Some of you may know that last December my friend and doula partner of 7 years, Kari Hollingsworth left Birth Rhythms. It has been such a big transition from being a team to having to hold the deep vision by myself. I have been moving forward in some exciting and big ways, but some days they serve to exaggerate that loneliness I feel. I miss her.
Kari and I were 'born' as doulas together. We attended our first births in the same year, 4 years before we ever met. We both volunteered as doulas and held similar jobs talking to teens in the high schools and then landed in the same doula training course in 2003.. Just as I have seen women bond and go on to practice together in the course I now teach, Kari and I saw eachother's spirit. Spirit sisters she calls it. We served women separately in birth, came in as a back up when needed, and dreamed together of ways we could make doula care and better prenatal education available to women in Saskatoon. We loved the women so much we held classes that we never made a dime on. Why? To make sure they had a chance to own their births. To share with them the joys of childbirth, and tell them about the secret paths, the untold obstacles and that every birth where the woman is in control, is a victory and a miracle.
We did it. We loved the women together for seven years and things started to change. We needed more women to hold the vision, and to serve as doulas, but as the vision expanded life shifts for both Kari and I meant the end of a partnership. Is it the end of that vision? No, surely not. Is it the end of Kari and I serving women in birth, no again. We are just called to do it differently now.
Kari continues to work as a doula privately in Saskatoon. We are dear friends.
Birth Rhythms has expanded its offerings to mothers and families to include comprehensive childbirth education, two fitness/labour prep classes and various pre and post natal support groups. Are we going to make a pile of money? No. Are we going to be a part of the revolution to give birth back to women. YES!
I also have a new focus on expanding access to doula services as we train new doulas more effectively and mentor them through an apprenticeship system so that they can establish their own work and reach more women with their unique gifts. There is nothing else like it in Canada. It is exciting to tell you that six women will be a part of this program this fall! I will be posting about them and introducing you to them over the next two weeks.
August 15th our new website will be live http://www.birthrhythms.ca/ and we are all looking forward to meeting you at our grand opening celebrations on September 19th. I will post more on that next month but mark your calendars!
Birth Rhythms Complete Pregnancy Support Services
Friday, July 30, 2010
Monday, July 12, 2010
Doulas Play Key Role.- Star Phoenix Article!!!!
After more than 30 hours of labour to give birth to her first child, Brooke Graham was convinced she'd never have another.
During the birth she took every medication offered and later suffered severe postpartum anxiety.
Four years after her daughter's difficult birth, Graham became pregnant again. She was terrified. A counsellor suggested she hire a doula.
She'd never heard the term. "I thought, 'Whatever, we'll give it a try. It can't hurt,' " Graham said.
Now, after the birth of her son -- the "most empowering experience" of her life -- she's training to become a registered doula.
"It's the greatest secret ever kept," Graham said.
The term doula means "caregiver" or "woman of service." The loose translation Graham is most fond of is "mother of mothers."
Doulas provide non-clinical support or care before, during and after birth for the woman and her partner.
Lisa Wass began working as a doula before she knew what they were. In 1998 Wass left teaching and began working in mental health services. Her first client was pregnant. Three weeks later, she supported the young woman in labour.
"I realized that day that . . . every birth at our hospital was very much a part of the big birth machine," said Wass. "I wanted to advocate for women so they understood that they had choices."
A few years later she was in the library doing research when she met Debbi Mbofu, the province's first registered midwife.
"She said 'Oh, you're a doula.' I said, 'a do-what?' " said Wass.
Misconceptions about doulas abound.
"When I first started meeting clients and I'd come in and have a conversation they'd say, 'This is cool. You didn't come in waving incense and crystals,' " Wass said.
Doula work is anything but hocus pocus. Wass details the different angles used in child birth, how a position change could mean the difference between delivering the baby in a yoga position or relying on vacuum suction.
Though they can provide suggestions, doulas are not midwives. They cannot prescribe medications, do medical interventions or conduct clinical examinations.
A doula responds to the wishes of the expecting mother, whether that means an all-natural, at-home water birth, or a planned caesarean section.
"We provide resources so that they can make informed decisions," said Wass.
"Somehow I would love to dispel the myth that doulas are all hippies," Graham said.
Both doulas say they support the concept of a doula for every woman who wants one. For that to happen, more women must become doulas.
"We need a lot of different women. Variety is very important," said Wass.
Though diversity is desired, it's difficult to come by. The work is demanding -- once the doula arrives, there are no shift changes. Labour lasts on average between 12 and 20 hours. The maximum caseload is one to two births per month, and that means being on call 24 hours a day. It's too much for many doulas, which means turnover is high.
From 1998 until 2007 there were about five or six doulas taking clients in Saskatoon at one time.
Wass has since trained 45 doulas from Saskatoon and area. She's worked to expand services into northern Saskatchewan, and is one of a few doulas who travel around the province. She has also spearheaded the Prairie Birth Collective, an organization of doulas, hypnotherapists, birth educators and massage therapists.
Evidence shows that doulas' efforts work. Intervention rates drop drastically and epidural requests are reduced. Caesarean sections also drop by 30 or 40 per cent when a doula is involved, says Wass. Studies show a woman's birth experience directly relates to her experience mothering, and women have fewer instances of postpartum depression and problems breast feeding.
It equates to a cost saving for the health-care system, but it's up to the mother to seek out.
Doula care can cost on average between $300 and $1,000. In British Columbia, where demand is very high, people pay thousands of dollars. Because of the demand, and the results of a task force study that show the rates of intervention drop dramatically if a doula is present, B.C. has begun incorporating doulas into public-health programming.
Right now there are no plans to incorporate doula care into the health-care system in Saskatoon, where the focus is expansion of the year-old midwifery program, says Sheila Achilles, director of primary health services for the Saskatoon Health Region.
"We don't have the capacity to pursue bringing them on as employees," Achilles said. "We certainly are supportive of any mom who chooses to have a doula with her."
After more than a decade serving mothers and their partners, Wass says the medical community is finally responding positively.
"It's a huge shift in Saskatoon," said Wass. "We used to come into the hospital and they'd say 'You're a what? Your name's Abdula?'
"For a little while there was a lot of hostility, because there was that needing to define roles. But now, there's such a great understanding of what a doula brings to the birthing woman and how we can work as a team," she said.
jstewart@sp.canwest.com
Read more: http://www.thestarphoenix.com/health/Doulas%20play%20role/3265290/story.html#ixzz0tVyWa6S1
During the birth she took every medication offered and later suffered severe postpartum anxiety.
Four years after her daughter's difficult birth, Graham became pregnant again. She was terrified. A counsellor suggested she hire a doula.
She'd never heard the term. "I thought, 'Whatever, we'll give it a try. It can't hurt,' " Graham said.
Now, after the birth of her son -- the "most empowering experience" of her life -- she's training to become a registered doula.
"It's the greatest secret ever kept," Graham said.
The term doula means "caregiver" or "woman of service." The loose translation Graham is most fond of is "mother of mothers."
Doulas provide non-clinical support or care before, during and after birth for the woman and her partner.
Lisa Wass began working as a doula before she knew what they were. In 1998 Wass left teaching and began working in mental health services. Her first client was pregnant. Three weeks later, she supported the young woman in labour.
"I realized that day that . . . every birth at our hospital was very much a part of the big birth machine," said Wass. "I wanted to advocate for women so they understood that they had choices."
A few years later she was in the library doing research when she met Debbi Mbofu, the province's first registered midwife.
"She said 'Oh, you're a doula.' I said, 'a do-what?' " said Wass.
Misconceptions about doulas abound.
"When I first started meeting clients and I'd come in and have a conversation they'd say, 'This is cool. You didn't come in waving incense and crystals,' " Wass said.
Doula work is anything but hocus pocus. Wass details the different angles used in child birth, how a position change could mean the difference between delivering the baby in a yoga position or relying on vacuum suction.
Though they can provide suggestions, doulas are not midwives. They cannot prescribe medications, do medical interventions or conduct clinical examinations.
A doula responds to the wishes of the expecting mother, whether that means an all-natural, at-home water birth, or a planned caesarean section.
"We provide resources so that they can make informed decisions," said Wass.
"Somehow I would love to dispel the myth that doulas are all hippies," Graham said.
Both doulas say they support the concept of a doula for every woman who wants one. For that to happen, more women must become doulas.
