This is a wonderful get post by Neve Spicer, researcher and editor at WeTheParents.com
If you’re reaching that 40th week of pregnancy and waiting in eager anticipation, you’re not alone. It’s not always the most comfortable state of being – quarters can get a little tight during the last leg of your baby’s nine month lease – plus, meeting them is the only thing on your mind. Now, no doubt you have heard that baby knows best and that they are just where they should be, however, if you’ve gone past your due date but your baby simply isn’t budging, you may also be concerned about medical induction, which can sometimes lead to a more complicated delivery.
Just as natural medicine has been inextricably linked to human history, so too have natural treatments suggested to induce labor. Traditional wisdom suggests a variety of methods which vary by culture, but sadly, the amount of actual scientific research that has been done on naturally triggering labor is minimal. Despite this, the veracity of the existing research does help to give moms some perspective on some of the most commonly used methods of natural labor induction.
Whileinducing labor naturally may sound like a gentler solution than the medical alternative, the studies that do exist show us that not all suggested natural labor triggers are safe or effective. Some may have no effect at all, and others may have unpleasant or outright unsafe side effects which contraindicate their use entirely. This can include labor and birth complications, so being educated on the topic isn’t optional if you’re attempting a natural induction.
It’s also essential to consult with your OB-GYN before considering natural induction methods. It’s important that you and your child be medically ready for your labor and that the method you’ve chosen is one that’s safe for you. To help parents understand the effects, benefits and risks of the most common methods of natural labor induction, WeTheParents have created this visualisation examining nine purported natural labor triggers with regard to if they work, how they work and the side effects parents should know about.
When a person goes into the hospital in labour, one of the first things that the staff of the hospital will do is strap two little disks on the persons tummy. This is what we call Electronic Fetal Monitoring, or EFM. These little disks are meant to detect the baby’s heart rate and when the uterus is contracting, and it prints this information on a little graph we call a Strip. As an Edmonton doula, I get to see strips a lot as you can imagine, but technically speaking doulas in Edmonton are not officially trained to read and interpret strips. That being said, some of you may know that I am the daughter of a retired labour and delivery nurse, and my wonderful mother who knew how much of a birth nerd I am gifted me with something really special: her old nursing textbooks! One of the books she passed along is called Fundamentals of Fetal Health Surveillance (produced by the Canadian Perinatal Programs Coalition and on it’s 4th edition published in 2009), and I’ve got to say as an Edmonton doula who loves ALL things birth, this is probably the most interesting one! EFM is such a huge part of birth in our current culture and as I sift through it, I’m realizing that all doulas in Edmonton should have an opportunity to learn more about this standard procedure.
Before reading this text I really never thought there could be any cons to monitoring the baby in labour. I mean, more information is always good right? Well, to be honest this statement isn’t entirely true, especially when you’re looking at a labouring person. The issue lies in the fact that not all of this information is completely error-proof, and even if it were we can’t always know why the strip is showing what is shows (more importantly if the issue requires intervention or not). First off, as wonderful as this technology is those damn disks are tricky to get placed right! And if you’re like most birthing people you want to be able to move around and cope with contractions however feels right – and you can’t fully do that with the disks on. So if say the person birthing is laying on their back in bed and strapped to the monitor and decides to roll onto their side, the disk measuring the heart can slide out of place and all of the sudden the baby has no pulse! (Except they do, it just wasn’t being detected). Now it’s common for this to happen often when being continuously monitored, so imagine how someone who needs to move around’s strip is going to look? Scary!
Second, when a birthing person is monitored, the idea is that the heart rate of the baby is constantly being watched and any deceleration or acceleration will be noted and recorded. So if there tends to be a lot of decels or accels or both, the care provider can take steps to remedy what is causing these fluctuations. The problem is… how do we know what that is? Most skilled nurses and doctors and midwives (and probably some Edmonton doulas) can take a really good educated guess as to what’s causing them, but at the end of the day it will only ever be a guess. I can’t tell you how many clients I’ve supported as a doula in Edmonton, that we’re told one thing because of their baby’s strip, and then when it comes time to deliver we find out it’s something completely different. At the end of the day we all need to remember that EFM is a source for information, not a solution or remedy to anything adverse that is happening.
