¿Es Ud. Una Mujer Embarazada Que Vive Cerca De Portland?

May 012013
 

Una mujer que está embarazada

¿Sabía que dar a luz en casa es una opción que una mujer embarazada que vive en (Portland) Oregon tiene? La verdad es que tiene muchas opciones para su parto aquí en Portland. ¿Quisiera hablar con una comadre (una partera) que hable español para aprender más?

Aquí tengo tres recomendaciones de comadronas hispanohablantes:

Si está en busca de a una doula (dula) hispanohablante, estoy a su servicio.

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Introducing Lucy!

Apr 302013
 

 

Portland MamaBaby Doula Clientlucy in her doulas rock onesie

I have been so busy that I forgot to post photos of this little sweetie that I took at our one-week postpartum visit. She’s just a week old and looking a little sad, which is why I didn’t ask her to pose for another photo after this one. She much preferred to be snuggled into her Mama’s chest. She was more than happy to pose for the 2nd photo – you can tell she has grown a bit and is enjoying the world. <3

This precious girl was born into a super peaceful and calm space with the lights down low and voices shushed. In fact, her entire labor was quiet, still, and calm – a hypnobirth baby!

Welcome to the world, Lucy! Your Mom and Dad sure do love you (and your doula does, too!)

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Want a Avoid a Cesarean Section? Avoid the Induction!!

Apr 302013
 

Q&A

Q: What do you recommend for your doula clients who are planning for a natural (physiological) childbirth?

A: Avoid the unnecessary induction.

The clients who hire me to be their doula are looking to have a natural (unmedicated) physiological birth experience and are committed to avoiding an unnecessary induction.

The Medically Necessary Induction vs. The Medically Managed Induction

It can become a bit tricky to discern between the usual protocols for medical management of birth and individualized medical advice when doctors tell my clients that their babies are too big to possibly fit through their big American pelvises, their baby’s amniotic fluid looks to low and they are drying up in there, or the baby may suddenly die as a result of passing the due date. Plans to induce are frequently discussed before the baby’s due date and those plans are often executed at 40 weeks and 1 day in the medical model of obstetrics and nurse-midwifery.

Why so many inductions? 

Henci Goer Quote about Pitocin

It’s a totally new phenomenon to chemically push a baby out of the womb. Are we to believe that women are incapable of having babies if doctors don’t give them a pharmacy full of drugs to start labor? That at some point in the last 60 years, almost half of the females in human species are incapable of reproducing without chemical intervention? If that’s true, then that’s a very sudden and severe threat to our existence, don’t you think?

It seems more realistic that American society has gotten caught up with the false notion that more intervention means better maternal-fetal care. Meanwhile, Cuba, Malaysia, and Portugal do less and do it better. In fact, the US ranks 39th in global maternal health. Perhaps this medical management of birth isn’t good for babies after all?

Induction has no business in natural childbirth. The mere fact that you are forcing the baby to be born before it is ready to be born is, by definition, unnatural. To pursue an induction and a natural childbirth is oxymoronic.

So how do inductions lead to cesarean births?

Starting an IV

Well, to begin with, an intravenous (IV) drip of fluids and Pitocin is placed in one arm. The fluids, while necessary due to the anti-diuretic properties of Pitocin, are associated with early newborn weight loss. Now one arm is kind of immobile and there are stress hormones rushing as a response to a needle and foreign object being inserted into your skin.

Pitocin is noted to cause low blood pressure, and so therefore, requires frequent blood pressure monitoring. A blood pressure cuff will be placed on the other arm (the arm without an IV in it) and left there to electronically monitor regularly.

Continuous electronic fetal monitoring is required, which measures the strength and duration of your contractions along with the baby’s heartbeat. Two plastic discs will be placed on your abdomen with elastic straps attaching them to your body. With an IV in one arm, a blood pressure cuff on the other, and two abdominal monitors, you are in bed for a while.

It’s not likely the hospital staff are going to allow you to get up and walk around or be in the tub. This is a problem for laboring women, who need the freedom to move as their body needs to move during labor. Even if you are allowed to, it is a burdensome chore that most women seem to avoid. Most women report feeling really ‘strapped down’ with an induction.

epidural-anesthesia-300x300

An epidural is added to this package of interventions that come along with labor induction, because the Pitocin makes the contractions unbearable for most women.

Along with the epidural comes also the placement of an urinary catheter (a tube is inserted into your urethra and placed into your bladder to collect urine), which further limits your ability to move about, which is crucial in a physiological (natural, vaginal) birth. To learn more about epidurals, please read the article on Science & Sensibility: Straight Talk on Epidurals for Labor and Pain Management for Women in Labor: A Research Review. It’s also worth noting the correlation between epidurals in labor and breastfeeding problems.

Further, inductions put you on the hospital’s time clock. Once you start, you had better have your baby and have it quickly and on their schedule, because any variation from the Friedman’s curve and you could be cut open for failure to progress. Of course, to assess your progress means you’ll be given a lot of vaginal/cervical exams and each of those increases your risk for infection. If they break your water, another common induction intervention, you have 12 hours before you can add on some antibiotics to this birth plan, too… tick tock.