"We need a lot of different women. Variety is very important," said Wass.
Though diversity is desired, it's difficult to come by. The work is demanding -- once the doula arrives, there are no shift changes. Labour lasts on average between 12 and 20 hours. The maximum caseload is one to two births per month, and that means being on call 24 hours a day. It's too much for many doulas, which means turnover is high.
From 1998 until 2007 there were about five or six doulas taking clients in Saskatoon at one time.
Wass has since trained 45 doulas from Saskatoon and area. She's worked to expand services into northern Saskatchewan, and is one of a few doulas who travel around the province. She has also spearheaded the Prairie Birth Collective, an organization of doulas, hypnotherapists, birth educators and massage therapists.
Evidence shows that doulas' efforts work. Intervention rates drop drastically and epidural requests are reduced. Caesarean sections also drop by 30 or 40 per cent when a doula is involved, says Wass. Studies show a woman's birth experience directly relates to her experience mothering, and women have fewer instances of postpartum depression and problems breast feeding.
It equates to a cost saving for the health-care system, but it's up to the mother to seek out.
Doula care can cost on average between $300 and $1,000. In British Columbia, where demand is very high, people pay thousands of dollars. Because of the demand, and the results of a task force study that show the rates of intervention drop dramatically if a doula is present, B.C. has begun incorporating doulas into public-health programming.
Right now there are no plans to incorporate doula care into the health-care system in Saskatoon, where the focus is expansion of the year-old midwifery program, says Sheila Achilles, director of primary health services for the Saskatoon Health Region.
"We don't have the capacity to pursue bringing them on as employees," Achilles said. "We certainly are supportive of any mom who chooses to have a doula with her."
After more than a decade serving mothers and their partners, Wass says the medical community is finally responding positively.
"It's a huge shift in Saskatoon," said Wass. "We used to come into the hospital and they'd say 'You're a what? Your name's Abdula?'
"For a little while there was a lot of hostility, because there was that needing to define roles. But now, there's such a great understanding of what a doula brings to the birthing woman and how we can work as a team," she said.
jstewart@sp.canwest.com
Read more: http://www.thestarphoenix.com/health/Doulas%20play%20role/3265290/story.html#ixzz0tVyWa6S1
Sunday, July 11, 2010
Dads and Doulas
I am a 35 year old father of two beautiful, naturally birthed boys (4 years and 3 months). Our first child was born naturally in a hospital setting with the help of a doula. The experience completely validated our decision to include a doula in the process of pregnancy and birth. Especially for first time parents committed to learning about the natural birthing process, a doula is an absolute must. Our first experience gave us the confidence to have a home birth for our second child.
In preparation for our second child we needed a refresher on the natural birthing process and the many natural tools and techniques that can be employed to joyfully support the arrival of a new human into the world.
We came to Birth Rhythm for the Labour Intensive – Embracing the Beauty in Birth – hands on workshop for the refresher. WOW! It was exactly what we needed to re-engage with the tools and techniques we already knew of and to learn some new ones too! The most valuable thing we learned from the class was the distinction between the typical birthing process and the natural birthing process. The workshop was many things… hands on, educational, eye opening (especially for first timers), casual, friendly, respectful, and fun! The whole experience was extremely valuable to us.
My wife and I have a deep appreciation and respect for doulas. Our doula and the Birth Rhthym doulas have given us the key to the empowerment necessary to have a normal, natural and healthy birth experience.
For anyone who has never engaged with a doula, this workshop is a brilliant way to learn first hand how a doula empowers the birthing couple.
The experience was worth every penny.
I have the utmost appreciation, respect and gratitude for the Birth Rhythm team.
Aaron Chubb
-Saskatoon, SK
For more info read: 5 Reasons Dads Should Demand a Doula!
In preparation for our second child we needed a refresher on the natural birthing process and the many natural tools and techniques that can be employed to joyfully support the arrival of a new human into the world.
We came to Birth Rhythm for the Labour Intensive – Embracing the Beauty in Birth – hands on workshop for the refresher. WOW! It was exactly what we needed to re-engage with the tools and techniques we already knew of and to learn some new ones too! The most valuable thing we learned from the class was the distinction between the typical birthing process and the natural birthing process. The workshop was many things… hands on, educational, eye opening (especially for first timers), casual, friendly, respectful, and fun! The whole experience was extremely valuable to us.
My wife and I have a deep appreciation and respect for doulas. Our doula and the Birth Rhthym doulas have given us the key to the empowerment necessary to have a normal, natural and healthy birth experience.
For anyone who has never engaged with a doula, this workshop is a brilliant way to learn first hand how a doula empowers the birthing couple.
The experience was worth every penny.
I have the utmost appreciation, respect and gratitude for the Birth Rhythm team.
Aaron Chubb
-Saskatoon, SK
Wednesday, June 30, 2010
New Doulas!
Look these gals up on Facebook! They call themselves the Birth Ninjas!
Thursday, June 10, 2010
Summer Schedule is Now Out!
Saturday, June 05, 2010
Robbie's Birth Story
Robbie's birth story doesn't begin with a contraction, nor does it begin with his conception, it began several years ago when I became pregnant with our first baby. It was the summer of 2005. Dave and I were SO EXCITED to be expecting our first child. I had the usual first trimester nausea and fatigue, until one Sunday evening I went to the washroom and discovered I had started spotting. The following week was a blur of doctor's appointments, ultrasounds and tears. We heard the news we never, ever expected to hear...we had lost the baby. At 2:30am September 19th, 2005 I woke up in the guest bedroom on my inlaws house with intense cramping (we weren't living in Saskatoon at that point, but were there for work stuff). I ran to the washroom where I birthed my angel baby ('passing the pregnancy' sounds like such an awful term to me). I sat there for a few minutes, holding my baby in my hands. I sobbed until I had nothing left in me. I felt empty, I felt numb, I felt broken.
After the miscarriage Dave and I tried and tried and tried to conceive again. After seven painstaking months, we conceived again, a couple of weeks after our angel baby's due date. This time, we were terrified. I was OBSESSED with having a healthy pregnancy. I read, and worried and did everything I thought I should do in order to carry a healthy baby to term. We knew that Dave was not a 'medical' kind of guy, so hired a doula half way through my pregnancy. We prepared for the birth, but throughout that entire time, I carried this major fear that I was unable to carry a healthy baby to term. I didn't believe or trust in my body. I went to term, in fact I went over due. When I was a week overdue, I went in to labour. It wasn't the labour I had expected. I didn't trust my body, I didn't trust the process. After 3 days of labour and an epidural I finally gave birth to our beautiful boy, James. He was 10lbs 4 oz and 22 inches long and he was a very healthy baby :)
When James turned one, we decided we were ready to try for a second child. This time I knew my body was capable of growing a healthy baby, but I still lacked confidence in my body's ability to birth the way it was designed to do. From the beginning of my pregnancy I began preparing for the birth. We hired our doula again and decided to go with a midwife instead of a doctor. Throughout my pregnancy we had decided that plan 'A' would be a hospital birth, but if all was going well and we were comfortable, we would be open to a home birth. Again, my due date came and went. This baby was COMFY and NOT ready to come out. I knew this baby was going to be big. James was a big boy and there was no doubt that this one was going to be big too. We set up the birthing pool in our kitchen area so we were ready for when labour began. On Sunday, June 28th (11 days over due) I began nesting like a crazy lady! Of course, I didn't realize that I was nesting, I was just SO pissed off that this baby was still inside and needed to clean in order to get the anger out. My doula asked me if there was any doubts I was having and I told her that I didn't believe that I could do this. She told me to be positive for the rest of the day and to watch some home birth videos on YouTube. I watched them and bawled my eyes out. They were beautiful, I realized that I REALLY wanted to see my baby. I went to have my afternoon nap and woke up 2 hours later at 3:30pm feeling very rested and happy.
