The Lost Art of Uninterrupted Pushing

Doula in Edmonton

I’ve officially entered back into the adventures of being an on-call Edmonton doula, after taking a hiatus from attending births following my own pregnancy… and boy did I miss this! In the coming months I’ll be pushed out of my comfort zone and attending primarily home births (most of my previous clients have delivered in hospitals). While there are some things I quite like about attending hospital births (yes, a doula in Edmonton who likes hospital births… who would have thought!), one thing I definitely will not miss is the coached pushing phase. Many of you will be familiar with this method of stage 2 management, and this is one I’ve seen many-a-time. This type of management is characterized by health care providers essentially telling you what to do and when to do it when it comes time to push your baby out. And while this can sometimes be necessary and actually crucial to birth a baby, like in the case of an epidural on board for example, women who are unmedicated should never be told when they can or can not push (in my opinion).

Let me start off by giving those of you who have never experienced unmedicated birth a bit of back story. When a woman labours with natural surges of oxytocin and endorphins, a certain rhythm just sort of happens to the labour. There are times when contraction strengths and lengths shift to the next phase and then the next, until finally the birth person is ready and starting to push. Us Edmonton doulas can often visibly see when these shifts happens due to the birth person’s body language. Some classic signs of shifts into a further labour stage are low moans, inability to communicate and towards the very end, uncontrollable grunts and bearing down. These sensations are our body’s way of communicating that our baby has made it’s way through most of the pelvis and is ready to come earth-side, and these little pushes that we begin to involuntarily make actually help the tissues to stretch at a good pace to avoid tearing. Watching a birth person experience stage 2 of labour this way is incredible to see – it often doesn’t even look like they are pushing at all, and I guess technically they aren’t (it’s their body doing the work for them).

Now if a women is heavily medicated often this urge is blocked or less noticeable, in which case it may be best for nurses to monitor the tocodynamometer to see when your contractions are coming and when (and for how long) you should be pushing. Coached pushing is meant for these cases and important, so I definitely don’t want or mean to de-value the place that medical advances hold in certain circumstance. However, how can anyone tell you how big your baby is going to be, exactly what position their head is in during all stages of labour, therefore determining how long or strong a birth person can push, other than that particular person? The answer is, no one can. The female body is absolutely incredible and is expertly designed so that when it comes time to labour and birth a baby, an intricate concoction of hormones give us the signals to know what position we need to be in and what we need to do to get baby from in to out. Another fascinating component of labour are the cardinal movements (I really think this needs to be my next blog topic, kind of obsessed with these). Baby instinctively will move down and through the pelvis in just the way that they will fit through these crevices and passageways, and causing no or minimal damage along the way. Allowing baby the freedom to do this without exerting voluntary force is important and necessary for a safe birth.

So the problem begins when medications and instruments are used to block and interfere with these natural systems. In some cases these medications and instruments are life-saving or very important to the health of mom and baby. But many more times than us doulas in Edmonton would like, these resources are used at a time when they are not truly needed, thus removing the natural sensation labour gives the birth person to know how to bring baby out. Even more problematic is when a women has not had any of these medications or instruments used on her and is still being coached or told to push/not push. In our most natural state, our body knows when pushing is needed, and this is not the same for every women and can not be predicted. One woman might be fully dilated and feel that she needs to wait for an hour before that urge has kicked in, and another might just barely reach full dilation and be ready to get that baby through the finish line. Birth is unpredictable, and this is one of the things that makes it such an impactful and meaningful experience – we can truly see the variety of human form from childbirth. So let’s embrace these differences and leave a woman who’s experiencing a natural labour to push on her own terms!

What was your pushing stage like? Did it go smoothly or would you have wanted something different? Share your “pushing” stories below, I love to hear them all!

5 Common Myths About Doulas

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Doulas, and especially doulas in Edmonton, are notorious for being misunderstood. And when I say this, I don’t mean by our clients but more by the general public. I even find myself when teaching childbirth classes in Edmonton educating my students on what a doula actually does. Or let’s not forget about the countless number of times us Edmonton doulas are met with the response from hearing our profession, “oh, so like a midwife?” or “wow you deliver babies?!” and so on. As funny as some responses can be and as much as we reason with the public not knowing what we do (doulas only recently rose in popularity), us birth doulas really need to do our part in clearing up some myths and fog when it comes to our work. So today, I’m going to explore some common misconceptions that this doula in Edmonton has heard many a time!

#1: Every woman who is having a baby needs a doula

So some Edmonton doulas will disagree with me on this one, but in all reality a woman, or couple, does not need a doula to birth a baby. Babies are born everyday without us! While many feel that all women deserve a doula, and I do believe this is true, all doulas deserve to earn a fair wage and this is often a barrier between us an potential clients. However, doulas are a luxury, and one that is worth the money you spend on it. We really do enhance the couple’s birth experience, and this has been proven through various studies (this Evidence Based Birth article sums it up really well).

#2: If you have a midwife, you don’t need a doula

Midwives and doulas have very different roles at a birth. Midwives are primary care providers and perform any and all necessary medical tasks of a low-risk pregnancy and birth. Doulas are not medically trained, we help moms through education, advocacy and emotional/physical comfort. Read here for more information on the role difference between an Edmonton midwife and an Edmonton doula.

#3: If you have a doula, your partner doesn’t need to do any work

No one can replace the role of your partner in a birth. The birth partner is key because they know you best and what calms you/fires you up. A good birth doula will know how to contribute ways for the two of you to feel more connected, and help with comfort strategies when everyone is out of ideas. Plus, the partner is put on the spot to remember everything from their prenatal class! Read here for more information about the roles of a doula and the birth partner.

