8.02.2016

Coping At All Stages - Early Labor


"For my first I was set for an induction at 7am. I woke at 2:30am with period like cramps. I didn't know what labor would feel like, my doctor didn't give me any information and I didn't know about childbirth classes. Around 4am, I figured out I was having mild contractions. We went in at 7am and I told my doctor this. I still got Pitocin, though, and he broke my water and away we went. They were fast, intense and back to back. 

For my second, I woke at 3:30am to go to the bathroom, when I sat up I felt a trickle. I went to the bathroom and there was more fluid leaking. I was so excited. I was having mild contractions. 

For my third, I woke at 12:15am. As I opened my eyes I couldn't move because I was having such an intense contraction my whole body felt paralyzed..."~ Allison

"I woke to a pop and a gush - so there was no mistaking that I was going to be in labor - although, from what I hear, only about 10% of women's labors start with the water breaking. When my contractions started about 30 minutes later, I was in the shower rinsing off and my husband was putting the laundry in the washer. They started out subtlety, like a nearly continuous menstrual cramp. It was all under my belly button and all dull and achy. Within a few hours, the continuous dull menstrual cramp had spaced out to full belly hugs that wrapped around from the sides, the top, and the bottom, lots of water balloon-like pressure the full size of my uterus; like this giant water balloon being blown up inside, at the same time that this flat wide band wrapped around the water balloon and tried to pop it from pressure alone. The dull menstrual cramp of my lower belly was still there. As the day went on, the menstrual cramps got bigger, and the pressure got stronger...." ~ Amili

"I first considered that I might be in labor when I started experiencing crampy-like contractions at regular 6-7 minute intervals...." ~ Chelsea

"My contractions were confusing - I think everyone else knew I was in labor before I did. I woke up about 4am to a backache. It would start as a pulling on my lower back that would intensify, last for awhile, then go away. I woke repeatedly in the night to this sensation and I thought it was just a muscle strain. After I got up, my husband asked how I slept and I told him. He noticed I said 'about every 15 minutes I woke with a nagging backache; so no, I slept like crap'. He kept that observation to himself, which I'm happy for. The backache waves got closer and closer - until about every 7 minutes apart, before he said 'Do you think this is labor'? Until then I had no idea. I thought I needed a massage or a chiropractor. Luckily I had a chiro appointment for that morning..." ~ Liv

"With my first birth, I woke up to brief light cramps every 10-15 minutes. It took 24 hours for them to meet the "every 5 minutes" criteria my OB had given me, and even then they were still light. 

With my second,  I was induced gently. Acupressure and nipple stimulation worked to bring a light contraction pattern to around 7 minutes apart. 

With my third birth, I was in a meeting at work and I started having period cramps. They were probably every 7-10 minutes at first and lasted that way until dinner..." ~ Terri

"With my first pregnancy, I never had cramps or Braxton Hicks. I felt my insides twist up all of tha sudden. Then ten minutes, again. I knew right away. For my second, I'd been feeling crampy since the morning. I didn't know if it was worthy of mention since I'd been crampy for a month. My mom picked up my three year old for her usual weekly babysitting gig. As soon as he was gone the cramps became what I'd most certainly call contractions. Purposeful, dynamic, big, moving. I felt my uterus lifting up like a skirt with each one. I felt relaxed knowing this was probably "it", and suddenly very feminine too..." ~ Holly

"I had a midwife appointment at my house at 38 weeks and I asked her to check my cervix. This was around 4pm. We went out to dinner and called it an early night; going to bed at 9:30. I was glad because I woke at midnight. I had contractions that felt like cervical tickles. They would come for about 20 second every 3 minutes. I woke my husband after a few hours of this. At that time I got up to go to the bathroom (diarrhea) and saw I had pink discharge and my mucous plug in my panties. I called my midwife because they were so close so soon. She said to wait until they felt more intense OR got longer OR they spaced out to match the intensity and length. I called my doula hoping she'd say it was going to be a fast birth. She said 'it might be or it could be [midwife] touching your cervix' and then told me the same thing my midwife did. So I put on a pad and went back to bed. I woke intermittently, never fully rousing, and slept for a good part of the night." ~ Trinity

