How to use your BRAIN for birth!

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If you have been following my previous posts, you’ll know by now how much of a fan I am of informed decision making during the childbirth process. Being an Edmonton birth doula and Edmonton prenatal class instructor, it should come as no surprise that I believe women should be respected and given the option to make their own choices according to how they want their birth to proceed. I like to think of it as practice for motherhood, where you’re constantly making decisions for your child’s future… and believe me, they sure don’t get easier! Breast or bottle feeding, co-sleeping or bed sharing, cloth diapering or not, decisions decisions decisions! As long as you are educated in the risks and benefits of both, no two decisions are better than the other.

But exactly HOW do we go about becoming educated and making these important decisions in our child’s life, or more specifically, during childbirth? Us Edmonton doulas like to refer to a cool acronym, BRAIN, which is a method of decision-making using a combination of the facts and how you feel. Here’s what all of the letters in BRAIN represent, and how to use BRAIN properly:

B РWhat are the benefits?

Begin the decision-making process with the positives – what good things will come out of this decision you are about to make? Let’s take, for example, using an epidural. The obvious benefits are the sweet, sweet relief of not feeling contractions as intensely as you did before. Another benefit is the possibility that you are able to relax enough (maybe even get some much-needed shut-eye!) to allow the labour to progress. Like everything else in life, I love looking at the positives first ūüôā

R – What are the risks?

Now on to the less-happy portion – what are the potential risks you may face by making this decision? Going back to the epidural example, you could be facing a prolonged labour, difficulty pushing, an increased need in labour augmentation (which could put baby in distress), difficulty breastfeeding, etc. Listing out these risks will help you decide if it is worth the benefits to YOU (not to anyone else).

A – What are the alternatives?

Usually, there isn’t one route to go during labour… hence why educating yourself completely is so important! Now that you’ve established the good and the bad, is there anything you can do other than this particular path you are deciding on? For example, if you are thinking about an epidural, are you able to try Nitrous Oxide or a shot of Morphine first? Have you explored all of the natural pain-coping techniques yet? Know your options so that you don’t feel backed into a corner with nothing else you can possibly do.

I – What is your intuition telling you?

Women are very lucky to naturally possess an incredibly strong intuition. I rely on mine quite heavily in everyday life and childbirth is no different. This time, you also get to factor in your motherly intuition which is an added bonus! So what does your gut tell you to do in this situation? No one can help you with this particular point, and it’s important to not let anyone interfere with what your intuition is telling you. Take a moment to be alone and away from other opinions if you need, but be sure to tap into your inner self for a moment to stay on your preferred path.

N – What if you do nothing?

The last point of the process is looking at the possible scenarios if you avoided this decision completely. Is this decision so important that by not doing it, you are threatening you or your infant’s life? By not making this decision, is it going to weigh on you forever? In the example of possibly getting an epidural, if you were to not do anything for just another 30 minutes, will you be okay to deliver your baby and be happy with your decision? Will an epidural be possible at any other time (perhaps you’ve got a very busy anesthesiologist who can only see you right at this moment)? Play out this scenario in your head first and see which seems more appealing.

I love the BRAIN acronym, not only because it allows moms to make educated decisions, but it temporarily takes you away from what might seem like total chaos in the labour room and brings you to a slowed-down mindset. Going through each point will bring you some relaxation and stillness, and we all know how relaxation is key when having a baby. What decisions are you thinking about right now that you could use the BRAIN acronym for? Have you ever taken these steps to make a decision prior to today?

Preparing for the BIG day!

So you’ve got the fetus growing inside of you, you’ve made it through the morning (or as I like to call it, all-day) sickness, the extreme sleepiness, the weird dreams and the common aches and pains. Now you’re on the home stretch! But… now what? How do you begin to prepare your body for one of the biggest physical events of your life?!

Preparing for childbirth is not super difficult, but it is very important. After all, you wouldn’t register for a marathon and head in with no training or preparation, would you? Childbirth is your marathon, and labour can be a long, strenuous journey or a quick-and-chaotic sprint, or somewhere in between. Regardless of what the birth gods bless you with, you and your beautiful bundle need to be ready for what lies ahead in order to look back on this day with love and joy, instead of disappointment or fear. Here are my tips and tricks to getting ready for childbirth:

Eat a balanced, nutrient-dense diet

In my infographic you’ll notice that I say eat like a diabetic, because in my opinion (which was passed down from my L&D-nurse mother who I think is brilliant), the diabetic diet is THE healthiest diet for anyone and everyone. Especially pregnant women. The concept behind a diabetic diet is simple: balancing your carbohydrate intake with your protein intake, choosing whole-grain carbs which have a higher fibre count, being mindful of your fat intake and going crazy on your veggie intake. Any of you who have Gestational Diabetes like I did totally get what I’m saying. Keeping your blood sugars in check during pregnancy will not only keep your weight gain steady and healthy, but it will also ensure baby’s blood sugars are balanced at the time of birth. Unbalanced blood sugars in baby mean struggles with bonding and breastfeeding in the first 24 hours of life.

Go Easy on the Lifting

This one is a topic that’s important to many women these days, as fitness competitors seem to be everywhere and women are finding empowerment through being strong and muscular. However, pregnancy may not be the best time for all of the ‘gains’ (excuse my non-fit-girl lingo). It’s true that given an absence of any issues that would place you into a high risk pregancy category, you should be able to continue all of the exercises you were doing before becoming pregnant. The one thing to remember is that having craaaazy strong muscles isn’t going to help you in labour… in fact, it would possibly hinder it. One of the most important concepts that I teach students in my Edmonton prenatal classes is that relaxation is key, but women who have such highly developed muscles will naturally have a harder time relaxing the muscles enough to make labour steady and more simple. One thing is for sure, save the “kegels” for after the birth!