#4: Doulas are only for natural births or home births

This myth probably ranks number one in the amount of times I’ve heard it. Too many times doulas are passed up because the couple think we’re “hippy dippy” or don’t go to births in hospitals or will judge a mom for opting in for the epidural. While we do have personality and philosophy differences (spoiler alert – I’ll elaborate on this next), a good doula understands that it’s just as important that we support and help the mom advocate for what she wants in the birth experience. It’s very important that all decisions come from a place of education, and we will provide that… from there you decide the path that you want to take in your birth journey and we support you 100%.

#5: All doulas are the same

Like every other professional support person in this world, not all of us are made equal! Many may think that hiring a doula based on level of experience is the way to go, and perhaps that could be an important requirement for you but not for everyone, as in certain ways a doula with little experience could have a personality trait or a philosophy that just works really well with you. Also, when you book a consult with a doula, that interview is for us just as much as it is for you, because it is imperative that we are a good fit. For this reason, many of us will turn down a couple after an interview that leads to a hire. It’s no beef with you as a person, we just don’t vibe that well! You’ll never be able to open up as much as you can or feel truly comforted if you genuinely don’t mesh well with your doula’s personality. Birth is an incredibly raw and vulnerable time in both the birthing mother and the birth partner’s life – you’ll definitely want everyone who is in that room with you to fit into your team nicely.

What did you not know about doulas that you now know? Have you heard any of these myths before? Leave your comments below!

Prenatal Mood Disorders – They exist too

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In light of this month (January) being Postpartum Mood Disorders Awareness month, I thought I would share my thoughts on the well-being of moms prenatally and during birth… because let’s face it, from the time you find out you’re pregnant, it never seems to be about you anymore. As a birth doula in Edmonton and from teaching childbirth classes in Edmonton, I’ve seen many expectant mothers as their lives start to change, day-by-day, week-by-week. Many of them are told that the real change happens after baby is born and while it is true that most of us have to make many sacrifices once baby is home, the prenatal period as well as the birth of our littles are very important in ensuring this transition is smooth. I was at an event that was put on by the Doula Association of Edmonton recently and got to hear some of our city’s experts in PPMD speak about this topic, and what really resonated well with me that they both touched on (Claire Wilde and Jennifer Summerfeldt, click their names for more info) was hearing how important it is to have a plan BEFORE you go into labour. One reason I think this stood out for me is that I’ve seen women suffer even before the birth of their child and I feel that we don’t put enough energy into helping moms who struggle with prenatal depression and mood disorders as well.

During my time so far as an Edmonton doula, I’ve seen many cases of difficult pregnancies and how this can impact a couple who are embarking on their journey as parents. Things like hyperemesis gravidarum (extreme morning sickness), fertility issues and treatments, hormonal imbalances (which impact mood, which impacts relationships), etc. are more than just things you have to deal with for the sake of having a baby. These are all real problems that should be addressed in order to enter motherhood in a positive, empowered head space. These things are all contributing factors to PPMD and many don’t realize that having a difficult pregnancy can increase your chances of suffering once you baby has arrived.

Another is birth trauma. Now I really need to clarify the meaning of birth trauma, as many don’t really understand what makes a birth a traumatic one. Trauma can happen at any and all births – vaginal, cesareans, assisted deliveries, water births, all of them. Trauma is not defined as a specific event or chain of events that occurred at your birth. It’s caused by the mother’s (and partner’s) lack of self confidence and not being heard and respected by their birth team. I’ll use myself as an example for this one, as along with being a doula in Edmonton I am also a mother of two. My most recent birth story (read it here) may have been what many would consider “traumatic”, but in all actuality, it wasn’t. In fact, it may have been a better experience then a lot of women who have “textbook” labours in the hospital and feel minimal pain. The reason for this? I had an amazing team supporting me throughout pregnancy and labour, and that team provided me emotional support when I thought I couldn’t continue, gave me choices, and supported those choices as they knew they came from an educated stand point. I know many moms who have babies with very little knowledge of the childbirth process, and they came out saying it was traumatic not by the interventions or the kind of birth they had, but because they truly felt that they could not control anything. We all know childbirth has many elements that you can’t control, but there are definitely elements you can and when this right is removed, it’s very common to be left feeling betrayed. This is a common reason why moms and even partners can develop a PPMD.

There are of course many other risk factors for PPMD – things like the use of synthetic oxytocin in labour (read here about inductions) and previous struggles with mental illness all contribute. However, if we start to look at PPMD as a potentially preventable (or at the very least, reducible) illness during the prenatal period, and start to take moms seriously before they’ve had their babies, I feel like the number of severe cases would significantly lessen. This is a call to action for all of you expecting moms – reach out to your local resources and make a plan of attack for your mental health, both now and after baby arrives.

Have you suffered from a postpartum mood disorder? Feel free to share your experience or questions in the comments section.

Twin Birth: What’s it Really Like?

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For many first-time and even second-time moms, preparing for labour and birth can be overwhelming. With all of the conflicting advice out there, couple with the common media fabrication of childbirth, it’s no wonder many women have a tough time becoming mentally ready to give birth. And if one baby isn’t enough, imagine preparing for two! Twin births might seem scary and impossible, but prior to much belief vaginal births are achievable with a little confidence and a lot of knowledge and prep.

Today I am going to share the experience of a dear friend and new twin-mom Danielle, who recently had her 2nd and 3rd babies vaginally, confidently and using informed decision-making:

You’re such a champ and delivered both twins vaginally after undergoing an induction! Tell us a bit about how you managed to cope with the intensity of labour with two babies.