Finally, let’s talk about “Pit to Distress“, which is really the culmination of all of these interventions leading to results in electronic fetal monitoring that cause concern for the well-being of the baby that leads to an immediate cesarean. With an epidural already in place, the doctor easily recommends an emergency cesarean.

Do the right thing for yourself and for your baby. It really does matter how your baby is born. Inform yourself. Demand to be treated as individuals. You and your baby deserve better than if-then-else protocols that are created by administrators and litigators who have their own interests at heart, not yours and your baby’s. I encourage you to research labor inductions, epidurals, and cesareans for yourself. Knowledge is power.

The Bottom Line

Happy mother holding newborn baby after birth

“Is the mother doing ok? Is the baby doing ok? Then let’s wait another day,” needs to be the mantra of the pregnant woman who facing pressure to induce. If there is no reason to force the baby out, then let her be. Inductions are contraindicated in most cases if the goal is a physiologic birth. A natural birth is best achieved with a natural labor.

[Ask your question: email | Facebook | Twitter | tumblr]

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Doula Tip #12: Master the Smoothie

Apr 292013
 

Doulas Make The Best SmoothiesWhile I was an apprenticing midwife at the birthing center, I learned how to master the smoothie. I hadn’t ever made smoothies before working at the birth center, but now I ::am:: The Master of the Smoothie!!

Now, whenever I doula at a home birth, I always make sure that I ask my client to purchase (ahead of time!) all the ingredients necessary to make a postpartum smoothie.

Here’s the basic smoothie recipe:

  • 1/2 cup organic yogurt
  • 1/2 cup organic milk
  • 1 cup organic berries or a banana (or half and half!)
  • 1 Tbsp flax seed oil

Blend it all together and serve it up with a bendy straw.  Double it and make a smoothie for Mom’s partner at the same time – s/he will appreciate the loving doula care, too!

NB: Frozen berries work great, too!!

I’d love to make a smoothie for you after you have a baby, too! If you are interested in hiring me to be your doula, please contact me (KateDonahue@gmail.com) and let’s meet!

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This Week In Birth Blogs #2

Apr 252013
 

Signpost "Blogosphere"

This Week In Birth Blogs is a weekly blog round-up of my favorite birth related blog posts.

Birth Stories:

Breastfeeding:

Childbirth Advocacy & Activism:

Books/Videos:

Doula-Related:

Midwifery:

Do you enjoy This Week in Birth Blogs? Would you like me to continue doing it? Would you like to submit your blog for inclusion? Please leave a comment and let me know what you think (and include your link!)

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Just the (VBAC) Facts, Ma’am

Apr 232013
 

VBAC Facts Class and Webinar

Do you know the facts about VBAC (Vaginal Birth After Cesarean)?

I took the VBAC Facts class in April in Portland and I loved it!  I want you to take it, too, if you are planning a VBAC or you work with VBAC clients and here’s why: It’s important to understand that not all VBACs are alike – there are individual factors to consider – and what you need is knowledge. Knowledge is power in a VBAC.  The very first thing you should do if you are pregnant after cesarean is to inform and empower yourself. Jen Kamel, the founder of VBAC Facts, as a mother who had a VBAC, has some really important information to share – she has read and reviewed and analyzed all of the studies and data that exists about the history of VBAC politics and policies, and the risks of VBAC. She took this on like you would if you were doing an MPH thesis – she looked at all the data, all the studies, all the public documents that are behind the policies and recommendations – basically she did ::all:: the work and I got to sit back and benefit (for $85.00) and you can, too!

For more information about local classes and webinars, see the VBAC Facts Classes page on VBACFacts.com. You can also find VBAC Facts on Facebook and Twitter.

If you’d like to plan your VBAC with doula support, I’m ready to help you. Contact me today for a free doula consultation.

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2012 Doula/Monitrice Birth Stats

Dec 282012
 

2012 Portland Doula Monitrice Stats Photo

  • 0% Unnecessary Inductions*
  • 0% Cesarean
  • 100% Breastfeeding

*(before 42 weeks/medically necessary for Baby or Mother)

Someone asked me why I think none of my clients choose to have their labors induced when it’s so prevalent in our society. After some reflection, I think there are 3 key factors for this rate:

1) I’m so openly anti-unnecessary-induction for women/babies that women who are inclined to them don’t seek me out. Seriously. Given that Mom is objectively healthy and psychologically intact, and baby is objectively healthy and thriving, there is no reason other than selfish motivation to force a baby out before they are done gestating. I offer Moms some evidence-based research, they educate themselves, and they prepare mentally for the potential obstacles to a natural, physiological, birth. They have self-selected into my practice knowing how I feel. They are strong in their resolve to have a natural vaginal birth without unnecessary interventions.

2) Their partners were active participants – they also studied and learned about interventions that are commonly used in hospital birth, the potential effects, and the “package of interventions” that go together and what that means for labor and birth. They actively supported their partners in pursuing a natural, physiological birth. They weren’t apathetic – it wasn’t that they didn’t care and just put it all in the woman’s hands to decide – they also wanted the same things for the birth that the mother wanted.

