Sometimes a cesarean is necessary and a family knows this before labor begins. This gives them a chance to prepare in ways they may not have thought of during a regular labor-turned-cesarean birth.
There is such emphasis on what to bring to the hospital -- you can find a hundred lists on Pinterest and other places. While we try to anticipate what a laboring person will need, inevitably, something may be forgotten. Here's a handy list of things you may already have access to simply because you are in the hospital.
Every doula learns her own tricks according to the laboring person's needs, the hospital's set up, and the nurses' suggestions. It's always a good idea to ask before you go searching in drawers and cupboards. But I have found, if you have a need or an idea, the staff is supportive of out-of-the-box ways to comfort someone in labor. What has worked for you?
I fell in love with this birth story! I have a penchant for birth stories written by doulas, and this one does not disappoint! As a woman in labor, I can also relate to how incredible and soothing water can be -- one midwife I used to work with called sitting in a big tub of water an "aquadural," and I know many find this to be true. I hope you enjoy this uplifting tale of birth!
I find childbirth to be an absolutely beautiful event. It is certainly not at all glamorous by any means, but it is such an amazing experience to view not only as a bystander, but also as a participant. I have had 4 children, all girls, with 4 completely different experiences. All 4 birth experiences, in addition to my losses, have shaped me into the woman I am today.
My youngest daughter is now almost 4 months old, and she was conceived the same month I had a miscarriage. The pregnancy went very well, but I was very afraid that my labor and delivery would mirror the delivery of my third daughter, Spirit, which was extremely traumatic. This led to a lot of anxiety and fear, despite my knowledge on the subject. It was for this reason that I hired a birth doula.
My due date was Saturday 11/21 and absolutely NOTHING was happening, only slight Braxton-Hicks here and there. My older kids were at my parents’ spending the weekend, so I figured it was the perfect time to put together my bed frame and make sure the room was arranged for baby’s arrival. So I took everything out of our room, and with a little help, put the bed frame together. My boyfriend Jermaine wasn’t too happy about it, but it needed to be done so I had access to our bedroom closet and I could start setting shit up. That probably should have been my sign that something was up since I was so determined to get it done RIGHT THEN, lol. Mind you, I had already partly cleaned my kitchen (still had dishes to do, but had cleaned the floor by hand and had already done enough dishes to fill the dishwasher and dish drain by the sink), and had cleaned my bathroom the day before.
Once I was done, I wanted to start putting everything back in our room, but Jermaine was hungry so we ordered food and I went to go get it. By that time it was about 8-8:30p, and still nothing was happening. I was exhausted and my back was starting to hurt a little, which I chalked up to it being from bending over to clean and work on the bed frame. We started getting ready for bed and I left the place a complete mess thinking “Oh, I’ll just get up early and move everything back, etc etc”.
So around 12:45-1a, the back pain was still just annoying and then suddenly got really intense. I posted on Facebook in a pregnancy group I was in asking if anybody had experienced back labor and what it felt like, and called my OB as I had began feeling some pressure as well. He told me to wait it out a little since I wasn’t having any contractions at all, but said he would call the hospital just in case I decided to go in so they knew to keep me. Right after I got off the phone with him, I used the bathroom and then went to bed. I woke up at about 3:45, 4a because I had to pee again (had been drinking tons of water to see if it would help the pain, which it had) and began feeling the intense back pain and pressure again. Still no contractions at that point, but I just couldn’t move much anymore so we decided to head to the hospital.
Because of the pain, it took me awhile to get dressed and then at about 4:30a, BAM! First contraction hit! And the back pain and pressure literally stopped and I was cool. Started timing the contractions and they were 3-5 min apart straight off the bat and lasting from 30-45 seconds each. So, through all the mess I had made, we grabbed my bag, got as dressed as I could, and we were out the door. In the hurry, I tried calling my doula, Sam, and couldn’t get in touch with her since my phone was acting screwy so to keep my anxiety down I just texted her what was going on and updates as they happened.