We are all very fortunate that everybody read the textbook! I had been induced with my first pregnancy after PROM, in which I originally planned no pain medication. I was severely unprepared for birthing a child at that time and had no clue about my options/choices/tools available to me and it really did a disservice to me and the experience. This pregnancy/birth was different, I really did look into my options and making informed decisions. I opted for an epidural once contractions were becoming unmanageable. I was ok with an induction because of the high risk nature of twins going overdue and because of my desire to have a vaginal birth. I work in a field where I see the benefits of Peri-operative Pain Management and how it can reduce recovery time with vaginal or cesarean births alike. Having appropriate pain control before trauma/stress to the body occurs really does help greatly reduce recovery time and with a 3-year-old and now two newborns, I don’t have time to be laid up in bed. Because I chose to have an epidural earlier than others might have, it was my only comfort measure. After carrying an extra 70lbs of fluid, placenta and babies for what felt like YEARS, walking wasn’t my cup of tea so I felt happy with this choice.

I can’t imagine how amazing it would feel during that very first moment after birth to have two babies in your arms. Describe that a bit for us!

It was a very surreal experience expecting twins and even more surreal when they arrived! It took me a week after they were born for it to really sink in that there was TWO of them. I was so relieved that they were both safe, perfect, healthy and fortunate enough to have been born without the need of a cesarean. I remember crying in the OR and the medical team thinking I wasn’t happy to hold them. They were in fact happy tears but not happy for them, more so happy that we were out of the scary parts that is birth of multiples. Now I could tackle having newborns without surgery or complications! It made everything we’d been through the past 8 months so worth it.

Us Edmonton doulas are big fans of informed decisions in childbirth, and you seem to be quite knowledgable. What tips or advice do you have for other expectant parents to help them prepare to navigate their birth their way?

Informed decision making is something that is used everyday in my industry (I work in a veterinary clinic) so I am no stranger to critical thinking, asking questions and thinking about what makes the most sense. At the end of the day we are our own advocates and need to be able to defend ourselves and our choices. I also didn’t want to experience not being informed like I did with my first birth. When considering an induction its important to look at credible sources of information as to why they are used, what types there are and when each would be used. Look into the risks and benefits of each. If you don’t want to be induced thats 100% ok but you need to be ok with all the possible risks of not being induced. When considering pain control of any kind, use the same kind of thinking. Also, it’s a good idea to look into what happens when pain control is delayed vs. planned early.

Thanks to Danielle for sharing your story! This is a wonderful example of why us doulas in Edmonton do not have a preference on how women birth their babies. The most important part of childbirth is understanding your options and the risks/benefits associated with each. We love and support all kinds of births as long as they come from a place of knowledge and confidence.

Doulas – they are for birth partners too!

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One of the biggest struggles with being a doula in Edmonton is selling our service to the birthing person’s partner. I’m going to be real with you… I totally get why! If you have no idea what a doula is, you probably assume that the service is not a needed one, and you’re not wrong. People here have babies all the time without Edmonton doulas supporting them! However, as I take off my birth doula in Edmonton hat and put on my Edmonton mom of two hat, I can say that doulas really do make a difference for partners. My hubby and I did not use an Edmonton doula for the birth of our first born but we did with my second, and I can say that he specifically really came into his own during that second birth! Along with him getting to take some much-needed breaks to call family and grab a coffee, I was a much happier labouring mama when he wasn’t cracking jokes at inappropriate times and getting in the way more than helping (reminiscing about that first birth…ugh haha). So let me break it down for all of you out there who are on the fence about hiring a doula in Edmonton because your partner just isn’t sold on the idea.

The doula balances the birth partner’s strengths

So the one obvious advantage that the birth partner has going into the birth person’s labour is that they know them well. We all have pet peeves as well as things that comfort us in times of chaos, and odds are your partner will know what these are (or you’ll have lots of time to talk about them – 9-10 months actually). The only problem is that it’s extremely hard to think fast when you are in a high-pressure situation about things that are quite new to you. Where you’d normally feel lost after trying every trick in the book to help your birthing person to feel comforted, a doula can give you a nudge in the right direction or bring some much-needed calm energy to a highly charged situation. For an example, if a woman normally likes light touching and soft speaking to relax her but the partner is not getting a good response from this, their doula can suggest a different technique of touching, some good phrases that might help or some new comfort techniques all together.

The doula is there for the stuff that the partner doesn’t know

Partners, as much as you might think you know about the woman, birth and motherhood will bring out a whole new side of her that you’ve never anticipated! It’s such a beautiful transition to witness, but also can be quite scary. ‘Is she really ok?’ ‘Should she be making those sounds?’ ‘I can’t help her and I don’t know why!’ These thoughts commonly run through the minds of loved ones in the labour space, but with a doula you get answers! You’ll know why things are happening when and how they are, what you can do to help or if you’re doing the right things. We are your coach just as much as we are the birth person’s. You’ll never have to be put on the spot to know all of the information you learned in your Edmonton childbirth class, as we are there to educate you on all the unknowns, when you need to know them. And in all honestly, it’s what we love doing best! (well it’s what I love doing best at least)

The doula allows the partner to take breaks

There’s a reason why labour laws in Alberta insist on workers getting a 15 minute break for every 2-3 hours worked. No one should be going at a tough job for an extended period of time without a break for their physical or mental well-being, and this applies to birth partners too! I’m not going to say that the partner’s role is nearly as tough physically as the birthing person’s role, but mentally and emotionally you partner will become drained. Imagine watching one of you favourite people in the whole wide world go through hours and hours of physically intense discomfort and not being able to help take their pain away… it can be torture if you aren’t fully prepared or get any sort of break. Doulas are there for times like these, to relieve the partner so they can grab a cup of coffee and decompress, catch a breath of fresh air, clear their head temporarily, etc. and be reassured that the birth person is not left alone. When looking back on the birth of your child, you’re going to remember how you felt and you’ll want to look back on that moment thinking that you felt inspired and in awe of your birth person’s strength, instead of thinking how you felt foggy, frustrated and ready for it to be all over.