3) Their providers were supportive of their choices. In every case, either the physician or the midwife at the birth “sat on their hands”. They were present and monitoring labor, providing support, but they were happy to sit back and let things unfold naturally. They offered various options, and even offered inductions at times, but they didn’t ever try to scare my clients. My clients reported feeling supported by their physicians and midwives. This is probably the single biggest factor. We put a lot of trust and faith into our providers.

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Barbara Harper on Continuous Labor Support

Aug 122012
 

barbara harper gentle birth choices on continuous labor support (doulas)

Barbara Harper from Waterbirth International was here at the Portland MamaBaby Center for her Embracing the Miracle: The Science & Soul of Birth & The First Hour workshop and I felt a very strong connection with her. I have been fortunate to get to know her better and to talk with her more and every interaction leads me to the same conclusion – we were destined to meet and work together in some way. …that’s a blog post for another day.

With Barbara’s permission, I am posting the following excerpt from Gentle Birth Choices. Today I thought I’d continue to share what the leading expert in gentle birth and water birth are says about continuous labor support. There are two copies of this book (and DVD) in the lending library. Gentle Birth Choices is a book I always recommend for our doula clients as they are beginning to formulate their birth plans. I highly encourage you to add this copy to your own reading list if you haven’t read it yet and you are pregnant or planning to become pregnant. And now, Barbara Harper on Continuous Labor Support (p 20-21):

Gentle births are easier when the mother chooses and trusts the people around her during her labor. Very few women desire to go through labor alone. There is comfort and ease in sharing the experience and having a loving touch, a cool drink, a smile or embrace when it is most needed. Fathers can provide this type of care and relish being there when the baby is born, but women sometimes desire the presence of another woman, someone who is experienced in labor and birth to provide support and assistance. Experienced mothers, sisters, and friends can easily step into that role if the mother chooses them and feels safe with them. Some mothers seek the services of a doula, a trained labor assistant.

The professional doula is a relatively new addition in hospital birth rooms. Women have been caring for each other during childbirth since the beginning of time. Even when a woman is armed with education, the intensity of labor often takes her by surprise. A doula can bring reassurance to both the mother and father that everything is progressing normally. She can suggest position changes, provide massage, or employ other techniques to assist a woman in avoiding drugs in labor.

Nurses on busy maternity units often cannot stay in the labor room due to the fact that they have many duties and care for more than one woman in labor at the same time. Having a midwife in the hospital can sometimes provide a mother continuous support, but more often the reality is that she is responsible for many other tasks. A midwife or physician is making decisions and evaluating the medical aspects of labor, whereas a doula is there solely to provide physical and emotional comfort and support.

A doula will help a mother achieve the birth outcome that she desires. Often meeting with a family a few times before labor begins, the doula becomes familiar with what a mother and father want out of their birth experience. She will work very diligently to establish an environment that is conducive to an undisturbed birth. A doula does not make decisions for parents about their care, but helps them understand the implications of certain procedures so that they can make an informed choice. Her presence gives couples confidence in their choices. She will support women in all their choices for pain management and see that every effort is made to keep the mother and baby together immediately after the birth. A birth doula will stay with the family from the time that her presence is requested in labor until a few hours after the birth, assisting with the initiation of breast-feeding, if needed.

A doula’s purpose is to help a family create a positive and loving birth memory, fostering a great start for this precious little new being. I received a letter in the mail from a very young teenage mother for whom I had served as a doula a few months before. Handwritten on school paper, she wrote:

I am back in school and taking my baby with me to class. I thought it was about time to send you an update on us. My birth was an incredible experience, hard… but I got through it. I would tell you that your being with me made it easier, but in reality, the baby was going to come out no matter what. You kept telling me that and I finally believed you. After that it got easier. I think every mom should have a doula.

Sometimes all that is needed to keep a birth normal is simply to be present – not just physically, but in the moment with the mother. Holding the energy of the birth space is an important job that is more easily accomplished by someone outside of the emotional or the medical aspects of the birth. [emphasis mine]

Did you have a doula with you at your birth? I’d love to hear about ::your:: experience with a doula by your side. If you’d like to share your own doula story or experience, please email it to me along with your permission to post it here, among the opinions of experts, because as the Mom, you are also an expert. My email address is Kate@PortlandMamaBabyCenter.com.

To schedule an hour long free consultation with one of our doulas or monitrices, please send an email to info@PortlandMamaBabyCenter.com. We are adding doulas to our staff and are currently accepting clients due in September and beyond. It’s never too late to find a doula, we can accommodate your last minute requests, as well. If you prefer to call, the number at the center is (503) 206-7715. We also offer childbirth education at the center, as well as midwifery services.

También ofrecemos los servicios en español (hable con Kate.)