I got out of bed and felt like I had to go to the bathroom (I had eaten an entire watermelon the day before in an attempt to empty my bowels and stimulate labour...yes, I was DESPERATE!). I went to the bathroom and went downstairs to continue my nesting. All of a sudden I felt like I had to go to the bathroom again. I went, thinking nothing of it. Finally, after the third trip to the bathroom, I said to Dave "I think I'm having false labour again, I'm going in to the tub to see if anything happens". I grabbed a glass of water and my watch. As I sat in the bath I realized the contractions were coming every 3-4 minutes, lasting about 30-ish seconds, they weren't going away. At that point, I called my doula, she agreed that it sounded like labour and to call her when I needed her. I decided to give my midwife a call and while on the phone with her, I had a few contractions. She decided to come over immediately. Soon after talking to her, I called my doula and asked her to come over. During all of this, Dave was trying to fill the birthing pool and locate my mother-in-law to come get James (she was on the golf course, having an amazing game WITHOUT her cell phone).
My doula arrived and she helped me through a few contractions. It was obvious I was in active labour and was having a lot of trouble getting comfortable in the tub. We decided to move to the bedroom where I laboured on my hands and knees on my exercise ball. Once I moved in to the bedroom I did what I had been preparing so long for...I surrendered. I allowed my body to take over, I simply allowed it all to happen, I didn't fight it, I didn't analyze it, I just was. It was very primal, very raw, very real. It was amazing. My midwife arrived and checked the baby's heart rate, my blood pressure and checked my cervix. I was 6-7 cms with membranes bulging. She said everything was going really well, but this was the point at which we needed to decide whether to stay or go. We called Dave in (who was still trying to fill the birthing pool...he had managed to locate his mom, who had taken James to her house). After a quick discussion between contractions, we decided to stay at home. I felt SO confident in that decision. After our discussion, I went back into myself, simply allowing myself to surrender to the process. I remember at one point looking at our bedroom clock and it said "5:30pm", I thought to myself "I am going to have this baby in the next hour". At 6pm, my midwife checked me again because I had begun to bear down at the peak of my contractions. I was at 10cms with my membranes still bulging. My doula and midwife suggested that I move to the toilet to see if my membranes would rupture while I sat on the toilet. Sure enough, first contraction on the toilet, they ruptured, nice and clear! At that point I felt the ring of fire! Yup, that head was definitely there! I didn't freak out, I didn't think much about it, just continued to follow my body. I tried pushing on the floor, but felt I wasn't able to get my knees wide enough. So I climbed up on the bed and pushed while I laid on my side. At that point the secondary midwife had arrived and they were getting set up for the birth. As I was pushing I had my doula to my right, holding one leg, my primary midwife at the end of the bed, supporting my perineum and the secondary midwife cheering me on. I felt like something was missing. I said "I need Dave" (still filling the birthing pool....) so the three of them all screamed "DAVE!" and he raced in to sit on my left hand side. I recall that time stood still, an out of body experience. After 30 minutes of pushing, Robbie was born. His cord had been wrapped around his neck twice, but the midwife calmly removed it. He was placed immediately on my chest and we hung out and snuggled together. We let the cord finish pulsating and then I cut it. After delivering the placenta the midwives checked me over and told me that I had one small 'scratch' inside my vagina, no actual tears. After some bonding, they did the newborn exam. Robbie was perfect :) When they weighed him, we were all shocked. He weighed 11lbs 14oz and 23 inches long!!! The biggest baby that both midwives had ever delivered at home.
I had done it. Woke up in active labour and gave birth 3 hours later to an almost 12lb baby! I had my birth the way I had wanted it, the way I had NEEDED it. It completely changed me. It gave me confidence in myself that I never knew I had. Now I know who I am. Now I know what I'm capable of. I no longer doubt myself. I believe.
After the miscarriage Dave and I tried and tried and tried to conceive again. After seven painstaking months, we conceived again, a couple of weeks after our angel baby's due date. This time, we were terrified. I was OBSESSED with having a healthy pregnancy. I read, and worried and did everything I thought I should do in order to carry a healthy baby to term. We knew that Dave was not a 'medical' kind of guy, so hired a doula half way through my pregnancy. We prepared for the birth, but throughout that entire time, I carried this major fear that I was unable to carry a healthy baby to term. I didn't believe or trust in my body. I went to term, in fact I went over due. When I was a week overdue, I went in to labour. It wasn't the labour I had expected. I didn't trust my body, I didn't trust the process. After 3 days of labour and an epidural I finally gave birth to our beautiful boy, James. He was 10lbs 4 oz and 22 inches long and he was a very healthy baby :)
When James turned one, we decided we were ready to try for a second child. This time I knew my body was capable of growing a healthy baby, but I still lacked confidence in my body's ability to birth the way it was designed to do. From the beginning of my pregnancy I began preparing for the birth. We hired our doula again and decided to go with a midwife instead of a doctor. Throughout my pregnancy we had decided that plan 'A' would be a hospital birth, but if all was going well and we were comfortable, we would be open to a home birth. Again, my due date came and went. This baby was COMFY and NOT ready to come out. I knew this baby was going to be big. James was a big boy and there was no doubt that this one was going to be big too. We set up the birthing pool in our kitchen area so we were ready for when labour began. On Sunday, June 28th (11 days over due) I began nesting like a crazy lady! Of course, I didn't realize that I was nesting, I was just SO pissed off that this baby was still inside and needed to clean in order to get the anger out. My doula asked me if there was any doubts I was having and I told her that I didn't believe that I could do this. She told me to be positive for the rest of the day and to watch some home birth videos on YouTube. I watched them and bawled my eyes out. They were beautiful, I realized that I REALLY wanted to see my baby. I went to have my afternoon nap and woke up 2 hours later at 3:30pm feeling very rested and happy.
I got out of bed and felt like I had to go to the bathroom (I had eaten an entire watermelon the day before in an attempt to empty my bowels and stimulate labour...yes, I was DESPERATE!). I went to the bathroom and went downstairs to continue my nesting. All of a sudden I felt like I had to go to the bathroom again. I went, thinking nothing of it. Finally, after the third trip to the bathroom, I said to Dave "I think I'm having false labour again, I'm going in to the tub to see if anything happens". I grabbed a glass of water and my watch. As I sat in the bath I realized the contractions were coming every 3-4 minutes, lasting about 30-ish seconds, they weren't going away. At that point, I called my doula, she agreed that it sounded like labour and to call her when I needed her. I decided to give my midwife a call and while on the phone with her, I had a few contractions. She decided to come over immediately. Soon after talking to her, I called my doula and asked her to come over. During all of this, Dave was trying to fill the birthing pool and locate my mother-in-law to come get James (she was on the golf course, having an amazing game WITHOUT her cell phone).
My doula arrived and she helped me through a few contractions. It was obvious I was in active labour and was having a lot of trouble getting comfortable in the tub. We decided to move to the bedroom where I laboured on my hands and knees on my exercise ball. Once I moved in to the bedroom I did what I had been preparing so long for...I surrendered. I allowed my body to take over, I simply allowed it all to happen, I didn't fight it, I didn't analyze it, I just was. It was very primal, very raw, very real. It was amazing. My midwife arrived and checked the baby's heart rate, my blood pressure and checked my cervix. I was 6-7 cms with membranes bulging. She said everything was going really well, but this was the point at which we needed to decide whether to stay or go. We called Dave in (who was still trying to fill the birthing pool...he had managed to locate his mom, who had taken James to her house). After a quick discussion between contractions, we decided to stay at home. I felt SO confident in that decision. After our discussion, I went back into myself, simply allowing myself to surrender to the process. I remember at one point looking at our bedroom clock and it said "5:30pm", I thought to myself "I am going to have this baby in the next hour". At 6pm, my midwife checked me again because I had begun to bear down at the peak of my contractions. I was at 10cms with my membranes still bulging. My doula and midwife suggested that I move to the toilet to see if my membranes would rupture while I sat on the toilet. Sure enough, first contraction on the toilet, they ruptured, nice and clear! At that point I felt the ring of fire! Yup, that head was definitely there! I didn't freak out, I didn't think much about it, just continued to follow my body. I tried pushing on the floor, but felt I wasn't able to get my knees wide enough. So I climbed up on the bed and pushed while I laid on my side. At that point the secondary midwife had arrived and they were getting set up for the birth. As I was pushing I had my doula to my right, holding one leg, my primary midwife at the end of the bed, supporting my perineum and the secondary midwife cheering me on. I felt like something was missing. I said "I need Dave" (still filling the birthing pool....) so the three of them all screamed "DAVE!" and he raced in to sit on my left hand side. I recall that time stood still, an out of body experience. After 30 minutes of pushing, Robbie was born. His cord had been wrapped around his neck twice, but the midwife calmly removed it. He was placed immediately on my chest and we hung out and snuggled together. We let the cord finish pulsating and then I cut it. After delivering the placenta the midwives checked me over and told me that I had one small 'scratch' inside my vagina, no actual tears. After some bonding, they did the newborn exam. Robbie was perfect :) When they weighed him, we were all shocked. He weighed 11lbs 14oz and 23 inches long!!! The biggest baby that both midwives had ever delivered at home.
