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.

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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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The October Doula Tea and a Topic (Doula Workgroup)

Sep 262012
 

 

Yikes, I turned around and September is over! I wonder how many of you Mamas are feeling the same way after getting your children back in school and returning to a “school days” state of mind and how many of you homeschool and year-round school and unschool? We are lucky that we have so many different ways to bring up our children.

It’s time for Doula Tea and a Topic.

Our next meeting will be Wednesday, October 3, 2012 at 3:30pm at the Portland MamaBaby Center, which is located at 5528 SE Woodstock Blvd (Portland, OR 97206). At the last doula tea we talked about how nice it would be to work together as a group to update our resource lists, and after giving the logistics of it a lot of thought, we decided to hold this as a Doula Tea and Work Party. We also decided to make it a snack potluck, so please bring a snack to share!

If you’d like to attend, please try to bring a laptop with you (if you have one). We have all the wifi you could want. We’ll bring our laptops and we’ll have the iMac available to use at the center, as well. If you have your resource lists printed out, you could share that – if you have them bookmarked, we can form a collaborative Pinterest board? We can all work together to fill in the gaps of our resource lists and share our bookmarks this way and ultimately we all serve our clients better as a result of our collaborative efforts.

Any questions? Just drop Kate an email.

(PS: If you didn’t hear, my email exploded metaphorically and I lost every email through last week, so if you’re reading this and wondering why I haven’t replied to you already, please resend your email because I no longer have it :( It’s a very sad story, but sometimes technology blow up in your face.)

 

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Join Us For Doula Tea and a Topic: Boundaries and Self Care for Doulas

Aug 132012
 

Our next doula tea is scheduled for Monday, August 27th, 2012 from 10am-11:30am. [calendar]

This month rather than just gathering to meet and support each other, we have a guest speaker and a topic.

Portland therapist and doula, Keely Helmick, will be joining us and the topic will be setting healthy doula-client boundaries to avoid vicarious traumatization along with some self-care strategies.

There is no fee to attend, but we would gratefully accept your $5-10 donation toward funding guest speakers and mini-workshops like this one (we can take your debit/credit card via Square, to make it extra convenient for you to be able to contribute if you don’t carry cash.)

Please plan on attending if you are a doula, doula in training, or a student doula in the Portland Metro area, and please plan to bring a friend. We would appreciate your help in spreading the word to reach all the doulas in our birth community!! Paraprofessionals are also invited to attend, though we will be speaking specifically to the topic as it relates to doulas, the information will be beneficial to others in related fields.

If you have any questions, please contact Kate@PortlandMamaBabyCenter.com.

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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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Weekend Intensive: Doula Workshop for Your Doula Business

Aug 082012
 

Doula

What: Doula Workshop for your Doula Business (Weekend Intensive)

Where: Portland Mama Baby Center located at 5528 SE Woodstock Blvd, Portland, OR 97206 [map]

When: Saturday, September 29 and Sunday, September 30th from 9am – 5pm (with an hour for lunch)

Your doula training is done and all the leads you got while working towards certification are gone or dwindling – now what? You have to very quickly get your practice up and running. Portland is a very competitive doula market. Learn how to set up your doula practice, get samples of forms that will save you hours of time, and pick up some tips and tools for being the most effective professional doula you can be and turn your calling into a career that you can sustain and grow in.

I’ve taken the Doula Business Workshops and condensed them and edited them down to fit into a weekend intensive.  The dates for the next session are September 29th-30th, 2012 (9am-5pm with an hour for lunch for a total of 14 contact hours) at the Portland Mama Baby Center.

Doula Workshops for Your Doula Business Topics will include:

  • How to set up your practice (a holistic view)
  • Defining your target client
  • Branding/logo
  • Basic marketing materials
  • Advertising vs. Marketing vs. Networking
  • Social Media and Birth Work
  • Creating a simple marketing plan that works
  • Contacting companies for samples
  • Client Forms
  • Charting/Record Keeping
  • Client educational materials
  • Preparing for the consult, prenatals, and postpartum visits
  • Being on call
  • Managing difficult clients
  • Boundaries and Self Care
  • Doula Tricks and Tips
  • Working with home birth midwives

Each participant will receive a binder with useful samples/resource lists/and examples, as well as typed notes covering each topic. . Lunch is not included, but Mezza is next door and offers a 10% discount to class participants. (YUM!) We will have snacks and drinks available to you.