"I started having mild cramps after a doctors appointment. He said to go on a walk. My doula mentioned eating dinner and heading home to settle in early for the night. I went on the walk. We went to dinner, then I walked more. I didn't want the cramps to stop and they only stopped or spaced out when I stopped moving. So I kept moving. I checked in with my doula and said they were getting stronger, but were still short and only picked up in frequency when I walked. She again suggested I go to sleep. I really didn't want them to stop though, so I kept walking. About midnight I was thoroughly exhausted and had to go to bed. So I got a shower and we tucked in for the night. I woke up to nothing the next day. That evening, we repeated the events of the prior evening and night. Again, I tuckered myself out and went to bed only to wake up to nothing. The third night, I didn't go walking, but instead just hung out at home and went to bed early. Around 2am I woke to a different contraction. I can't explain it but it was more... encompassing...." ~ Kelly

Early labor is a time when your body is working, but you usually don't need to actively adjust your activities to accommodate the sensations. A textbook early labor would last around 10 hours and start with contractions far apart (10 minutes or further apart), lasting for a short time (30-45 seconds each), and be crampy, light, and not very intense. Over time, these contractions would get CLOSER, LONGER, and STRONGER (all three). 

But we all know that our  bodies didn't read the medical textbooks and every body has a mind of it's own, so early labor can last a few hours (or less) or a few days. Some women have labors that skip early entirely, and others have early labor patterns that don't follow the 'early labor patterns'. 

Sometimes early labor contractions will start out close together, but the intensity (strength) isn't there and the duration (how long they're lasting) isn't there. In those cases, your birth team would be looking for the strength and duration to pick up to match the spacing...  or for the frequency to space out to match the other two. This pattern is very common when your cervix is checked or stretched/swept at a prenatal appointment and you have contractions afterward. 

Sometimes early labor contractions are far apart, but the intensity is quite strong. This can sometimes be the result of baby being in a different position than on your left side or lined up with your belly button. If this is the case, call your doula or midwife to help you get some ideas for how to get the intensity to match the frequency and duration. 

Some Pro Tips from birth workers who have been around the block a few times with laboring mamas: 
  • Make sure you're taken care of - sometimes practice labor, UTIs, bladder infections, and dehydration can look like early labor. Make sure you're well hydrated, if you were walking, try lying down (and vice versa), and make sure it doesn't hurt or burn to pee. If you've been spending a lot of time doing physical activities and that's what started everything, try getting on all fours and swaying your belly back and forth to make sure baby isn't playing with the braxton hicks button.
  • Don't pay attention too soon - if you think you're in labor, let your team know, but then try to ignore the sensations and do what you would normally do during that time of day or night. If you'd normally be sleeping - SLEEP. You never know how long your labor will be and there will come a time you will probably want to sleep and can't. If you had plans for lunch, keep them - it's probably a good distraction, there will come a time when your labor won't let you be distracted from the work your body is doing. 
  • Don't get hung up on timing contractions - try timing them in sets of 3-5 contractions, update your birth team, then put the app (or paper and pencil) away. When your labor sensations change (more intense, markedly closer, or markedly longer) time another set and send them to your birth team. 
  • Don't try to walk your baby out during early labor - it rarely works and usually only serves to exhaust mama. Then when she really wants to sit or lie down, active labor kicks in and she can't sit or lie down. Walking your baby out is best reserved for active labor. 
  • Eat and Drink - again, you have no way of knowing how long it will take. Eat when you're hungry or during your regular meal times. Drink water often. Pee often. 
  • Greet labor with patience - you have been waiting for this moment for around 9 months. Remember it might be fast, but will probably take time and patience. Clocks have no place in the labor room and the more you can disconnect from worrying about how long it is taking or going to take, the more seamlessly it will evolve. 
  • Change things when labor changes - when your labor says 'no more side lying, I don't like that' listen to your body. If you suddenly feel like you need to get rinsed off, take a shower. 
This is an overview of early labor.. next up is active labor, the time when we need to actively participate in the process. 

