does a doula assist with communication in hospitals during labor & birth?
During prenatal meetings doulas learn what’s important to clients and discuss how to make informed decisions. A doula may remind or encourage their client to ask the questions necessary to understand a procedure and make informed decisions. Doulas do not speak on a client’s behalf nor intervene in their clinical care. They do not make decisions for clients, nor judge the decisions clients’ make, but are there to support those decisions.

What difference does the presence of a trained doula have on birth outcomes?
The presence of a doula tends to result in shorter labours with fewer complications and less interventions. When a doula is present during and after childbirth, women report greater satisfaction with their birth experience, make more positive assessments of their babies, have fewer caesareans and requests for medical intervention, and less postpartum depression. In case of unplanned circumstances, doula support helps reduce negative feelings about one’s childbirth experience. Studies [1],[2],[3],[4] have shown that babies born with doulas present tend to have shorter hospital stays with fewer admissions to special care nurseries, breastfeed more easily and have more affectionate mothers in the postpartum period.

Analysis of six randomized trials1 demonstrates that lack of doula presence correlates with:

  • Double the overall caesarean rate
  • 33% increase in length of labour
  • 67% increase in oxytocin use
  • 2 ½ times more requests for epidurals

Will a doula make my partner feel unnecessary?
A responsible doula compliments and enhances the father / partner / birth-companions in their supportive role rather than acting as a replacement. (While I respect people’s individual circumstances, I will use “father” words for most of this paragraph, as that’s who most often asks this question.) The presence of a doula allows the father to support his partner emotionally during labor & birth without the pressure to remember everything he learned in childbirth class! The father typically has little-to-no actual experience with the birth process, yet is expected to act as a “coach”. Some partners feel (accurately) that this is a huge expectation. Many fathers experience the birth as an emotional journey of their own and find it hard to be objective. A doula is supportive to both the birth-mother and her partner, and plays a crucial role in helping a partner become involved in the birth to the extent they feel comfortable. Studies have shown that fathers usually participate more actively during labor with the presence of a doula than without one.

When a couple works well together during the birth process they’re better able to handle the challenges of early parenthood. An incredible bond forms or is made stronger.

How often and when do we meet?
After we’ve met and agreed to work together, we’ll meet at least twice more before the birth; as many times as we need to feel prepared. I do not charge extra for additional meetings. It’s never too early to start our meetings and I ask that the two main meetings are complete by 35 weeks, ideally. After your baby is born there will be a minimum of one postpartum visit, more if needed or desired. I welcome questions and communication from my clients between meetings.

Are doulas only useful if planning an un-medicated birth?
The role of the doula is to help attain a safe and pleasant birth, not to choose the type of birth. The presence of a doula is beneficial no matter what type of birth is planned. In fact, people who choose a medicated birth need as much support as those who choose a natural birth, but a different kind of support. For women who know they want a medicated birth, doulas still provides emotional support, informational support and comfort measures to help through labor and the administration of medications. Doulas can help  with possible side affects and by filling in the gap that medication may not cover; rarely does medication take all discomfort away and sometimes there’s a wait involved.

For a people who are facing a caesarean birth, a doula provides comfort, support and encouragement. Often a caesarean is an unexpected situation and parents-to-be can be left feeling unprepared, disappointed and lonely.

What if I planned a drug-free birth then change my mind during labour?
Doulas don’t make decisions for clients or intervene in clinical care, nor do they judge their choices. They provide informational & emotional support while respecting their client’s decisions.

What kind of comfort measures do you use during the labour & birth process?
While there are common comfort measures taught in doula training courses, each doula also brings their own tools and methods. Mine include the following:

  • Positioning suggestions specific for stages of labour, circumstances, client preferences, situations that arise through the birth process
  • Massage & various touch methods
  • Homeopathy & Bach Flowers (optional; no extra charge)
  • Aromatherapy (optional, you provide the oils; only available out of hospital due to scent policies)
  • Encouragement & reassurance
  • Setting up the birth space
  • Heat or cold as desired
  • Hydrotherapy (water for comfort in labour, and/or water-birth)
  • Create space for partner, and recommendations to help partner to offer support
  • A calm, reassuring presence who trusts the birth process

When do we call you in labour?
Details are discussed in our prenatal meetings. Please call at the first signs of suspected labour. From then on you’ll keep us posted on your progress and what’s happening.

When and where do you join us in labour?
That depends on the labouring person, partner, and what’s going on in labour. Early support often takes the form of checking in by phone and/or dropping by your place.  Your doula joins you either at your home or in hospital or birth center once you need in-person support and remains with you until 2-3 hours after the birth.