There are 12 openings for this weekend intensive, so the time to register and reserve your spot is now. Doing this is very simple, just download the registration form, print it out, fill it in, include your $70.00 deposit, and return it via snail mail to the center or via email if you’re the techy kind. Once I have your deposit, I will forward some reading to you to get you started.

Cost: $140.00 [$70.00 deposit when registering is required, the remainder can be paid on or before September 29th, 2012]

To Register: Download this registration form, fill it out, and mail it to the above address with your deposit.  Checks should be made payable to Portland MamaBaby Center or you can opt to pay by debit/credit card. If you would like to pay via PayPal, please email me (Kate) and I will send you a PayPal invoice to make it easier.

For more information or to ask questions: kate@portlandmamababycenter.com or you can always just submit your questions through our contact form.

 

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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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Our First Monitrice-Doula Baby as the Portland MamaBaby Center

Apr 092012
 

Welcome Audrey!! 

My last client was also our first monitrice-doula baby since opening the Portland MamaBaby Center on March 1st, 2012. This sweet little girl decided to be born on her due date with that full head of thick black hair weighing 8 lb. 4 oz.

I am so lucky that I was there to witness Audrey’s birth. Her Mama labored so peacefully and calmly, really reaching inward and focusing internally on bringing her down and relaxing to make it easier for her to wriggle her way out. Her Papa physically held them up as Mama slow danced her way through many contractions. The nurse (Sarah) never once mentioned pain meds or epidurals and only provided positive, supportive affirmations, suggestions for position changes, and offering great advice. Her doctor sat on the floor and caught her as she was born into her own Mama’s loving arms and given a chance to transfer all of her blood from her placenta to her body before her cord was clamped and cut. She was allowed to snuggle right into her Mama’s chest where she remained until long after I left. And this doula was happy to keep her Mantra promise that, “Soon I’m going to be leaving you all cuddled up with your sweet baby girl to rest and sleep.”

After every birth, I try to reflect and learn and grow as a human and as a birth worker. The gift I was given from Audrey’s birth was a restored faith that women can and do labor and deliver their babies in hospitals without interventions and medications (just like I did almost 18 years ago!) It’s been a while since I’ve seen a natural hospital birth like this. Dr. Michelle Sang was the attending OB and she came in for the birth, despite being off call (that rarely happens, in my experience, with most obstetrics practices.) She was totally supportive of her client’s natural childbirth, reminding Mama not to fear the intensity and to trust in her body. She was so positive and I could tell that her presence and affirmations were really helping Mama to more effectively push through the intensity. I was also reminded by this birth just how important it is (lucky?) to have the right nurse, the right doula, and the right obstetrician (and ideally, the right partner) by your side if you are pursuing a natural childbirth

placenta pills portland mamababy center

I took this photo of Audrey on day 4 when I stopped in to do a little postpartum follow up visit and bring Mama her placenta pills. She looks like she was posed in that position for a perfect little newborn photo, but really she had just figured out how to get her tummy full and fallen asleep contentedly.

Is natural hospital childbirth something you’re planning? Laboring at home for as long as possible is undeniably the first rule of avoiding unnecessary interventions.

Monitrice-Doula care with a midwife is the best of both worlds. Labor at home with a midwife and have your baby at the hospital with your doctor. Give us a call (503) 206-7715 or email to arrange a consultation with our monitrice-doula team.

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The Birth of Felix As Told By The Doula (Kate Donahue)

Jul 052011
 

I’m going to begin to write about Felix’s birth today. Please know that his Mama and Papa gave me full consent to write about his birth and share his birth story from my perspective. Everyone remembers things a little differently in births. I’m sure that there are things I recall that she has forgotten and things she would highlight that I have omitted. This story is only a part of Felix’s birth story. Hopefully he will enjoy reading it someday. 