Im sure many of you are saying “well, there’s no risk in knowing more information”… except there actually is. According to my moms wonderful textbook, for every 58 births 1 additional cesarean will replace a vaginal birth because of EFM. The reason why (in my opinion) is that the strip may have told the care providing team that issues were going on with the baby that needed intervention, and we know that medical interventions tend to take on a domino effect (once one thing is added, then things keep being added until the result is a cesarean birth). Another issue is that with continuous EFM, those darn disks make it pretty hard to move, and anyone who has given birth can attest that staying still during labour is IMPOSSIBLE unless you’ve got an epidural on board. So a scenario that as an Edmonton doula I’ve seen time and time again is: birth person goes into the hospital, the strip doesn’t look perfect so continuous monitoring is recommended, person can’t move and cope with labour pains how they need to, person gets an epidural. And here my friends, is where Edmonton’s 90-95% epidural rate comes from!
Now I definitely don’t want to disregard EFM as a useless medical intervention either – as a doula in Edmonton I’ve seen the information gathered from EFM be used to save mom’s and baby’s lives. I’m definitely a supporter of its use when necessary, but there are ways that it can be used more responsibly. First, many hospitals will offer what we call Intermittent Auscultation, or IA, which is the monitoring of the baby in intervals for shorter periods of time. This provides a sort of “check in” to make sure baby is still tolerating labour. If your strip does look abnormal and it warrants being monitored continuously, take breaks! In this textbook it does state that SOGC (Society of Obstetricians and Gynaecologists if Canada) recommends when a normal heart rate is identified , taking 30 minute breaks (as long as baby’s heart rate is stable) is appropriate. That being said, many hospitals and care providers in them don’t practice this way and want you to stay on the monitor always. If you find yourself trying to compromise in this situation, just remember that the monitor in itself is not a cure for anything – it will only give you information. And if it comes down to either getting off the monitor to use the shower for 30 minutes so you can make it all the way to pushing, or staying in bed on your back and baby can’t make it through the pelvis and now a cesarean is required, I would like to think that most of you would insist on a small break. Breaks can also clear any mental and emotional distress that may have arisen from hearing fluctuations in baby’s heart rate.
Sorry, this post is a long one – but it has totally got me pumped up this Monday morning! We’re you continuously monitored in labour? What was your personal experience with EFM?
So I have to apologize peeps, I’ve been off of my blog pretty well the entire summer! There’s been a lot changing in the realm of Dancing Doula that I wanted to update you on finally, and maybe this will explain my crazy hiatus over a few months (while also factoring in chasing around two crazy toddlers of course 😝). First, I’m in the midst of starting up a VERY exciting local non-profit society. I can’t give you any more details at this time to avoid drawing attention away from our big reveal, but be sure to stay tuned on my social pages for an announcement in the next month 🤗. Second, summer was pleasantly full with a variety of births that I learned a ton from, so I’m really excited to start posting again about some of these things and hopefully educate some of you on some things you didn’t already know. Third, and the BIGGEST news of all… I’m officially moving from a solo doula to a shared-care doula and partnering up with my wonderful friend Vanessa!
So for those of you who have never hired an Edmonton doula or don’t know the common structures of doulas in Edmonton and how we run our practices, this is a big change. I’ve only ever taken on clients as an Edmonton doula on my own – something that allowed me to always call the shots but also made it incredibly difficult over the years to juggle working and being a stay-at-home parent with a hubby who works away. With V heading back to school, we both decided that pooling our resources and working as a team was the best option to make our lives more manageable.
So what is shared-care? Let me fill you in! In a shared-care setting, you will hire a team of two Edmonton doulas to support you during pregnancy, birth and postpartum. Many Edmonton doulas structure this differently, but what V and I have chosen to do is to share the prenatal load (private visits, the group class, text and phone support, emails, etc) and then work an on call/off call schedule that works around our limitations with time. When our client goes into labour, they will get the doula who is set to be on call that day. Long births would warrant us to swap out for the other so that you’ll always have the support of a well-rested and we’ll-functioning doula. After the birth, the doula who attended will do the postpartum visit.
