Inducing Labor Naturally {what works and what doesn't}

Once women hit the 39th week of pregnancy, many are eager to meet their babies and may try all the various old wives tales to "induce" labor naturally. Before we begin, I feel like I need to make a disclaimer: if you are in any way putting anything into your body to try and start labor, it's considered an intervention, and isn't actually "natural". Walking, squats, and sexual activity are considered natural, because those are things you could do at any point in your pregnancy without causing labor. Waiting for spontaneous labor to start greatly reduces your risks of complications and medical interventions, however, there is no harm in trying some of these once you are full term {defined by the ACOG as 39 weeks pregnant}. But it is important to note- none of these things will work until your body and baby are ready. I realize that the end of pregnancy seems to take forever, I've been there myself. But as I and many others will tell you, it's over before you know it. But enough about all that- let's talk about these wives tales and what makes them work {or not}.

WALKING
If you are at the end of your pregnancy, there is no doubt in my mind that at least one person has said to you "are you walking?", "walk that baby out," or something to that effect. By the last week, you feel somewhat like a planet with legs, so walking probably doesn't seem too appealing. When walking is recommended, no one means you need to take up power walking. A relaxed 30-60 minute stroll around your neighborhood daily should be enough. Even walking around the mall or through Target {which is an absolute must if you live in South Florida like me and the outside will try to kill you with heat} for 45 minutes can help greatly.
How does it work?
Staying in an upright position helps your baby's head engage against your cervix. As you walk around, your baby's head will rub against your cervix, which can cause dilation, and will release oxytocin, which can bring on labor contractions. Working with gravity is the key with walking- you are helping baby move into the right position. Walking can be exhausting for a hugely pregnant person, so try not to overdo it. You don't want to wear yourself out prematurely.
Once you are in labor, walking during labor is encouraged to keep things moving in the right direction.

SEX
Oh, that's right. I'm going here. Small disclaimer here: there's no reason NOT to have sex during pregnancy unless your doctor has expressly put you on pelvic rest, or your water has broken. If neither of those things apply to you, go to town. There are several ways sex and intimacy can help get things going, and I'll start with the most obvious.
Orgasm
A female orgasm stimulates the abdominal and vaginal muscles, and releases a flood of oxytocin. This combination can bring on some pretty intense contractions, and the more intense the orgasm, the more intense the stimuli. Same goes for the amount of orgasms in a row, the more the better.
Sperm
There is a protein contained in male ejaculate, called prostaglandin. This helps the cervix to ripen, soften and dilate. There is not enough to cause an actual induction of labor, but if the cervix is already beginning to dilate and efface, the semen helps it along. During a medical induction, if the cervix is not yet favorable, a drug called Cervadil is often used to help speed the process. This drug is essentially synthetic prostaglandin {some say it's derived from pig semen, but I have yet to see a credible study done on that particular claim}, it is much more concentrated than a natural placement of male ejaculate, but it has the same purpose.
Oxytocin
During any sort of intimate activity, whether it's cuddling or full intercourse, oxytocin {the love hormone} will be released into your system. This hormone is known as the labor hormone, it's what fuels contractions and then assists in breastfeeding once baby has arrived. Any release of oxytocin is good for your body, and especially good for helping move labor along.
Cervical Irritation
Often, sex can 'irritate' the cervix, which can cause uterine contractions to begin. Typically, those contractions caused by irritation alone will peter off if left alone, but if you encourage them, they could possibly turn into the real deal. But of course, this will only work when your body is ready.

ACUPRESSURE & ACUPUNCTURE
These methods rely on pinpointing certain pressure points and nerve bundles in your body to cause another area of your body {in this case, your uterus} to respond.
Acupuncture should only be done with a trained professional in a sterile environment.
Acupressure is more relaxed, and can be done at home. Some of the main acupressure points for inducing labor are LI 4, SP 6, UB67, UB60 and Kl 1. More information about acupressure techniques for inducing labor can be found in this article.