Did you have an Edmonton doula attend your birth? How did it help your partner during the rough parts of your labour? Leave your experiences with doulas and partners in the comments section below!

 

The 4 P’s, a.k.a the driving force behind your labour

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Us doulas in Edmonton and those of us who teach childbirth classes in Edmonton very frequently consider four factors when trouble shooting or anticipating any stalls in our clients labours. These bad boys are what we like to call the 4 P’s of childbirth! (and how convenient that they all happen to begin with the letter P, right?). So here’s the deal with the 4 P’s and why they matter: essentially, these four factors are going to determine how, when and even if your baby will be delivered vaginally! They are all very complex and have many different possible scenarios, and today I’d like to dive in to each individual “P” and what it might mean for your birth.

Powers – oxytocin, the uterus and the strength of birth

Powers is the first of the 4 P’s and refers to the strength of the birthing person’s contractions. As most of you will know, oxytocin is the beautiful hormone that causes much of the power behind labour. Oxytocin is released when your baby is ready to meet you, and sends a signal to your brain to start producing it in super high amounts (getting higher and higher through out your labour as well). The oxytocin pulsing through your blood is what will cause your uterus to contract, and the contractions are the “powers” that bring baby out – therefore the amount of oxytocin will obviously determine the strength of your contractions. Many women experience what is referred to as “prodromal labour”, when your body starts to produce oxytocin but maybe in an amount that’s not high enough to progress the labour forward. This can cause days and sometimes weeks of labour and can cause women to get so frustrated that they decide that it’s a good time to get pitocin (the oxytocin drip) at the hospital. One thing to always remember about pitocin (or syntocinon, what us Edmonton doulas know it as) is that it is a synthetic form of oxytocin – it’s not the real stuff. Sure it will give you power that you might need to get baby out, but it may be more than your body can handle. You run the risk of over-stimulating your uterus, aka too much power, to the point in which it can tire out and stop functioning properly on its own. So how can you add some of this natural power that’s signaled by your own brain? Well, oxytocin is in fact the love hormone, so having intimate time with your partner, using nipple stimulation or even having an orgasm can start to bring up that oxytocin naturally so your uterus can work its magic!

Passage – your pelvis!

The pelvis can sometimes be a complicated factor in childbirth. Many do not know that the pelvis is so much more than just a bone structure; it’s meant to move into a more open state during pregnancy and birth to make room for baby. It does this by its structure also containing ligaments and joints, which soften with the presence of relaxin (which I’m sure you can all guess the function of this hormone!). With all of this in mind, there’s more than just simply opening involved with the pelvis. Unfortunately in today’s society things like driving, working in an office, accidents, etc. have the potential of causing our pelvis to be unbalanced and make it hard for it to function properly. Another thing to note is that there are 4 types of pelvic shapes, and not all are ideal for a vaginal birth (but not impossible!). There are lots of healing modalities that can help to better balance the pelvis to allow for optimal opening – things like chiropractic work, massage and cranio-sacral therapy can all help it become ready for the birth of your baby.

Passenger – your little human

Believe it or not, your little one plays a part in how they are born too! Things like their position or presenting part might be a bit tough for them to control, but there are a few ways in which you baby will control the outcome of your delivery. First of all, unless in the presence of a medical reason to induce, you baby actually determines when you will go into labour. Studies have suggested that babies lungs secrete a certain protein when they are near the end of development that signals the mother’s body to begin preparing for labour. It’s your baby that signals your brain to start producing large amounts of oxytocin (necessary for labour), and this ensures that baby is fully developed and ready for life outside the womb. Finally, babies instinctively move in the right directions to make their way through your pelvis. This involves their head rotating, chin tucking and others called the seven cardinal movements of labour (check out more information on this here). So as you can see, babies don’t just rely on their birthing parent to get them to come out!

Psyche – controlling your experience with your mind

The last of the P’s and probably the most under-estimated of all is your psyche. Our minds are hard-wired to shut down labour for a reason, and that has to do with our most primal instincts for survival. In our earlier years as cave men when we had predators who were going to attack, our brains would trigger an adrenaline release which actually halts oxytocin production. This is so that we aren’t giving birth when we fear an attack, instead we are able to find a safe space to birth. However, in today’s society with all the wacky stories and misinformation about birth out there, our fear is cultivated through reasons that aren’t really rational – but nonetheless, it’s still fear and still inhibiting our oxytocin regulation. So in other words, if we are afraid, our labour will not start or continue! Our mind is so powerful in regulating all of our systems, its no wonder that it has so much impact on birth. Keeping a calm mind, exercising regularly to reduce stress and being educated to eliminate irrational fears will all help labour start at the exact perfect time for you and baby, and will help to avoid any stalls along the journey.

So you can imagine that we can’t completely control the 4 P’s of our labour, but how can we positively impact them to have the smoothest experience possible? A big answer to your question is to hire a birth doula, as we have various tips and tricks to keeping your mind and body on the right path. Check out my post here to find out a bit more about doulas, and I’ve also got some helpful posts about our relationships with midwives, nurses and birth partners.