 

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Top 10 Reasons To Hire A Doula (Written By Ann Douglas)

Aug 112012
 

ann douglas mother of all pregnancy books cover

Top 10 Reasons To Hire A Doula

  1. A doula can help you to feel better about your birth experience. A group of researchers in California found that women who had the support of a doula during their babies’ births were more likely to feel positive about their birth experiences (82.5%) than women who did not have the benefit of such support (67.4%)
  2. A doula can leave your partner free to focus more fully on his or her key role during the birth: providing you with the emotional support. Doulas have knowledge of birth that partners, who may have no prior experience with birth, simply may not have.
  3. A doula can help to take some of the pressure off your partner. Having someone else on hand to support you can allow him or her to take a guilt-free dinner or bathroom break. (It’s hard for your partner not to feel like the world’s biggest heel if he or she has to take a bathroom break just as your contractions are starting to peak.)
  4. A doula can help to reduce the likelihood that you will require an epidural. A study conducted at Case Western Reserve University in Cleveland, Ohio, found that 7.8% of women using doulas requested an epidural as compared to 55.3% of women laboring without a doula.
  5. A doula can offer helpful suggestions on ways to cope with the labor when you’ve pretty much run through your own repertoire of coping strategies.
  6. A doula can help breastfeeding get off to the best possible start. A study conducted in South Africa found that women who have support from doulas during labor are more likely to be breastfeeding exclusively when their babies are six weeks old than other moms.
  7. A doula can help to answer your questions about the birthing process and provide on-the-spot reassurance when you need it – something that can be truly invaluable if you find yourself with a lot of questions and concerns.
  8. A doula can help you advocate for yourself with the hospital staff and ensure that your voice is heard.
  9. A doula can promise to be there, even if your partner can’t. If there’s a chance that your partner isn’t going to be there at the birth (possibly because he or she is scheduled to work out of town around your due date) or if you’re going to be giving birth without a partner, a doula can provide you with some much-needed support.
  10. A doula can act as your cheering section. When you’re trying to weather the storms of transition, sometimes you just need someone to tell you that you’ve got what it take to get through this – and to say it with enough conviction that you actually believe her. (That’s an important part of the doula job description, by the way.)

Thank you to Ann Douglas for the copy of her newly released 2nd edition copy of The Mother of All Pregnancy Books! We are grateful for the donation to our lending library.

 

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Monthly Doula Tea Meeting at Portland MamaBaby Center

Jun 062012
 

Doula Tea Meeting at Portland MamaBaby CenterI hesitate to name it a doula tea, because that limits us so much! Maybe one day we’ll decide to have a potluck, or like this month we’ll eat hummus (and you can still have tea if you want it!)

Just to clarify, this isn’t a BSN sponsored event, just a MamaBaby come and hang out tea and chat time.

So here’s the plan for June: We’ll have “Doula Hummus and Pita” from Mezza at the Portland MamaBaby Center [map] and you can still have a cup of tea or a coffee if you wish on Wednesday, June 20th at 1pm .

You’ll still find it as “Doula Tea” on the calendar. There is no cost or fee to attend, but we will gratefully take your donation towards the MamaBaby Clinic if you feel so inclined as to contribute to midwifery care for women regardless of their ability to pay.

All doulas are welcome

Certified doulas and uncertified doulas, doulas in training, and aspiring doulas, you are all welcome to attend!  I figure this will be a chance to just sit and enjoy the company of sister doulas without the pressure of a workshop or a presentation. This is your moment to capture the spirit of the sorority of the doula community that surrounds you. This is just some you time to refill your spirit tank.

You can also bring your questions about the DONA doula training that begins the next day and any questions you might have about the Business of Being a Doula workshop I’m teaching.

Please RSVP if you plan to attend by June 19th.
You can just RSVP to the Facebook Event
or by emailing me (Kate)
so that I know how much hummus to order:

[kate@portlandmamababycenter.com]
Or just use the contact form

Babes in arms and nurslings are welcome.
Please arrange for childcare for older children so that we can all relax
and enjoy the sacred sisterhood we are creating.

 

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Doula Workshops for your Doula Business at the Portland MamaBaby Center

May 102012
 

the business of being a doula

If your doula training was like the typical 24 hour DONA Birth Doula Training, you spent 99% of your time talking about pregnancy, labor, childbirth, postpartum care, and practicing hands on comfort and relaxation measures and then approximately 1 hour talking about establishing and running a doula practice. It was probably something that you touched upon at the end of your training, when you were worn out and tired and ready to just start attending births. Maybe you did your training a long time ago and you just never really managed to attract clients and so your practice has just kind of sat stagnant?

This course is designed with this question in mind:
“I’m a doula – now what?”