7.26.2016

Doula 2 Doula - Why I Don't Offer In-Home Consults


I've had potential clients get miffed from time to time over me not offering in-home consultations. Sometimes they've even compared my practice to other local doulas who do offer in-home consultations.

I get it, it's more convenient to the potential client, especially if they have children. It's more private, intimate, etc...

But let's talk about the other side of things.

As a human, and a female human, I would like to think the best of people. But there's no denying that we live in times where we need to be considerate of our safety. If I were to meet a complete stranger in their home without any prior knowledge except an email and possibly a phone call, I have no idea what I am walking into.

There are a number of stories in the birthing community of doulas who found themselves in scary, and even dangerous, situations because they trusted the strangers that they were going to meet. In one, the woman backed out last minute and said 'go ahead and meet with my husband at our home, I have to go to an appointment.' (this was when the doula was literally on the front step knocking on the door). In another, someone blocked her ability to leave the home when she had to leave for another appointment. In yet another, the home was abandoned and a car pulled up to block her leaving the driveway, but then her husband (who happened to be with her for that day) stepped out of their car and the other vehicle drove off.

So please know, potential client, it isn't because I think badly of you. It's because I am thinking safety for all when I say 'let's meet here'. And doula to doula - staying safe in our field isn't difficult with simple boundaries and safe business practices.


4.05.2016

The Empowering Cesarean

Empowerment - making one stronger and more confident, especially in controlling their life and claiming their rights.

Let's get one thing straight from the start - noone can empower another person when it comes to the humanistic experience of empowerment. Empowerment is, by definition, one finding ones own strength. So, I cannot empower you... but, you making a choice that feels good and resonates within you can be empowering to you. It is your power of making that choice that feels good. 

I am a huge advocate of low intervention, no pain medication birth. In healthy and low risk birth, less intervention (medications, tools, equipment, etc..) means less inherent risk. But just because I believe in that truth does not mean that it is going to be true for every birthing journey. Every birthing journey doesn't stay healthy and low risk, not every birthing journey couldn't benefit from weighing the pros and cons of an intervention and erring on the side of the intervention. So, that is where we start.

Women can have very empowering births in whatever way that they birth. My years as a birth worker have taught me that truth. The number one deciding factor that makes or breaks the case for a woman's fulfillment of a birth experience and decreases her chances of seeing it as a trauma is choice. When a woman is provided with choices, and is given the space to be a partner in her healthcare and birth planning, she is able to look forward to her birthing time with joy and not fear, fulfillment and not trauma.

If you find yourself planning for an upcoming cesarean, here are some options that are specific to you:
 In addition, you can talk with your provider about using a clear drape or a drape with a window in it, see if your hospital offers the TAP block for post-operative pain management, and talk with them about having a photographer in the OR with you to document those first moments.

Knowing your options, and finding a provider who will have an open dialog about these options, helps to ensure a happy and healthy mom in all birth experiences. 

3.30.2016

Continuing Education

To her faithful readers, friends, and clients -

Hi there, this is a letter from a friend of Cole's. She was my doula a number of years ago and she is now on her way to becoming a midwife. As she continues this journey, she has a number of opportunities to continue her education and keep her skills up to date. There are two opportunities that she would like to be able to take advantage of in 2016, but I also know it is virtually impossible with the cost of midwifery training. And that's why I'm writing this letter.

Cole has said, in conversation, that she would love to go to the Association of Texas Midwives Conference this year. This conference will be an evening and two full days of lectures and hands-on learning for the midwife and midwife student, specific to the state of Texas. The dates are May 5, 6, and 7, 2016. The total cost for the Conference is $420 for a double occupancy room.

The other continuing education opportunity that she has is the Farm Midwife Assistant Workshop. The Midwife Assistant workshop that she would like to attend is either August workshop dates: Aug. 7-13 or Aug. 28-Sept. 3. The 6-day workshop is very intensive and integrative. This workshop will fulfill many of the requirements of her midwifery module training through Via Vita School of Midwifery. The total cost for the workshop is $1,345. This includes her meals and her materials. She already has the book and a place to stay.

If you think that you can help fund her in any way, simply click on the PayPal button on the side bar that says "Want to Help A Midwife Apprentice?" with the amount you would like to donate and a note in the donation 'for the ATM conference' or 'Assistant Workshop'. If she doesn't raise the entire amount for the ones denoted, she'll refund it.