When we got to the hospital, we were immediately taken to triage after they verified my documentation and weighed me. In triage, they hooked me up to the monitors and checked me. I was a stretchy 4-5 cm dilated, had bulging membranes, and was almost completely effaced, this was at about 5:15a. They moved me into my room, which had a relaxation tub, and immediately started filling it up for me. That tub was AWESOME!!!!!! Definitely consider laboring in a tub of warm water if you can, it feels ABSOLUTELY AMAZING!
So, my doula comes and having her there was so relaxing and completely made the difference between a good, stress-free experience and a stressful, anxiety filled experience. I labored in the tub for about 2 hours and only got out to use the bathroom. At about 7:50, the contractions that hadn’t been bothering me suddenly felt different and I was feeling much more pressure so I asked to be checked. I told them that if I was a 7 or less, I wanted the epidural but if I was more than 7, I would tough it out. As soon as I stood up, I got hit with the most intense contractions back to back that I had EVER felt. After about 5-10 min of contractions where I couldn’t move, I finally made it over to the bed. I couldn’t sit, it was unbearable so I was on all fours moaning through the contractions.
The nurse checked me and I was at a 7, so they hooked me up to fluids and called the anesthesiologist for my epidural. My Dr. and a midwife came in and right then I got the unbearable urge to push and couldn’t stop, so they helped me roll over, my water broke, and in 2 pushes (about 2-3 minutes), my little rainbow was Earthside and super alert! 6lbs, 19.25in long, no stitches or repairs needed, and the anesthesiologist walked in not even a minute after she was born to give the meds, lol.
Oh, and did I mention that this was my second VBAC!
Jennifer Silvera is a pediatric LPN, RN BSN student, and mother to 4 beautiful little divas. She loves all things to do with birth and has a passion for birth and helping others. Ever since she can remember, she has loved pregnancy, children, and learning. In 2005 Jennifer was motivated to learn all she could about birth when a close friend became pregnant -- and she delved even deeper during her first pregnancy in 2007. Since that time, she has had 4 completely different birth experiences ranging from your typical hospital birth to an unmedicated almost home birth. She is a Birth Arts International trained birth doula. "I believe every woman should feel supported, educated, and empowered in her decisions regarding her pregnancy and child's birth, none of it has to suck or be a horrible experience."
Jennifer is currently working toward her BSN, hoping to work in L&D. Once that is accomplished, she plans to continue school and become a CNM (Certified Nurse Midwife). She truly believes an informed woman is an empowered woman. You can find her through her website, as well as on Facebook.
All images copyright Wanderlust Birth & Photography 2015 -- go and visit her website, her images are amazing! Find her on Facebook as well.
Sometimes I feel like we don't hear enough about the benefits of being active and laboring/birthing in upright positions. Babies have to navigate the pelvis in a series of necessary movements. When Mom is sitting in bed, a baby must do this all on his own; if she is moving around -- sqautting, walking, climbing stairs, rocking on a birth ball, changing her positions from being active, to resting, her baby has more help to get into optimal positions. This is a true partnership between Mom and Baby -- she helps her baby in the race to meet the outside world. And as Bernie points out, this makes things better for birth.
You have just grown a tiny person,
You are Wonder Woman,
Stand up and be proud!
OK, so you may or may not feel like adopting the Wonder Woman stance for your entire labour and birth, but here are 7 great benefits to being upright during labour:
1. Do You Know the 3 Cs? Feeling Calm, Confident and in Control!
2. Shorter labours!
3. Less chance of Distress to your Baby!
4. More Comfortable Labour!
5. More Room for Baby!
6. Decrease Chance of Assisted Delivery by 23%!
7. Decrease Chance of Episiotomy by 21%!
Whole, Healthy and Intact - Avoiding Perineal Trauma, by Tracy Donegan
What is the Evidence for Pushing Positions?