In this six (6) week course that meets for 3 hours weekly (that’s 18 hours total, for people who are keeping track) at the MamaBaby Center, you will expand your doula education to become a certified and professional doula. You will also have the opportunity to create a doula collective with other doulas who are also registered for the course as you get to know each other over the six week period. The business part of doula work is the part I actually enjoy the most – it’s where my passion lies – in helping new doulas get started! Here’s how I’ve broken up the sessions:

Doula Workshops for your Doula Business

Session 1:

  • How to set up your practice (a holistic view)
  • Defining your target client
  • Branding/logo
  • Basic marketing materials

Session 2:

  • Advertising vs. Marketing vs. Networking
  • Social Media and Birth Work
  • Creating a simple marketing plan that works
  • Contacting companies for samples

Session 3:

  • Client paperwork
  • Doula charting
  • Client educational materials
  • Client goodie bags/gifts

Session 4:

  • The consult! Who is interviewing who here?
  • Prenatal appointments
  • Postpartum appointments
  • Being on call

Session 5:

  • Your First Official Client
  • Packing your doula birth bag and your own personal birth survival bag
  • Dealing with difficult situations/difficult clients
  • “Secret” Doula tips and recipes

Session 6:

  • Doula personal life and professionalism in an internet world
  • From doula to …? Options after life on call
  • working with home birth midwives (guest speaker)
  • wrap up and plan a 1 year reunion!

The cost for this 18 hour course is $360.00. I know that is nearly as much as you paid for your doula workshop, if you took one, but I think the practical nature of this course and the hands on workshops that will help you develop your practice are a smart investment in your new doula business.

You could be the best doula in the world, but without clients, you won’t ever make you any money, so you need to invest in both a doula training workshop and a doula business workshop if you really want to create a thriving practice. Preregistration is required by June 30th. If you have the resources and you’d like to save $60.00, register by June 10th [AMENDED DATE]  for an early bird discount! You can download the registration form for this class or email me and I’ll send it to you.

Recommended articles will be provided as .pdf files to registrants, and the lending library at the MamaBaby Center has the books that will support our curriculum. Participants will receive educational/client materials for their clients as well as develop their own. The first course begins on [AMENDED DATE] Tuesday, July 10 at 6pm [calendar]. Appetizers and refreshments will be served at each class, since it’s a 6-9 pm class!

Questions? Please send an email to
Kate@PortlandMamaBabyCenter.com

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DONA Birth Doula Workshop Training at the Portland MamaBaby Center

Apr 192012
 

Doulas Rock by Ravyn StadickRecently I met with independent DONA doula trainer, Debra Catlin, and we spoke for about an hour about her birth doula workshop happening June 21 through June 24th at the Portland MamaBaby Center [map].

I love that this is a weekend intensive workshop – you can just devote one weekend to completing all of the instructional hours (24) necessary for DONA certification and be on your way to your new career as a doula!

June 21st is the Introduction to Childbirth for Doulas class that is a DONA prerequisite to the birth doula workshop. This $100 class is one way to meet the DONA requirement to “Obtain basic knowledge about childbirth prior to the Birth Doula workshop.” There are other options on Debra’s web site that might be available to you to meet this requirement. If you have questions, be sure to ask Debra. Her contact info is below. Here’s a quick glance at what that class offers:

Introduction to Childbirth for Doulas

The DONA birth doula workshop is from June 22-24th and includes 12 distinct sessions or units, making it an intense, but yet comprehensible and salient course that has a logical progression, leading student doulas step by step to the next lesson.

Day 1     8:00 AM-6:00 PM
    Session 1  Implications of a Woman’s Birth Experience
        I.    Introductions and Overview
        II.   The Heart of Doula Work-Emotional Support
        III.  Sharing Birth Stories: “What Women Remember about Birth”
        IV.  Listening for Needs

    Session 2  Influences on the Childbearing Experience
        I.   Beliefs and Messages About Childbirth
        II.  Shaping Human Development-Lessons from Perinatal Psychology
        III. Personal and Cultural Influences
        IV. Maternity Care Practices
        V. The Gentle Birth Movement- and “Ecstatic Birth”

    Session 3  The Role of the Birth Doula
        I.    The Doula’s Role: Meeting Labor Support Needs
        II.   Benefits, Qualities, and Realities of Doula Work
        III.  Working with the Partner
        IV.  Birth Doula Certification Requirements

    Session 4   Therapeutic Presence
        I.    Exploring Beliefs, Promoting Confidence
        II.   Setting Intentions
        III.  Mastering Fears
        IV.  Centering and Grounding
        V.   Connecting Through Entrainment

  Day 2   8:00 AM-6:00 PM
    Session 5    Early Labor Assistance
        I.   The Doula’s Bag of Tricks for Pain Management
        II.  Early Labor Care Plan
        III. Emotional Needs of Early Labor
        IV. Guidance with Relaxation and Breathing
        V.  Working as a Team with Mom and Partner

    Session 6     Active Labor Support
        I.   Emotional Needs and Responses of Active Labor
        II.  Assisting Breathing, Vocalization and Attention Focusing
        III. Incorporating Massage and Rhythm
        IV. Coping Strategy Assessment
        V.  Supporting the Mother and Partner in Active Labor

    Session 7    Challenging Labors
        I.  Fast Labors
        II. Promoting Labor Progress
                    A.Optimal Fetal Positioning
                    B. Characteristics of Prolonged Labors
                    C. More Positions and Movement
        III. Posterior and Asynclitic Variations
                    A. Positions for Rotation and Descent
                    B.Back Labor Pain Relief Measures

