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 would 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. 

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.

So let's be doulas who use wisdom, prudence, sense, logic, reason, astuteness, and perception! 

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.

12.21.2015

The Empowering Epidural

Empowerment - making one stronger and more confident, especially in controlling their life and claiming their rights.
wikipedia picture
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. Not every birthing journey stays 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. 

The Empowering Epidural

I always start with the nitty gritty. Epidurals, like all interventions, should be used as tools to achieve a desired outcome.  In prenatal appointments, I provide women with a sheet that details the risks involved with getting an epidural. In childbirth classes, we role play getting an epidural and all that comes with it. Each time, I tell women 'this is not to scare you, this is to give you information about a procedure that you might decide you want, or your birthing journey might require you to get'. 

So let's talk about that some, shall we? 

B*E*S*T Doula Service has an epidural agreement very like my own that I give to clients. You can see it here. I love that they outline what will be required if you choose an epidural vs what might happen with the epidural. This is very important information to share with clients because it takes the 'I didn't know' and the 'if I'd only known' out of the experience. I cover with them: 
  • It will require continuous fetal monitoring
  • It will require at least one IV bag of fluids to be given prior to getting the epidural
  • It will require a blood pressure cuff to read your BP every 15-30 minutes (depending on the hospital's protocols)
  • It will require that a pulse oximeter to be placed on your finger for at least 30 minutes during administration
  • It will require that your partner and doula leave the room for administration (in nearly all area hospitals)
  • It will require a urinary catheter to be administered (depending on the hospital, some leave it in, others empty your bladder and then remove it. It may increase your risk of UTI or bladder infection, require antibiotics, or cause trauma to the urethra).
  • It will restrict your mobility during labor. Depending on other possible risk, you will be limited to the bed, and perhaps your back. 
  • It will provide a level of numbness... some women it fully numbs them to the point they cannot move their bodies from the ribcage and down without assistance, some women can feel quite a bit of discomfort even after the epidural and move without assistance).
  • It will deprive both baby and you of your natural production of endorphins, which allow for both of you to cope with pain (both during labor and you, postpartum).
That way, if their organic experience requires, or they request, an epidural, they know this information and nothing surprises them about it. We also talk about the possible risks, so that they can fully accept them, weighing the pros and cons in the moment having already read and understood the possible risks, and make an empowered choice free of the fear of unknowns. 

Another thing I always suggest is watching one. Why? Well, for the same reason we encourage women to watch birth: it takes the mystery out of the experience. 


When might a woman choose an epidural? 
  • For pain management - some women simply want to have that control over their experience. Although the control over pain requires they relinquish control over their bodies and their functions, many women accept this and feel this is  best suited for their needs. 
  • For emotional and mental clarity - some women who have had sexual trauma or birth trauma in their past prefer to labor and birth with an epidural. We talk through their desires, including the fact that it might be triggering based on it taking away mobility and possibly requiring mom to feel 'tied down' and on her back. If she feels confident about the choice, we usually try to move the equipment and tubes/wires all onto one side of the bed so that she can feel less restrained. 
  • For rest - a number of women cope marvelously well with labor and only even consider an epidural to rest... this is usually the case when she is going on days without sleep. 
  • For a reset - this would be the case when moms labor pattern becomes 'dysfunctional' from maternal exhaustion (cntx space or stop, sometimes with ROM, but stay intense, usually after long early labors, and dilation stalls along with it). In certain situations mom and her provider might feel an epidural combined with pitocin will be the best thing to get her a vaginal birth.
  • As a tool for vaginal birth - if the woman is unable to relax her legs and pelvic floor to allow for dilation to occur, or if she is beginning to run a fever and, although contractions are strong and dilation is occurring, she needs baby to be born sooner than later and opts for a more aggressive augmentation, she might choose an epidural as a tool to help her achieve a vaginal birth. 
In all of these situations a woman can feel empowered that she chose an epidural that fit her needs for her birthing time when she is fully educated and understands the possible outcomes, and the desired results. 

The one situation where I find women routinely don't feel good about their choice? 
  • For fear - fear of the future (how much longer will this take? I don't think I can do this much longer), of the pain (how much more painful is this going to get, I can't take too much more painful), fear of an intervention (I heard pitocin is horrible, if we add that, I can't do it... I can't stand those cervical checks, one more and I want an epidural), or of the experience (if it feels like this now, how will it feel later? My friend told me pushing felt this way and that's scary to me). 
In these cases, we try to get to the root of these fears and dispel them. I remind them that any choice made in fear is not a good choice, even if you would make the same choice without fear. So we attempt work through that fear to see if they still feel the same about the intervention afterward. 

Have you had an empowering epidural? Did you experience an un-empowering epidural? Do you know what might have made the experience better or helped you make a different choice? 

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