How does shared-care work?
Doulas often team up to provide enhanced service through busy times, holiday seasons, summertime. Clients benefit from combined experience, education, and availability. Since doulas are on call for up to a month for each client, shared care allows them time for important life events and days off without having to turn clients away or rely on unfamiliar back-up. Clients may wish to meet both doulas prenatally so they’re familiar with whichever one attends birth. In cases of unusually long labours, a doula-colleague may be called in to provide a break for the primary doula.

What if you can’t be at the birth?
In the rare circumstance that your doula can’t be there, you will be well supported. I  work with reliable back-ups who offer excellent care. Fees remain the same. If the back-up is likely to be part of care, a meeting with my doula-colleague can be arranged.

Do we pay more to work with 2 doulas?
No. Fees are outlined in the Client Agreement. The cost covers doula services, no matter how many doulas are involved.

What kind of postpartum support do you offer?
Your birth doula usually stays for 2-3 hours after the birth, until you’re ready to be on your own with your baby. Your doula will be visit on the first day or two postpartum, offering basic breastfeeding support, answering questions, and going over your birth. I am available for questions and can offer resources (educational and community). A second postpartum visit is offered.

What if I need extra help with breastfeeding or baby-care?
The information above describes care provided by birth-doulas. Another kind of doula, a “postpartum doula”, specializes in extended care and breastfeeding support. There are also breastfeeding counselors and lactation consultants that can be arranged through public health or hired privately. I can provide resources and contact info for them. If you’re on the Mother-Baby Unit the nurses or unit Lactation Consultants can provide support.

Where’s that name from?
In ancient Greece “doula” meant the highest female servant who helped the “lady of the house” through child-bearing. Medical researchers Marshall Klaus and John Kennell, who conducted several randomized clinical trials on the medical outcomes of doula attended births, adopted the term to refer to labour support as well as prenatal and postpartum support.

[1] Klaus, M.H.; Kennel, J.H.; Berkowitz, G.; Klaus, P. “Maternal Assistance and Support in Labor: Father, Nurse, Midwife or Doula?” Clinical Consultations in Obstetrics and Gynecology 4 (December 1992).

[2] Sauls, DJ. Effects of labor support on mothers, babies, and birth outcomes. J Obstet Gynecol Neonatal Nurs. 2002 Nov-Dec; 31(6):733-41.

[3] O’Driscoll, K. and Meagher, D. Active Management of Labor. 2d ed. London: Bailliere Tindall, 1986.

[4] Klaus, M.H. and Kennel, J.H. Parent-Infant Bonding. St. Louis: C.V. Mosby, 1982.

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 $1500-1800 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 $1200. 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 $1200. 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.

Doula Interview Questions

Posted by on in Birth Prep, Birth Support, Doula, Education

Most doulas offer a complimentary initial meet-n-greet to determine if you’d be a good fit to work together. It’s an opportunity to learn how the doula works, their point of view, what they offer, and also to share what you’d like for your birth and support, if you know. Many people don’t know much about what kind of birth they want to plan; experienced doulas can help sort that out.  After all, if you don’t know your options, you have none.

People learn all about their options and choices (there are many!!) in my Prenatal Classes.

Here are some questions you might wish to ask when you’re considering working with a doula for your birth.

BACKGROUND, EDUCATION, PHILOSOPHY

  1. How many births have you attended?
  2. How long have you been in practise?
  3. Where have you worked? (Hospitals, birth centres, homes. Which ones?)
  4. With which primary practitioners have you worked in my area? (Midwives, doctors, OBs).
  5. What’s your educational background in general?
  6. What experience, education and training do you have, specifically related to birth (childbirth education, birth support, breastfeeding, postpartum support and newborn care)?
  7. Do you have complimentary training e.g. natural remedies, modalities for pain management & comfort measures?
  8. What is your philosophy about pregnancy, birth and support?
  9. What’s one thing you wish all parents-to-be knew about birth?
  10. Are there limitations of support?  E.g., natural vs. medicated birth, time-lines for gestation & labour, home vs. hospital birth.
  11. What compelled you to start doing this work?

GENERAL PRACTISE ORGANIZATION

  1. What are you affiliations? e.g. Professional associations, memberships
  2. Do you provide community links and resources for and relationships with other practitioners with skills who may benefit pregnant and postpartum people?
  3. What’s your offer, in detail? e.g. # of prenatal visits, on-call schedule, post-partum support/schedule.
  4. Fees – cost, payment schedule, return policy. What payments do you accept? Do you offer payment plans?
  5. How do you support partners / birth-companions?
  6. How do you like to communicate with your clients?
  7. What expectations do you have of your clients?
  8. Do you have privileges in all or limited birth centres & hospitals?
  9. Do you work with out-of-town clients?
  10. Are there additional perks? Are they included or do they cost extra? e.g. Lending library of books & videos, informational resources, health related therapies, workshops or classes?