I had done it. Woke up in active labour and gave birth 3 hours later to an almost 12lb baby! I had my birth the way I had wanted it, the way I had NEEDED it. It completely changed me. It gave me confidence in myself that I never knew I had. Now I know who I am. Now I know what I'm capable of. I no longer doubt myself. I believe.
Tuesday, May 04, 2010
Promoting Midwifery Care for All Saskatchewan Women
May 5th is the International Day of the Midwife, a day that is recognized around the world as an opportunity to celebrate midwifery and to promote awareness of the care that midwives provide. On March 14, 2008, midwifery became a regulated profession in Saskatchewan, joining 7 other provinces and territories to offer a safe alternative to traditional physician care. Two years later, many people still do not understand the role of a Midwife and are not aware that midwifery care is an available option for some women.
• Midwives are specialists in normal birth, providing primary care for women and babies throughout pregnancy, labour, childbirth, and first 6 weeks postpartum.
• Midwives are able to do deliveries in hospitals or at home, and they are trained to provide immediate emergency care to the mother and newborn.
• Midwives provide women with information and options regarding their care, encouraging informed consent, and follow guidelines that determine whether a medical condition or complication indicates a need for physician consult or transfer of care.
• Midwives are able to order diagnostic tests and assessments, prescribe and administer many drugs commonly used in pregnancy, childbirth, and immediate postpartum period.
• Midwifery care reduces the rates of intervention including cesarean section, result in shorter hospital stays, increased success rates of breastfeeding, and reduce health care costs.
There are currently over 800 Registered Midwives throughout Canada, with over half of those in Ontario alone. Despite having the most Registered Midwives in Canada, the demand for midwifery services is so great that more than 40% of women seeking midwifery care in Ontario are turned away due to a full case load. Across Canada, almost all other provinces are experiencing the same difficulties with meeting the demand for midwifery services.
Despite the goal of Saskatchewan Health to make midwifery care accessible to all women in the province, full scope of midwifery services is only available to women who live within the Saskatoon city limits. The Saskatoon health region has only five Registered Midwives and due to the demand for services, these midwives are not able to accept clients outside of Saskatoon which leaves women in other communities and rural areas without access to midwifery care. Regina Qu’Appelle and Cypress health regions are in the process of recruiting midwives but services will be limited until more midwives are hired. Until the Saskatchewan Government provides funding for independent midwifery services, rural women will continue to have insufficient access to midwifery care.
In order for midwifery care be accessible to all women in Saskatchewan, funded Independent Practice is an option that must be considered. Although independent midwifery practice is a legal option in Saskatchewan, the midwife must first obtain liability insurance in order to be eligible for registration (legally allowing her to practice). Liability insurance costs $25,000 - 50,000 each year, in addition to all other business expenses such as emergency training courses, supplies, and equipment; a prohibitive amount of money for a midwife in independent practice. As well, until the Saskatchewan government provides funding for independent practice, clients must pay the midwife “out of pocket” for independent midwifery services, a service that is free for Saskatoon (urban) women. Midwifery service fees range from $2500 - $3100 per course of care. For those health regions that employ midwives, expenses such as liability insurance, supplies, equipment, emergency training courses, and office and clinic space are all paid for by the health region. These health regions also pay the midwives’ salaries so midwifery care is “free” to women in that area.
Obstacles to having midwifery care accessible to all women in Saskatchewan:
• Only four provinces in Canada offer university midwifery education programs, and Saskatchewan does not have one.
• A full range of midwifery care is only available to women within the city limits of Saskatoon at this time.
• Two other health regions are in the process of hiring midwives who will be limited in the care they can provide, such as providing care only to women who choose to birth in a hospital.
• Home birth with a Registered Midwife is not an option for women outside of Saskatoon.
• Rural women in Saskatchewan have no access to midwifery care and most women have to travel long distances to receive prenatal care and give birth in hospitals.
• The costs required for midwives to set up independent practice are prohibitive.
• Although Saskatchewan Health has provided funding for midwifery services, it is not known when ten of the 13 regional health authorities in Saskatchewan (including Saskatoon District Health Region) are planning to implement further midwifery care.
• Saskatoon’s midwifery program automatically discriminates against women who live rurally, but within the health district, by disqualifying based on their address. Thus more than half of the SDHR families who chose midwifery in 2008, before regulation went into effect, now have no access to this important form of maternity care. The SDHR has placed a hiring freeze in 2010 its midwifery program, even though the demand is high and waiting lists are long. There can be no waiting lists in maternity care. This makes it imperative to provide access to independent midwifery services now.
• Submitted by Midwifery For All, a consumer group for the advancement of midwifery services in Saskatchewan. For more information contact Amy at amycassonis@gmail.com or midwiferyforall@yahoogroups.ca
Monday, April 26, 2010
Celebrating Birth Trust
May is the International Month of the Doula!
May 5th is International Day of the Midwife!
Birth Rhythms has trained 46 new doulas for Saskatoon and area to meet the demand for outstanding birth support.
We are joining a Birth Matters! celebration on International Day of the Midwife.
Where: Saskatoon
Kiwanis Park Band Stand, by the Bessborough Hotel
When: 1-3pm
May 5th, 2010
How: Casual Picnic with face painting and belly painting done by volunteers.
Why: To show our Support to those women who get up in the night and come to our sides as we usher in new life.
We have invited all our past and current clients and would love to see everyone who is interested in Doula and Midwifery Care come out and show your support. Birth work is by its nature a very isolating profession. Woman with Woman one birth at a time. It would be so wonderful to see you all at the same time!
We would love to see lots of people and hopefully the event will be covered by the media.
Many Birth Rhythm Trained Doulas and other Members of the Prairie Birth Collective will be in attendance to answer your questions.
All are welcome!
May 5th is International Day of the Midwife!
Birth Rhythms has trained 46 new doulas for Saskatoon and area to meet the demand for outstanding birth support.
We are joining a Birth Matters! celebration on International Day of the Midwife.
Where: Saskatoon
Kiwanis Park Band Stand, by the Bessborough Hotel
When: 1-3pm
May 5th, 2010
How: Casual Picnic with face painting and belly painting done by volunteers.
Why: To show our Support to those women who get up in the night and come to our sides as we usher in new life.
We have invited all our past and current clients and would love to see everyone who is interested in Doula and Midwifery Care come out and show your support. Birth work is by its nature a very isolating profession. Woman with Woman one birth at a time. It would be so wonderful to see you all at the same time!
We would love to see lots of people and hopefully the event will be covered by the media.
Many Birth Rhythm Trained Doulas and other Members of the Prairie Birth Collective will be in attendance to answer your questions.
All are welcome!
Tuesday, April 06, 2010
Surgical Birth; been there, done that, now what?
Saskatoon has a wonderful ICAN chapter that supports women who have had a surgical birth and teaches others how to avoid one. With a local C-Section rate of 26% in Saskatoon so many women are looking to connect with others who understand how surgical birth affects the mother, chid and family long term.
Our local Chapter leader , Nicole Eramian , has had two Cesarean Births and holds monthly meetings to encourage others who are recovering and those who are planning a VBAC (Vaginal Birth After Cesarean).You can find her in the ICAN database link below, or through her own website:
Inner Strength Doula Services.
I have attached the ICAN April newsletter below for you to peruse below.
Dear friend of ICAN,
Thank you for your continued support of ICAN's mission! In honor of Cesarean Awareness Month, I invite you to do something concrete to show your commitment to moms and babies everywhere. I encourage you to become an ICAN subscriber or renew your subscription by visiting the ICAN Bookstore or contacting your local chapter today.
Cesarean Awareness Month is the perfect time to subscribe to ICAN. In addition to reduced subscription rates, we will be offering three fantastic webinars, all of which are free to ICAN subscribers:
Cesarean Scar Care in the Post-Partum Period: Sunday, April 11 at 7 pm EDT.