      Session 8     Supporting Second Stage
        I.   Transition-Emotional Needs and Support
        II.  Role Play of Pushing Guidance
        III. Second Stage Challenges
        IV. Birth Videos

  Day 3    8:00 AM-6:00 PM
    Session 9    Role of the Doula in Difficult Births
        I.   DONA Standards of Practice and Code of Ethics
        II.  Being a Maternity Care Team Member
        III. Challenges and Dilemmas in Doula Work
        IV. The Advocacy Role
        V.  ”What if, What next?” Exercise

    Session 10    Supporting Difficult Births
        I.    Emotional Challenges-The Take Charge Routine
        II.   Compassionate Care with Medications
        III.  Supporting Cesarean Birth
        IV.  Unexpected Outcomes

    Session 11    Prenatal Client Contact and Birth Attendance
        I.  Initial Contact and Prenatal Interviews
                     A.Your Birth Package and Fees
                     B.Letter of Agreement
                     C.Labor and Birth Preferences
                     D.Addressing Special Needs/VBAC
        II.  Values Clarification
        III. Getting Ready for the Birth
                     A. Arranging Back-up
                     B.Being on-call
                     C.     Taking Care of Yourself

    Session 12    Postpartum Care and Your Doula Business
        I.   Doula’s Role in Immediate Postpartum
        II.  Postnatal Contacts
                     A. Assessments of Well-being and Supporting Breastfeeding
                     B. Debriefing and Integrating the Birth
        III.  Starting Your Business
        IV.  Marketing and Promotion

Early bird registration ends on May 18th, 2012 (save $25 and register early for $400.00) and the final closing registration date is June 8th ($425.00). To save you the searching time, I did some research to compare prices for doula training in Portland: the labor doula training at Birthingway is $485 and the DONA birth doula training through MotherTree Birth Services is $450.00.

There are many labor and birth doula workshops and trainings regularly available in Portland, so why would I choose to host Debra Catlin’s workshop at the MamaBaby Center and register my own staff in her training? I love a weekend intensive – I’m just that kind of person. I want to do the hours, get them out of the way, and get to the births. I like other programs, but I ultimately think if you’re going to invest that much money into a certification, then you need to invest in a certification that offers a return on your investment quickly, and I believe that’s what you get with Debra Catlin’s DONA training workshop.

The full agenda for the labor and birth doula training

Prerequisites for the workshop

Register for this DONA birth doula workshop

Questions? Just ask Debra Catlin 
deb@side-by-sidedoulas.com
541-998-3380

Photo credit for the Doulas Rock photo above goes to our center’s birth photographer, Ravyn Stadick. She’s pretty awesome and I really appreciate all the photos she provides for these blog posts, for this web page, and for our marketing materials!!

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Top 5 “Ask The Birth Doula” Questions

Apr 182012
 

There are some questions that almost every pregnant woman, client or not, asks me when she finds out I’m a labor and birth doula, so I’m going to share them with you. For more general frequently asked questions, check our our FAQ page.

1. What exactly does a birth doula do?

Pregnant Belly Beautiful DoulaWell, that depends on the client and the type of birth she is planning! In general, a doula is there to provide you with prenatal education and counseling, to educate and support you in the choices you make in planning your birth, and then to help you through your labor and delivery by providing emotional, physical, and spiritual support. A doula is not just a ‘lamaze coach’, but I feel like when I say that a doula is kind of like the a good old fashioned labor coach, most people begin to understand what it is that we do. Of course we do more then hold your leg and yell “PUSH” in your face… in fact, your doula shouldn’t probably do that…

At a birth I may be talking a Mama through each contraction. Later I might be out of the room giving a woman and her partner some space and time to enjoy their last moments as a couple. When I return we might try a different position or grab some equipment like a birth stool or a birth ball. I might suggest a hot shower or soaking in the tub. …I might just stand back and take photos as Mama and her partner(s) slow dance through contractions. No labors are the same, and accordingly, no doula experience is the same.

In some cases, your doula may be the ::only:: person on your birth team who is with you from start to finish. Nurses come and nurses go. Doctors go off call and their partners cover them, and even midwives in some practices have a partner who covers births for them under certain circumstances. In a home birth transfer, your doula will be a familiar face that will never leave your side. Most people who had great doula experiences express that their doula becomes a part of their family – that they are bonded by the birth experience. This is definitely the case for me, and each and every one of my clients and their babies hold a very special place in my heart.

2. Why the big differences in doula fees?

It’s hard to say why or how other doula set their fees. I think some doulas set their fees very low because they are trying to gain experience. Of course, location is a big factor. After evaluating the hours each doula invests in prenatal and postpartum visits, the time and energy each doula lovingly puts into emails, texts, and phone calls between visits, before, and after the birth, the actual labor and delivery (which could realistically last as long as a 40 hour work week in just 2 days) along with factoring in the cost of workshops and continuing education necessary to be the best in our field, I set our standard doula package at $950.00. It’s certainly not the highest doula fee in town, but you won’t have to do a lot of searching to find a cheaper doula either. Our doulas, however, do have to make a living as birth professionals because a hobbyist doula who has to works another job cannot be the professional doula that you want at your birth.

