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.

Family-Centered Cesarean

April is Cesarean Awareness Month.  Currently, about 1 in 3 births occur via cesarean in the U.S and cesareans are the most common surgical procedure worldwide.

As with any birth, when planning a cesarean birth you have options to explore and the right to consider what you want for your experience and your baby's birth.

Often, moms giving birth by cesarean feel they miss out on being an active participant in the birth, making decisions from a variety of choices like those presented as part of a vaginal birth. A surgical birth doesn't mean you're merely a passive participant.  This is your baby's birth, your body, and your birth experience and often you do have choices available to you.

Enter the family-centered cesarean.  Also called a gentle cesarean or natural cesarean, a family-centered cesarean is about recognizing that cesarean birth is birth and not just a medical procedure. It's about celebrating life and family and asking you what your hopes and desires are for the special moment when your baby enters this world.

When considering options for birth I think it's prudent for all families to consider what their preferences are regarding cesarean birth because you never know exactly what your journey to birth will be.

Some options you might consider for cesarean birth:

• In the event of a planned cesarean, wait for labor to begin on its own before birthing by cesarean.  

• Schedule for the earliest time slot available.  The birth is more likely to happen on schedule (or close to) and you will be asked not to eat after midnight the night before so you won't have to go all day without food.

• Discuss the procedure ahead of time.  Have your care provider walk you through what to expect, what type of closure they prefer and why, what your anesthesia options are, what kind of dressing they prefer and why, what pain medication will be available to you after the birth, will there be a support band offered during your recovery, etc.

• Your birth partner and/or doula, or other support person be allowed to support you emotionally throughout the birth including pre-op, the O.R., and recovery.

• Have your partner apply an essential oil or scented lotion that appeals to you on your chest, upper lip, wrists, or even their wrist for you to smell throughout the birth.  A good scent option is lavender.

• Dim surrounding lights to create a more relaxing atmosphere.  

• Play music out loud, an alternative might be to wear headphones.  

• Keep non-medically necessary chit-chat to a minimum among the medical staff.

• Place pulse oximeter on your foot to allow your hands to remain as free as possible. Place ECG leads somewhere other than your chest so it's free to receive baby after birth.

• Do not administer supplemental oxygen unless medically necessary

• Arms remain free of restraints

• Warm blanket be placed on you once pain medication has been administered.

• Have your doctor, nurse, or doula inform you of what is going on with the birth throughout.

• Lower the drape and slightly raise the head of the table so you can watch your baby coming into the world.  An alternative could be a clear drape or mirrors.

• Allow baby's birth to occur slowly with a more "hands off" approach.  Once baby's head is born they can begin to breathe while still attached to the placenta, allowing time for uterine contractions to squeeze fluid out of their lungs and auto-resuscitate similar to a vaginal birth.  

• Reach down and assist with helping baby from your womb.

• Take pictures, video tape the birth, and/or record your baby's first cries.  Ask that your birth photographer be present to document the birth.

• Allow baby's cord to stop pulsating before it is clamped and cut.  Ask that your partner be allowed to cut the cord.  

• Place baby skin-to-skin on your chest as soon as possible after birth.  Your partner can help support baby on your chest while your medical team is completing the surgery. If you are unable to be skin-to-skin ask that baby be placed skin-to-skin with your partner. 

• Swab baby with vaginal fluids to seed microbiome.

• You, your baby, your partner, and doula or other support person(s) transition to recovery together and baby is not separated from you after birth unless medically necessary.  In the event that baby must go to the nursery for medical need, ask that your partner be allowed to accompany them while your doula or another support person remains with you in recovery.  

• Warm blankets and plenty of pillows be made available to you in recovery.  

• Lactation support be made available to you in recovery so that baby may begin breastfeeding as soon as they are ready.  It's possible you may need some help getting baby situated and yourself comfortably supported to allow for this to happen.  

These are merely a list of options to consider.  There is no one right way to birth by cesarean just as there's no one right way to birth vaginally.  Any preferences will need to be discussed with your care provider ahead of time and then again immediately before the birth with the other care providers who will be involved, especially the anesthesiologist.  You can contact the hospital ahead of time to find out if they routinely offer family-centered cesareans.  And remember, you are a consumer.  If necessary and possible, feel confident in shopping around to find the right care provider and birth location for you.

Family-centered cesareans are gaining in popularity and accessibility with major media outlets reporting on the topic and hospitals beginning to implement some family-centered practices as standard for uncomplicated cesarean births.  Individual birth experiences can be so profoundly impacted when personal preferences are considered by a supportive birth team and family-centered births are the heart of positive experiences.

A Positive Birth Experience Isn't About How You Birth

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I have two children and neither birth was my ideal experience.

Both births were very similar on the surface, yet when describing the birth of my second child I use words like: healing. empowering. positive.

What changed?


My second birth was about more than just getting baby here safely, the journey was important as well.

I was more than just a vessel carrying the baby who was the main focus and priority.

My thoughts, feelings, and opinions mattered.

I was an active participant in my baby's birth, making choices I felt good about.

I had a supportive birth team whom I trusted.  Our relationship was built on a solid foundation of mutual respect.

We had common goals: healthy mom, healthy baby, positive experience.

Instead of finding myself a few hours postpartum, holding a newborn, feeling dazed and disheartened as I did with my first birth, I snuggled my second baby, feeling confident and satisfied.


What changed?

Support.  