Its a simple concept really, but I’ve already noticed how much of an advantage our clients have when getting two Edmonton doulas. V and I have similar energies and philosophies, but our experience with birthing babies ourselves and our particular interests are very different. So when you ask a question, you’ll get different perspectives but the same evidence based information following. This really enhances your ability to make an informed decision – knowing that the intuition has been challenged by hearing information in a multitude of narratives. Another bonus is that our response rate to clients has increased with two people being available to answer non-urgent questions.
Im really excited for what the future holds for Vanessa and I! If you’re looking to hire a doula in Edmonton be sure to send me a message about what we as a team can offer you. We are in the process of working on a site page to outline ourselves and our partnership in more detail, but for now you can see Vanessa’s profile on the Full Circle Birth Collective website.
There’s no way around it — doula work can be isolating.
The fact that any independent birth worker is a small business owner provides a lot of huge benefits to that person in so many ways. It can be exciting and empowering to own your own company, be your own boss, have ultimate power on business decisions ranging from how your website looks, to how many days a week you work, to which clients you take.
There are also downsides to running everything on your own, but one of the biggest is the feeling of being alone in the woods when it comes to your skills and performance.
One HUGE thing doulas can start doing to combat the issues of accountability and isolation is forming and attending peer reviews.
These are the basic components of a peer review :
1. First and foremost, this is a confidential and nonjudgmental arrangement. What is said in peer review stays in peer review. Even if the topic at hand is a complaint or concern, the advice given is done compassionately and in an effort toward improvement, not pettiness.
2. To conduct a peer review, there needs to be at least three peers present. In the case of most colleague peer reviews, there will be three doulas who are able to sit or present or both. In the instance that peer review is called as arbitration between parties, there will be a panel of at least three doulas in addition to the parties presenting their issue.
3. The order of peer review is as follows : One person presents a concern, uninterrupted, for 20 minutes. Following that, those who are there to “sit” may ask questions and offer advice for another 20 minutes. There is a quick check in with the presenter to make sure they feel ok about what’s been discussed and then the next presenter goes. This repeats until everyone who came with a concern has had the opportunity to be heard. In the case of peer review being offered as a form of out of court arbitration, the party presenting a concern goes first, followed by the person to whom the issue is being addressed, then the panel can ask questions of either party and give advice till a resolution is agreed upon. If there is no conclusion made, the next step would be to repeat the process with a third-party mediator brought in.
Peer review or professional performance review is a common practice in many professions, and it should be more common in doula work. This is both for our ability as care providers to check in with our community, work through trauma, obtain valuable resources, connect with one another, and grow as well as to holding our profession to the highest standards. Particularly as issues around certification and self-definition emerge, peer review can serve as valuable grounds for finding weak spots in our profession / community and addressing them from within so they’re not mandated over our heads.
This isn’t to say that peer review should be an intimidating process; quite the opposite. The point shouldn’t be that there is a firing squad or mob to tell you that you’re doing something wrong, but that you have the backing of your peers in working through the common issues in our difficult work. The rules and structure of a peer review — confidential, contained, focused on moving forward productively — can go a long way toward giving you applicable tools rather than tossing you to the sharks of online chatrooms and closed groups on social media alone. These in-person gatherings ensure you’re talking to colleagues familiar with your local community, which can make a much bigger impact on addressing your concerns, too.
Being able to offer the existence of a structured peer review system as a form of out of court accountability can be a huge selling point to expectant parents. Whether it’s through your doula agency, collective, or group, letting parents know that you are expected to live up to the standards of our profession and that they’d have resources outside of the tediousness of small claims court can offer them a sense of trust and relief when signing into a contract with you.
Additionally, peer review should be part of the membership requirements of any community doula group. It offers an amazing opportunity to get to know the other doulas in your area on a deeper level, to disseminate important information about primary care providers in a HIPAA compliant and professional manner, strengthens referral networks, and offers an avenue for handling the occasional bad seeds amongst us.