ICAN Birth Class: Cesarean Prevention: Tuesday, April 20 at 9 pm EDT
ICAN Birth Class: Journey to VBAC, date TBA
We also encourage you to join us for an ICAN meeting live, online on Thursday, April 15 at 9 pm EDT.
As always, ICAN subscribers also receive the Clarion, ICAN's quarterly print newsletter and discounts to the ICAN Bookstore and the ICAN Conference. Professional subscribers enjoy a free listing on ICAN's Professional Subscriber Network, and Childbearing Years and Lifetime subscribers will receive a special mention in the next Clarion. Subscribers who participate in our online forums also receive public recognition by means of special ribbons every time they post.
ICAN is an all-volunteer organization working tirelessly to improve maternal-child health. Through the financial support of our subscribers, we have been able to:Provide support through over 130 chapters in the US, Canada and around the world, through our 1-800 number and through our online forums
Provide evidence-based information through our website
Increase awareness of cesarean and VBAC issues through our blog and social networking sites.
Offer live, interactive online webinars to educate health care consumers and professionals
Send ICAN representatives to our nation's capital to bring light to insurance discrimination due to cesarean as a "pre-existing condition"
Send ICAN representatives to conferences around the US to raise awareness of cesarean and VBAC issues
Thank you again for your support. Please let us know how you will be honoring Cesarean Awareness Month by sending an email to feedback@ican-online.org.
Warmly,
Desirre Andrews
ICAN President
www.ican-online.org
Saturday, March 27, 2010
Plan E: A Birth Story
Hi Lisa!
We have a beautiful baby girl named Cecilia Anne!! She is a pipsqueak and weighed just 6 lbs 4 oz. She was born on March 12, three days before my scheduled c-section.
Here's my story (the longish version) :
I went into labor at 1:30 am on March 12th. My water broke, but just in a tiny trickle (I went up to go to the washroom and was so tired that I wasn't sure if I was imaging things or not - seriously, there was just the tiniest trickle). I was having some contractions which were irregular, and felt like the cramps I used to get as a teenager. Uncomfortable but somewhat painful, but nothing crazy, I called Ros and talked to her. I was pretty sure I was pushing the panic button so I tried to go back to sleep or at least rest, in case I was in early labor. Contractions were still irregular, but I had a couple of batches that were quite close together and my water continued to break in small trickles. Mike took me to the hospital at 4:30. I was already 4 cm - oops! Guess I was in labor after all :).
The OB on call was Dr. Stewart, who does not do breech deliveries, but did train with Dr. Martel. She suggested that we wait for shift change and then Dr. Martel could do the delivery. However, she contacted Dr. Martel and unfortunately she couldn't come in due to personal reasons (she was supposed to be available). The resident did an ultrasound and the OB consulted with Martel, but baby was still not in a favourable position. So, I had a c-secction and baby arrived at 7:27 am. Boy things sure move fast at RUH. It makes your head spin. Fortunately Ros was able to join us in time for the section and was able to stay with us in recovery until she was off to see another one of her ladies who was having contractions!
We weren't able to keep much from our birth plan (basically, Mike was able to tell me the she was a girl). No to skin to skin (the OB said it's a sterile environment, so nope, and NICU said it was too cold in the OR). Ros unfurled her from her swaddle as soon as I was across the hall in recovery.
I wanted to thank you so much for your excellent classes. Mike and I both learned so much and your classes got us talking a lot about issues we never considered. We were able to prepare for our plan B (or E by my estimation), even though it was not an option we would have chosen for bringing Cecilia into the world. Not to say that I haven't had a few weepy moments about what we weren't able to do, but at the end of the day I really am okay with how things unfolded and was not traumatized by having a c-section ( as I am quite sure I would have been if it wasn't for your classes). It was also a lot less traumatic since Cecilia got to pick her birthday! It was very exciting to know that I was in labor and Cecilia was on her way to meet us. I know that a scheduled section would have been a lot more difficult for me to cope with.
Thanks again Lisa! If you ever need any testimonials for your website, please let us know!
I hope you had a good trip to the U.S. !
Keep in touch!
Gill
Thursday, March 25, 2010
5 myths about Homebirth
My Best Birth .com has a great post. Click here to read it.
http://www.mybestbirth.com/profiles/blog/show?id=3120006%3ABlogPost%3A56595
Much like the topic of homeschooling, when I am asked why would anyone have a homebirth, I turn the question around. "Why would anyone have a hosptal birth?"
For those of you who don't know me, I like to question the norms. Let's pull on a string and see what unravels shall we?
Believing in Birth,
Lisa
Wednesday, February 24, 2010
Thursday, January 28, 2010
We can create our birth experience
Oh boy, having just returned from attending a birth I have a hundred things going through my mind! But what I want to share is that over and over again I see the same thing in birth. What you bring in is what you get. Let me explain.
Every birth is so individual, so special in its own right. We have the power as women to decide what the first day and moments of life for our new family will be like. What I am learning in my work with birth is that the experience is actually determined long before you feel those first twinges and tightenings. Time after time I have seen strong women prepare themselves both mentally and physically for the birth experience they dersire and then I have the pleasure of witnesssing as they achieve those goals. There seems to be at least 2 factors involved. One, these women want to own their birth experience. They are not ready to just let it happen to them, they want to see the map, check out altenate routes to the destination and even pick up some tools and skills that will make the journey easier. Secondly, they act on their desires! They ask questions, face their fears, seek out other sources of information and truly desire to do what is best for them and the child to come.
This pre- determination of your birth experience occurs whether or not you invest yourself in the process. We all carry our preconceived notions of birth, pain, and parenting, We all drag our baggage along with us. We have those terrible or joyous birth stories that we have been told by other mothers swirling through our heads. We have our own issues around self confidence and trusting that our bodies can actually do this thing it was created to do.
Regardless of how you plan, intentionally or by default, your experience will bear that out in the end. Now, I am not saying that every women can plan herself a quick, painless, effortless birth. I am also not saying that things will always go the way you have planned. What I am saying is that when you plan you can handle whatever curve balls birth might throw at you with confidence.
A huge chunk of our birth experience depends on how we mentally process the things that are happening through us and around us. Any competitive athelte will tell you, physical preparation is vitally important, but the mental stamina to complete the challenge is just as important!
The first step is finding out what you don't know about birth that could influence how you prepare and the choices you will make for your child. Start by questioning the obvious. Challenge notions that have been accepted as truth. For example: Why do we feel 'pain' in birth? Sounds like a stupid question doesn't it? But, could our experience be a reflection of our expectations? I have seen the full spectrum of responses to the work a woman's body does during birth. They have ranged from intense pleasure to out of control writhing. The factors affecting these births all seemed to lay within the mother's mind. Her responses to the work. Her ability to flow with and relax into the experience all aided the coping with 'pain'. When we are prepared for the work ahead, when we realize that the work is really coming through us. Women seem to be able to tap into an amazingly deep well of strength and focus.
I am going to be posting some birth stories and reflections from women I have worked with at some point either prenatally or during their their births as a Doula. They are filled with wisdom. I hope they will help you to start asking yourself how you need to prepare. What do you really want from your birth ? What can you do? What is within your power to control and what is not?
Welcome to the journey.
Believing in Birth,
Lisa Wass
Every birth is so individual, so special in its own right. We have the power as women to decide what the first day and moments of life for our new family will be like. What I am learning in my work with birth is that the experience is actually determined long before you feel those first twinges and tightenings. Time after time I have seen strong women prepare themselves both mentally and physically for the birth experience they dersire and then I have the pleasure of witnesssing as they achieve those goals. There seems to be at least 2 factors involved. One, these women want to own their birth experience. They are not ready to just let it happen to them, they want to see the map, check out altenate routes to the destination and even pick up some tools and skills that will make the journey easier. Secondly, they act on their desires! They ask questions, face their fears, seek out other sources of information and truly desire to do what is best for them and the child to come.
This pre- determination of your birth experience occurs whether or not you invest yourself in the process. We all carry our preconceived notions of birth, pain, and parenting, We all drag our baggage along with us. We have those terrible or joyous birth stories that we have been told by other mothers swirling through our heads. We have our own issues around self confidence and trusting that our bodies can actually do this thing it was created to do.