So Felix came into my care after his Mama began planning an unassisted birth at home when after learning that he was in a breech position and she started to change her plans. First she went to the Legacy Emmanuel midwives and obstetricians to attempt an external cephalic version. After attempts to turn Felix were unsuccessful (and quite painful, and according to his Mama, totally not worth it) his Mom came into my care. OHSU was willing to allow Mama to have a trial of labor, and so plans were made for a vaginal birth in the breech program on the hill.

The docs at OHSU wanted to induce my client, but she was adamant that her baby (and herself) not be exposed to unnatural interventions. She did, however, agree to a Foley bulb induction and labored in the hospital overnight to 4 cm (the diameter of the Foley bulb). She was discharged left the hospital AMA after she refused Pitocin to augment her labor and went home to labor peacefully.

Several days passed, along with her due date. I am sure she was increasingly concerned that OHSU would not allow her to labor if she went too far postdates, so the pressure began to build for Felix to arrive. She went in to have her membranes stripped on Thursday and again on Friday morning. On Friday (July 1) after her membranes were stripped by her OB, her water broke and she began to have contractions that increased in duration and intensity. I was called to the hospital Friday afternoon.

Amanda and Jason were at OHSU working through contractions when I arrived on Friday evening. I felt familiar with Amanda in labor, since we had been to the hospital before with the Foley bulb and worked through contractions together, but she had a much different vibe. She couldn’t seem to find that space within where you can manage the pain, instead every contraction was like a wave of fear and pain that washed over her. She tried position changes, back pressure, hip squeezes, and light touch, but nothing was taking off the edge enough for her to get on top of the contractions. She was tearful and sobbing, crying out in pain.

At 11:30 that night she decided that she wanted an epidural. I didn’t question her much. The fact is, she is a grown woman who has educated herself about the risks of epidurals – ask her about the ‘Cascade of Intervention’ that is associated with epidurals – she can tell you all about it herself. Knowing that she had probably been weighing the benefits and risks in her head for quite some time, I merely double checked that she was positive that it needed to happen and it couldn’t wait even one more contraction.

I think that the waiting period between requesting an epidural and actually receiving an epidural might be one of the worst times women experience in their lives. You know that pain relief is on the way, but yet… it’s so far away. Why aren’t they just here yet? What is taking them so long? Where is the damned anesthesiologist?! I think the only time I made a pest of myself as a doula at this birth was pestering them to get the anesthesiologist in the room faster than he was coming. Once a woman has made that decision, and it’s her ‘final answer’, then people should move expeditiously.

While she was waiting for her epidural, it stands out in my memory that Amanda felt intuitively that something was ‘wrong’ with her labor. She was prepared for a painful birth, she was in the Navy; this is not a woman who expected a baby to just pop out of her vagina without some work! But, after nearly 2 weeks of prodromal labor and a rocky start, she was in for a rough birth. I think that the epidural was an excellent choice for her.

 

The anesthesiologist placing her epidural took quite some time. It’s ::really:: difficult to hold still while you are having contractions that are so intense that they require an epidural. First they use Lidocaine to numb up the area, which hurts from the injections and burns from the liquid. Then, as you can see in this picture, they insert a needle very carefully and attempt to inject fluid from the syringe through the needle into the dural space. In Amanda’s case, the anesthesiologist had to ‘dig around’ to try to find the right space and it took quite some time. He had to actually completely withdraw the needle and repuncture her skin in a different space.

Once the needle is in the right space, a catheter is threaded in and medicine begins to be delivered. They tape down the catheter to your back so that it won’t be pulled out of the space and it remains there for the duration.

By 3:00am on Saturday (7/2), she was sitting upright in bed, resting and chatting comfortably. It took a bit to get the epidural just right. She was more heavily affected on the left side than on the right, but her pain seemed to be under control. The epidural meant, though, that she was now confined to bed with a catheter, a BP cuff, and continuous electronic fetal monitoring.

Amanda was able to rest with the epidural. She sat herself straight up in bed to try to keep the baby’s bottom against her cervix and rested upright for a few hours.