2012 Cochrane review, Gupta et al., de Jonge and Lagro-Jansenn 2004; Green and Baston 2003; Green et al. 1990. Lawrence et al 2013
Bernie Burke is a GentleBirth Instructor and DONA trained Birth Doula, with a background in Holisitic therapies. Bernie found GentleBirth during her second pregnancy and fell in love with the program, it transformed how she felt about birth. She is passionate about all things birth and she has seen first-hand the positive change in her clients and their partners while using the program.
Bernie believes that when women and their partners feel empowered to make decisions about their birth, no matter what path it takes, they step into parenthood feeling confident and secure. Bernie is looking forward to assisting families as a Doula in 2016.
Supreme love and thanks to my friend Christine for allowing me to share her amazing pictures. She deserves to be a meme <3. Stacie
Wow. I cannot say enough good things about Kasaundra and her style of writing. You really must promise me you will read her website and blog -- she has a lovely way of placing words together to present emotionally-descriptive ideas and pictures. Here she offers an informative look at where doulas came from.
Just two years ago, I was like most of you.
"DOULA? What is that? Ummm....no thanks. I'm not into voodoo."
I'm not gonna lie, I am a little surprised that "doula" caught on instead of something more generic and white bread like "childbirth coach." In fact, the word "doula" comes from the Greek word for slave.
Errrr...hold up. This isn't making it any less weird. Let's try again.
The lovely title of "doula" was coined in 1976 by Dana Raphael. She used it to describe a woman with experience in helping mothers breastfeed in the postpartum period.
The actual role that a modern-day doula fills goes back centuries though. Talking about America specifically, our childbirth culture was strongly influenced by English culture.
That makes sense, right? 1776 may have cut the cord to the mother country, but there were a few things worth keeping.
Neato art piece, huh? I'm loving all the support that dear mama is getting. And the chair setup? Pure genius. Hospitals and birth centers are equipped to mimic that labor position with those amazing moving beds of theirs.
Social childbirth philosophy follows the "it takes a village" concept. A woman's childbirth support circle came from her friends, relatives, and midwives. These women took their role seriously and worked hard to make sure that mom felt strengthened and assured. The qualities of this model of childbirth include togetherness, care, and support. It sounds like a pretty darn near perfect system.
Well, almost perfect. Progress necessitated the advent of running water, sewage systems, hygiene, etc. These measures provided for a safer childbirth experience for both mother and baby.
However, progress ended up being a double sided sword in the birth community. By 1930, richer women felt drawn to the medical model. I can understand the draw. Doctors with years of training, nurses in clean white dresses, sterile facilities, and people who look like you are hard to compete with. Most people made the shift to hospitals and the traditional role of midwives fell from the pages of history.
"All the baby ladies
All the baby ladies
All the baby ladies
All the baby ladies
Now put your hands UP..."
Fast forward a few decades.
Medical advancements made hospital birth even more appealing. Electronic Fetal Monitoring meant that nurses didn't have to stay with any one patient and were able to care for many at a time.
The cons? Nurses didn't have to stay with any one patient. Also, when your entire labor requires electronic equipment to be strapped to your belly, moving around isn't exactly encouraged. So there went moving around in labor--which had been normal until then.
Since so many women give birth in hospitals now, the traditional birth support system from the social childbirth model is no longer the norm. And when women are reduced to numbers on a chart and beds in a hospital, dehumanization becomes a new concern.
Unfortunately, a 2001 study showed that first-time mothers expected their nurse to spend 53% of their time providing the social childbirth model for them. That includes "physical comfort, emotional support, information, and advocacy."
Because of modern medical technology and the quite wonderful way in which many patients can be cared for at once, nurses simply do not have the time or training to provide that level of support to each mother. The reality is, nurses spend only 6-10% of their time in active labor support.
So what can be done to bridge this gap in maternal care? Who in this dark wide world can possibly help?
That's me. I'm a doula.
We doulas came back onto the scene in the 80s, when women started to get concerned with the growing number of cesareans. They started hiring their childbirth educators, their friends, or even obstetrical nurses they were on good terms with to come into the delivery room with them. They were looking for an advocate.