Get your cardio on!

Now when I say take it easy on the lifting, that doesn’t mean this is your excuse to ride the couch all day every day (unless you’re struggling with extreme fatigue or nausea… then I feel for you girl, do what you gotta do!). Light cardio is the greatest for pregnant moms as it will keep your weight gain controlled, give you a much-needed energy boost and help build up your stamina for that long journey of labour ahead. The BEST prenatal exercises, in my opinion, are: brisk walking, swimming and prenatal yoga. Walking will also do the job of balancing your pelvis and uterus (yes, your uterus can get twisted!) which will help with optimal fetal positioning… which I will cover on a different blog post.

Keep your stress levels at bay

Whether we like it or not, stress is a part of most of our everyday lives. This is especially true if you’re still working or have children to care for already, but some of us just don’t tolerate stress well (I can definitely relate to you). The big problem with stress in pregnancy is that it’s impact on our entire body, like an increase in muscle and joint pain and holding tension in parts of your body to the point of causing imbalance, is going to effect our labour. It’s important that we find effective ways to manage our stress long before our labour starts to minimize these effects and teach our minds to be calm while bringing baby down. Some excellent methods of reducing stress, and things I often indulge in on the regular, are breathing exercises, meditation, intimacy with your partner, going for a float (floats are huge in the Edmonton pregnancy industry!) and shutting off to enjoy your favourite book or TV show.

Embrace fear

We’ve all got em! Maybe your fear stems from the pain of childbirth, or maybe the random obstacles that could get in your way, or so on. Whatever it may be, hiding your fear or pretending it doesn’t exist is not only unrealistic, it just doesn’t work. You see, childbirth has the incredible ability to bring up a lot of repressed, negative thoughts, sort of like th body expelling everything before the baby is ready to come. I’m not going to tell you that you are not allowed to be afraid, because that’s unrealistic as well. What I am going to tell you is that acknowledging and addressing these fears will significantly prevent any blocks or stalls in your labour. It’s a human, primitive instinct to stop your body from birthing a baby in a fearful environment – it was the way that our earliest species avoided surrendering our spawn to predators. With this in mind, speak about whatever fears you have with your partner, care provider, doula, mother, etc, think of ways to try to minimize this fear, and then simply embrace what you cannot change.

Select the right care provider for YOU

We are lucky enough to live in a country (if you’re reading this from Canada) that allows us choice in who delivers our baby, according to what we want. We are different in how we envision our birth going – perhaps you want all of the medical equipment at your disposal, or perhaps you get freaked out by hospitals and want to birth in your own bedroom instead. Maybe you want ALL of the pain meds, or maybe you want to try and let your body lead the way with little intervention. Regardless, it’s important to remember that you have the final say, and who you choose as your care provider will directly effect your birth outcomes. Don’t be afraid to harness your inner hot-shot CEO and interview multiple candidates before you select the right provider. Ask their standard practice with things like labour augmentation and desired pushing times, etc. There ain’t no shame in the birth preferences game!

Hire others to make your experience great

For the amount of stuff that happens while your pregnant and during labour, there’s just no feasible way that a single care provider can cover everything. This is where people like pelvic floor physiotherapists, prenatal instructors (particularly an Edmonton childbirth educator like myself), birth doulas and masseuses come into play. The best place to start is to enrol in a really good Edmonton prenatal class (or a class where you are located) and get some ideas of what you might need from there. Pelvic floor physio is a must in my opinion, but no one enjoys a luxurious pampering more than a pregnant lady with swollen feet and a sore back! As for doulas… we are just awesome. We are the factor that separates positive birth outcomes from negative ones. Just make sure you interview lots of Edmonton birth doulas and choose the one that meshes well with you, your partner and the unique relationship you have.

Birth in your happy place

Ok so maybe thats a bit of a long shot, I mean we all can’t have our babies on the white-sand beaches of Aruba (if only!). We can, however, birth in a place that feels safe. That could be your home if you dislike hospitals or a hospital if you’re a better-safe-than-sorry kind of thinker. Either way, be sure to determine where you are going to feel safe. Remember what I said before about our primal instincts… our bodies will not allow us to birth in a space that does not feel comfortable!

Keep those partners in the loop!

The fathers or other parents are so often overlooked which is a total bummer, as this is a major experience for them too! In order to break this unfortunate predisposition, why not prep them as you would prep yourself. For starters, a good Edmonton prenatal class will teach you ways of how your partner can play the comfort role in the birth space. As well, it will prepare your partner on what kind of sounds and visuals they will experience, which will prevent them being emotionally scarred. It might seem like their role is so minuscule compared to yours, but they will take away a lot from birth as well – particularly, they will remember everything and have visual memories to last forever. Let’s made sure they are positive ones!

So there you have it folks, my drawn-out list of things to do to get ready for the big day. What kind of things are you going to do to prepare for your birth? Leave me some unique prep ideas in the comments!

Tales of a Pregnant Doula, Pt 2

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Its been a crazy couple of weeks for me, being at my last birth before my next child arrives and teaching some prenatal privates. However, I thought I was long overdue for a post… and what better to write about than a follow-up on my last post about being an Edmonton doula (while pregnant)!