If you don’t already have a peer review system in place in your doula group or agency, will you consider starting one? It might take a few tries to get people feeling comfortable with this process, but it’s a truly essential part of brining this profession out of the shadows. It’s low-to-no cost, too, so its an accessible way for doulas of all stripes and experience to gain knowledge from one another. It’s also a really good way for us to each grow as individuals. Understanding how to give and take constructive criticism and utilize it effectively in our lives can have lasting benefits to ourselves and our clients.
Emily Flynn has been a birth and postpartum doula for over a decade, additionally working with hundreds of families a year as a birth attendant, educator and student midwife. With her legal research background and focus on broader policy issues around pregnancy and birth options, Emily has begun supporting doulas through writing better contracts through workshops and private consultations. She is also a gentle infant sleep coach and educator, and trains doulas independently and with Cornerstone Doula Trainings on infant sleep basics and sleep coaching.She currently lives in Felton, CA.
Birth is a sexual act. This statement may make some of you uncomfortable, but regardless it is true. Looking at the hormones involved in both sex and childbirth, it becomes impeccably clear that humans have the right tools to feel pleasure during the birth of their children, and from seeing dozens of couples birth babies this Edmonton doula can absolutely tell the difference between those who are comfortable being intimate and those who are not. I say we need to start educating people on how sex plays a part in all aspects of childbearing, so that expecting parents can avoid feeling shameful or strange if they feel sexual feelings in this time when it may have previously been perceived as “wrong”.
Lets start by looking at one of the very basic facets of birth: the hormone oxytocin. Oxytocin is coined “the love hormone” as it is what creates the feeling of falling in love. Butterflies, goosebumps, feeling completely attached to someone’s soul… all of that good stuff is made possible because of this wonderful hormone. There are a number of hormones that cause physical orgasm, but can you guess what one of them is? Oxytocin! When you achieve that lovely, magical, big O, you are feeling the surge of oxytocin and various endorphins rushing through your blood. And this, my friend, is how babies are made 😉 Going further into this, is the fact that orgasms often cause involuntary muscle contractions in various areas – particularly in females, they cause rhythmic contractions about 0.8 seconds apart for around 15 to 30 seconds. Sounds familiar doesn’t it…
Looking at birth, you may already know that oxytocin is what causes your uterus to contract. But what you probably didn’t know, is that the other hormones I mentioned in the previous paragraph, endorphins, are also released during a contraction to help stimulate relaxation and reduce a pain response. So my friends, contractions and orgasms are chemically the same process! Woah!
Ok let’s go even deeper (pun intended, hee hee) into how similar contractions and orgasms are. Have you ever been disrupted while self-pleasuring? Im not embarrassed to admit that I have, and I can attest to what you probably are all thinking – it sucks! You get this sudden feeling of anxiety, shakiness, and wanting to run and hide, very similar to when you are put in a high-stress situation like coming close to a car accident or someone frightening you very suddenly and abruptly. This feeling is caused by adrenaline… our “fight or flight” hormone that’s secreted in order for us to direct enough energy to survive whatever is threatening us. When adrenaline is released in large amounts, oxytocin can’t flow and therefore pleasure has no room to exist. That feeling that I just described is actually what birthing people feel when they aren’t given the space to be primitive and physiological in their birth space. Its our brain’s way of saying “let’s just continue this somewhere more private”. So contractions stall out and labour takes a break until we can feel more intimate and safe. What soooo many expectant parents don’t know beforehand and what I, an Edmonton doula, want to tell you is that letting go of those inhibitions is what it really takes to have a physiological childbirth. Your body and your primal self do not care about what society thinks about being vulnerable or sexual during labour – your labour will not continue progressing naturally without the optimal setting – a safe, comfortable, ambient space and supportive, non-judgemental and non-controlling people around you.