Have you ever experienced a slow or stalled labour? Post about your experience in the comments section!

Midwives and Doulas: the “Dream Team” of Childbirth

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As a doula in Edmonton and even during my childbirth classes in Edmonton, I hear more times than I can count that midwives and doulas are the “same thing”. This is problematic for so many reasons! First, as amazing as it would be to deliver babies for a living, I can not take that kind of credit. I haven’t gone through years of school, vigorous training and practiced delivering babies under guidance of a registered midwife for years in order to earn this amazing title. Also, if many of us think that doulas and midwives are the same, then it really wouldn’t make sense on hiring one if you have the other would it? Ah, but we are in fact not the same, and equally important in a birth setting. In fact, we work together like the PB&J of your birth team! So to better clarify, I’ve listed out some differences between Edmonton doulas and Edmonton midwives below for your reading pleasure.

The difference between our care

Midwives and doulas are cut from the same fabric of respect, dignity and informed consent in childbirth, so we both base our philosophy around this. However, as mentioned before midwives are baby-catchers! They provide the comprehensive care you need during your pregnancy, birth and postpartum period – including ordering blood work, prescribing medications, checking your blood pressure, performing cervical exams, etc. On the other hand, us doulas in Edmonton are not trained for any of this. Instead, we focus all of our time on staying up-to-date on the latest and greatest evidence-based information and support techniques to provide for you during the whole process. Never will an Edmonton doula check your baby’s heart rate with a doppler or check to see how dilated you are (unless they have some sort of additional schooling that would allow them within this scope of practice). If a doula offers you this, be sure to investigate them further!

The difference between our role at your birth

For starters, midwives in Edmonton are extremely popular… so much that they often have MANY clients due in the same month! Therefore, a midwife must divide her time between her clients wisely, so having them around right when you go into labour at your home just is not feasible for their overall health (that could, after all, be days!). Once your midwife joins you during the “thick” of your labour, she is there to ensure you and your baby leave this experience healthy and safe. This means frequent heart rate checks, administering any medication you choose and charting the whole process for your medical records. Makes it pretty hard for them to also rub your back and offer encouraging words during contractions right? Well, thats where us Edmonton doulas come in! We will join you at whatever point you need us during labour – for some this means after the first contraction, for others this may be once active labour has begun. We will never say no to an opportunity to help you through this! Once we join you during your birth journey, we focus entirely on you and your partner, and on your well-being. We love babies, but during the birth of one we don’t focus on them as our entire world revolves around how to help you bring them earth side in a pleasant way!

The difference we both make on your health

During my experience receiving care from my midwife and my doula in Edmonton, I recall both helping me in very different ways. My midwife was “the boss lady” – she told me what I should/shouldn’t do in order for me and my baby to stay safe. My doula was more like my counsellor/best friend/biggest supporter. She was there when I needed to vent about “still being pregnant”, she said things to me that made me feel like I was doing a good job, she reminded me that I was a warrior and that I CAN birth the way I wanted. So looking at both, my midwife was amazing for my overall physical health (and a pretty cool lady to talk to too, but without as much time to do so), while my doula contributed to my overall mental health (aka. my sanity). Both kept me healthy in equally important ways!

Did you have a midwife, a doula, or both at your birth? Did you feel they worked well together during the process? For more information about the role of a doula in Edmonton, check out our amazing advocacy organization the Doula Association of Edmonton

Breast is Best? Fed is Best? Forget both, and stick to #InformedIsBest

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Im going to switch up this post from my normal basic birth topics and dive into my opinions on a more controversial subject: breastfeeding vs. formula feeding. Now before you peace out and write me off as an Edmonton doula telling you that you’re feeding your child wrong, know that I am not going to express that one is better than the other! I’ve read countless postings voicing opinions on both sides of the argument, and this is my chance to tell you why I am choosing neither side. That’s right, I plead the fifth! (Ok I’ve been watching too much Law and Order, haha).

So here’s the scoop, in the eyes of this Edmonton doula and Edmonton prenatal class instructor. Both the “Breast is Best” and the “Fed is Best” arguments are not conducive to support for new moms. Why? Because what is THE most important part of feeding our child is not how we feed, but that we do our freaking homework and make our own decision. Following, I’ll go into this a bit more deeper for you!

Breast Milk is pretty incredible

So I’m going to start with what I know a lot about, which is breastfeeding… only because that is the path that I chose to take. When it comes to the composition of nutrients in breast milk and formula, breast milk scientifically takes the cake. You can check out a compilation of the nutrients in both foods here, but breast milk has exactly what your individual baby needs. Right down to the right fat content, water content and even the right antibodies to prevent them from catching whatever flu bug is making its way around your home. You can also add in the benefits that moms who breastfeed have to the list of pros. Things like burning more calories, strong bonding time with baby from that beautiful oxytocin flow, a reduced risk of ovarian cancer, etc. are pretty flippin’ great. They don’t call it liquid gold for no reason – breastmilk is incredible and the whole process of breastfeeding (when it is going well) is so good for mom and baby.