There have been times I’ve hummed and hawed about taking on more clients closer to my due date, but I think my cut off of 2ish months is perfect after my last experience. Here are a few cool and interesting things I’ve observed about attending a birth during my own pregnancy:

Sleep is a must

During this particular birth, I found myself very keen and committed to helping mom have a wonderful experience. I don’t know if it was all of the training and education that I’ve been doing, or just the fact that I wanted to finish off big before my temporary leave from the industry… and by no means am I saying that I’m not always so keen. Either way, this was the first time in a long time that I headed over to the mom’s place well before labour really kicked into high gear and helped with positioning and pep talks. While I don’t regret doing this as it was wonderful to bond with mom and dad before heading to the hospital, sleep was definitely an issue this time around! I found myself hitting a wall after being up all night and this time I couldn’t just rely on adrenaline to stay awake. I remembered the advice that a few senior Edmonton doulas gave about grabbing rest when it’s needed to be more effective at your job, and once this mom decided to have an epidural and get some much-needed sleep herself, I ran home for a quick cat nap. Boy did it make a difference! So when in doubt, sleep it out.

People always listen to the pregnant lady!

Walking in with your doula tag on, sporting a round tummy definitely catches some eyes, but when it comes right down to it, I really found that I was heard well this time around. The nurses in the hospital took what I said very seriously and my clients seemed to be focused in on what I was saying. I can’t help but feel that being pregnant played a role in this. I mean, it could just be that I was giving some stellar, well-backed information and tips on how to keep the labour progress moving along. Maybe… but I’m going to stick with that I physically looked like the pregnancy expert ūüėČ

Consider your body mechanics

I, like many other Edmonton doulas, always attend births with my “bag of tricks” (for lack of better term) to help mom through the intense parts of their birth. My strongest assets are physical forms of support, like counter pressure and supportive labour positions, but I’ve never felt so spent after doing a belly sift before! I’ve never put much thought into HOW I am performing these services for mom, but I think it’s about time that I do. Having lasting energy through an entire birth ¬†process is crucial in order to do your best work. I also think speaking to a physiotherapist might shed some light on how to ensure what I do is body ergonomic.

Watching a birthing mother brings more passion and love than ever before

For any of my previous clients who know me, I’m definitely one to shed a tear when baby makes his/her entrance into the world. Watching a baby being born is one of life’s most miraculous sights! However, watching one while your hormones are at an all-time high brings on a whole new level of emotional fluctuations. I’ve never been so proud of a client and of myself for helping the clients get a birth experience that they will look back on with joy. Also watching that inevitable turning point, where the mother feels she can’t go on and having to bring her back and ensure her she can – I felt I was really able to shine at this moment with one of my infamous motivational talks. And you know what? A lot of it this time was me telling myself the same things that I want to hear before my own birth!

So being a pregnant doula is not an easy task, but all-in-all it’s so incredibly rewarding and humbling. When you start to have doubts in yourself, seeing other women do this amazing thing really restores your faith in female preserverence and heightens the importance of a strong connection with your partner. I can’t wait to return to supporting births in Edmonton once my mat leave ends!

What you should know about the Stages of Labour

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Any basic Birth 101 class *should* teach you the 3 stages of labour and what to expect from your body during each. As an Edmonton birth doula and Edmonton childbirth educator, I’ve studied these stages like the back of my hand and have seen or heard of them coming to fruition in various ways. I really want to talk about these from a doula perspective, as there’s so much to be said about what these milestones¬†actually mean.

For starters, if you’re a first-time mom (or FTM in cyber lingo), you might be told that this is the way labour looks and if it doesn’t look like this, your birth is not normal. The truth is, a normal birth has a tonne of different outcomes, time lengths and perceived experiences. It is incredibly true when people say that no two mothers, no two pregnancies and no two births are the same! The lovely graphic you’ll see above is what I’ve designed to represent the rough estimates of a typical birth, but I’m going to expand on the important things of these stages below.

Stage One is the longest and the time when some incredible hormonal shifts happen

There’s a reason why the first stage of labour is broken into three parts. Just from looking at the graphic, pain levels will vary hugely and the amount of time this stage typically takes is 84% of the time your birth will be total. It’s important to keep in mind that the rough time estimates shown in the graphic are NOT always the norm… I’ve been to much longer births myself! This is mostly just an average, and it’s totally okay to not conform to that of your average peers. What’s really cool about the three parts of each stage of labour is the cycle of hormones that run through your body and the shifts that progress how far along you are. So to start with, when baby decides he/she is ready to come, they will signal your brain to start producing oxytocin. Oxytocin causes contractions which hurt, so in response your brain will produce endorphins which is¬†your body’s natural pain-fighting chemical and will reduce the pain you get from the contractions. The cycle keeps going and going (as long as there aren’t any medical interventions disrupting the cycle) until baby is born, but what many people forget about is that in order for contractions to be productive, they must get stronger. Many people think that this strengthening of contractions is supposed to happen gradually throughout your entire labour, and for the most part it does, but there are two times when the increase in oxytocin is rapid. Can you guess when these times are? That’s right, between early and active labour and active and transition! So keeping this in mind, I hope you remember that when you’re all of the sudden unable to cope as well as you were with contractions before, to take some time, relax and wait for just 20 mins or so – your body is playing catch-up with the endorphins it’s producing.

Stage Two is (usually) NOT the most painful part!

One thing I actually thought to be true before¬†I had my daughter was that pushing was going to be the worst part of labour. Understandably so, thinking about squeezing a human through a seemingly small hole sounded excruciating! However, let’s talk logistics of childbirth. First of all, your cervix gets to be a whole 10cm wide which is roughly the size of a bagel… not so small after all. Second, your vagina is ultra-stretchy, kind of like the neck of your favourite turtle-neck sweater. It will conform to the size of baby and then retract right back to normal size after the birth. Finally, the pain you’ve been feeling during the first stage of labour is partially due to your pelvis making some major shifts to fit baby though… so that part is done with. Now all you’re left with is exerting all of that built-up energy into the physical act of pushing. Not surprisingly, this stage can actually be somewhat relieving! Now, as I mentioned before labours vary hugely so there are some women who may experience painful second stages. A big culprit will be if there is an emergent situation where baby needs to come out right away and assisted birth tools are used. However, preparing yourself to understand what is happening and to make informed decisions will lessen the likelihood of falling victim to a painful push.