Doulas have come a long way since then, and although unnecessary cesarean prevention is still near and dear to our hearts, we have evolved into so. much. more. This type of support is beneficial to women who desire to birth unmedicated. It's beneficial to women who desire to birth medicated. It's beneficial to women who desire to birth in a hospital. It's beneficial to women who will have a cesarean. It's beneficial to women who will birth at home. It's beneficial to women who give birth in a birth center. It's simply beneficial to women. Being a person gives you the right to matter. You matter. Your experience matters.
Doula: "One who nurtures and protects the woman's memory of her birth experience."
Kasaundra is a SoCal girl in a Utah world. She married her high school sweetheart and has three little ones. Like many, her experiences of birth set her on the doula-path. After a cesarean birth with her first pregnancy (twins) where she felt disconnected to her babies and her husband, she was compelled to make changes with her next birth. Kasaundra achieved a VBAC and was left awestruck by the experience -- and the rest is history! You can find Kasaundra on Facebook, her website, and her blog.
Doulas love doulas. Moms and dads love doulas. But what intrigued me about this piece is, Crystal is an aunt who now loves doulas. She shares her experience witnessing a doula-supported birth -- after just learning what a doula even does. I can think of no other powerful witness of the care doulas offer than this -- one that comes from a family member who not only saw the affects of a doula offered to Mom, but also to Dad and the extended family.
My brother and his wife were expecting their second daughter any day and I desperately wanted to be there for her arrival. Now, it should be known that we are a family of “moderate hippies." Grow-ing up in the Pacific Northwest, you are subject to crunchy granola-ism by proxy. Like it or not, you will be more “green” than people from, say, Detroit, just by default. So I was confused, but not surprised when my sister-in-law announced that she would be using a doula for her second child’s delivery. “A what?” I asked…”a doula.” was the reply. “What is that? Is that like a midwife?” “No, it’s like a birthing coach or a mother’s helper.” “Huh.” I was picturing a stern matronly woman that smelled of patchouli and wore Birkenstocks. Someone that espoused the virtues of going drug-free while standing on your head and breathing like an Iditarod racer through contractions…no thank you. With three children to my credit, I have always been happily pro-drug, pro-hospital, pro-doctor.
Despite the fact that I have given birth more than once, I still became quite excitable as we timed the contractions. My sister-in-law braved the pains from the comfort of her upstairs bedroom as we waited for her doula to arrive at the house. I was timing them at three minutes apart and was wondering why we weren’t just meeting this delivery person at the hospital. I harbored secret fears that my niece would be accidentally born at home and I don’t know if I could’ve kept from passing out if she had tried that business…
The doorbell rang and I was quite surprised to meet the woman that (I still thought) was coming to deliver this baby. She looked fresh from a yoga workout and she drove a Volvo. What happened to the flowing mu-mu and the hippie mobile, I wondered silently. Brief introductions ensued and Ashley the doula was ushered upstairs. Right away, I was impressed at how she commandeered the situation. She went directly to Carla, asked a whole series of questions in a very calming way, and the whole mood in the room changed. I fear that between my hushed anxiety, and grandmas verbal duress, you could have cut the tension running through that house with a knife. In came the doula and palpable anxiousness lifted from the room like a fog. In its place, there was a quiet calm punctuated by breathing and gentle coaxing. I think I could actually see the colors of her aura, that’s how calming her demeanor was.
It was also interesting to watch her “work the crowd." You could tell she had assessed the situation (slightly hysterical grandmother, worried sister-in-law, sick husband – did I mention at that very moment, my brother, the father-to-be, had been struck by a gastrointestinal bug?) Ashley diffused all that was ramping up. Focusing on mom, but speaking to all present, she assured everyone that the baby would not be there in the next hour and that we would calmly work our way to the hospital. I’m certain that my sigh of relief was audible when she made it clear that this baby would not be born in the upstairs bedroom of their family home.
I stopped perspiring when it became more-and-more clear that this gal knew what she was talking about. So far the baby had not fallen out en route, despite my misgivings about contractions that were three minutes apart and our not being hauled by screaming ambulance to the emergency department. Remain calm faithful reader.