In the morning the doctor checked her cervix and she was 6 cm. I could tell that she was disappointed to hear that she was ‘only’ six centimeters. Doctors started talking about keeping her to Friedman’s Curve, and conceded by giving her 2 hours to make a change instead of 1 hour. The next time they checked her, she was 7 cm.

It felt really positive. The baby was tolerating the contractions well, without decelerations and with good variability. Amanda was clearly more comfortable, despite the hinderances of the cables and cords and the numb left leg that she couldn’t move. She was aware of the contractions, but not in pain. She could feel the pressure the doctors were beginning to put on her to take some Pitocin and asked for a breast pump to do some nipple stimulation. For 20 minutes every hour she pumped, relaxing and envisioning her baby, intentionally trying to increase the levels of oxytocin in her body. Her contractions did seem to intensify while pumping and immediately after, but after several hours of pumping cycles, her cervix was rechecked by the doctors had not changed, nor did it feel as though the baby was well-placed on her cervix.

At this point, the doctors began to really talk about a Cesarean. Their concern was that she was ‘stuck’ for several hours at 7 cm., despite the pumping and several position changes intended to keep her vertical and keep the baby on her cervix. The doctors suggested earlier that she try some Pitocin and cautioned that if she went on too much longer, Pitocin wouldn’t be an option (implying that a Cesarean would be her only option). She continued to labor and work her baby down, asking for a little more time.

The last time she was checked, she was still dilated 7 cm. The doctors came in and began discussing Cesarean. Her pulse started racing. The baby’s pulse began to race, reaching into the 170′s and everybody began to worry about signs of an early infection in the baby – a risk when vaginal exams are done, in this case no fewer than five times, after a woman’s waters have broken. She asked if she could just be alone and rest for a minute. She attributed the tachycardia to anxiety. Jason and I went down to the cafeteria to grab a bite to eat while she napped. We were called back into the room very quickly.

When we arrived back to the room, the nurses and doctors were getting consent from her for the Cesarean. I gave her time alone with Jason and waited outside their room while they spoke privately. The baby’s heart rate had skyrocketed and meconium was pouring out of the baby. It was clear that he needed to be born quickly. She was prioritized and prepped for a Cesarean immediately. She tearfully begged the anesthesiologist to allow me into the room with her. How could he deny her? He let me in with Jason with the caveat that I remain seated and behave professionally.

I sat with Jason while she was prepped, rubbing his back and reassuring him. He was terrified that he would lose his baby and his partner all in one, but determined to be a strong support for Amanda in the operating suite. He was amazing! He sat with his lips to her ear, whispering loving affirmations about their baby the entire time. I sat behind him, rubbing his back and listening, watching the surgery in the lights above. Very soon after we were seated, the incision was made. Within minutes the baby was born. His cord was immediately clamped and cut and he was transferred to the baby warmer where I watched from around the drape and listened for his first cry.

Felix's first pic in the NICU

The four minutes and some odd seconds that I watched and waited for him to cry felt like four hours and some odd minutes. I heard his first Apgar announced as zero. They had to help Felix get started. He needed some PPV and they did some pretty deep suctioning. Then I heard his cry… and made sure his Mama heard it, too. His Apgars improved. At 5 minutes they were 6 and at 10 minutes his Apgar score was a 9. He was pinking up and coming into himself.

 

Soon he was all swaddled and brought to his Mama, who was still being sutured. His Daddy held him next to her face so she could love on him and talk to him. His Papa is such a rock star that he even tried to put Felix next to his Mama’s nipple so that he could smell it and bond with her. I’m really, really proud of him for his support!

Daddy went to the NICU with the baby for a 4-hour observation period while I stayed with Mama in the recovery room. Soon, after she was stable and resting in recovery, I went down to the NICU to take some pictures, get some video, and get a report for her. This is Felix’s first picture:

Daddy holding Felix in the NICU

Felix still had some purple toes and fingers, but he was otherwise doing great! As you can see, he looks a little bewildered by the whole thing and has quite a story to tell himself!  I stayed with Felix and Jason for a few minutes in the NICU and then he came back with me to get the colostrum that Amanda had expressed for him while she was in the recovery room. Jason went back to the NICU to give Felix some kangaroo care and finger-feed him the droplets of colostrum that his Mama had so carefully collected for him. On the right is a picture of Jason holding his son in the NICU.