Stage Three: there’s a lot more going on than you’d think

Another common misconception (and one that I was previously guilty of) is that stage three doesn’t really matter much. The bulk of the pain is gone, your baby is here and everything is rainbows any butterflies. But remember the love hormone oxytocin that ruled your labour? She’s still not finished yet! Oxytocin is SUPER important in stage three of labour as it is going to allow your uterus to contract and prevent excessive bleeding after delivery. Roughly 18% of women experience this bleeding so it’s very important that you understand what’s going on after baby comes, even if your main focus is going to be on swooning over your new bundle. If you’re going to deliver in a hospital with a doctor, they will often make one important decision for you if you have not voiced an objection to it previously. This is called active management of the third stage and involves getting a synthetic form of oxytocin administered and controlled cord traction (which is when the doctor will pull slightly on the umbilical cord to stimulate the delivery of your placenta). Now, this may be exactly what some women want, but it’s important to know that you do not have to do things this way! It is your decision to do active management or expectant management, which means using natural methods to bring about more oxytocin. Things like breastfeeding right away, nipple stimulation, immediate skin-to-skin with baby, keeping the room atmosphere conducive to mom’s comfort, etc. will all help the oxytocin to keep flowing enough to get that uterus contracting and avoiding postpartum haemorrhage. The choice is yours and no one choice is better than the other – do some research into the statistics and process of each before your due date approaches.

There’s obviously a lot of info about the stages of labour that I’ve left out of this post, but unfortunately this blog will not replace the good prenatal education you should have going into your birth! If you’re in Edmonton and having a baby, I’d love to guide you through the important things to know about childbirth (head over to my¬†contact page to get ahold of me), and if you’re outside of Edmonton, AB I highly suggest looking for a prenatal class with a TRAINED childbirth educator (if you can find a Lamaze class, even better!)

Fear-Tension-Pain Syndrome, De-bunked!

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So as a first-time-mom preparing for your birth, I’m sure either one of two things are happening in your life right now. You’re either A) freaked right out by stories that people are telling you about the “worst pain you’ll ever experience everrrrr” or B) so annoyed with everyone telling you “I just did this and it totally helped me in labour. You should do it to” (insert pain coping method or type of drug here). Needless to say, there are a lot of ideas of birth that FTM’s have before they actually get to experience any of it. What many don’t realize is these ideas are shaping how your birth will go down!

There’s a crazy, yet accurate¬†theory that a lot of us Edmonton birth doulas refer to when helping a new mom and her partner prepare for the birth. It’s called Pain-Tension-Fear Syndrome, and it was first adopted by Dr. Grantly Dick-Read who was an advocate of natural childbirth. This syndrome, or cycle as many of us explain it, has the power to lengthen and even stall out your labour, as well as be a trigger for a cascade of interventions that wouldn’t be necessary had the birthing woman been aware of her fear. Here’s the cycle explained, followed by how to avoid it:

Fear

The cycle starts out with fear, and fear surfaces for a multitude of reasons. As I mentioned before, in our day and age we hear stuff… scary stuff. Some of our friends are elaborate story-tellers who can make birth sound like something out of a gruesome horror movie. We also tend to rely on Dr. Google when it comes to educating ourselves, but let me tell you – Google is the WORST when it comes to childbirth education. There is sooooooo much false or dated info on the world wide web. Perhaps you are even someone who lacks confidence in her body, or who truly doesn’t think she is capable of birthing a human being. It’s not ridiculous and it’s more common ¬†than you’d think! For whatever reason, fear is often instilled in our minds before we head down the journey of childbirth and this is where the unfortunate cycle begins.

Tension

Now once fear commences, and you throw in contractions, your body naturally tends to tense… and so does your mind. It’s easy to envision how your body would tense up during a scary situation, just think about the last time you were in a vehicle and almost hit something (if that’s something that’s never happened to you, I envy your driving skills). I don’t know about you, but for myself I personally cramp up like crazy after one of those close-calls and I think many people can agree that our body experiences the aftermath after a fearful situation. What a lot of people don’t know is that fear actually causes tension in your mind as well. This tension effects how the hypothalamus (area in the brain) creates or reduces stress hormones. So fear creates tension inside and out.

Pain

Then comes the worst part: the pain. Oh the pain! The pain is derived from the tension we just spoke about actually creating barriers in the natural birth process. Particularly, this is done by preventing dilation and preventing the body from producing endorphins which are our body’s natural pain-coping hormones. This causes pain in the form of more intense contractions, or erratic contractions as your body attempts to keep your labour moving along. Inevitably, you can’t go on without a nice cycle of hormones, so your labour will stall out and the pain along with the ever-lasting life of birth will cause more fear.

So how can you change this?

Dick-Read suggests three things to combat this never-ending cycle before it’s too late. First is to educate yourself, and I mean FOR REAL, not the search engine kind. If you’re in Edmonton, check out my childbirth education classes! If not, find someone local who is trained and can teach you what it actually is like being in labour. Not just one person’s perception, especially if that person painted¬†you a totally out-of-this-world picture of what it is like. Every single woman and every single birth is different, and you owe it to yourself to enter your journey into motherhood confident with no trauma. Second, daily exercise is super important but I’m not talking about going full-out at the gym. A daily brisk, 30 minute walk, swim at a local pool or prenatal yoga class is beautiful in loosening up and balancing your body, which will in turn prepare you for a more simple labour. You’ll also need the endurance, because birth can be a marathon – train for this particular race! Finally, find someone to be an outside support person at your birth. Birth doulas are THE BEST for this task, but if hiring a doula is not in your budget, talk to a trusted family member or friend. Someone to support both you and your partner, someone who can be an outside point-of-view and who can let you know that you are a strong, powerful birthing person. Support is so important, and you can not rely on your care provider for this as they have the actual job of bringing your child into this world to worry about!