CASTOR OIL
This is a widely-debated method of induction, and before I go any further, I need to say this.
DO NOT ATTEMPT TO USE CASTOR OIL TO BRING ON LABOR UNTIL YOU ARE WELL PAST YOUR DUE DATE AND YOUR DOCTOR HAS APPROVED IT.
Now that I've shouted that warning, we can proceed.
Castor oil is a bowel stimulant. It's pretty gross to choke down, but mixing it with something, like OJ or a chocolate milkshake, can help. It works by causing bowel contractions and diarrhea, which then irritates the uterus and may cause uterine contractions as well. It does work for some people, but there are side effects, such as severe diarrhea, nausea and possibly dehydration. Castor oil should only be attempted if your cervix is already at least 1.5 cm dilated and you are beyond your due date, as the contractions it may cause are intense and could put your body and baby in distress. If your cervix is not favorable, and your body experiences contractions before it's fully ready, this could cause your baby to be distressed and affect their health. It can also be extremely painful, as well as generally uncomfortable thanks to the diarrhea and nausea.
There are many success stories out there about castor oil, but there are just as many horror stories and "all I got was awful diarrhea and nausea, no real contractions" stories. Always check with your doctor before attempting to use castor oil to induce your labor, and make sure you are past your due date and your cervix is favorable {did I stress that enough? I think I did}.

RASPBERRY LEAF TEA
This is commonly thought to help induce labor, but that's a common misconception. Raspberry Leaf helps to strengthen and tone the uterus, which in turn can help labor be more smooth when the time comes. It is not meant to actually jump-start your labor. Another common mistake is thinking any raspberry tea will do this- it needs to be organic red raspberry LEAF tea. Not just any raspberry flavored tea.

EVENING PRIMROSE OIL
This is the same concept as the raspberry leaf tea. EPO is not meant to kick start your labor, merely help it along when it's time. Inserting a gel capsule of EPO vaginally in the evening can help your cervix to ripen, making it ready to dilate when the time comes. EPO can be taken orally as well, for the same reasons.

SPICY FOOD
This trick works much like castor oil- the spicy food is meant to irritate your bowels, which in turn could irritate your uterus. If spicy food is already part of your diet, or you don't usually experience tummy troubles after eating a spicy meal, this method likely won't do anything at all on that level. However, often, your body will release prostaglandins during the digestion of spicy foods, so at the very least, you can enjoy a nice meal out without worrying about dishes, and you get some prostaglandin cervical and uterine preparation.

NIPPLE STIMULATION
Nipple stimulation is often one of the first suggested ways to get labor started, or to augment a slow labor. Stimulating your nipples releases a flood of oxytocin {oh hey, thought I forgot about good old oxytocin, did ya? Nope!} and causes your uterus to contract. If you plan to breastfeed, the same thing will happen post-delivery, and those contractions will help shrink the uterus down to size and tuck everything back where it once was before you grew a whole other person. Rolling your nipples between your fingers is a gentle way to get things moving, but for more pressure, use a breast pump. Don't pump for more than 20 minutes at a time, and rest for a bit between the 20 minutes intervals. You don't want to wear out your nipples before baby even arrives, and you want to ensure that you are pacing your contractions. Too much nipple stimulation could cause them to become too strong or close together too quickly.

PINEAPPLE
Some say eating fresh pineapple is a great way to jump start your labor. On a scientific level, this is correct.  A raw pineapple has enzymes that have the potential to cause uterine contractions. However, you'd have to eat roughly 5-8 raw pineapples in one sitting to get enough to actually start your labor. I don't know about you, but that's a lot of pineapple for one sitting!

CIMICIFUGA AND CAULOPHYLLUM
Also known as Black and Blue Cohosh, these herbs have been used to help induce labor by midwives and herbalists throughout the ages. Always consult a professional before using either of these herbs in any dosage during pregnancy. They work best when taken together, black cohosh stimulates the contractions while blue relaxes the uterus and helps establish a pattern. Taken alone, blue cohosh can help stop Braxton Hicks and prodromal labor. There are several recipes online involving these herbs, but I will stress again, do not use these in any dosage without the supervision of your care provider and a professional herbalist.


I said it in the first paragraph, and I'll say it again here at the end for the spirit of continuity. These wives tales to induce labor work for some people, and some tricks work better than others. But they will not work for anyone unless your body is 100% ready. You can do everything on this list 10 times over, but if your body is not ready, you won't get the results you want. The most surefire method to start labor is being patient. No one has ever been pregnant forever, you will go into labor and birth your baby. Wait it out, especially if you are a first time mom. Most first time labors don't start until well past the due date, and remember- your due date is not an expiration date. It's merely an estimate. Your baby will come when they are ready, and waiting for spontaneous labor is beneficial to both you and your baby.