Support for me as a woman.  Support for me as a mother.  Support for me as someone worthy of an opinion on what happens to my body and my baby.  That support is key.

Having your ideal birth is not required in order to have a positive experience.  A positive and satisfying birth experience has more to do with how you feel while you're birthing than how you birth.

My personal birth experience is a significant piece of why I became a doula.  I understand just how important is is to feel supported on your birthing journey. I want to support you in having your confident, empowered, and satisfying birth.

Rebozo: A Traditional Tool for Pregnancy, Birth, and Beyond

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I recently had the privilege of attending a rebozo workshop with a group of lovely ladies.  It was great fun and I learned a lot of awesome techniques that I'm excited to use!


What is a rebozo?

A rebozo is a traditional Mexican shawl.  It is a long piece of woven cloth with fringe at either end. Rebozos are used in many ways: as a head covering, a shawl for warmth, to block the sun, carry babies or goods, and as a tool for pregnancy and childbirth.  I loved learning about the historical context of the rebozo and how important it is in Mexican culture.  It has uses for birth, death, and everything in between.

During labor I can use the rebozo to help you relax physically and mentally, assist you in a variety of positions, and encourage baby into a more optimal position, if necessary.  The rebozo is an incredibly versatile tool!


Here are some ways that you might be interested in utilizing a rebozo:

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During pregnancy:

A rebozo can be wrapped around your belly in the later weeks of pregnancy to help support the extra weight and give your back, hips, and pelvis some relief.  It can also be wrapped around your hips and tightened if you're experiencing hip or pelvic discomfort.  You can use the same technique postpartum if you would like to feel a little more supported.

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During labor:  

A rebozo can be used in many ways during labor.  Some easy, yet effective techniques include supporting your belly while in hands and knees position, wrapping it around your hips and tightening for counter pressure, or using it to tie on a warm rice sock or tennis balls (tie them on, then lean against the wall for counter pressure).

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Once baby is here:

Wear your baby!  And enjoy all the benefits of babywearing, utilizing a tool that helped you during pregnancy and birth.













Additonal resources:

Labor Tool - Rebozo
Amazon - Mexican Rebozo Shawl

What's a Doula?

My older daughter is a doula.  

...What's a doula?


My mother, who is very supportive of the work that I do, tells me that when she tells other people I'm a doula she's often met with confusion.  People think I'm some sort of midwife or they have no idea what she's even saying because it's a term they've never heard before.  I've certainly encountered the same confusion.  Although the role that doulas fulfill is in some ways as ancient as birth itself, the modern role of a professional doula is relatively new.  A birth doula is a trained and experienced support person offering women continuous physical, emotional, and informational support before, during, and immediately following childbirth.

Simplified, as a doula I am a personal guide on your birthing journey.  I use my knowledge and expertise to help you achieve the birth experience that you desire.  It may sound simple, but the support I provide as a doula is invaluable.  Mothers who have doula support tend to have shorter labors, fewer complications, increased success with breastfeeding, and a smoother transition into motherhood.  Most importantly, they are more likely to feel satisfied with their birth experience overall.

So, what exactly is this support that I provide?  What do I actually DO?

I meet with you prenatally to discuss your options and help you decide what your preferences are.  I talk you through the labor and birth process so you know what to expect.  I demonstrate ways you can help to facilitate the labor process and remain as comfortable as possible.  I help you formulate questions for your care provider, prepare for breastfeeding, point you toward quality resources, and talk you through fears you may have.  I want you to enter your birthing time feeling knowledgeable and confident!

I provide hands on support throughout the birth process.  I join you at your home when you don't feel ready to go to the hospital, yet need an extra set of hands with fresh perspective.  I place a comforting hand on your shoulder, breathe with you through contractions, and remind you that you're doing awesome!  We transition to the hospital together; I'm a familiar face in unfamiliar surroundings helping you and your partner settle in to this new environment.

I hand you your cup before you realize you're thirsty, get you a cool washcloth, and suggest another trip to the bathroom because an hour has already passed without your realizing it.  When your partner looks uncertain I remind them of how great they're doing, suggest that they slow dance with you or rub your back or get you another cup of ice.  I offer all sorts of fun positions for you to try, brush your hair out of your eyes, remind you to stay in the moment, and squeeze your hips because it feels so much better.  I encourage you to vocalize through contractions and then I remind you that you're almost there!

When it's time, I remind you of all the strength you possess, and remind your partner to tell you out loud just how amazing you are in this moment because they're already silently thinking it.  I reassure you that those shakes are normal and fan you because you're suddenly so hot!  Your partner and I work together to encourage you as you bring your baby into this world.  I snap a few pictures with your camera while you and your partner marvel at your new little baby.  Then, I help you navigate that first nursing session.

We meet postpartum to review your birth, because it's nice to talk about it with someone knowledgeable who was there every step of the way.  Then I answer questions: any tips for getting baby to sleep at night?  How do I use this Moby wrap?  I'm thirsty all the time, how do I remember to drink more water?  And, if I'm lucky, I get a few baby snuggles.

As a doula I walk with you on your path to birth.  I am there to be an experienced supporter, a quality resource, and an unending source of comfort.  I bear witness, facilitate communication, and do what I can to make everyone's day just a little bit better.  It's amazing and humbling to be invited in to another's birth experience and it's incredible to be able to have a positive impact on such an important journey.

I'm honored to call myself a doula.