I wish for all of you reading this a life full of fearless births. Trust your body, you were made for this!

 

Tales of a Pregnant Doula – Part 1

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I am currently pregnant with baby number two, and expecting his arrival August 2017. This is an entirely new experience for me which some may find surprising, as I already have a child! However, when I was pregnant with my daughter I hadn’t ventured into the world of professional childbirth work and comparatively speaking, I didn’t know much (even though I spent SO much time researching. I for one can attest to the importance of getting your information from a professional and not Dr. Google!). It’s incredibly exciting to be able to take what I’ve learned over the past year and truly practice what I preach. So many of the things I have been taught, whether by my amazing doula instructor and mentors here in the Edmonton childbirth industry or by my experiences at Edmonton births, will now make sense on a deeper level. You can imagine how excited I am for my own birth! I will say that I am learning even more things that I can add to my array of skills as an Edmonton doula… things I never would have learned not being pregnant myself. Some things I’ve discovered as a pregnant doula…

Knowledge is power… but too much can be too powerful

One thing that went terribly wrong in my own birth was that my baby girl was OP (occiput posterior, which means head down but facing towards my stomach). For those of you who don’t know, OP position makes labour more complicated because it causes baby to put pressure from the back of the head on to mom’s back and spine, causing the dreaded back labour. It also doesn’t encourage head flexion, which is needed for baby’s head to exit the birth canal effectively. In can even, and in my case it did, cause baby to not fully descend into the pelvis before labour, which slows things right down in terms of when labour starts and the length of time it takes. So naturally, I’ve been somewhat obsessed with the position of this baby. From religiously reading the Spinning Babies website everyday to analyzing every little bit of baby’s movement, and even refusing to lean back EVER… things are getting a little crazy in this head of mine.¬†All of this is based on information I’ve gathered since becoming a doula, tips and tricks I’ve learned to correct baby’s posture in the early stages. While I’m happy I know what I know, I think that all of the information I’ve gained has me thinking a bit too much into things. It’s important to be educated, but it’s also important to enjoy the good parts of pregnancy – aka second trimester, where I am right now.

Just because you work in the field, doesn’t mean your birth has to be “perfect”

I know, it’s a bit premature to be thinking about my birth already… but hey, what else would you expect when a doula is having her own in the near future! My last birth ended in a c-section, and while I don’t resent the birth at all (my daughter made it out safe and healthy and I experienced a lot of birth outcomes in one shot), I do want things to be different this time around. I want to be able to share the experience of what a VBAC feels like to my future clients, but I also feel as though I, of all people, should be able to have a birth that my clients strive to achieve! I’ve had to spend a lot of time talking myself down from this high horse and reminding myself that I am, in fact, just another Edmonton¬†mom. A birth is a birth – as long as mom and baby make it out safely and trauma-free, it’s absolutely perfect just the way it is. Also, just because someone has experienced a particular (or any) birth,¬†it does’t mean that this person is more or less capable of supporting another mom through that scenario. I’ve felt completely comfortable with my previous clients who have had drug-free births and though I am obviously curious as to what that is like, I don’t need to personally have that particular experience to be able to cultivate that for other moms.

A doula needs a doula too!

I’ve recently hired my own local Edmonton birth doula… how exciting! It took a bit of explaining to my partner, as he was a bit unsure as to why I needed someone who works in the same field to do a job for me that I do for other people. In all honesty, there were even times when I was second-guessing why I needed my own doula. I am no expert and definitely not a senior birth doula in Edmonton, but I take pride in my skills and the amount of knowledge I have when it comes to birth. Then my midwife said something that really sealed the deal for me. She said, and I won’t quote as I can’t remember her exact words, but something along the lines of¬†you can’t be expected to remember everything you were taught, just as you don’t expect your clients to. That’s what you are there for, and what your doula will be there for.¬†Brilliant, and so accurate. I feel like with the doula I have selected, I will not only have amazing, top-notch support, but I may even learn through experiences to add on to my own knowledge.

It’s been so nice sharing my experience as a pregnant Edmonton doula so far, and I’m totally going to do this again! But not before I go and heckle others in my industry who have been in this position and find out what they¬†have to say ūüôā

Types of Births

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If any of you reading this are expecting your first child and feeling totally “green” when it comes to what to expect… you’re not alone! I too was in your position, as I had my first child before I became an Edmonton labour doula or Edmonton childbirth educator. I relied heavily on my mom and older relatives for birth advice, but I found that a lot of them (other than my mom, who’s an L&D nurse) had very dated or one-sided info for me.

In our day and age, we’ve got choices galore when it comes to having a baby. Everything from how late or early our baby comes, to how they eat and even if they are vaccinated or not – the choice is left in our hands as parents. Some of us struggle with all of these choices, but the important thing to do is make sure you become as educated as you can before you make any final decisions. One of the first choices you will make as a parent is what type of birth setting you’d like to be in for the birth of your child. Though things aren’t always going to go your way, it’s a good idea to explore all options so you can be prepared. Let’s dive into what the many types of births look like!