Also, it’s important for me to share with you that $50 of each birth that we do benefits the MamaBaby Clinic, providing prenatal care for women who cannot otherwise afford to see our midwife, so by hiring one of our doulas, you are helping other Mamas.

3. Do doulas bill insurance?

Typically, no. Like every other birth doula I know, we do not bill any insurance plans for doula care at this time. We are happy to provide you with all the paperwork that you need and the codes that you’ll need for the forms to submit your own claim to your insurance company and we definitely encourage you to do that. Every once in a while, an insurance company pays and reimburses you, especially if you can get your OB or midwife to write a letter that supports your claim that a doula is medically a necessary part of the birth team and potentially could save them a lot of money. Even if you are denied, the more claims that are submitted to insurance companies, the more it demonstrates an objective need for the insurance company to decide that doula care should be covered. Without customer demand (that’s you) they will never supply the benefit.

4. If you have a doula does that mean you can’t have an epidural?

Generally speaking, people who hire us to be a their doulas are trying to avoid an epidural and the cascade of interventions that often accompanies them. Our clients are typically educated about epidurals and we work in our prenatal visits to educate them even more about the risks vs. benefits of epidurals. epidural placed low back tattooLike most professional doulas, I set a code word with Mamas. Sometimes they just want to vocalize, “I want an epidural so bad…” but they don’t actually want to change their plan, they just need to feel safe to say that. If women are serious about it, we have ‘the talk’. I remind my client that it was her original plan to avoid an epidural and I check in to make sure that her choice isn’t coming from fear that she isn’t strong enough or powerful enough to manage the contractions. Sometimes Mamas are so tired, they just need to be reminded that this is a finite process and I will soon leave them tucked in to rest with their baby, and extra emotional support is all they need to make it through a rough patch.

Sometimes, Mamas really do need or want an epidural, and then I see my duty to see that she feels good about that decision. So no, having a doula does not mean that you can’t have an epidural. In fact, you may end up feeling more empowered about your choice to have an epidural because of your doula. You should never be made to feel like you disappointed your doula if you choose an epidural for yourself! It’s your birth. You don’t have to have your doula’s permission to do ::anything:: you choose to do at your birth. It’s our job to support you. Period.

5. Do doulas have any tricks to start labor?

I’m a firm believer that labor starts when the baby is ready for it to begin. This is one area where I really think that birth is safe and interference is risky. I don’t believe that it’s ethical for obstetricians to be talking about inductions at your 38 and 39 week appointments (I’m just going to go right out and say that, even if I take a hit in client referrals from obstetricians). I think it’s normal for some babies to come at 37 weeks and I think it’s just as normal for some babies to come at 43 weeks.  My only ‘trick’ for starting labor is lots of sex (really go for it, let that oxytocin flow) and swallowing semen. I know some people say you should apply the semen directly to the cervix, but I’m telling you that swallowing semen is the key because the prostaglandins are absorbed systemically through the stomach, which is better than the direct application to the cervix.

Do you have “Ask the Doula” questions you’d like to ask? As soon as I have 5 more, I’ll do another post and share them. Chances are, if you have the questions, so does someone else, so let it rip! You can’t shock me with your questions. I think I’ve heard them all by now :) My email is kate at PortlandMamaBabyCenter.com or you can use the contact form on the website. It also comes to my email.

 To schedule a doula consult, please contact Kate
503.206.7715
kate@portlandmamababycenter.com

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DIY Postpartum Herbal Healing Soaking Tea

May 122011
 

postpartum sitz bath herbal soaking tea at portland mamababy centerThis herbal bath “tea” mixture recipe was shared with me so long ago that I can’t remember who to credit. I am pretty sure that I got this recipe from my own midwife in Ohio back in 2005, but I’m sure it’s been around a lot longer than that and there are many midwives who have included this recipe in their home birth packets.

It should be prepared in a large non-aluminum pot, strained in a fine strainer, and put together in a large storage container. Make sure that the container is very clean and well-rinsed. You don’t want any residue. I would probably use two half gallon Mason jars if it were me.

The bath should be taken shortly after birth. (Alternatively, you can use muslin spice bags to contain the spices, but ultimately it does work better to let it all just flow in the water and use a very very fine strainer to get out the big stuff)

Use comfortably warm water, not hot, to fill the bath to waist level. Add the whole herbal bath “tea” mixture and enjoy a soothing, relaxing bath for a minimum of 30 minutes. This recipe makes one tub bath or several sitz baths. (Be sure to use the best quality organic herbs you can find, like the herbs at The Herb Shoppe in Portland, Oregon)

Ingredients for Postpartum Healing Soaking Tea:

  • 1 – large non-aluminum pot
  • 1 – blender
  • 1 – very fine strainer
  • 1 – large storage container
  • 1 – ounce dried UVA URSI (approx. ¾ cup)
  • 1 – ounce dried SHEPARD’S PURSE (approx. 1 cup)
  • 2 – ounces dried COMFREY (approx. 2 cups)
  • 1 – large bulb FRESH GARLIC, unpeeled
  • ¼ – cup SEA SALT
  • 4 – 6 quarts water plus 1 cup