Breastfeeding has it’s challenges

When it comes to breastfeeding, things are not always rainbows and butterflies. I’m not going to lie, for some people, breastfeeding is really freaking hard! Getting the latch down pat is huge and without proper help of a lactation educator or consultant, it will be impossible for some moms and babies to get right. Your boobs hurt often – that first day that baby sleeps a long stretch is hell on your poor tata’s, and if you’re like me, every time your baby cries or starts a feed, you get that pins-and-needles feeling of your let down. Though we have come a long way, there are still tons of public-breastfeeding-shamers that just can’t handle the thought of a boob or nipple being waved right in their faces (note the sarcasm) that comes along with feeding in public. Finally, dare I say, some women just don’t want to! Whether they are stressing from the feeding issues they are facing, or struggling with a postpartum mood disorder in which breastfeeding is a major trigger, or they just want their body back for themselves, forcing this breast-is-best pill down their throats is just hurtful. If a mother is educated, knows exactly what the risks and benefits of both are, than how can I as an Edmonton doula push this on her when I have made a career out of supporting informed choice? I can’t 😊

Breastmilk is fresh food for babies

So to put it in comparison to what we as adults eat, it’s like a diet of strictly fresh foods vs. a diet of canned or packaged foods. Many of us (myself included) live on a lot of canned and packaged foods and are perfectly healthy and thriving. Perhaps a personal trainer or dietician wouldn’t commend what I eat, but the fact of the matter is I don’t suffer from any major health concerns and the minor ones aren’t from simply not eating fresh all the time. That being said, I might feel even better than I do, be a bit more healthy or even be able to combat my minor health concerns better if I ate more fresh foods instead of packaged ones. This is how I view breast milk and formula. In the end, whatever is chosen will not impact whether or not the baby will thrive, and there will always be a chance to introduce a more fresh food diet once solid foods are added to the mix.

But what about #FedisBest?

The Fed-is-Best trend was started when moms who were sick of being shamed for not breastfeeding decided to fight back and stick up for themselves. Makes sense and good for them! However, two concerns have come out of this: 1 – mom’s are focusing more on sticking up for those being attacked than on actually educating themselves and others, and 2 – formula companies are “latching” (pun intended) right on to this and using what is supposed to be about empowering choice to further their sales. They capitalize on women who don’t know as much as they should about breastfeeding, and deliver the message in their marketing of “we are just as good for your baby, and a hell of a lot easier”. The fact of the matter is, as I alluded to earlier, formula is not as healthy as breastmilk. It does not have the same nutrients as breastmilk. It’s not the same, period. Some mom’s are fine with that and are better off sacrificing some of these added nutrients to choose a method of feeding that is better for them and their baby individually. But it should be the mother making this decision without influence of a company trying to profit from their money. Mothers need to focus on informing themselves on both and looking at the consequences that will come out of either route. And so, I stand with those who preach “Informed-is-Best”. Inform yourself, make a decision based on the info out there. Leave the other non-expert opinions out!

Have you chose to breastfeed or formula feed your child(ren)? Have you ever felt shamed for either of your decisions? If so, I feel for you! I hope you’ll fight back and remind those shamers that you have made your decision based on the correct information out there and lifestyle behind both. If you struggle to find information and support with breastfeeding, comment here if you’re in Edmonton and I’ll connect you with some great local resources!

What it’s like to lose a pregnancy

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As some of you may know, October is Pregnancy & Infant Loss Awareness Month. As an Edmonton doula and instructor of Edmonton prenatal classes, I have a great deal of knowledge on what goes into getting pregnant. However, like many of you who are reading this, I am an unfortunate member of the pregnancy loss club as well, as I suffered miscarriages before both of my children. I have been no stranger to this world – my second loss became quite public and although it was never my intention, I am proud to be an advocate for supporting mothers and normalizing this extremely hard life event. Today in this post, I want to talk a little bit about what it is like to suffer a loss, why they do (or do not) happen and how those of you who have never experienced this can appropriately support someone in your life struggling with pregnancy loss. **Disclaimer – though also incredibly hard and equally important to talk about, this post will be based off of personal experience so I will not be diving into infant loss.

A day in the life of a loss victim

The loss of a pregnancy is gut-wrenching for so many reasons, one being that you don’t really see them coming. While the majority of losses actually happen before you’ll even pee on a stick (unless you are monitoring the crap out of your cycle and test early), the people who suffer are the ones who knew they were in fact pregnant to start with. You start out with that first positive and after the shock wears off, you’re incredibly happy! You start planning out where the baby’s room will be, thinking up names, dreaming of what they’ll look like… if it’s your first pregnancy the thought of losing all of this probably never crosses your mind. Until you don’t feel sick, or your boobs don’t hurt or stop hurting, or you feel energetic rather than tired. Many of us don’t realize that these can be signs that our pregnancy is no longer viable, until the unthinkable happens… you go to the washroom and see blood. Some of us don’t even get that part, we go until our next routine ultrasound to find out we’ve lost our little growing bean. That initial panic, followed by the unbearable confirmation, is probably one of the worst feelings I have ever had in my life. Coming from someone who has had a 7 week loss and a 13 week loss, no age of your baby makes losing them any easier. They were once there and then suddenly they are not. Then comes the part where you have to start making the decisions that you wish you never had to make – do I let this happen on it’s own or use medical interventions to carry along the miscarriage? Do I tell people or hide it? Do I try to get pregnant again or not, and how soon? Decision-making while grieving can almost be numbing in a way, as you’ve got to put your emotions to the side for a bit and think about your body and it’s well-being. Many of us feel ashamed to tell anyone what happened, almost like our body failed us and we don’t want to let the world know. After the miscarriage is over, we’re trying to heal while seeing pregnant women on the streets or watching a mother feed her newborn or seeing small children play. This is no small event and takes a lot of time, love and support to fully get over, which is why it is important for people to know how to help us through this obstacle (which i’ll get to later). Even after having two healthy children after losses, I still get choked up listening to stories about loss, as it brings up memories of my journey and it still feels so incredibly raw.

Did I do something wrong?