The most common type of birth (though I’m sure they are losing popularity slowly with all the other options being presented) is a regular ‘ol hospital birth. Hospitals are a common place to give birth as there is a plethora of medical staff at your disposal should you need it. If your care provider is an OBGYN or a family doctor, you’ll almost always be delivering in a hospital, but midwives do deliver there too. A birth in a hospital (specifically an Edmonton hospital, which is where I practice) usually follows this protocol: your labour starts and you head in at whichever point you feel is necessary, you are sent into an assessment area where nurses will decide if you are far along enough in your labour to be admitted or not. If you aren’t, they will send you home to wait a bit longer (limited beds mean you don’t get one until you’re dilation is at a certain point) and if you are, you’ll be brought into your own room where you will likely spend the rest of your time in labour. Nurses will perform a number of checks to see how you and baby are doing, including electronic fetal monitoring, temperature checks, blood pressure checks, etc. If all is well, you’ll be left alone and checked on approximately every half hour until the second stage, however if things don’t look completely normal you’ll be monitored more constantly by the nurses. Once you reach second stage (pushing), a nurse will be by your side the entire time and once your baby is crowning, a few more nurses and the doctor will come in for the big finish. There are many other scenarios of a vaginal, hospital birth but this is what an average¬†birth looks like. After your birth, as long as you and baby are thriving you’ll be sent home anywhere from 3 to 24 hours later to go start your journey as a mom.

The other type of birth that some women experience in a hospital is a cesarean birth. This type of birth is performed if an emergency arises where a baby cannot be delivered the natural way (vaginally). The procedure involves making an incision just above the pubic bone, and through this hole the baby is delivered. Cesarean births are performed only by OBGYNs and should only be done when absolutely needed. As scary as open surgery can be, c-sections save moms and babies lives in some cases so this type of birth is very important! You will be allowed one support person in the operating room with you along with all of the medical staff involved, and cesarean births usually mean longer hospital stays to ensure that you are healing well form the surgery before heading home. Recovery times are general longer – usually around 6 weeks and more painful. Luckily with our advanced medical knowledge, a cesarean birth usually means you can still go on to have more children, sometimes even vaginally (known as a VBAC).

Are hospitals not really your jam? Well why don’t you try birthing at home! That’s right, many women choose to birth their children in the comfort of their own space, and as long as your pregnancy is healthy and low-risk, this is a perfectly safe birthing option. Home births are performed by midwives so it’s crucial that you are under midwifery care in order to have a¬†home birth. Your midwife will bring all of the equipment she will need to deliver the baby with her, but if by chance medical care is needed you’ll be transferred to the hospital quickly and efficiently. In a home birth, you’ll spend most of the early moments of labour at home with your partner and your doula, if you’ve hired one. Once you get into active labour your midwife will come and check on you and either stick around, or head out and return when it makes sense to do so. Once you have reached second stage, your midwife will be accompanied by an additional midwife to ensure that they have enough hands to care for both you and baby. Home births are a great option if you are someone who prefers to be left alone or in a more quiet space when you birth, but they aren’t always the best for the type of people who worry easily or who are planning for pain medication during labour. In order for a home birth to be successful, you have to have a lot of trust in your body and it’s ability to birth (which all women should!).

If you’re like me, and you were living in a rented apartment when you first gave birth, then you might not like the idea of such a special memory being in a place that is not your own. Or maybe staying home just doesn’t sit well with you… whatever your reason may be there is another option to giving birth outside of a hospital, which is at a birth centre. Birth centres are sort of like hotels – they have beautifully designed rooms that are super cozy and all set up for babies to be born in them. They have some birthing tools on hand like a big soaker tub and special beds, but once again your midwife will bring all of their tools with them to the birth. It’s quite similar to what you would expect birthing at you home, only you’ll have to pay to rent a room (like a hotel) and often you won’t need to cook the first meal you eat post-birth (as it will be provided for you – yum!). Here in Edmonton, the birth centre is located in very close proximity to one of the city’s hospitals so a quick transfer is simple if you were to require more medical assistance.

Finally, this last type of birth is more a style of birth than a location. In all areas I’ve listed previously, home, hospital or birth centre, there is often an option to do a water birth. Yes, you can birth you baby directly into a pool – how cool (rhyming intended)! I know you’re probably thinking won’t my baby drown? The cool thing about infants is that they don’t actually take a breath until they hit the air outside of the womb. They do “practice breathe” while in the womb but they take in amniotic fluid instead of air in order for their lungs to mature. Babies receive their oxygen through the placenta in utero, and the placenta stays attached and functioning for a while after baby is born so as long as the umbilical cord has not been cut or baby doesn’t hit the air before the water, baby will not drown. Your midwife will still pull the baby out relatively quick though so that you can begin the bonding experience and they can see how the baby is doing. Many women rant and rave about water births being quite comfortable and pain-free, so they are definitely worth a try if you’re intrigued! Like any other midwife attended birth, water births are a safe¬†option if you are experiencing a low-risk pregnancy.

There are so many other scenarios we could chat about when it comes to “types of birth”, but these are the actual options you have when it comes to birthing your child. I encourage you to do more research and become more familiar with these options, or book a prenatal education class in Edmonton with yours truly – I’d love to build more on these exciting options for bringing your baby earthside ūüôā

Why every mom needs Postpartum Physio

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Let me start this post by asking you all a question: how many times have you been told that being a mom means almost (or actually) peeing yourself every time you sneeze/jump/laugh? Or that as soon as the 6 week immediate postpartum period is up, you can jump right back into your exercise regime to “get your body back”? Or even that pain or reduced pleasure during intercourse is normal? I can’t be 100% certain, but I’m pretty sure that all of you have been told one of these ¬†at some point on your journey of becoming a parent (even partners hear these too when referring to their partners!). This is because for a very long time, women did not go for routine physiotherapy after having babies. In fact, many women did not know such thing was there or was necessary. Well, let me be the first to say to some of you that postpartum physio is a MUST for all new mothers. Here is why:

Your body adapts and needs to be retrained

In every circumstance, your muscular system, bones, ligaments, tendons and fascia adjusts to whatever body composition you’ve got. Our bodies structures are constantly changing through the aging process, and pregnancy and childbirth are no exception. Towards the end of your pregnancy especially, you’ve got a ton of extra weight that came on pretty quickly, and your body needs to adjust the way it moves and the way your structure supports you to fit this new mass. So whether you realize it or not, your posture, your core muscles, your back, etc are all working in a new and less favourable way. So after you have a baby… then what? It can’t be reasonable to think that your body will just remember everything from before this 10 month period immediately without help? No, you need to appropriately re-train how you perform tasks. Things like lifting, running, jumping, are all hard to do when your core no longer automatically engages. A trained physiotherapist can give you exercises to slowly bring strength and mobility back into these long lost areas so that you can function normally again.

Pregnancy is long, recovery can be just as long 

One thing I have learned, as an Edmonton doula and a millennial having babies, is that “bouncing back” doesn’t look the way we see on TV. In many ways, your body might change forever – and for the better. Birthing a child is part of our primal functions and the process we go through actually helps our body mature gracefully. With that being said, work does need to be done to get to your version of new normal… slow and gradual work. Regardless of what kind of pressures our culture puts on you to look rail thin or lean and cut 2 months after having a baby, this is not what being a mom really looks like. Being a mom is looking at the amazing thing that your body did for the last 10 months. Being a mom is treating your body extremely well in gratitude for what it made, and seeking out professional help in getting it to function well again to help you keep up with your growing kids. Being a mom is being patient with yourself, and taking the time to make the right steps to allow your body what it needs to be your very own beautiful, well-running mom machine.

Abs? Where art thou?

If you are already a mom, you’ll know that after you have a baby, your abs sort of disappear for a bit and are replaced with a layer of skin/jelly. This is due to the fact that a human stretched you to the point where your ab muscles were stretched and even pulled apart from each other. Most women will suffer ab separation to some extent, and some even suffer from a condition called diastasis recti – where your abs are so separated that specific training in physio or even surgery is needed to get them back together. Here’s the thing about ab seperation: it gets worse if you try to work these muscles without them getting back to where they need to be. Doing crunches with seperated abs will not only make the situation worse, it can lead to a hernia or other organ prolapse. This is why it’s so important to head to physio and find out how and when you can start to build back your core strength.

The “right of passage” that we can all do without

Finally, the stigma that I hate the most – no, it’s not normal for moms to pee themselves forever after they’ve had a baby! Yes, incontinence is normal after pregnancy and birth, but you CAN fix this issue and live a wonderful, pee-pants-free life! Or here’s another one: sex doesn’t have to hurt, or suck, after having a baby! You can, and WILL orgasm from sex again. Your pelvic floor (the trampoline-like muscle mass that holds up your pelvic organs) is under stress both from the weight of your baby and from the pressure of contractions and pushing your baby out. If any other part of your body was injured at that level, no one would hesitate to seek out some therapy to heal appropriately, so pelvic floor physio should be no different. Also, contrary to many beliefs simply doing Kegels will not heal all cases of incontinence or bring back the firey pleasure of coitus. Its easier than you’d think to do a Kegel the wrong way and a pelvic floor physiotherapist can assist you in doing them right, along with provide other exercises you’ll need to heal properly. So protect your panties and get the help you need!

Have you suffered with any pelvic floor or core muscle injuries from pregnancy and birth? Have you gotten the help you need? If you have or are having a baby in Edmonton, leave a comment and I’ll hook you up with the info of the best pelvic floor Physio in our city!

To Induce or Not to Induce…

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Induction should be a word that you all have heard before. In today’s birth culture, getting induced is incredibly common, with roughly 21% of births in Canada being either medically or surgically induced (according to the Canadian Perinatal Health Report from 2005). As an Edmonton birth doula and an instructor of Edmonton prenatal classes, I am oh so familiar with induction. It also helps that the birth of my first child was induced! So as someone who knows how inductions feel and has seen them happen, I wish for every parent to understand what really constitutes a necessary induction. In today’s post, I’m going to talk about what an induction really is, when they should happen and when they shouldn’t, and how you can navigate the health care system so you don’t experience one of these bad boys unless it’s truly needed!

Inductions don’t just happen with your care provider

Theres a saying that’s very common in the world that us Edmonton doulas reside in, and that’s “baby will come when baby is ready”. The only way to get your baby to come before they are truly ready is by heading into the hospital for medically-necessary synthetic oxytocin… and even this has not brought on labour before! However, attempting any form of induction, both “natural” and not, before your baby and body are ready does have consequences. Things like PROM (premature rupture of the membranes), infections, prodomal labour, etc. can all be a result of trying to jump the gun. Many women believe that things that are considered more natural, like castor oil and nipple stimulation, are safe regardless of when they are performed because they don’t involve medicine. It’s very important to remember that EVERYTHING that could potentially bring you into labour earlier has risk. Always speak to your care provider and obtain the lastest evidence-based information on any of these natural methods before attempting them.

Humans do not all gestate for 40 weeks

Shocker! Babies don’t have a time stamp, and I don’t even really like the term “due date”. Many of us doulas in Edmonton like to refer to it as “guess date” because honestly, it’s a total crap shoot! What we need to remember is that research has shown that BABY initiates labour. Once their last bit of necessary development has completed, its Baby that sends signals to your brain to start producing oxytocin and get things going. I can’t tell you how common it is for women to be told “if you haven’t had your baby by our next appointment, we’ll schedule an induction for (insert date here)” at their 39 week appointment. But whyyyyy? Sometimes there’s a good reason, like blood pressure issues, or there may be risks in going too far along like with gestational diabetes, but in a lot of cases this is more out of convenience. Waiting until labour starts on its own can seem excruciating when you’re overdue and anxious – and unfortunately society doesn’t make it any easier (I’ve heard the “you STILL haven’t had your baby yet?” more times than I’d like to remember). But trust me when I say, the beautiful cocktail of hormones that your body will produce when you go into labour on your own time is soooo worth it.