I said goodbye to Amanda in the recovery room and left with her baby’s placenta after a couple of hours. She was ready to sleep and Jason was with the baby down in the NICU. I left them with instructions to call 24/7 if they needed me back for any reason. On my way home, I dropped off her placenta to be encapsulated.

I was happy to sleep and wake up to hear that Mama and Baby were both doing excellent the next day. I went to visit that evening, admiring the baby and bringing Amanda some flowers and a little gift for Felix. Here is a picture of Felix, 24 hours old. You can tell that he was a frank breech – just look at his foot up next to his head! That’s how he likes to be swaddled.

Felix the breech baby with his feet up by his ears

Amanda and Jason both felt really positive about the birth, knowing that they had done everything they could to bring Felix into the world naturally and also knowing that they did the best thing for Felix by consenting to the Cesarean when they did. He was clearly in distress and this was not at all an unnecesarean. Felix is a champ nurser, and focusing on a positive breastfeeding relationship felt very healing to Amanda. I left with warm fuzzies, knowing that things were going so well for my Mamababy pair.

Welcome to the world, Felix Bahir Hashim Heath! Weighing in at 6 lb. 7 oz. after a very long labor and a surgical birth. You are the best thing that ever happened to your Mama and Papa. I saw their lives change while you worked your way out. You are loved <3.

[Update 3/27/12: I am still close with Amanda and Jason and baby Felix via Facebook and I have enjoyed watching him grow up into a very smart and very engaging baby! It's fun to see infants become babies and babies toddlers and soon they're in kindergarten and off to college... it happens fast! The days are so long sometimes, but the years are always short when you have children or you are a birth worker!]

 

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Interview Questions for Post Partum Doulas

Jun 012011
 

Let’s face it, being a new parent is really hard work!  We no longer live in a society where our sisters and mothers can drop everything to help us.  Nowadays, most people have to work and/or family does not live close enough to help.  Sometimes even with family and friends around, new parents just need a little professional help.  Postpartum doulas provide care for Mama and baby (or babies), newborn education and care (including overnight care), breastfeeding support and encouragement, and postpartum depression counseling.

Here are some interview questions I came up with for new parents interested in postpartum doula care:

  • Did you have any formal training? What qualifies you to work as a postpartum doula?
  • How many families have you served as a professional postpartum doula?
  • How do you see your role as a postpartum doula different from that of an infant nanny?
  • Do you support Moms who choose not to breastfeed (for any reason)?
  • What’s your experience with SNS, milk sharing, and alternative forms of breastfeeding babies?
  • Do you support families who have chosen circumcision for their sons?
  • What postpartum services do you provide?
  • Do you lead any parenting groups or new Mom groups?
  • What do you do to continue your education as a postpartum doula?
  • What is your fee structure? Do you offer extended packages? Prepaid rates?
  • What trainings have you attended specific to newborns or breastfeeding?
  • What is the next book in your reading list? What training will you take next?
  • What are some of your favorite parenting books and websites?
  • Do you have any special experience with NICU babies? Twins? Preemies?
  • When you say you give ‘breastfeeding support’ what does that mean exactly?
  • Do you do overnight care? What does that usually look like?
  • Do you do light housework?
  • Do you do placenta encapsulation?
  • Do you provide herbal therapies and home remedies?
  • How do you feel about attachment parenting?
  • Do you cook healthy meals for the family?
  • How do you help the entire family (do my husband and other children benefit?)
  • Can you show me a copy of your infant first aid and CPR card?
  • If I choose to do so, will you sign consent for a background check?

 If you’re looking for a postpartum doula, we can definitely help you out! Please give us a call at the center (503) 206-7715 or contact us through the website. If we don’t have a great postpartum doula available for you, we’ll refer you to our favorite sister doulas. 

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