I’ve noticed as I’m attending more and more births as a doula in Edmonton, that the toughest thing to overcome is trying to birth in a hospital when you land a team of care providers that you don’t feel comfortable with. Some of the staff at the hospitals in my area are wonderful for allowing you the private space to work through labour without trying to intervene… but some really don’t do this well. Perhaps they don’t believe that birth is more of a natural process than it is a medical one, or maybe some are bound by hospital policy and fear of losing their jobs. Whatever the reason, many medical professionals take a more “hands on” approach and are either constantly with you and offering up their unwanted advice on how you should get through your labour, or demanding that you follow a specific procedure without a full explanation of the risks and benefits of what they are wanting to do. Never are these individuals ill-willed, it’s just simply a lack of understanding or belief of the power of a truly physiological birth. This is something that I, as a doula in Edmonton, struggle deeply with. It is not an issue that can be easily resolved as our entire healthcare system has been taught to believe that their standard procedures are correct – more correct than a birthing persons ability to follow their own body and act while fully in tune.
So how to we go about changing the verbiage around not just sexuality during your birth, but sex as being “shameful” in general? Well I believe that drawing these parallels to sex and birth, both being instinctive parts of human nature, can help people to realize that they are not in fact shameful. Being open about talking about sex and birth, alone or together can help others to feel more comfortable over time.
How did you feel while reading this post? Did you feel comfortable or not? I encourage you to explore why you had the reaction you did and how society has maybe impacted that!
After about an 8 week hiatus from attending births, I got to witness an incredible mama give birth this past weekend. Now as an Edmonton doula that’s witnessed many births, I’ve gotten used to the weird hours, the various bodily fluids and seeing women be incredibly primitive (to learn a bit more about what the life of an Edmonton doula is like, read this blog post). However, there’s one thing that just doesn’t seem to get easier with attending more and more births – and that is the hormonal come-down that I, your Edmonton doula, experience after a birth.
To further explain this interesting phenomenon that I and many other Edmonton doulas experience, I first want to find another situation to relate to. In my earlier adult years I attended many concerts and festivals (ok I’ll just say it, raves) where many of the patrons partook in various substance use. I actually worked as a character model for a while in which I’d wander around these raves dressed up in various costumes and interact with guests to enhance their experience. This would require me to be in close proximity with many people who were high on various things, and one thing I was warned about was the “contact high”. For those of you who have never heard this term before, it’s a theory that if you get close enough to someone who is “trippin’” to the point that you touch them, you can experience some of the side effects of the high just by physical contact. Many people I know think this is just a silly excuse that ravers made up to deny that they used drugs, but others are adamant that it is true and I now belong to this group!
My reason for sharing this (other than establishing that I in fact used to rave a ton and I’m proud of it!), is because for an Edmonton doula, birth can cause a massive contact high. We hip squeeze, massage, hold, hug, rub your back, etc… it’s not very often that we aren’t in physical contact with our clients at some point. Even without physical touch, as Edmonton doulas we are empaths and absorb a lot of the energy from the room. So after a birth, many of us experience very real and very intense “birthy” feelings. I’m sure many Edmonton doulas manifest and process these very differently, but personally I experience intense emotions (crying spells, feelings of euphoria, moments of anger, etc), uterine cramping and even sometimes, when it’s a really intimate birth, mild interruptions of my menstrual cycle (increased fertile mucous, intense cramping if I am bleeding at the time, a delay in bleeding, etc) after getting home from a birth. It’s like we absorb oxytocin in huge amounts and then when we get home, we have to come down off of that surge in oxytocin! Totally wild I know and I don’t have any evidence to share that this is a real thing, but I can give you some names of some Edmonton doula sisters that will attest to experiencing the same thing!
Are you a doula or another birth worker? Have you experienced a hormonal come down after a birth? Tell me about your experience in the comments!
In the few years I’ve been writing on this blog, I’ve seen posts like these done but have never gotten around to writing one myself. Based on the high number of Edmonton doula clients that ask me what to pack, I think it’s time! Today I’m going to share the top 5 items that, in the opinion of an Edmonton doula, you MUST bring along to your birth.
Now I will preface this post by saying, LESS is MORE! Especially if you don’t have an Edmonton doula at your birth, you’re not going to want to be lugging around a million bags once it’s time to go to the hospital. Us as doulas in Edmonton are willing to help with bags, but trust me when I say that it’s the lowest on our priority list. We do bring a lot of helpful items ourselves, but there are many things that you can bring that are small and don’t take up much space.