Many of us go through a state of trying to figure out where we went wrong. How we let this happen, or what we did to cause this. It doesn’t help that society has it’s own ideas of how “women cause themselves to lose their babies”. As an advocate for shedding the truth on losses, it doesn’t seem to matter how many times you correct or fact-check people, someone will always tell you that you did something wrong to cause you to lose your pregnancy. Maybe you jumped on a trampoline, or you had a headache so you took an advil, or you drank alcohol when you were 2 minutes pregnant and you didn’t yet know, etc. Some might even try to tell you that your body might not be capable of bearing children, and I’ve even heard these crazy theories from potential clients as an Edmonton doula. Let me tell all of you, right here, right now, THESE ARE WRONG. Unless you have been to a doctor after recurrent losses (3 or more) and have been diagnosed with some sort of issue that won’t allow your body to carry out a full term pregnancy (and event if you have), YOU did nothing wrong. First off, 60% of known miscarriages are due to a chromosomal abnormality (and much more of unknown pregnancies). This means that either the egg that you released that month, or the sperm that made it to the egg, was not suitable for life. We all have them in our system, it is literally a crap shoot on which we release at that time. Aside from this uncontrollable issue, there are a number of disorders such as PCOS, Endometriosis, cervical incompetence, etc. that can cause miscarriages but once again, none of these are from anything you did/did not do. Sure a healthy lifestyle will help you to get pregnant quicker and might even allow your body to release more “good eggs” than “bad”, but we all know someone who does not eat well or exercise often or who does not take care of themselves that has had a healthy child. It’s important for moms to get this incorrect and detrimental idea that they caused their pregnancy to end out of their head.

Saying the right thing

So here comes the hardest part about loss. What the heck do you say to someone who has just lost a baby? I’ve heard it all, from “well at least you know you can get pregnant” to “your baby was so small, at least it wasn’t actually alive” and much more. And for some of you who have not suffered a loss, these might look like a totally normal and considerate things to say. The thing to remember is that we lost a part of us, and that part of us mattered. We aren’t interested in thinking about future pregnancies, we want this one back, and going back to my earlier statement, it doesn’t matter how far along we were, a baby is a baby and losing it really sucks. A general rule of thumb to navigating communication with a loss mom is less is more. A simple “I’m sorry, please let me know how I can help” or “I’m here for you if/when you are ready to talk” goes a very long way. Bringing your personal agenda into this situation, such as religion, is also a bad idea unless you know that the loss mom is religious. It probably goes without saying, but please don’t use this time to push said agenda – this will only cause resentment or distrust. Finally, know when to reach out and when to back off. Showing up unannounced might seem like something really nice to do in any other situation, but a lot of loss moms want to be alone or grieve by themselves with their partner or family. Give space when space is needed, and hold space for them to release their sorrow if/when they are ready.

I feel like I am in an extremely unique position to help moms with pregnancy loss. As a doula in Edmonton, I can fully understand the importance of being confident in your body’s process of giving birth… but as a mom who’s lost multiple pregnancies, I know the feeling of almost being let-down by your body. The grief and disappointment of pregnancy loss often extends past the physical healing period and into viable or “rainbow” pregnancies, and we often feel as though our body may fail us again. It’s important to take back that confidence and to feel empowered in your rainbow birth, and this is where I’ve got a unique skill set. I’m hoping for the future of my Edmonton doula career that I can support as many moms as possible through rainbow pregnancies. So if you are a newly expecting mom who has suffered a loss prior and is feeling overwhelmed, please reach out! You can get ahold of me through my contact page, and for more information about what my role as a doula would look like see my 5 Myths About Doulas post and my Doulas Are For Partners Too post. If you are in the process of trying to conceive again after a loss, I’d love to hear from you as well (even if it’s just to talk).

Regardless of where you are at in your pregnancy loss journey, you are not alone and it’s time to talk about your loss. You owe it to yourself and future children to process and heal from this experience. I’m here for you ❤

A Birth Story: My Perfectly Imperfect CBAC

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At just over 2 weeks postpartum, I feel like I’m ready to share the story of the birth of my second child. This post will be unlike the other posts I’ve made – it’s personal and from a very sensitive place for me. I hope you all can appreciate my journey and take away some lessons from how things went down!

With the birth of my daughter being a cesarean, I was going to be attempting a VBAC with this child and was pretty darn excited to do so. I took my doula training shortly after my first baby was born and after attending many labours as an Edmonton birth doula, I felt pretty well prepared. However, being an Edmonton doula I am very much aware of the unpredictability of childbirth, and I was reminded of this in what seemed like a hard lesson on not being able to control birth outcomes… no matter how hard you try.

My labour started out in the most perfect way I could have imagined – at 40 weeks and 6 days, I spontaneously went into labour on my own. This was HUGE for me, seeing as one of my fears (yes, Edmonton birth doulas have fears too) was having to be induced after undergoing a painful induction with my last. So while most people would prefer to not be woken up at 1am with contractions, I was thrilled! Things continued just as I expected from here – contractions got to 7min apart, lasting 45 secs and not unmanageable. They started to space out as the sun rose but grew in strength and length and I was coping pretty well. I was talking to my doula regularly, called my midwife to give her the heads up and both encouraged sleep at this point which I was actually able to do in about 10 min increments. I even thought that there was a chance that things could still peter out… until around noon when BAM! My contractions got super intense and 4-5 min apart lasting over a minute. Tears were shed, a couple of phone calls were made by my hubby and before I knew it, we were on our way to the hospital. This was it!