Our doula (yes, at this point she has become “our doula”) was as steadfast in her calm and patient demeanor as I was borderline hysterical. I watched this magical gift of a woman do her thing. Yes, at the risk of sounding like a crazy, hippie-dippy, magical loving, fruit loop of a nut job, I will put it out there. I will say it: This magical gift of a woman, this doula, was wonderful.
In what was, for me, the comfort zone of beeping machines, copious hand sanitizer and droves of personnel equipped with advanced degrees and special badges, I watched the most basic of all things natural unfold: A woman, comforted, coached and calmed a laboring mother while the laboring mother brought her baby into the world. It was a revelation for this mother, how a delivery could go so smoothly…
Because we are led to believe that laboring women need monitoring, constant checking, IV’s, medications, interventions and whole carts of instruments to bring a human being into the world. When maybe the most effective, and dare I say, most important vehicle to assist in delivery is a calm companion -- someone who knows, with unshakable conviction that women were designed to have babies. That birth is not an instantaneous process. A person comfortable with the fact that labor and delivery take as long as they take, a person adept at soothing a laboring mother through the pain and anxiety of childbirth.
Having seen it for myself, watching a team work with a laboring mother in that hospital room, it dawned on me what a genius arrangement this was. Dad was watching the progress, eagerly engaged, free to ask questions and procure ice chips while mom was fully tended by a constant, unwavering support person.
During my own delivery, six years ago, the assigned labor nurse whom I had grown to love, had her shift end smack dab in the middle of my laboring! And she left! She went home because her work day was done. The second shift came on as I was transitioning into hard labor and I hated that second delivery nurse. She was loud and obnoxious, interjecting her belligerent opinions with every breath. And I was too wrapped up in birthing a baby to tell her where I really wished she’d go. What a different experience that could’ve been. If I’d had a doula, as a personal support person at my side, “Nurse Ratchet”, as she’s become infamously known in my birthing story, could have gone away. Or at least shut up. But I had not known there was this option. I only knew what the hospital staff told me…
And let me tell you another story where a doula could have quite possibly changed the course of history. A couple of years back, I was invited to photograph at a delivery. Not a National Geographic-type assignment, but a tasteful, photo-journalistic capture of the first moments of life. Mother laboring, father cord cutting, baby weighing in, all of those moments. At three centimeters, this laboring mom was beside herself with pain and she became petrified at the prospect of having to birth a baby. She screamed frantically until an anesthesiologist came in and gave her an epidural. She was dilated to four centimeters. As her contractions continued, the epidural was not enough and she became terrified. Her mother could not talk her down, the daddy had to leave the room – everyone was asked to leave the room. The epidural was turned up and medication was administered intravenously. The shrieking subsided as we all waited in the hall. She was dilated to seven centimeters. Her labor progressed. Before she was ready, she was at ten centimeters and there was no more medication to be given. This birthing woman screamed and cried and swore and shrieked and there was nothing more to be done (pharmaceutically) as she endured that transition into second stage.
The doctor arrived amidst chaos and hysteria while a crowd stood, wide-eyed, in the hallway. Suddenly and abruptly, all of the ruckus stopped. Dead silence. Minutes later, a nurse emerged with a silent, swaddled infant. I will never know what actually happened in that delivery room in the wee, wee hours of the morning, but I do know there was no audible first squeal from that baby, there was no “war cry” as that laboring mom delivered her infant with her own body. I can speculate that when her practitioner walked in, he evaluated the hysterical situation and whacked that mom up with something akin to the old twilight sedation that women in the 1950’s delivered with, and he pulled that baby out before things got any crazier. That is what I honestly believe happened, but I will never really know for sure. What if she had a doula?