1. A Pillow
Not sure where exactly you all are from, but for those who are Edmonton parents the hospitals here have the worst pillows. They are flat, hard and the hospitals usually won’t give you more than one. Seriously, sleeping on a rolled up towel will be more comfortable! Bringing your own pillow is great for comfort, but there are also ways to “spruce up” your pillow to help with labour. A couple of examples: get a really soft pillow case to rest your face on (the softness will awaken the nerve endings on your face and block some of the pain receptors according to the Gate Control Theory) and spritz it with your favourite perfume, cologne or drop with a relaxing essential oil (using aromatherapy during labour is an evidence-based comfort technique).
So snacks are important, but not every snack is made equal. When it comes to birth, you likely won’t feel like eating many things but you want to keep your energy up. While most hospitals will give you juice, that is about the extent of what you’ll get while you’re there – so make sure to bring your own! My go-to snacks even as an Edmonton doula who usually stays up into wee hours of the night, is energy-boosting fats. Think nut butters, bags of nuts or trail mixes, granola bars mad with flax seed and/or chia seed, dark chocolate… anything high in “good” fats (the omegas) to keep you satiated and energized. You can even pre-make your own snacks like fat bombs, granola, etc. Even something as simple as coconut water can be a game changer! Also, pro-tip from an Edmonton doula: pack candy! The sweet in your mouth will activate the nerve endings on your tongue to help with pain.
3. Lip Balm
This is a big one surprisingly! For the amount of breathing you *should* be doing during your birth, plus factor in not feeling like eating or drinking, your lips get dry AF. It might seem like something so small in the grand scheme, but dry, chapped or peeling lips are going to distract you in a bad way and bring more discomfort to an already uncomfortable situation. Plus, us Edmonton doulas don’t want to get in the habit of sharing lip stuff with all of our clients. Bring whatever style of lip balm that you normally use day-to-day, but if you’re in the mood to buy something new, try a really sweet and fruity flavour or a minty one!
What would we do in this world without music! I honestly can’t think of a time when music did not calm me down or help me through a high-stress time in my life. This one is important but I know personally as an Edmonton doula I always come equipped with music I find relaxing. I love to try and personalize my playlist based on what kind of music you respond well to in labour, but what’s even better is when the birther makes their own and brings it. If you don’t have an Edmonton doula or they don’t have a speaker, you’ll want to either bring your own or bring your headphones so that you aren’t listening to poor phone quality music. The sound should be loud enough that it drowns out some of the hustle and bustle of the hospital (your oxytocin can’t optimally flow with beeps and buzzes going off all of the time) but not too loud where it’s not relaxing. In regards to style of music, think genres that are mellow. Acoustic instruments, even a very mellow style of electronic music like drum and bass or deep house can be nice and have a steady beat to follow to help with focus. Avoid high-frequency sounds like really dance-y music or rock… unless these are normally sounds that relax you. When in doubt, Spotify!
5. Hair Brush/Hair Tie
One thing I very vividly remember as a child is that when I would get upset or worked up about something, my mom would put me in my bed and brush my hair. It was the beeeeeeest – instant calm. The gentle strokes of the bristles running down my scalp, feeling each little hair gently pull away from my head, it was like a rush of pleasure signals to my brain! So I always remind women in labour that I support that hair brushing, such a simple act, can feel super nice. You’ll also likely be getting out of the bath or shower at some point too and you won’t want your hair tangled and matted for the remainder of your birth. A hair tie is a MUST when you start to sweat a lot, perhaps vomit or it just starts to bug you. Never leave without a hair tie ( I’m sure most of you don’t!).
Bonus: This one is for the Partners!
Partners, when you are at the hospital and start using water, many birthers will want you to help them and sometimes, even get in with them. It can be soooo therapeutic and allow hormones to flow beautifully if at some point, you are given an opportunity to be skin-on-skin in the water. So, bring swim stuff! This way you won’t have to either pass up on an opportunity to be physically with your partner or just go in the buck. Most people wouldn’t feel comfortable with this but if you would, you GO!
What other essentials do you think need to be added to this list? What was your most useful hospital birth bag item?