PRENATAL CARE

  1. What information is covered in prenatal meetings?
  2. Do you help create a birth-plan?
  3. What kind of preparation tools/materials do you offer?
  4. How do you help prepare clients for their ideal birth?
  5. Do you expect your clients to do any homework?
  6. Do you help your clients prepare for the postpartum stage? If so, how?
  7. Are you available for extra meetings, questions, phone calls? If so, are there additional fees?

LABOR & BIRTH

  1. Do you work with back-up? If so, who and can I meet them if I wish?
  2. Under what circumstances would the back-up attend?
  3. What if you miss the birth?
  4. What if I go into labour before on-call dates?
  5. When do you join your clients in labour?
  6. Where do you join your clients? At home or place of birth?
  7. How long do you stay?
  8. What are your methods or tools for support during the birthing process? e.g. Pain management techniques such as massage & knowledge of positions; complimentary therapies such as homeopathy, acupuncture, aromatherapy.
  9. How do you help keep labour progressing efficiently?
  10. What do you do to help with difficult labours (long, stalled, and/or back labour)
  11. Are you knowledgeable and comfortable supporting labour with medical interventions?
  12. How do you work with my partner and/or anyone else I might wish to be part of my labour?
  13. What if I have a Caesarean birth?
  14. What if I’m transferred to (another) hospital or city?

POSTPARTUM & NEWBORN CARE

  1. Do you help with breastfeeding? How? When? e.g. Immediately after birth or at home in the following days too?
  2. What if I need specialized help with breastfeeding and/or recovery from birth?
  3. What does your support look like in the postpartum stage?
  4. How long do you offer postpartum support?
  5. Do you have resources to help with postpartum recovery? For the birthing person and/or the baby?

MOST IMPORTANT NOTE FOR PARENTS-TO-BE:

  1. Do you feel comfortable enough with this doula to share your baby’s birth?
  2. Are they kind, warm, and have the other personality traits you’d like in a doula?
  3. Is the doula knowledgeable about your particular concerns?
  4. Do they listen and communicate well?
  5. Are they comfortable with your choices or do they seem to have their own agenda?

Weight Gain During Pregnancy

Posted by on in Birth, Education, Placenta, Postpartum, Pregnancy, Recovery

Weight and fundal (abdominal) measurements are usually recorded at prenatal appointments. However avoiding weight gain is a concern for many women, even during pregnancy. If the number on the scale is an issue or trigger, people can ask their doctor or midwife to record the number in their chart without telling them. Another option is to decline being weighed; many other things are measured throughout a pregnancy that can provide information about pregnancy health and fetal growth.

There used to be strict guidelines for weight-gain ranges, but an increasing body of research indicates it’s most important to focus on good nutrition and a healthy maternal patient, rather than an exact number of kilos gained through pregnancy. 

There are too many variables to pick an ideal number. Factors include height, pre-pregnancy body composition, bone structure, carrying a single fetus or multiples, genetics, metabolism, health of the pregnancy, diet, activity level, pre-existing health conditions, cultural considerations, age, and pregnancy-related health issues.

Someone who eats well will almost always gain exactly what they need for a healthy pregnancy. 

Where does the weight come from and where does it go?

Many postpartum women are surprised to find they don’t return to their pre-pregnancy weight immediately after birth. Less than half of the weight gained makes up the baby, placenta, and amniotic fluid!

Here’s a list of approximate weight distribution for a healthy pregnant woman of an “average-size” with a single fetus:

  • Baby at birth – average of 6-8.5lbs / 2700-3900g
  • Uterus* expands during pregnancy – 2lbs / 900g
  • Placenta – 1.5lbs / 680g
  • Breasts* – may increase by up to 1-2lbs / 450-900g (total, not each)
  • Blood volume* increases by 150% during pregnancy – 4lbs / 1800g
  • Fluid* will be retained by pregnant woman – up to 4lbs / 1800g
  • Amniotic fluid surrounds the baby – 2lbs / 900g
  • Maternal fat & nutrients stores, muscle development* – 7lbs / 3175g (3.175kg)

* These things do not magically disappear through the birth but rather will take some time to resolve. Good thing! It takes months to grow all the extra blood volume and other elements and it would feel quite terrible to undo all of it in a few hours. These things are a normal part of pregnancy. Some people return to their pre-pregnancy shape and weight while others do not.