Regardless of how you plan, intentionally or by default, your experience will bear that out in the end. Now, I am not saying that every women can plan herself a quick, painless, effortless birth. I am also not saying that things will always go the way you have planned. What I am saying is that when you plan you can handle whatever curve balls birth might throw at you with confidence.
A huge chunk of our birth experience depends on how we mentally process the things that are happening through us and around us. Any competitive athelte will tell you, physical preparation is vitally important, but the mental stamina to complete the challenge is just as important!
The first step is finding out what you don't know about birth that could influence how you prepare and the choices you will make for your child. Start by questioning the obvious. Challenge notions that have been accepted as truth. For example: Why do we feel 'pain' in birth? Sounds like a stupid question doesn't it? But, could our experience be a reflection of our expectations? I have seen the full spectrum of responses to the work a woman's body does during birth. They have ranged from intense pleasure to out of control writhing. The factors affecting these births all seemed to lay within the mother's mind. Her responses to the work. Her ability to flow with and relax into the experience all aided the coping with 'pain'. When we are prepared for the work ahead, when we realize that the work is really coming through us. Women seem to be able to tap into an amazingly deep well of strength and focus.
I am going to be posting some birth stories and reflections from women I have worked with at some point either prenatally or during their their births as a Doula. They are filled with wisdom. I hope they will help you to start asking yourself how you need to prepare. What do you really want from your birth ? What can you do? What is within your power to control and what is not?
Welcome to the journey.
Believing in Birth,
Lisa Wass
Wednesday, January 27, 2010
The Other Side of the Glass -- the trailer
The YouTube version of the fund raiser trailer is finished!! It is a very full ten minutes.
The other side of the glass
SO MUCH is in that ten minutes and so much yet to say! I actually am doing an 18 minute trailer that will be more inclusive, and will even be a stand-alone to just get the basic premises out there -- babies are conscious, fathers are also disempowered, it's not about where or with you give birth, but that they know that the baby is feeling and remembering the experience, so fathers must be re-trained to be protectors in the hospital.
It will be the first 18 minutes of the full film .... which will have the interviews of a wider spectrum of professionals and fathers, and will include a third birth, at home, where the caregivers do a necessary intervention, suctioning, while being conscious of the baby.
The 18 minute video is going to be available soon for a minimum donation of $15.
It is designed for women and men to present to their caregiver -- midwife, nurse, or doctor; and for childbirth educators, midwives and doctors to show to expectant men and women. It will provide the basic information men and women need to have to make birth safer -- wherever they give birth.
This final version will include the science needed to advocated for delayed cord clamping, and the science that shows when a baby needs to be suctioned and addresses other interventions. Experts in conscious parenting will teach how to be present with a sentient newborn in a conscious, gentle way -- especially when administering life-saving techniques.
The goal is to keep the baby in the mother's arms so that the baby gets all of his or her placental blood and to avoid unnecessary, violating, and abusive touch and interactions. When we do that, whether at home or hospital, with doctor or midwife, the birth is safe for the father. The "trick" for birthing men and women is how to make it happen in the hospital.
With the information in the film, a father can defend this critical need of his baby's without any doubts.
Finally, and very importantly, most of us were born surrounded by people who had no clue about how aware and feeling we were. This trailer triggers a lot of emotions for people if they have not considered the baby's needs and were not considered as a baby. The final film will include detailed and profound information about the science-based, cutting-edge therapies for healing birth trauma.
The other side of the glass
SO MUCH is in that ten minutes and so much yet to say! I actually am doing an 18 minute trailer that will be more inclusive, and will even be a stand-alone to just get the basic premises out there -- babies are conscious, fathers are also disempowered, it's not about where or with you give birth, but that they know that the baby is feeling and remembering the experience, so fathers must be re-trained to be protectors in the hospital.
It will be the first 18 minutes of the full film .... which will have the interviews of a wider spectrum of professionals and fathers, and will include a third birth, at home, where the caregivers do a necessary intervention, suctioning, while being conscious of the baby.
The 18 minute video is going to be available soon for a minimum donation of $15.
It is designed for women and men to present to their caregiver -- midwife, nurse, or doctor; and for childbirth educators, midwives and doctors to show to expectant men and women. It will provide the basic information men and women need to have to make birth safer -- wherever they give birth.
This final version will include the science needed to advocated for delayed cord clamping, and the science that shows when a baby needs to be suctioned and addresses other interventions. Experts in conscious parenting will teach how to be present with a sentient newborn in a conscious, gentle way -- especially when administering life-saving techniques.
The goal is to keep the baby in the mother's arms so that the baby gets all of his or her placental blood and to avoid unnecessary, violating, and abusive touch and interactions. When we do that, whether at home or hospital, with doctor or midwife, the birth is safe for the father. The "trick" for birthing men and women is how to make it happen in the hospital.
With the information in the film, a father can defend this critical need of his baby's without any doubts.
Finally, and very importantly, most of us were born surrounded by people who had no clue about how aware and feeling we were. This trailer triggers a lot of emotions for people if they have not considered the baby's needs and were not considered as a baby. The final film will include detailed and profound information about the science-based, cutting-edge therapies for healing birth trauma.
Sunday, January 24, 2010
Monday, January 04, 2010
Tuesday, December 15, 2009
Sunday, December 06, 2009
MOM NATURALLY BIRTHS 7 lbs 14 oz BABY GIRL!
Let’s take a minute to recover from that thought, shall we?
Another baby girl made her grand entrance into the world on Novemeber 13th, 2008. She was born in hospital and was home three hours later. With today’s advance Health Care system, how could something like this have occurred?
Nine months prior to this delivery both her mom and dad were shocked that they were expecting another baby. After a traumatic delivery with their first child, born by caesarean section, they had not known if they would risk another pregnancy, another surgical delivery. Mom is quoted to have said ‘if I ever get pregnant again, I will have a Vaginal Birth After Caesarean (VBAC), even if it means we stay at home to deliver the baby’!! The nerve! This topic has remained quite controversial among health care professionals. Some physicians have even gone as far as to suggest that first time caesarean moms schedule surgical deliveries for all subsequent births. Not this mom, she would hear nothing of it. So, as a new reporter for Confessions of a Birth-a-holic, I desperately wanted to chronicle the couple’s experience with this thing called natural birth, and a VBAC at that. How would they succeed? Here is their story…
First of all, these parents took matters into their own hands. They researched and planned for a successful VBAC delivery. How? First they made sure they understood the evidence surrounding the risks and benefits of a VBAC. They were confident in their decision that a VBAC was best for both mom and baby. After much searching, they also located a physician who would support their decision. Many of the doctors they talked with discussed a trial of labour. But this mom was not comfortable with that kind of terminology; she was focussed on a successful natural labour and delivery. Baby’s mom really felt that she had been robbed of the natural childbirth experience with her first baby, who was a footling breech and subsequent caesarean section. With this pregnancy, she was determined to welcome the marvels of womanhood through a vaginal birthing experience. Wow, I think to myself as I reflect on this ideology, the wonders of a woman.
There were many other facets involved with the preparation for the birth. In order to prepare mom for the physical and emotional challenges of labour and delivery, she took a self-instructed hypnobirthing course. That said, during labour she is quoted to have said ‘turn this s--t off’ while listening to her hypnosis CD’s. Apparently the hypnosis preparation was not as efficient as their other chosen support system, a Doula. Huh? What the heck is that you ask? I was dumbfounded upon hearing of this professional but apparently there are women experienced in childbirth who want to provide physical, emotional and informational support to mothers, before, during and after childbirth. News to me (and now you) but not news to this couple! Their Doula was hired because they knew her, liked her, admired her and trusted that she could provide them with the information and support they would require to accomplish their goal of a VBAC.
Since mom had much invested in the vaginal birth of her second child, the Doula had her work cut out for her. She knew personal details about this couple, and the mom specifically (which is a whole other story), that meant she would have to have a heightened awareness of the labour progress and when to head to the hospital. Although mom had earlier said she would rather stay at home than risk a caesarean, she also knew that, as a VBAC patient, her doctor was more comfortable with her delivering in hospital (even if they would have to get a disco ball to give mom the birth experience she so desired).