Directions for Postpartum Healing Tea

  1. Put 4 – 6 quarts of water, Uva Ursi, Shepard’s Purse, and Comfrey in large non-aluminum pot.
  2. Simmer for 20 minutes.
  3. Remove from heat and allow the simmered herbs to cool & brew for 30 minutes.
  4. While the simmered herbs cool, break up the unpeeled garlic bulb into individual cloves of garlic.
  5. Place the garlic cloves and one cup of water into the blender, pulse to blend.
  6. Once the simmered herbs have cooled for 30 minutes, thoroughly strain the simmered herb blend.
  7. Next, thoroughly strain the blended garlic & add to the strained herb blend.
  8. Lastly, add the sea salt & mix together.
  9. Pour into the large storage container and refrigerate for up to 24 hours.

Alternatively, you could just stop by the center [map] and buy our prepackaged postpartum herbs made by Radiant Belly. We sell them in $5.00 packs and to make it easy to brew up several batches for different purposes – just brew with some sea salt.

You can also make some peri tea pads, but there is a method to this to make them well – otherwise you end up with tea soaked brick pads, and that’s not comfy on a sore vagina.Here is a file we give in our client education and information package at our second postpartum visit called Portland MamaBaby Postpartum Tea Uses and Instructions. We typically give our clients a few complimentary packages of postpartum herbal soaking tea along with these instructions as a standard part of our doula package. at the second prenatal visit to give our Mamas plenty of time to make the tea and make peri-pads.

Good Karma Note: The links for the non-aluminum pot, the jars, and the very fine strainer are affiliate links. That means if you buy them, the Portland MamaBaby Center will make a small amount of money from your purchase. Any funds that we receive from affiliate sales on Amazon.com fund the MamaBaby Clinic, so I hope you can make your purchase in good conscience, knowing that you are helping other women who could otherwise not afford midwifery care to access prenatal services and counseling.

To schedule a doula consult, please email me:
Kate at PortlandMamaBabyCenter.com
or call me at the center:
503-206-7715

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PDX: Why Portland, Oregon Is The Best City To Have A Baby

Apr 062011
 

Portland, Oregon, is the #1 city to have a baby*:

word cloud map of the state of oregon portland

I love Portland. It is truly the single best place in the United States to work as an advocate for Mamas and Babies. We’re not without fault, our cesarean rate is still high and consistent with the national average. We could be doing better, but I think the fact that so many women and men in Portland are actively working to improve our maternal health system and protect our right to birth where we want and with the provider we choose is ultimately our greatest strength. Portland women, especially, seem to agree that women have the right to birth in a way that even they themselves may not themselves choose. The right of other women to VBAC or birth at home with or without a midwife if they choose to seems to be something that most women who I come into contact with agree should be the individual woman’s right, not the government’s decision to impose upon them.

  • According to data from the CDC, infant and maternal mortality in Oregon is especially low.
  • Portland babies are 24% less likely than average to be born with low birth weight.
  • Babies here are 21% less likely than average to be born prematurely.
  • 88% of Portland mothers attempt breastfeeding. That’s the 3rd highest percentage of any city in our report. The average for cities in our survey is 75%.
  • By six months of age, 56% of Portland babies are still being breastfed. That’s the 6th highest percentage of any city in our report. The average for cities in our survey is 43%.
  • 19.% of Portland mothers breastfeed their babies exclusively (meaning no solids, formula or other liquids) for 6 months or longer as recommended by the American Academy of Pediatrics, making it the 2nd highest scoring city in this category. The average for cities in our survey is 12%.
  • Once Portland mothers begin breastfeeding, they are 14% more likely than average to continue through 6 months. That’s the 8th highest level of follow-through of any city in our report.
  • Oregon has particularly progressive laws guaranteeing a nursing mother the right to breastfeed in public.
  • 14.3% of births statewide are attended by midwives, compared to a national average of 7.3%.
  • Portland has one doula for every 146 live births, the 4th highest ratio in our survey. The national average is one doula per 649 live births.
  • Portland has 116 midwives for every 1,000 births, the highest in our survey. The national average is 37 midwives for every 1,000 births.
  • Portland has 61 lactation consultants for every 10,000 live births, the 2nd highest ratio in our survey. The average city in our survey has 23 lactation consultants per 10,000 live births.
  • Portland has plenty of high-risk pediatricians, 69% more than average per capita and the 9th highest in our survey.
  • Portland has more OB-GYNs than average, the 5th highest in our survey.

*According to a 2008 study conducted by FitPregnancy.com

As a birth worker, I appreciate my sister doulas, the birth support network, and the network of midwives that I have available to guide me. As a Mama, I appreciate knowing that even if my family is ‘weird’ that there are other families just as ‘weird’ as ours is and I can find a playmate for Little. As a women I am grateful for the activists who work to preserve my daughters’ birthing options. After our 7 year adventure around the United States, I can say that there is no better place to have a baby and raise a family than in Portland, Oregon.

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