Angie The Doula – Complications and Congenital Issues

Posted by on in Baby Care, Education, Resources

It’s one of the worst prenatal scenarios parent-to-be’s may have to face – being told their baby will have complications or congenital issues (a disease or physical abnormality present from birth). Complications can range from a variation of normal (e.g. extra digit) to one that’s moderate but can be managed with medical care (e.g. club-foot, cleft lip/palate) to something that can range from mild to having the potential to completely change a family’s life (e.g. Down’s syndrome, spina bifida). 

This article addresses some considerations for families that are expecting a baby with complications.

How severe will the Complications and Congenital Issues be?

With the testing and ultrasound schedule commonly recommended during pregnancy, surprises are uncommon. In most cases of complications, people are made aware before the baby is born.  

Until the baby is born, it’s impossible to know for sure what the severity will be. It’s important to maintain hope and a connection with your baby. Dr. Sarah Buckley writes extensively on prenatal screening, which includes false positives (a screening or test result showing an issue when there isn’t one). In that case, a suspected problem is found to be non-existant or milder than expected. 

I’ve seen several of my clients go through this terrible roller-coaster, waiting for news, expecting the worst, and then finding everything is normal on the next ultrasounds and at the birth. It’s hard for them to ever believe their baby is OK. When parents-to-be are in limbo like this, it can lessen their attachment with their unborn baby, even after further testing confirms all is well. 

Photo by Topato at Flickr. This file is licensed under the Creative Commons Attribution 2.0 Generic license.

What do I need to be aware of?

As you learn about a condition, the list of risk factors can leave parents – especially the pregnant ones – feeling like they are to blame. Find a counsellor or other parents in the same situation to help you work through these feelings. In many cases, no one is actually to blame.

Another sad reality about having a baby with complications is that it can be very hard on the parents’ relationship. Knowing that ahead of time can allow you to find resources, strategies and counsellors to help. 

Keep in mind:

  • You can have a smart, beautiful, amazing baby that happens to have a congenital complication.
  • Many humans far surpass the limits put on them by stats and well-meaning medical care providers. Don’t limit your child! Their environment and how they’re treated can really make a difference in how their potential plays out. (Of course, that’s true for most children.)
  • Focus on your child’s strengths while also being aware of their circumstances.
  • There are countless people living normal productive lives and accomplishing great things in spite of being told they’d never be able to do it…
  • Healing and thriving happens in the community. Humans are not meant to fly solo. 
  • Almost all parents struggle with worry, exhaustion, uncertainty, feel the pain of their child when they’re unwell, are learning to navigate life with a baby, love their baby and will do anything for them, have hopes and dreams for their child. This is common to parenting no matter if your baby is healthy or not.

To Prepare:

  • Seek out support groups – in person or online. Social media can be a bit of a minefield and provides a much different experience than a setting where you connect with actual humans. It can be scary, especially for introverts, to join a group but most people are glad they did so.  
  • Find an excellent online resource or two – not 10!  
    • Good sites will describe the condition in clear, understandable and kind terms.
    • Those sites will have a section directed at parents
    • Links to articles and resources that resonate with you
  • Look at images online, only from those vetted sites, so you’ll know what to expect
  • Find out what the policy is at your birth-place regarding family bonding and skin-to-skin contact in case of known complications, and yours specifically.
  • Learn about local resources from your medical community. Many places have an excellent team of social workers, occupational therapists, medical people, therapists, geneticists that can help you navigate.
  • Find out about social and government resources. You may be eligible for grants, programs, respite plans, and all manner of assistance available for families that have extra challenges related to a child with complications. Sometimes they’re hard to find.
  • Learn as much as you can about the complication:
    • Best and worst-case scenario / mild to severe case
    • Learn the language – technical terms, acceptable language
    • What future treatments might your child need? When? Is treatment invasive or painful? Is it necessary?
    • You have choices!  What does the future hold for your child without treatment or by taking a different approach?  

How can I manage my Baby’s health?

You will be your child’s best advocate and may have to become somewhat expert in their condition. Keep a binder or digital folder of every test-result, procedure, appointment. Also, have a section for resources. Do not assume every medical care provider you meet knows the full picture of the specifics of your child. 

If necessary and if you’re able, look outside of your own geographical region for treatment options.

What words and terms should I use?

The way people talk about your baby can be unknowingly hurtful. It helps everyone if you address this with those close to you. Many people want to be helpful or at least respectful but don’t know how. They tend to either stay away or blunder through, possibly adding stress or misery to your situation. 

Here are some suggestions you can share:

  • Use language that puts the human first e.g. baby with Down’s Syndrome
  • “Birth defect” is inappropriate. Terms that might feel better: Complication, congenital disability, variation of normal, congenital abnormality. 
  • A list of acceptable terms in general and for specific issues:  https://www.ncbi.nlm.nih.gov/books/NBK64884/ 

Prepare a cheat-sheet for loved ones and those that will be in your child’s life.