So, if you've ever wanted to help give back to your community, this is a tangible way to do so. To see more about her, or to read about her vision as a birth worker, check out her website, http://www.houstondoulas.org/ .

Sincerely,

A. Gentry

1.21.2016

Judgmental Doulas

Recently I've been noticing a theme in the doula community. The majority of doula websites state they provide "unbiased and judgment-free" doula support. Now that sounds marvelous, and I've never batted an eyelash at it.. until a recent discussion got me thinking...

I would love a doula who's unbiased, but I sure hope my doula has judgment. 

I'm going to start by saying that I bet 99.9% of the doulas who have this on their website agree with everything in this post, and never meant anything by their statement. But let's break it down (because we all know I love definitions and semantics). 

There are different types of judgement. There's good judgement and bad judgement. Positive judgement and negative judgement. 

Positive Judgement
"the ability to make considered decisions or come to sensible conclusions. synonyms: discernment, acumen, shrewdness, astuteness, sense, common sense, perception, perspicacity, percipience, acuity, discrimination, reckoning, wisdom, wit, judiciousness, prudence, canniness, sharpness, sharp-wittedness, powers of reasoning, reason, logic;"
Negative Judgement
"having or displaying an excessively critical point of view. "I don't like to sound judgmental, but it was a big mistake" synonyms: critical, censorious, condemnatory, disapproving, disparaging,"
Here's a little secret: No doula is non-judgmental. And I'd hope you'd want a judgmental doula too. 

I'd hope you'd want a doula who makes choices for our own business practices that show discernment, wisdom, prudence, and sense. I'd hope you'd want a doula who makes choices in the way that we serve the women we've been entrusted to attend that show discernment, wisdom, prudence, and sense.

I equally hope you wouldn't want a doula who was a Wesley - (think Princess Bride), one who simply said yes to everything, because then you'd miss out on the educational portion of doula work - the options and choices and personal experiences and head space of doula work. Doulas should give non-biased resources and education to their clients so that they feel good and positive about their choices, whether they go 'according to plan' or not, and no matter what those choices are. As I have said time and time again, how can we hope to make mothers out of women when we treat them like children

And then, on the other side of the coin, I would hope (for all doulas) that none of us would be judgmental in the fact we make choices for our own business practices or ways we serve women that are excessively critical, condemning, disapproving, disparaging, or censorious... to their clients, their clients choices, or their peers.

It would do us well to remember the difference between good and bad judgement, and bias; I hope none of us provide biased support, but I hope we all show good judgement. So let's be doulas who use wisdom, prudence, sense, logic, reason, astuteness, and perception to benefit our clients through education, resources, support, and community. 

1.07.2016

Aromatherapy and Herbal Remedies - Book Review

 
Herbal treatments and aromatherapy are valuable, time-proven, natural approaches to a healthy and more comfortable pregnancy and birth as well as a successful breastfeeding experience. Herbalist, instructor, and midwife Demetria Clark explains everything a woman needs to know about using herbs and essential oils during this important time of life.
Demetria Clark has written a beautiful and educational resource; Aromatherapy and Herbal Remedies is both insightful and useful. When I first began reading it, I had the bias that it would be something of a resource for myself, as a birth worker, but difficult to encourage my clients to read. I was wrong.

birtharts.com
I have already recommended this book to three clients and will continue to do so as the wealth of information and read-friendliness of Aromatherapy and Herbal Remedies is sure to make this a regular on bookshelves across America. Her book is broken down into aromatherapy for pregnancy, labor and birth, and breastfeeding, and remedies for pregnancy, labor and birth, and postpartum/breastfeeding. She also includes an introduction to herbs, aromatherapy, and information on how to grow, harvest, and prepare your own ingredients.

She has a concise list of herbs and essential oils, as well as their uses and contraindications. Additionally, she provides a substantial section on recipes for everything from teas to poultices, and diffusing blends to massage oils/salves. I'm excited to refer to this book time and time again and have no doubt it will become a staple on many birth workers book shelves.

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