Be smart, and be safe. Happy birthing.

Maternity Session: Baby Zeke

This week I had the beautiful honor of shooting a sunrise maternity session with clients of mine who are very dear to my heart. The weather was perfect, and this couple simply glowed with love.
I absolutely had to share some of the magic here. Enjoy.

Inducing Labor- the pros and cons

As the due date approaches, something strange happens. The pregnancy that seemed to fly by so quickly suddenly drags. Days seem to stretch on forever, and it seems as though baby will never arrive. Taking into account that most first time mothers will gestate well past the estimated due date, this time of limbo can be particularly frustrating. An option that is often presented to mothers who have reached term (redefined by the ACOG to be 39 weeks as of 2013) is a medical induction. There are many methods of induction, which I will tackle in a later discussion. Today we are talking about induction as a whole, and the pros and cons.

An induction can seem like a beacon of warm light to an impatient mother, beckoning her to the end of her pregnancy and birth of her child. It seems like the perfect solution- you can set a date, there is no guesswork involved {a la "was that just pee or my water breaking?", "are these contractions real?" "is it time to go in!?"}, and you can schedule your time around your induction. You can make sure family and friends are there and available, and you can pick the day you want, avoiding those pesky holidays or other family birthdays. If you have older children, you can pre-arrange childcare and make sure everyone is ready for the arrival of the new baby. You can make sure you are well rested the night before your induction {HA! who can actually sleep when you know you are meeting your baby soon!?} and have all the essentials ready to go. All of this seems wonderful, right? It's the perfect answer to your impatient, super-pregnant prayers!

But wait. There's more.

Induction is the artificial stimulation of labor, and with anything artificial, there are side effects. The most common method of induction is Pitocin, which is a synthetic form of Oxytocin which your body naturally produces during spontaneous labor. This drug causes your uterus to contract and essentially forces baby out. Labor by induction is more painful than spontaneous labor because your body has not had appropriate time to establish a contraction rhythm. The Pitocin quickly gets things moving and puts your body into high gear, often before it is prepared. This can have many effects on the body, and on your baby. Common side effects of an induction are fetal distress, 'failure to progress' resulting in cesarean, umbilical prolapse, premature birth, hemorrhage, and of course, the cascade of interventions. I will also be talking about the cascade of interventions as it applies to all types of labor at another time, but induction is a major leaping point for that cascade. The greatest risk of an induction is a cesarean birth- being medically induced doubles your likelihood of undergoing a surgical birth.

In some cases, an induction is medically advised. Situations such as preeclampsia, IUGR, previous post-term stillbirths, severe gestational diabetes, a gestational period of longer than 42.5 weeks, or a pre-existing medical condition of the mother or fetus are all reasons an OB may request an induction of labor. In those cases, induction can be the best choice for both mother and baby. It is always best to weight your personal pros and cons and discuss your medical needs with your doctor.

However, there is an instance where induction may be recommended but the grounds are not founded: the big baby. Often, women will be induced prior to the due date because "the ultrasound showed that the baby was huge". First, ultrasound measurements are notoriously inaccurate in late pregnancy. The weight estimates can be off by as much as 2 lbs. Many women are induced, expecting a huge 8 1/2 lb baby {that's actually a pretty average size} and then when baby arrives they are shocked to find he is in the 6-7 1/2 lb range. Second, the pelvis is not one single solid bone; it is designed to shift and open up, allowing baby passage. I've seen a tiny 5'3" woman birth a 10 lb 4 oz baby like it was nothing. The 'big baby' needing medical intervention for birth is a myth. Nine times out of ten, your body will not gestate a baby too large to pass through your birth canal naturally and without intervention.

Elective inductions are discouraged by the ACOG, due to the high volume of risks for both mother and baby. If it's not medically necessary, it is best to wait for spontaneous labor. Sabine Droste, MD, professor of Obstetrics and Gynecology at the University of Wisconsin-Madison says, "Induction is a medical procedure that carries risks, so it should be reserved for medical reasons only."