  1. Unacceptable terms
  2. Acceptable terms
  3. What makes the condition better and worse
  4. Special treatment the child may need e.g. can’t digest a certain food, needs a special baby-carrier
  5. What can they do that’s normal? e.g holding the baby won’t hurt them
  6. What you need – how can they help? How can they normalize life?
  7. Welcome them to visit or participate in your child’s life
  8. Links with more information
  9. Success stories, anecdotes

Online Resources:

Cochrane Review – https://www.cochrane.org/ the gold standard for reviewing and analysing medical research 
Stanford Medicine https://med.stanford.edu/ 
Johns Hopkins Medicine https://www.hopkinsmedicine.org 
Mayo Clinic https://www.mayoclinic.org/ 
Health Link British Columbia https://www.healthlinkbc.ca/ 
March of Dimes:  https://www.marchofdimes.org/complications/ (trigger alert: great info but some harsh language)

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.

Lending Library for Doula Clients

Posted by on in Books, Doula, Education, Resources

Below is my list of resources – books, DVDs, CDs – available for clients to borrow, and descriptions.  If you have a question please ask, as I have many evidence-based research articles I can share with you.

Books

Ina May’s Guide to Childbirth by Ina May Gaskin
My fave childbirth book ever!  First half is filled with empowering birth stories and for many women has totally turned around fears and negated all that societal mis-information about birth.  Second half has research based info on what you really need to know about your body and labour – the forgotten, empowering info you don’t hear about in our society unless you really search it out.  Most interventions aren’t even discussed which is why I like my clients to pair this with the Dahl book for a balance of a deep knowing of our power and modern day procedures.  But if a woman tells me she’ll only read 1 book this is the one.

Birthing From Within by Pam England & Rob Horowitz
What I call the third trilogy in really preparing for birth.  Not too much about hospital procedures because it really focuses on the emotional / spiritual preparation for both parents-to-be.  This work literally changed the face of birthing in North America.  Great info about how our non-physical selves affect the process (>95% in my humble opinion), how to uncover some of our beliefs and work toward really feeling confident.  (Pam did The Elk & the Epidural DVD and we get the ice-cube exercise from her teachings.)

Pregnancy & Childbirth Secrets by Gail Dahl
A best-seller to help you prepare for a positive childbirth in any setting.  Kind of like a non-scary, empowering version of What to Expect.  (That book scared the crap out of me while pregnant!)  Laid out month-by-month.  Packed full of info and includes sections on preparing for birth, every pregnancy issue and intervention I can think of, extensive sections on breastfeeding and baby-care.  An example of some of the top secrets for childbirth:  Go in with a plan for pain. There is much more to know than breathing. Her book lists over thirty methods to help reduce pain during labor.

Smart Medicine for a Healthier Child by Zand & Rountree
It’s the best kid-health book I know of from infancy right to teen years, and the only one you’ll need unless you plan to specialize in some aspect of kid-health.  There are short sections on basic safety, nutrition, health etc.  The bulk of the book is an alphabetical listing of specific illnesses and conditions – what it is, signs & symptoms, many ways to treat allopathically (i.e. Western medical style) and holistically (i.e. outside the medical model).  Each illness has a “when to seek medical advice” paragraph, which I found quite reassuring as a new mom.

DVDs & CDs

Birth Day (DVD) by Naoli Vinaver Lopez (10min)
Natural home water birth, empowering, short, non-graphic; good one to show siblings-to-be. Naolí’s birth takes place at home with her husband and two children. It’s a touching and intimate account of natural birth, waterbirth and close family dynamics. The love and support Naolí receives gives her courage to labor uninhibited. Her children are present to receive their sister and be part of the process. She provides narration about what she was feeling and thinking during labor.

Birth with Gloria LeMay (DVD)
Includes:

  • 9 Homebirths without narration
  • Same 9 Homebirths with commentary
  • 30 min intact PSA featuring Dr. Dean Edell
  • 25 min The Prepuce presentation by Doctors Opposing Circumcision. This is a film for medical students on the importance and function of the male foreskin.

It’s My Body, My Baby, My Birth (DVD) (27min)
An educational DVD that tells the story of 7 mothers and their emotional journeys to natural childbirth. Partners express their fears and concerns, ultimately transforming as well.
The story is enhanced with footage of partners and the roles of various professional birth workers.

Pregnant in America¬ (DVD) by Steve Buonaugurio (106min) – (may be on Netflix)
A story about the institutionalization of birth in North America – kind of like Business of Being Born but more fun to watch; follows a couple from pregnancy to birth. Shocked by the greed of U.S. hospitals, insurance companies and medical organizations, Steve and his wife Mandy set out to create a natural home birth in a world where everything is anything but natural. The film is educational and entertaining and prepares excepting parent for their uncertain journey of being pregnant and having their baby.