A “Big Baby” is not a reason to be induced

Macrosomic babies are babies that are born at over 4000g. So how can you determine if your baby is going to be big? Well actually, you can’t! Palpating the uterus and measuring the fundal height can give you a rough idea and ultrasounds are about 45% effective in guessing baby’s weight, but there is absolutely no completely accurate way to measure the size of your baby until he/she is born. And really, so what if you’ve got a chunky monkey growing in there? People deliver big babies every. single. day. If you truly understand the physiology of how babies are born, you’ll know that a baby’s size doesn’t matter. Things like fetal position, pelvic shape and genetics will impact whether or not you’re able to deliver your baby vaginally, but these are all things you have very little control over. Embrace those extra pounds on your sweet bundle and let them cook for as long as they want!

Don’t want to be induced? Then say no!

Somewhere along the line, we started to think that others should have the power make our childbirth decisions for us. While I understand that some care providers may make it hard to steer away from their preferences for your birth, you have every right to say no to anything and everything you don’t want – including induction. Now, this doesn’t mean that you get to take a shot in the dark or flip a coin, these decisions you make must come from an educated stand point. If you do your homework, you’ll realize that inductions do carry a lot of risk, and only in certain situations do the benefits outweigh the risks. However, you’ll need to have factual information to bring to your care provider if you want to refuse the induction date they’ve suggested for you – you owe it to yourself and your baby to have the right information.

Have you ever been induced? Have you been offered an induction when it was or wasn’t necessary? Feel free to share your induction stories with me using the comments below!

Why I wish more people would attempt VBACs

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The cesarean rate in Alberta and even in Canada, at the moment, is around 15% higher than the WHO (World Health Organization) recommends. I can’t say I am surprised at this statement, since so many of the people I talk to lately have had cesareans. I’m included in this population, so I know how valuable they are when needed. At the same time, as a doula in Edmonton and an instructor of childbirth classes in Edmonton, I can’t help but feel sad that cesarean rates are so high and not really budging at the moment. Honestly, it’s likely due to the fact that most of the cesareans performed (76.1% in Alberta to be exact*) are repeat cesareans. WE NEED MORE VBACS!

Are VBACs actually safe?

VBAC is an abbreviation for Vaginal Birth After Cesarean, and contrary to many beliefs VBACs are actually more safe¬†than cesareans. A cesarean carries the risk that any major surgery would carry – risk of blood clots, infection, nerve damage, damage to other organs, etc, and this is just the list of risks to the mother. In comparison, a vaginal birth only carries minor risks to the birthing person like perineal or pelvic floor trauma, and in a low-risk situation there are minimal risks to baby (I want to acknowledge that in some circumstances a vaginal birth is far more risky for the baby than a cesarean. Be sure to take a prenatal class to learn which situations these might be). The only added risk that comes with VBACs is an increased risk of uterine rupture (notice how I say increased… yes a uterus can rupture even without a scar from a previous surgery!). This risk, according to ACOG, is about a 0.2 to 1.5% chance. If you were to make a list of all of the risks of each, the surgery’s list would far outweigh the VBAC’s!

A trial of labour is valuable

When a woman attempts a vaginal birth, regardless of if she’s successful or not, it is called a trial of labour. When you think of what happens during a labour that is brought on naturally and is allowed to proceed even for a few hours, it makes sense why there are benefits to even trying for a VBAC. That hormone oxytocin which starts your labour and keeps it going is also responsible for the loving bond you develop with your baby and for letting down your breast milk when it comes time to feed. Additionally, natural oxytocin (the kind your own body produces, not the synthetic kind you get by the drip in a hospital) is linked to a lowered chance of postpartum mood disorders as it helps with stress and overall mental well-being. So, even a little bit of labour before a cesarean will get the natural oxytocin flowing and benefit you for years to come!

The added reward of finally getting your “big moment”

As a mother who has experienced cesarean birth personally, and a doula in Edmonton who has attended both cesarean and vaginal births, I know just as well as many that the moment you meet your baby isn’t quite the same in both scenarios. Some mothers are lucky to have care providers who are open to making their cesareans more “mother friendly” (allowing immediate skin-to-skin, breastfeeding in the OR, even dropping the drape to allow mom to watch the birth), but many of us experience the usual trends of not being able to have the Golden Hour and being separated from baby during the first moments of their life. Not gonna lie… this part really sucks. One beautiful part I’ve witness in vaginal births is that moment that baby comes out and immediately is placed on mom’s chest – the relief from mom that her hard work is over, the incredible sense of joy in getting to hold her little one for the first time, the pure, abundant love that the two share already. And if you think this is powerful with a mom who’s never had a cesarean, you should see what it’s like for a VBAC mom! Understanding how different the two moments are, the VBAC moms are just so proud of their happy ending. Witnessing this has moved me in ways that I’ve never before experienced.

So I’m obviously pro-VBAC, but I also understand that sometimes they aren’t the safest choice and sometimes your attempts don’t end up the way you plan. However, if you are a good candidate for a VBAC, even if it is unsuccessful, the attempt is a great choice for both you and your bundle. So if it’s an option for you, why not explore it?!

*Examining Caesarean Section Rates in Canada Using the Robson Classification System, www.semanticscholar.org