Along with the aforementioned risks, induction also usually goes hand-in-hand with an epidural. Because an induction is not natural, spontaneous labor, the body doesn't handle it as well and pain medication is usually required. The epidural brings with it a whole host of additional risks and side effects, most common being the labor stalls and often will be transferred to a cesarean. Other side effects include needing a vacuum or forceps assisted birth, difficulty breastfeeding, continued pain at the injection site, spinal headaches, loss of consciousness, and, most rare, paralysis.

Another thing to be aware of is that induced labors are notoriously longer than spontaneous labor. Inductions, on average, take 2-3 days, especially for first time mothers who are not yet 40 weeks. A few women get lucky and wind up with 8-12 hour inductions, but the truth is, the vast majority aren't that lucky.

While there are many, many cases of successful inductions, it is wise to be aware that approximately 50% of inductions do end in cesarean birth.  There are certainly pros to an induction, in that you have the luxury of choosing your labor day{s} and can plan around it. There are enormous risks though, and it is best if you are fully aware of all that an induction entails before choosing one. It is up to you, your partner, and your doctor to weigh your pros and cons and decide if a medical induction is the right choice for you.

Doulas and C-sections: can they go together?

A question I get asked a lot is “I’m planning a c-section, how can a doula help me? Why should I hire one?”  There is a common misconception that Doulas are only for women who are planning drug and intervention free births. I’m here to break that stereotype, and to tell you that Doulas are for EVERY birth. A Doula is meant to provide unbiased support and education, and to help her client achieve their dream birth. This includes C-sections. The rate of C-section birth in the U.S. is high, around 33%, which is 2x higher than the WHO recommends. This means that on average, 1 in 3 babies in the United States are born via C-section. Most of these are for emergent or medical reasons, while some are elective (in cases of RCS, birth of multiples, etc). Regardless of the reason for the C-section, it is a valid birth choice, and the birthing mother should be able to feel confident and in control.

A Doula is a wonderful resource to use, even if you are planning a cesarean birth. Many people don’t realize the benefits a Doula brings to a C-section, whether planned or emergent. Yes, one of the main “bragging points” of a Doula is that we reduce the risk of needing a C-section by about 30%. However, that fact doesn’t mean we become useless if a C-section is wanted or needed.

 

I've made a handy chart here that highlights key benefits

Before the Birth

Prior to your surgery, your Doula will provide you with any information you desire. She will go over the pros and cons of elective Cesarean surgery, various anesthesia options, the possibility of a “family” or “gentle” C-section, the various stages of the surgery itself, and the recovery. Having an extra pair of eyes, ears, and hands never hurts when it comes to planning the birth of your baby. She will make sure you are feeling confident and empowered in your choice to birth via Cesarean. She will talk with you in depth about any fears you may have, and can help you create a birth plan to cover your desires for your birth. Even if you are planning a vaginal birth, it’s worth discussing the possibility of C-section with your Doula, and creating a plan in the event of an emergency. Some Doulas may even be able to offer you access to a class that covers childbirth by C-section. 

Upon arriving at the hospital, your Doula will be with you during admissions and pre-op prep, and can help keep you calm. She can read to you, massage your feet, and keep the atmosphere of the room light. She can help you stay relaxed during IV insertion, and will remain by your side for as long as possible.

During the Birth

Some hospitals have a policy that only one support person is allowed in the OR in the event of a Cesarean. Speak with your doctor prior to delivery day about your desire to have your Doula present if possible. As an active and supportive member of your birth team, it is your Doula's desire to be with you if it is feasible.

If your Doula is able to be present in the OR, she will explain any procedures as they happen. The doctors and nurses are focused on their jobs- getting baby out and putting you back together. Your doula can explain what’s happening. She will hold your hand and be an extra voice of comfort and reassurance.  She can snap a few photos, especially of your brand new baby’s first few minutes of life. Those moments happen so quickly, and often memories of the surgery become blurred. A Doula will make sure you have details to remember this special day by. Typically, baby will be born in the first few minutes of the C-section. The rest of the hour-long procedure is the repair, during which time the baby is usually taken out of the room. During this time, your Doula will stay by your side while your partner accompanies baby to the recovery room to wait for you.