That car ride SUCKED. As most do when driving on bumpy Edmonton roads through tense contractions. I even remember saying to my partner “no more babies, this is our last one!” (To which he replied “let’s revisit this in about 6 months time”, haha). We got to the Royal Alex and met my doula Vanessa (Full Circle Birth Collective) and midwife Heather (Beginnings Midwifery) and got assigned a nice, big room. I was so excited to get my cervix checked at this point, I kept thinking that based on my contraction pattern I must be well into active labour and nearing the final stretch. The news was a bit disheartening – while I was at 4 to 5cm, very soft and thin, baby was still quite high. However, I saw the positives in the check and took these numbers with a grain of salt, as us Edmonton birth doulas know that these numbers can change quite rapidly. I got in the tub, laboured away and drove my doula and hubby crazy while in what I like to call “cranky labour mode” (that point you get to in labour where you don’t want to do anything but complain and say no to stuff… rightfully so, your about to pass a human!) I started to feel immense pressure, to the point where I felt the urge to push and sometimes couldn’t even stop myself. I kept thinking “this is it!” and my midwife decided to check me again. I was at 7cm, but to my disbelief baby was still super high. At this point my midwife mentioned that she thought baby’s head was asynclitic, which no one who works in the birth industry wants to hear. Asynclitic heads are tilted, and this little guy seemed to be stuck in a transverse (facing one of my hips) and asynclitic spot to the point where he just couldn’t engage into my pelvis. This started to sound oh so familiar, as the birth of my daughter was complicated due to her not being able to engage. Thank GOD for the fact that I had my doula and midwife with me, who both didn’t lose hope at this point and encouraged me to work some positions that might help baby drop.

The next few hours went by and I was definitely pondering ALL of the drugs. Contractions were quite intense and I found myself patiently waiting for my endorphins to kick in. Finally I decided on some nitrous oxide and a snack from my lovely partner and that really seemed to give me a boost to keep going. However, my baby and my pelvis had a different idea. While on the hospital bed on my hands and knees I let out a pretty large push that made my birth team all think that I could be nearing the pushing phase, so I got checked. Absolutely no change. It was gut wrenching. I decided to make an amendment to my ideal birth and opt in for an epidural. I hoped that maybe this all would start to progress if I could relax my pelvic floor (which I was desperately trying to do but n it doing a good job of with the strength my contractions reached). I felt so much support from my entire birth team with this decision, which I am so grateful for as it’s not what I originally wanted – I wanted to take a much more natural route. After the epidural, we decided to rupture my membranes and see if this combo would finally bring baby down. After my water broke I rested for an hour, hopeful that things were going to rapidly change.

My midwife was able to check me during a contraction, and unfortunately she informed me that I actually might not have been as dilated as she thought, as my cervix was much easier to feel with a bit of pressure from baby’s head. She called in an OBGYN for a consultation to see if they had any suggestions to get this baby out vaginally. While he was quite nice and calm, he said baby was still at -4 station (just barely past my pelvic inlet) and my contractions were strong enough that trying a pitocin drip wouldn’t make much difference. This was the moment where we ran out of options, and I consented to my second cesarean birth.

The birth itself went as expected. My midwife and partner were by my side which meant a lot and I was even allowed both arms free to hold my little guy after he came out. The procedure wasn’t the smoothest – baby really got nestled into an odd position meaning the medical team had to dig him out and cause bruising and swelling on my abdomen in the process. But he came out healthy as a horse, and much larger than I anticipated!

I had a few days in which I can only describe as slight grief. I don’t want to sound ungrateful, as I was I incredibly supported and educated throughout the whole birth and my little guy is alive and well, which is the most important thing. However I had a vision of how my birth was going to go, how I was going to announce to the world that I got my natural VBAC water birth and I was going to share my successful strategies with clients in future years. I was going to lead by example, but that was not how things turned out. Instead I quite possibly may never experience that beautiful moment of my baby being placed on my chest after working so hard to bring him earthside, experiencing that natural rush of oxytocin and feeling so incredibly proud and accomplished. This was the hardest pill for me to swallow, and no words were able to fully help heal that. I’m still emotional thinking about it.

However, there are so many important lessons to be taken from this birth, and I can see these now very clearly:

1. Regardless of how prepared you feel, how educated you are and how much you want things to go a specific way, you CANNOT control the outcome of your birth.

2. Regardless of the outcome of your birth, feeling supported and being able to make your own decisions and being respected for those decisions will help you avoid birth trauma. Consent is everything.

3. You birth team will make or break your experience. Husbands are incredible resources when they have good direction from someone. Doulas don’t just enhance your experience, they enhance your partner’s as well. And when your care provider lets you lead the way, you can feel in control of the most out-of-control situations.

4. The only things that are important in preparing for your birth are being well educated and developing a trust in your body. No amount of stretches, breathing exercises or pretty photos will amount to the importance of believing in yourself and understanding what’s going on in your body.

Im sure I could list off so many other things that I’ve taken away from this experience, but I will leave off by saying that this will most definitely make me a stronger Edmonton doula and and better instructor in my Edmonton prenatal classes. In many ways (possibly from the premature urge to push or the piggybacking contractions that resembled transition) I felt as though I got to experience a normal vaginally delivery. Only recovering from surgery rather than vaginal birth. I have many new memories from this birth that I wasn’t able to experience with my last, which I can’t wait to take to new clients in hopes of doing for them what was done for me this time around. I still believe that all births are beautiful. And I am forever grateful for the people who allowed me to have even a portion of the birth that I wanted. I can’t wait to pay it forward in the quest to make all births empowering. Thank you all for reading this and for being a part of my healing journey ❤️