The two experiences I’ve been witness to, (outside of my own personal deliveries) were so vastly contrasting that I’m not even sure they were the same situation. Granted, the outcome was akin – a baby was born – but one was a controlled, comforting example of what every expectant mother hopes for, and the other was an uncontrolled barbaric exper-iment in hysteria. Seriously. I would go that far. And I can tell you without a shadow of a doubt that they both could have been calm, satisfying moments. I will tell you that I am now the spokesperson for doulas. I will shout it from the rooftops. If you could have a personal, private labor coach that helped you to implement your birth plan, kept the hospital personnel on track (or at bay, if that’s what you needed), kept your pain levels down, utilizing natural methods – visualization, massage, quiet coaching, positioning, breathing instruction, even aromatherapy – and acted as a liaison between you and the delivery personnel, why would you do it any other way?
“Our doula” as I like to think of her (she was, after all, a huge part of a tremendous family event) met with my sister-in-law for weeks prior to her delivery; she got to know mom and dad. She knew their wishes, their preferences, and mom’s plan B if things were to change. Ashley the doula made sure a birth plan was on file and that the hospital stuck to mom’s wishes. She was invaluable in getting Carla through the tough transitions, sans epidural since she knew Carla’s previous back fracture would be an impediment to epidural placement (as it had after three attempts during the delivery of her first child). My sister-in-law knew what she wanted, and she knew from previous experience how hospital staff struggled to keep up with the wishes of patients from room-to-room. She knew how tough it would be to go without that epidural and I believe Ashley got her through it with confidence and an empowering sense of control regarding her own body. From the time she arrived on the scene, Ashley did not leave Carla’s side. She massaged, coached, offered sips of drinks and held the emesis basin. She kept the nursing staff informed when things changed regarding contractions and transitions. She was a relief for every person involved. I haven’t had a chance to talk to my SIL in-depth about her version of the doula experience since the arrival of their new bundle, but from what I witnessed, a doula is a real birth-saver
Crystal is not what you would call a "doula." In fact, she's not a doula at all. This makes her judgement of doulas all that more credible. She has a zany, crazy, outrageous family she resides with in North Carolina. A passionate blogger, she began writing as a creative outlet and a way to share tales and projects with her extended family who live thousands of miles to the west. Crystal is also a photograper. A Pacific Northwest native, she is currently trying to deny the small twang that may or may not be appearing in her speech. Ashley Greenwald is the one affectionately referred to as "our doula," and she serves the Reno, NV area.
With my third baby, I returned to the same practice of midwives I loved. When I went into labor, the midwife lived about a half an hour out of town. I called their answering service at about 7 at night. She was soon on the phone and she asked me, "Should I come to the hospital now?" I didn't want her to drive down if things weren't going yet; I told her to wait until I or a nurse updated her from the hospital. Carolyn decided to come down the hill anyway. Shortly after I was settled into my room, she walked in, and I felt an immediate release of tension I didn't know I was carrying.
After witnessing the incredible midwife-assisted birth of my nephew, I did, indeed, avoid an OB the next time around. We moved when I was 7 months pregnant, and I had this idea I would return the three-hours home to have my baby with the original midwifery group I started with. After a few trips, though, I decided I was finished with the traveling, and traveling in labor would be even worse. I found a midwifery practice in my new town of Chico, CA.
At my first appointment I was struck by how quiet the office was. I liked that I checked my own weight and dipped my own urine -- I was trusted to report my own findings and they were noted in my chart. I had my almost-two year old with me, and I was worried he would be a burden and get us the nod of disapproval from this office; instead, at my first appointment with Karen, she had a puppet on her hand with which she entertained Jacob while she and I had a great discussion about my fears and concerns. She took a full hour with me that first appointment, and the office immediately scheduled me weekly so I would have a chance to meet all three midwives.
When it came time for the birth, I knew it would be one of the three on-call for our hospital birth. I soon learned it was Karen, and it all just felt right. She was there with me during my labor and drawn-out pushing phase (as my baby was posterior-born, weighed 9 pounds, 9 ounces, and took 90 minutes to push out). She never rushed me, she helped me try different positions, and she filled the room with positivity when it seemed I was cursed to push forever.
There are two conversations we had during prenatals that have never left me.
♥ four young boys and a boy dog (offspring)