After the Birth

During the post-op time, things can be a bit fuzzy. As the anesthesia from surgery wears off, there is often discomfort, and sometimes some side effects. Your Doula can help you manage this discomfort, and can help get you up and moving. Walking is a critical component to recovery after a C-section, and your Doula will help you move. She can also help you to and from the restroom, and can help get you into more comfortable clothes once you are moved out of the recovery room. She will be an extra pair of hands for you during this awkward phase of recovery. Your Doula can help with initial breastfeeding attempts if you desire, and can update your family and friends. She will often return to spend time with you in the hospital during your stay there, and to help in your recovery. If you have hired her as a Postpartum Doula as well, you can expect full support once you return home. C-section recovery is lengthy and painful, and a Doula can help you manage and accomplish everyday tasks.  

A Doula can be useful in these ways in both planned and emergency C-sections. It’s best to talk with your care provider about your wishes for your birth, and for your desire for your Doula to be an active, present member of your birth team. Your Doula is there to help you feel validated and empowered, and to feel calm during the birth of your baby. Cesarean birth IS birth, and a Doula can help. 

Mother vs Doula: Childcare

Welcome to the second installment of Mother vs Doula! Last week I talked about how I make breastfeeding work for us, despite the crazy long hours and being on-call 24/7. If you missed it, you can read about it here: Mother vs Doula: Breastfeeding. Today's topic is, in my opinion, my biggest "hurdle" when it comes to working as a full time Doula with young children- Childcare.

Due to the unpredictable nature of labor, I need to have childcare options available at the drop of a hat. In my contract, I have it listed (several times!) that a client is responsible to call me the minute she believes labor is starting. This gives me at least 2-3 hours to alert my support team that I may be leaving to attend a birth within a few hours if it does turn out to be baby time. I am always able to tell my clients to relax, take a shower, drink some water, lay down, and time the contractions for at least an hour and a half and call me with the results. During this time, I'm figuring out my childcare options for that day/night.

I'm lucky, in the sense that I'm married to a guy who is home by 7-8 pm on the average night. He's home all night, and typically doesn't leave the house until 9-10 am for work. So if my client goes into labor at 10 pm, I can call my childcare options and tell them I'm headed to a birth and will probably need them for a few hours the next morning. If it's my husband's day off the next day, I don't even have to worry, I can just kiss everyone goodbye and head out the door. Otherwise, I tell my sitters that he or I will call them around 7:30 am to confirm that we need them, and what time to be at my house. If a client goes into labor around 2 in the afternoon, I start calling my childcare as soon as she tells me she thinks it's time. I find out who is available and who isn't. By the time my client calls me back 2 hours later with a progress report, I've got a game plan in place.

As I stated before, my clients are responsible for calling me the minute they suspect they are in labor, no matter what time it is. This is to give me time to set up. They are to call me back 2 hours later with an update on the contractions. The follow up from my client will be one of three things:

1. "My contractions are coming every 8 minutes apart, and have been for the last hour and a half!"
2. "I'm still having contractions, but they are still very mild and only every 10-15 minutes, not super consistent yet."
3. "Everything stopped, false alarm. Sorry!"

Occasionally, before the two hours are up, I'll get this fourth option:
4. "I know you said to time the contractions for two hours but my water just broke and the contractions are getting intense!"

Depending on the nature of the update, I will have different plans.

1. "Alright, I'll let my sitter know. Hang tight, I'll be there in about an hour. You're having a baby today!"
2. Ok, sounds like it could be early labor, but you also could just be dehydrated. Go drink 16 oz of water and try to take a nap. Call me if anything changes." I then let my sitter know that I'll update her when there's a change, but she is not needed immediately.
3."No problem! Call me if anything changes, get some rest." I will then call my sitter and tell her it was a false alarm, but I'll call her back if anything changes.

And of course,

4. "Alright, my sitter will be here soon, I'll be to you as quick as I can. You are having a baby today!" Then I call my sitter and tell her to get here ASAP.