As luck would have it, baby was one-week post dates (note sarcasm here). Mom went to a doctor’s appointment only to find out that her cervix was posterior. That’s right, there was nothing…notta…zip…zero…ziltch…happening ‘down there’. This news always causes stress for a pregnant mom, since every day after d-day is a ticking time bomb to induction. Not good news for a VBAC mom. But, as luck really would have it, one hour after hearing this news, pressure waves started. Mom had a feeling that these waves were ‘it’ despite having had two previous days of what she referred to as ‘surfing the waves’. So, in response to the realization of the impending birth, mom headed to Fuddrucker’s for a last supper of sorts (it is reported that women labour more efficiently after consuming the Hawaiian Chicken Salad from Fudd’s). Several hours later, mom called her Doula to let her know that the day had arrived, it was a second coming for the mom and she was prepared! The Doula responded by checking in on the emotional state of the couple and setting up a birthing tub for mom to labour in. When mom finally decided to use the tub, she knew the Doula and her tub were God sent.
After a few hours of labouring in the shower, on the bed and in the bathroom, it was finally ‘tub time’ and mom spent four solid hours squatting in that labour tub, with her Doula and her husband never leaving her side. She had finally found her rhythm, as the Doula had counselled them she would. The entire time in the tub, her Doula provided counter pressure on her back during each contraction. Looking back, the mom has said ‘it was almost relaxing…if one can call intense, bulldozing, abdominal pain relaxing’! The Doula also whispered encouraging words and ensured the couple that things were progressing normally. Whew! What a relief to both mom and dad! And speaking of dad, he was also an amazing support during this physically and emotionally demanding task. Eyewitnesses say mom actually bit his leg or hand during some of the contractions. I think we can safely assume that the Doula was happy that she was not on the receiving end of those fangs.
As labour progressed and got more intense, the impending transfer to the hospital was inevitable. The couple desperately wanted to labour at home for as long as possible, in order to avoid unnecessary medical intervention, but they still wanted to deliver in hospital. Time was of the essence and this couple completely trusted their Doula to know when to leave and how to get mom, so far progressed in labour, out of the tub, into the car and to the hospital. And the Doula did. She knew exactly when it was time; she remained calm and supportive while they relocated. They arrived at the hospital 10 cm dilated. Hooray! Mission accomplished. Ah…no…wait…she still had to actually deliver the baby!
Being at the hospital was a whole new experience that required additional support from the Doula. I mean, who makes these hospital policies where the husband is meant to wait in line to fill out forms, whilst a mom in need of physical and emotional support stands alone? Thank goodness for the Doula, who never left the birthing mom’s side. Not to mention, it might have been a bit awkward for a woman to be alone, wearing only a T-shirt and boots in the hallway, leaning over a wheelchair, moaning and groaning. Then again, this is the ER, so maybe not.
Once the paperwork was completed the threesome headed for labour and delivery. This is where mom was in for a real shock. No one had ever told her that the hallway from the elevator to labour and delivery is about a 100-kilometre distance! I was also shocked when she told me. It seems unbelievable. But, I feel it is my duty to let pregnant women know, if you deliver in hospital, you will be required to pass through this extremely long hallway. It’s the only way to get there. Apparently this dad is quoted to have said ‘it doesn’t look that long’ (I believe she may have bit his hand clean off with the next contraction). Luckily, the Doula reassured them that at the end of this little hallway, they would finally reach their destination.
Upon examination by the attending physician, the parents were thrilled to hear that it was time to welcome baby into their waiting arms! They thought this would be quick and easy. The baby would arrive in 20 minutes, give or take a few and they’d be calling all their friends and family with the dirty deets of the birth. Wrong. Thank goodness for the Doula. She was a calm presence, a wealth of knowledge and a great support for the parents while baby took her sweet time descending the birth canal. When the pushing wasn’t progressing, the Doula suggested switching positions, played soothing music, provided physical support and constantly whispered encouraging words to the mother. It was the Doula, not the doctor, nurse or spouse, who eased the fears the mom had of feeling the baby crown and her fear of tearing. She reassured mom that her perineum was being protected and that when the baby crowned, she would be born. It was exactly what mom needed to hear and with the next wave, baby arrived. Finally, with the collaboration of mom, dad, doctor and the Doula, the VBAC birth was successful. Mission accomplished.
I asked this baby’s mom about her feelings on her VBAC experience and this was her response:
“I believe birth is one of the most important, life-impacting journeys a woman goes through. It was a right of passage that I longed for. I wanted to be able to experience the complete submission of myself to my body, to let go and allow my body and my baby do the job they were designed to do. I did this with the support of my husband and my Doula. This was a major accomplishment and despite that, there was no hero cookie handed to me when it was over (which was fine, I wasn’t hungry anyway). Besides, I had my supportive Doula, my proud husband to give me all the kudos I required. The only thing I’ve pondered since the birth of my baby is this, where were the news media and television crews???”
I couldn’t agree more. Woman naturally births 7 lbs 14 oz baby girl! Now that is news worthy!
( this was submitted by an amazing mom who loves to write in third person)
Tuesday, December 01, 2009
Natural Approaches to Nausea and Vomiting in Pregnancy - by Denise Tiran
Originally posted on Nov 2009 on the MIDIRS WEBSITE
Nausea and vomiting in pregnancy (NVP) is an underrated and often disregarded condition which has immense significance for the mother and her family.
Indeed, it is not simply a condition which affects only the mother, but impacts also on her partner, her children, her job and her everyday life.
The term ‘morning sickness’ is a misnomer, because whilst many women have early morning nausea on waking, due to hypoglycaemia, many continue to suffer throughout the day and even into the night. Similarly, the traditional midwifery advice that symptoms will resolve spontaneously by the beginning of the second trimester can be discouraging, for many women feel unwell for the duration of the pregnancy, and others, whose condition may have improved in the mid-trimester, may experience a return to NVP towards term as the hormones change in preparation for labour.
Midwives should be able to differentiate clearly between physiological NVP (even when it is severe) and pathological hyperemesis gravidarum. Physiological nausea occurs in up to 85% of pregnant women (Jewell & Young 2003), with approximately half of these experiencing vomiting, but pathological hyperemesis occurs only in about 2.4% of the total (Power et al 2001), or between one and 20 cases per 1000 pregnancies (Kuscu & Koyunco 2002). Hyperemesis is defined as persistent vomiting causing weight loss of more than 5kg, with dehydration requiring fluid replacement, usually in hospital (Power et al 2007). However, undervaluing mothers’ subjective accounts of NVP may contribute to increased stress and unnecessary delays in instigating the appropriate treatment, particularly when the condition becomes pathological (Munch 2000). The effects of NVP are what the mother says they are, and the dismissive attitude of many GPs and some midwives is unhelpful and unkind.
NVP is largely considered to be ‘hormonal’, but this is an easy answer to a complicated question, because many different hormones are involved. Nausea has variously been attributed to oestrogen, progesterone, chorionic gonadotrophin, thyroid stimulating hormone and thyroxine, prostaglandins, testosterone and cortisol as well as other chemicals such as serotonin 5-HT, histamine and dopamine. Vomiting is triggered by changes in the brain, gastrointestinal tract and vestibular apparatus in the ear. NVP is exacerbated by tiredness, stress and anxiety, and appears to be worse in women with a history of muscusloskeletal problems, notably back, neck or jaw conditions (Tiran 2009). However, it is not the purpose of this paper to discuss the myriad causes and predisposing factors which contribute to NVP, and readers are referred to Tiran (2003) for a more comprehensive exploration of the subject.
Lifestyle advice
There are many suggestions which midwives can offer to women with mild to moderate NVP, although, often, women will try to cope alone until the symptoms have persisted for longer than they anticipated. The ubiquitous ‘tea and dry biscuit before getting up’ regime is not always appropriate, although those who feel more nauseous when they are hungry (as on waking) will gain some short term relief from eating. Unfortunately, biscuits are not the best means of satiating hunger, because the fast-release sugar is quickly metabolised and hypoglycaemia follows, leading to a vicious circle of eating – nausea – eating, and the risk of excessive weight gain. Slow-release carbohydrates are better, including bananas, porridge, jacket potatoes, wheatgrain toast, rice crackers etc. Women should not be made to feel guilty about eating a poor diet at this time, but should be encouraged to eat whatever foods are attractive to them, and which are not vomited back.