The Birth of Sabine (DVD) by Andaluz Waterbirth Center (10min)
Sabine’s video shows the excitement and anticipation of a first pregnancy. Follow a couple from the positive pregnancy test, prenatal visits, to the unexpected surprise of her water breaking days before labor begins. They are shown making decisions and using natural methods of induction up until the day they are (gratefully!) in labor. Dad helps catch baby as she is born into the water and placed immediately on mamas chest.

What Babies Want (DVD) by Debby Takikawa and Noah Wyle (58min)
Mind blowing info about infant’s experience of pregnancy, birth and early childhood. This info changed my life. An award winning documentary that explores the profoundly important and sacred opportunity we have in bringing children into the world. Filled with captivating stories and infused with Noah Wyle’s warmth as narrator, the film demonstrates how life patterns are established at birth and before. It includes information on early development as well as appearances by experts: babies and families.

The Elk and the Epidural (DVD) by Pam England of Birthing From Within (15min)
Discusses pros and cons, when use is appropriate, and how to support a family if epidurals are used. Candid info not presented by mainstream medicine, research based. Illustrates the truthful and typical experience of labor with an epidural. Parents learn about the advantages, disadvantages, and the cascade of medical support that accompanies epidurals. The message to parents is to develop and maintain a solution-focused, non-judgmental mindset, so that if an epidural (or any medical support) becomes necessary, they can stay present emotionally and spiritually for the birth of their child.

Gentle Birth Choices (DVD) by Barbara Harper (55min)
Blends interviews of midwives and physicians with footage of six different birth experiences–including a home birth, waterbirths, vaginal birth after a prior Cesarean section, and birth with other children present. The DVD vividly demonstrates the strength of women during childbirth and the healthy and happy outcome of women exercising gentle birth choices. It is a moving and powerful instructional tool, not only for expectant parents, but also for midwives, hospitals, birth centers, and doctors. This remarkable production combines art, education, and politics.

Giving Birth (DVD) by Susanne Arms (35min)
Lots of info about how nature equips us to handle labour and have a safe birth. Lots of great info about how hormones work in labour – every woman should know this. NOTE: Research done on Giving Birth proved that this film is effective in lowering the level of fear of birth in men as well as women.

It shows the model for normal birth and why it is important for mothers and babies. It contrasts the two different models for birth ~ the medical model vs. the midwifery model and explains the risks of routine obstetric practices. You will learn what scientific evidence has discovered about birth and hear it from three obstetricians a labor and delivery nurse, and a doula. You will learn why doulas are important if you birth in a hospital. You will also hear from a mother post-Caesarean and watch two (non-graphic) births. You will experience a woman giving birth in her own home, attended by a midwife, and see images of a water birth. This video explores common misconceptions about pain in labor, epidural anesthesia, cesarean, and many routine hospital procedures. Giving Birth presents what midwifery care is all about.

Birth As We Know It (DVD) by Elena Tonetti-Vladimirova (75min)
Variety of births clips in a variety of settings; watch as many or as few as you wish. This movie features eleven natural births, including home birth, water birth, twins, breech delivery and self-birth. Also featured are informative interviews on topics rarely discussed, such as the Sexuality of Childbirth, Circumcision and Limbic Imprinting, and conveys its message in a non-intrusive way.

Giving Birth & Being Born (DVD) (20min)
Shows 4 natural births in a European birth centre, in variety of positions. The women use a variety of equipment, including birth ball, wall mounted ladder, rope, stool and mats to increase their comfort, with their partners offering support and encouragement. There is no commentary, just simple music to underpin the visuals and a very few sub titles to explain what is being said by the midwives and women. Bonus (36 minutes) offers an explanation of the basics of the birth process, using video animation and short clips from Part 1 to illustrate the various topics.

Business of Being Born (DVD) by Ricki Lake & Abby Epstein – (May be on NETFLIX)
A documentary story about the institutionalization and financial business of birth in North America. This film interlaces intimate birth stories with surprising historical, political and scientific insights and disturbing statistics about the U.S. maternity care system. When director Epstein discovers she is pregnant during the making of the film, the journey becomes even more personal. The filmmakers ask: Should most births be viewed as a natural life process, or should every delivery be treated as a potentially catastrophic medical emergency?