As far as finding sitters available on short notice, knowing other Doulas in the community is a bonus in that aspect. Often they will watch your kids if you agree to watch theirs when the time is needed, or they will know a good reliable last-minute sitter. It also pays off to have family in the area who is always bugging you about spending time with your kids (hey mom!) and has a flexible schedule. Those options, plus a family friend or two who doesn't have kids of their own make a nice selection for last-minute childcare options. Just like I don't put my life on hold just because I'm a Doula, I don't expect my childcare options to just be chilling at home waiting for me to call. That's one of the reasons I have my contract written the way it is, with a clause that says to allow up to 90 minutes from the time we determine it's really go time for me to get to you. That's also why it is absolutely vital that a client let me know the minute they suspect labor. It gives me time to prepare without feeling rushed or panicked. I always tell my clients not to worry about waking me, or about "bothering" me by having a lot of false alarms. I would rather be very in the loop about what's going on than to get a call that says "my water broke 2 hours ago and the contractions are really picking up, I need you now!" That is so inconvenient for me, and with my responsibility as a mother to make sure my children are cared for in my absence, I may miss the birth of your baby. Yes, I have a responsibility to my client to be there. But my client has a responsibility to me, to keep me informed.

I find that by being completely transparent with my clients about WHY I want them to keep me in the loop, and call me with any changes, it makes all of our lives so much easier. They know I'm able to get to them when they truly need me, and I don't feel stressed or rushed. At this point, my kids are used to me going to births and being gone for 12-24 hours, so it's not a big deal in that aspect.

Childcare was my biggest fear when I first started working as a Doula, because it is such an unpredictable job. But once you get a solid network of options in place and have a system that your clients follow, it takes all the stress out of it, and you can pour your focus into your love for the job.

Mother vs Doula: Breastfeeding

It's no secret that a lot of Doulas have children of their own. How does one balance family life and a Doula business at the same time? Being a Doula isn't like having a normal 9-5 job; I'm on call 24/7 pretty much year round, depending on how many clients per month I have. I can be sound asleep one minute, and off to attend a woman in labor the next. I do have scheduled "office hours", during which I schedule prenatals, postnatals, consultations, file paperwork, and offer my Postpartum Services. But labor is unpredictable.

So knowing that, how does one balance having small children at home while being on call? In this mini-series, Mother vs Doula, I intend to cover the various aspects of Motherhood, and how I work around them as a full time Doula.

So, item one on the docket: Breastfeeding.

My youngest was exclusively breastfed until nearly 7 months old, when we started Baby Led Weaning. She is now 9 months old and her diet is 80% breast milk, 20% solid foods. I nurse her exclusively when I am home, and pump once per day, usually at night once she has gone to sleep. The milk I pump goes straight into the freezer (frozen flat, in 3 oz increments) for when I am gone. I currently have about 120 oz in our freezer, give or take a few. I am fully at ease knowing that even if I'm at an incredibly long labor (like the 45+ hour labor I attended back in June), my daughter still has more than enough milk in the freezer to cover the time I'm away. All of my childcare providers (aka my husband, my mother, and my backup Doula) are informed on paced feeding and know how to prepare the frozen breast milk.

When I am away from her at a birth, I do need to remove myself every 4-5 hours or so to pump. I bring a little cooler filled with ice and either leave it in my car or bring it to the nurses station. I am usually able to use the nurses lounge or an on-call room if I'm at a hospital, and I take 15-20 minutes and quickly pump. If a birth is intense and I am unable to pull away, so be it. It can certainly be uncomfortable at times, but that's a sacrifice I'm willing to make. I will not leave the room once transition (8cm+) is in full swing, so sometimes I have to wait 6+ hours between pumping sessions. I always wear a cloth diaper insert inside of my bra for these occasions, just in case. It doesn't look very professional to start leaking all over your clients as they are welcoming their brand new baby into the world!

Once I arrive home, depending on what time it is, I'll either pump and then fall asleep, or I'll immediately latch my daughter to the breast and relax. When I first began taking clients after my daughter's birth, I was worried about the breastfeeding aspect. Would I be able to juggle it and not have to resort to formula? My fears were valid, but I find that most mothers are totally understanding about needing to briefly step away to pump, and as long as you have some stored in your freezer at home, you are golden.

Most breastfed babies will drink 1-1.5 oz per hour, so that's a good base calculation to start with. If you anticipate a long labor and delivery for each client, say 30 hours, it's a good idea to consistently have at least 45-60 oz in your freezer stash. Some births will be quick, 8-12 hours, and you will be home before you know it. Others will be seemingly endless and may deplete your freezer stash down to the bones. If that happens, don't panic. Pump a little after each nursing session to slowly build your stash again. The odds of having two intense 30+ labors back to back isn't too likely, unless you take 5+ clients per month. If you are averaging 3-4 clients per month or less, you should have a bit of time between births to refresh your freezer stash. If you are able to pump during the labors, then you will be returning home with some liquid gold to replenish your stash anyway, so the rebuilding won't be from the ground.

