Friday, July 31, 2015

TENS for Labor

I recently completed an advanced doula training with Sunday Tortelli to learn about TENS for labor. I love continuing education opportunities and I strive to be able to offer my clients a variety of options to help them have a more comfortable birth experience!

TENS, or transcutaneous electrical nerve stimulation, is a method by which electrical currents are used to stimulate nerves for pain relief purposes.  TENS units are commonly used by physical therapists, chiropractors, and for women in labor.  They are not currently in widespread use for labor purposes in the U.S., but are a popular tool in Canada, Australia, and parts of Europe.

TENS units work by sending mild electrical currents through the skin via electrode pads placed on the area of discomfort, for labor purposes they are placed on the lower back.  The person wearing the pads controls the level of stimulation and feels a light pulsing or vibrating sensation as the unit stimulates the muscles.  These sensations work to interrupt the nerve pathways, which  decreases pain, while increasing the body's own pleasurable hormonal response, endorphins, to help naturally ease discomfort.

Research shows that TENS units are most effective at relieving back labor, which is often challenging to manage, and many women who have experienced TENS in labor report that they would want to use the tool again for future births.

TENS is a safe option for relief of some types of labor pain and can be easily utilized or discontinued if necessary.  I'm excited to now offer this as a tool for labor!

Tuesday, July 7, 2015

Use Your BRAIN

One of the topics that I always discuss prenatally with my clients is the importance of making the choices that are right for them. I provide non-judgmental support and it's important to me that my clients understand that this is their birth and I am there to support them on their journey.

Birth is a complex process and what might be best in one situation may not be the best fit in another. That's why we can't talk in absolutes when it comes to birth, every birth is unique!

An important piece of feeling empowered during birth is being an active participant in any decision-making processes. My desire is for my clients to feel confident about the choices that they make during their birthing time and my role as a doula is to help them navigate their options, often by facilitating conversation with their health care providers, their doctors, midwives, or nurses.

Informed choice is important and you need knowledge about the options being presented in order to make a decision that you feel good about!  B.R.A.I.N. is an easily remembered acronym that helps formulate questions to ask your care provider in order to obtain necessary information to consent to, or refuse any intervention that may be suggested.

Benefits - What are the benefits of this procedure?  How will this help me/my baby/my labor?

Risks - What are the risks of this procedure?  How might this negatively impact me/my baby/my labor?

Alternatives - What are the alternatives to this procedure?  Are there other options available to me at this time?

Intuition - What are my instincts telling me about this situation?

Nothing - What if we do nothing at this time?  What if we need more time to make a decision?  What kind of timeframe are we dealing with for needing to make a decision? 

These questions can be asked in a variety of situations such as while exploring options for prenatal testing, methods of induction, or interventions that may arise during your birthing time ranging from something as routine as I.V. fluids upon admission or something more invasive like artificial rupture of membranes. There is usually time to discuss these questions with your care provider, if not, that's when having a care provider you trust becomes even more important because you want to know that they understand your hopes and wishes for this birth and that they are making any quick decisions with these desires in mind.

When we discuss informed choice/BRAIN prenatally it seems very simple, but if it needs to be utilized during your birthing time it's often less straightforward.  This is when it's helpful to have someone knowledgeable, like a doula, there to remind you of these questions and make sure that you have not only the information, but also the space that you need for you and your partner to make a choice about which you feel confident.