Orgasmic Birth (DVD)
Yup – just like it sounds. A documentary about medicalization of births and how well women can cope in the right circumstances. Examines the intimate nature of birth and the powerful role it plays in women’s lives when they are permitted to experience it fully. This documentary asks viewers to re-examine everything they thought they knew about giving birth and the potential it holds. Undisturbed birth is revealed as an integral part of women’s sexuality and a widely neglected human right. Couples share their birth experiences, discussing their fears and how they found the support, nurturing, and ultimately the power and strength within themselves to labor and birth their babies in a beautiful, loving, and ecstatic way.

Relaxation, Rhythm, Ritual: The 3 Rs of Childbirth (DVD) by Penny Simkin (15min)
Penny shares 23 “scenes” from the labors and births of 10 women, illustrating with moving examples what she often refers to as “The 3 Rs of Childbirth: Relaxation, Rhythm, and Ritual.” Watching these different women and their unique responses to contractions as they progress from early labor to birth will inspire women looking forward to birth.

Reducing Infant Mortality and Improving the Health of Babies (DVD) (17min)
Free viewing at http://www.reducinginfantmortality.com/ Listen to Obstetricians, Doulas, Neonatologists, Midwives, Psychologists, Pediatricians, and other Physicians explain how our health care system is failing babies and mothers and what we can do about it. This film is a tool for everyone to use to draw attention to infant mortality and infant and maternal health issues as national health care policy is debated on Capitol Hill.

First Hour of Life (DVD) by Marshall Klaus (33min)
Dr. Marshall Klaus has studied infant bonding and newborns for over forty years. He, along with John Kennell, introduced the Doula concept into mainstream US medical practice. Now, filmmakers from Italy have combined an interview with Dr. Klaus and footage from four (Italian) home births in a profound and simple video which should be required viewing for all parents, obstetricians, nurses, and childbirth educators.

Kangaroo Mother Care I & II (DVD) by Nils Bergman, MD

KMC I – Rediscover the natural way to care for your newborn baby (26min)
This video summarizes the latest research to prove that the newborn thrives best on his mother’s chest, where the temperature is perfectly controlled all the time. How to wrap the baby to mother’s chest is also shown. Kangaroo Care is for all newborn babies, but especially premature ones. Dads can do it too!   This is the “How-To” video. Kangaroo Mother Care enables the baby to relax, and improve the heart rate and the body temperature. Breastfeeding is an essential and natural part of Kangaroo Care.

KMC II – Restoring the original paradigm for infant care and breastfeeding (52min)
This comprehensive, expanded video is instruction for health professionals who support the maternal/newborn dyad. Dr. Bergman clearly and simply presents what happens to a human newborn when separated from the mother. His own research plus >200 studies shows many benefits to the newborn in skin to skin care.

Dr. Jack Newman’s Visual Guide to Breastfeeding (DVD) (45min)
Simple reassuring info about breastfeeding. This is a no-nonsense approach to baby-led breastfeeding. It illustrates the numerous benefits of breastfeeding for both mother and baby, including detailed reviews on the importance of colostrum, proper latching techniques, latching the baby who does not yet latch, and how to treat the colicky baby by changing milk flow.

Topics covered:

  • How to know if baby is getting enough milk
  • Breast compressions
  • Avoiding sore nipples
  • How to get a baby to latch
  • Colicky babies
  • How to increase baby’s intake of breastmilk
  • Risks of formula
  • Using a lactation aid

Baby-Led Breastfeeding (DVD) by Christina Smillie (16min)
This film shows mothers learning to breastfeed naturally, by letting their babies show them how. Human babies are already hardwired to seek out and find the breast at birth and this film shows babies instinctively finding the nipple. The film includes babies of various ages with a variety of breastfeeding challenges. In this video we see just how babies can do it, when we get out of the babies’ way.

Prenatal Yoga (DVD) by Shiva Rea
Learn poses for each trimester. DVD includes:

  • Calming meditation and deep breathing
  • Gentle workout with seated poses, standing poses and floor work
  • Guided relaxation

Postnatal Yoga (DVD) by Shiva Rea Reconnect with your strength, your energy and your pre-pregnancy shape and lifestyle through warmth, guidance and inspiration of instructor Shiva Rea. Post-pregnancy is a most important time for a woman to regain her physical strength and stamina. This gentle program focuses on moves and exercises that help alleviate the stress incurred by giving birth.

Happiest Baby on the Block (DVD) by Dr. Harvey Karp (128min)
Note: I haven’t watched this yet so can’t share an opinion. It was donated by a client who highly recommends it. Aimed to help soothe most of baby’s cries in seconds…plus add 1-3 hours to tot’s sleep! Parents master these fun tips best by watching. Then, after they you get good at switching-on your baby’s amazing calming reflex, Dr. Harvey Karp, noted pediatrician and child development expert, reveals the amazing secret reflux that literally is ‘THE OFF SWITCH” for baby’s crying! Learn the 5 simple ways to turn on the calming reflex (the 5S’s).