Breastfeeding while being an on-call Doula can be challenging and at times uncomfortable, but it is by no means impossible. As with any job, it requires some time and dedication to pull it off, but if you have a game plan set in advance, it's not nearly such a daunting task.

On that note, goodbye until next time, and Happy World Breastfeeding Week!

It's Not About Me

When clients discover I have two children of my own, the topic immediately turns to my own labor and delivery experiences. I would love to be able to answer that the births of my children were beautiful experiences that were the best times of my life. But that would be a lie. So what do I say instead?  How can I share about my experience appropriately without absolutely terrifying my clients in the process? Simple answer- I really can't.

So instead, I usually reply with something along the lines of "Your birth is not about me or my experiences, every woman and every labor is different". Which is the truth. Occasionally, I am able to use my personal experiences as a teaching moment when we are designing the client's birth preferences, which is usually when the question about my own experience is posed. My own experiences are a great reminder that things rarely go exactly according to plan. I don't like to give details to my clients, but I usually am able to say "I had two births, neither went according to my plans, one varied slightly and one was totally different. However, my kids and I are all ok, and having a deviation from the plan isn't the end of the world. Birth is fluid and we must adapt."

I'll share my experiences here, but as a disclaimer, do NOT let this discourage you from preparing for your desired birth. I'm still holding out hope that when it's time for the next baby, I'll get the beautiful birth I've been dreaming of for years.


 I had my birth preferences (birth plan) ready to go each time. I had in my mind a beautiful picture of
how the labor and delivery would go. With my son, I wanted a quick, natural hospital delivery. What I got was weeks of prodromal labor, and horrible SPD. When active labor finally arrived, I was exhausted but hoped it would be over soon. 84 hours later, he arrived. During my time in the hospital, I was bullied, given pitocin to "speed things up" when I stalled at 5 cm for over 20 hours, threatened with a c-section, and given an episiotomy against my will. They whisked him away to the nursery and gave him formula without my consent, and that was the beginning of the destruction of our breastfeeding relationship. The whole experience felt rushed and like I was out of control.

With my daughter, I didn't want a repeat of my last experience, so I chose to have a home birth. I planned and prepared, and had the picture perfect pregnancy. My due date came and went, no worries from me. Then, I woke up in the middle of the night to my water breaking. I was so excited, it was finally time! I grabbed my phone to call my midwife, and I flipped on the bedroom light. All my joy turned to terror as I realized I was standing in a puddle of blood, with more rushing down my legs. I knew what bloody show looked like, and I knew what a placental abruption looked like. This was the latter. I sent a photo of the blood to my midwife and she immediately responded with what I already knew in my heart: go to the hospital ASAP, don't wait. So we grabbed a few things and flew out the door. Labor started in the car, hard and fast, and with every contraction more blood came running out. We got to the hospital about an hour after my water broke, and they took me upstairs. They took one look at me, and tried to get my daughter's heart on the monitor. It was there, but it was all over the place. My contractions were coming every 2 minutes, and I was already 8 1/2 cm, but I had lost too much blood and they couldn't wait. They rushed me back for a c-section and a blood transfusion. It all happened so fast, I felt completely out of control and for a minute there I actually thought I was going to die. It was without a doubt the worst experience of my life. Thankfully, both my daughter and I survived with minimal physical scarring, though emotionally it certainly took its toll on me.

So why am I sharing this here? What purpose does it serve? The point is, it's not about me. Yes, I have had birth experiences that were far from ideal. But that doesn't mean that happens to everyone. Especially what happened with my daughter, I'm in the minority. So when you ask about my birth experiences and I simply say "neither really went according to my plans, but we are all ok, but this isn't about me", now you know why. I don't want to scare you, or dissuade you from following your dreams for your birth. I don't want you to take my experience as the end all, be all. I don't want you to compare our experiences. I don't ever want you to doubt your ability, to doubt your body.

Your birth is about you and your baby. It's not about me.