Nausea may be exacerbated by iron, so avoiding routine ingestion of iron-containing multivitamin supplements in early pregnancy may have some effect in reducing the severity of symptoms (Gill et al 2009). Additionally, the palate tends to be very sensitive and resulting stimulation of the gag reflex triggers retching and vomiting, so attempting to swallow large tablets (such as vitamin B) is ill-advised (Koren & Pairaideau 2006); a liquid preparation such as Floradix™ may be more palatable if a mother is known to be vitamin and mineral deficient. Conversely, some authorities advocate the use of vitamin B6 as a treatment for gestational sickness (Power et al 2007), although Masino & Kahle (2002) advise caution as there is some suggestion that large doses may affect neurological development which could be permanent after fetal exposure. For women who are able to eat relatively normally, consuming foods rich in vitamin B6, such as avocado, bananas, yeast extract, wheat bran, wheat germ, sardines, mackerel, beef, poultry, brown rice, cabbage and free range eggs may help.
Rest and sleep are important to reduce fatigue and it has been shown that many women spontaneously resort to ‘napping’ (O’Brien et al 1997), although occupational commitments or dealing with other children may preclude this as a long term strategy. Any means of alleviating stress should be advised, including taking time off work or adapting working practices where possible, such as working from home. Manageable exercise and obtaining fresh air should be encouraged if the NVP is not so severe that it confines the mother to bed, and relaxation and complementary therapies can be advised (see below). It is also necessary to ensure that partners and family members appreciate the nature of the problem. Some partners become over-solicitous and fear that the NVP will be harmful to the mother or baby, athough it appears to be nature’s way of protecting the materno-fetal unit (Brown et al 1997, Huxley 2000). However most men find it difficult to cope if the NVP lasts more than a few weeks, and diplomatic counselling may be needed to assist them in dealing with the situation.
Ginger
Ginger, in the form of capsules, syrup or a tea made from the root has been shown in numerous studies to be an effective antiemetic (Ozgoli et al 2009), reducing the number of vomiting episodes and comparing favourably with vitamin B6 supplements (Ensiyeh & Sakineh 2008) and other prescribed medications (Pongrojpaw et al 2007). Ginger appears to be almost universally known as a remedy for morning sickness and is readily advocated by midwives (personal communications), despite many having insufficient information to advise women accurately and safely. Ginger is also recommended by many obstetricians (Power et al 2007) although little advice appears to be given regarding dosages and there is scant acknowledgement of the pharmacological nature of ginger, despite wide variations in the proportions of the active components in many commercially available preparations (Schwertner et al 2006). It should be remembered that ginger is a herbal medicine which works pharmacologically, with side effects such as heartburn, and that it also has the potential to interact with drugs (Marcus & Snodgrass 2005). There is evidence to suggest that ginger has anticoagulant effects, especially if taken in excessive amounts or for prolonged periods of time, a factor which may preclude its use by women with haematological conditions, those on warfarin or other drugs with anticoagulant effects, and in those suffering threatened miscarriage (Thomson et al 2002, Borrelli et al 2005, Jiang et al 2005). Mothers and midwives mistakenly believe that ginger biscuits are acceptable but, although the large amount of sugar may bring temporary relief from a rise in serum glucose, any antiemetic effect is not due to the minimal amount of ginger in a biscuit. In addition, ginger is, in Chinese medicine terms, a ‘hot’ or ‘Yang’ remedy which, if taken by a woman who is already too ‘Yang’, will only serve to increase her symptoms (Tiran & Budd 2005).
Wristbands
Commercially produced wristbands, originally intended for travel sickness, are widely available and can be very effective. They work by stimulating an acupuncture point, the Pericardium (P6) or Neiguan point, on the inner aspect of the wrist, from where an acupuncture energy line (meridian) travels through the body to rebalance internal energies to and from the heart. Stimulation of the P6 point with acupuncture needles can also be undertaken by appropriately trained professionals. There have been numerous good calibre research studies on P6 stimulation and sickness of various aetiology, including NVP (Helmreich et al 2006, Streitberger et al 2006, Shin et al 2007, Can Gürkan & Arslan 2008). Siting of the wristband, with the stimulation button directly over the precise area for the P6 point, is important as incorrect positioning will make the bands ineffective, and is one of the reasons why use of P6 stimulation may be unsuccessful in some women. Stimulation of the P6 and other relevant points may also be undertaken by an acupuncturist, but mothers should be advised to find a qualified practitioner, preferably one who is experienced in treating pregnant women.
Vestibular stimulation
NVP is triggered, and can be exacerbated by, abnormal effects on the vestibular (balancing) mechanism in the ear (Black 2002). NVP is often worse for women prone to travel sickness, and normalisation of the balancing mechanism can be a simple means of reducing the severity of symptoms. A study of women with hyperemesis gravidarum indicated that electrical stimulation of the vestibular apparatus was effective in reducing nausea and excessive vomiting (Golaszewski et al 1995), and a contemporary commercial DVD (Morningwell™) is now available from the National Childbirth Trust. This uses inaudible pulsed frequencies overlaid with music, and must be used with personal headphones so that the pulsations rebound on the vestibular apparatus in the ears. The manufacturers claim this to be 90% successful in suppressing NVP, a fact which was borne out by a small study by a midwife in Hampshire (Mayo 2001).
Relaxation complementary therapies
Relaxation therapies can be helpful in cases where the NVP is worsened by stress and psychological factors, but midwives with little knowledge of complementary therapies should be cautious when advising women about these. Aromatherapy is not always acceptable because of the dramatic changes in the woman’s sense of smell which can occur, and because many essential oils are contraindicated in pregnancy (Tiran 2001). Reflexology can be helpful when administered by an experienced and well trained therapist, but it should be noted that most reflexology training courses discourage practitioners from treating women in the first trimester. On the other hand, reflex zone therapy, practised primarily by conventional healthcare professionals including midwives, nurses and physiotherapists, can be extremely effective in reducing the severity of symptoms, in some cases completely resolving the condition (Tiran 2009). Shiatsu, given by a practitioner who is trained to treat pregnant women, can also be beneficial, and massage may appeal to some women (Agren & Berg 2006). Psychological therapies such as hypnosis may also be of use (Simon & Schwartz 1999). Often, just listening to the mother and validating her symptoms can be a relief which enhances her coping mechanisms.
Other complementary therapies
Osteopathy and chiropractic, which are ‘professions supplementary to medicine’ and whose practitioners are statutorily regulated in the same way as midwives, are safe in pregnancy and will be effective for many women with NVP, but particularly those with a history of musculoskeletal problems. Homeopathic remedies can be useful for some, but it is important that the remedy is selected carefully in accordance with the individual mother’s precise symptoms. Although many homeopathic remedies are available over-the-counter, inappropriate administration can prolong the symptoms and may exacerbate the condition. Other herbal medicines can sometimes be beneficial, but mothers are best advised to consult a qualified and experienced practitioner, rather than self-administering remedies which may not be safe during pregnancy.
Conclusion
NVP is a common physiological condition of pregnancy, but one for which the incidence appears to be growing, perhaps due to stressed lifestyles, work commitments, delay in childbearing, environmental toxins and other factors. Whilst midwives may not always see women in the first trimester and be in a position to advise them in the early stages, they frequently come into contact with mothers in later pregnancy who are still suffering. Advice about lifestyle, dietary adaptation and simple self-administration of natural remedies may be sufficient to ease the severity of symptoms in many women, and midwives can also refer women to appropriately qualified complementary practitioners. This is, however, a specialist area of midwifery practice which deserves more attention in pre-registration education and subsequently in clinical practice.
Breaking news
Ginger use during pregnancy is being questioned due to a new report from the Finnish government. Finnish authorities are warning pregnant women not to consume ginger supplements, drinks, or teas. Ginger contains chemicals that are cytotoxic in vitro. The concern is that these chemicals MIGHT be harmful if consumed in large quantities. So far, no obvious problems have been seen in pregnant women taking ginger supplements in doses of about one gram daily. Advise women not to overdo it. More is not necessarily better. Also, consider recommending pyridoxine (vitamin B6) first for morning sickness. Vitamin B6 12.5 - 25 mg three or four times daily is safe and often effective for mild nausea.
References
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Denise Tiran is Director of ‘Expectancy’, the leading provider of professional education on safety of complementary therapies in pregnancy and childbirth. She would be interested to hear from midwives who would like to consider training to become Expectancy registered ‘morning sickness’ consultants.
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