Babies Know… Seven Principles of Prenatal and Perinatal Psychology (DVD) (20 min)
Seven Principles of Pre- and Perinatal Psychology is all about infant consciousness from the moment of conception through birth, and the significance of our first experiences after birth on development. Becoming aware of this level of consciousness can have a profound impact on our babies being born today, as well as people of any age investigating how experiences from within the womb and birth have impacted the overall experience of being human.

Trauma, Brain & Relationship – Helping Children Heal (DVD) (30min)
This documentary is an overview to help those who care about children recognize, prevent and heal psychological trauma. Internationally and nationally recognized authorities who work with children and teenagers in the field of emotional trauma offer insight and information about the origins of relationship/developmental problems, as well as problems associated with PTSD later in life. A central message of the documentary is that even though psychological trauma often goes unrecognized in children, emotional trauma is very responsive to relational repair. It clarifies such points as the difference between emotional trauma and emotional stress.

Your Body, Your Birth (CD) by Lynn Griesemer (78min)
Inspires, encourages and reveals secrets for a rewarding birth experience – one you can cherish for the rest of your life. This CD is about taking charge of your birth and your life. Topics include: exploitation in pregnancy and delivery; medical aspects of birth (drugs, safety, myths, technology); natural childbirth (definition, advantages, why we should avoid drugs at birth, why more people don’t aspire to natural childbirth); tips for a successful pregnancy and birth; how to make birth-related decisions that you feel comfortable with; goal setting; imagination; body image; human needs; what obstetricians will do for you; strategies for a satisfying birth.

Wondrous Beginnings (CD) by Wendy Anne McCarty (49min)
This audio CD is part of the What Babies Want Audio Lecture Series about the consciousness of infants. This CD offers insights into our spiritual nature, right from the beginning of life.

Dr. McCarty intertwines amazing new theories and findings with heart-warming healing stories of families who have come to her for guidance. This CD is especially encouraging and supportive of pregnant families and families with young children. Wendy leads us on an amazing journey through a new understanding of the consciousness of the infant. Her emphasis on scientific research does not contradict her deep spiritual understanding of what it is to be human. She presents ideas and stories pertaining to the process of coming into the world from preconception through early childhood.

Ancient Encoded Wisdom (CD) by Joseph Chilton Pearce (45min)
This audio CD is part of the What Babies Want Audio Lecture Series about the consciousness of infants. This CD offers insight into our birthing culture. Joseph Chilton Pearce offers us a clear, no-holds-barred look at the developmental needs of babies and children, and clearly spells out for us the roots of violence inherent in our birthing and parenting practices. He also offers simple and concise choices that we can make for positive change.

Golden Nuggets for Breastfeeding Early Days

Posted by on in Baby Care, Breastfeeding, Education

Some little-known gold nuggets for breastfeeding in the first days (you may wish to print this and stick it on the fridge or by your feeding-nest):

  • Breastfeeding may take practise but is designed to work
  • Watch for feeding cues* and offer breast.  Crying is considered a late sign of a stressed babe.
  • Offer one cue, then pause to let babe work it out.  E.g. nipple to baby’s lips, then pause for 5 seconds to allow babe to sort out latch.  If she needs another cue, then give on, pause, and repeat if needed.  Baby is learning too.
  • Babies rest/pause with eyes closed.  If babe stops sucking but stays on breast, let him rest and resume feeding.  He’s likely not actually sleeping, so don’t take him off.  (Sleep test – lift and drop arm.  Sleeping baby’s arm will fall; wake baby’s arm will respond.)
  • You should feel a tug or pull, but no pinching.  Avoid the temptation to feed through a bad latch, no matter how demanding baby is.  Not even once!!  Break the seal (insert pinkie into babe’s mouth) and start again.  Even if it takes 10 tries.
  • Don’t hold baby’s head while feeding.  It may be sore from birth.  Sore or not, the stimulation causes baby to pull back from breast.  Hold head by putting hand on bones at top of neck if necessary.
  • Don’t “pet”, rub, stroke babe while feeding.  Holding and feeding baby is an act of big love in and of itself.  (Imagine if you were trying to enjoy a fine meal, and someone was petting and rubbing you all over.  Ok that might be fun, but not conducive to eating.)
  • After 3-6 weeks the effort of breastfeeding becomes way less than the effort of formula.  Keep going – it gets easier and is worth the early efforts.

Best Start has an excellent 1 page chart for the first days –  feeding guidelines, newborn stomach size, diapers and other info.  Print this!

* Here’s a great graphic to help you identify visual feeding cues.