Birth

Jessie Jaskulsky holding a baby

5 Things to Know About Surrogacy – Guest Blog by Jessie Jaskulsky

Gold Coast Doulas asked Jessie Jaskulsky to guest blog on the topic of Surrogacy since March is Surrogacy Awareness Month. Jessie is the mom of Lily and Luna. It is through her first-hand experience with surrogacy that she is passionate about simplifying the process for others. Having gone through this beautiful but wildly complicated process twice, Jessie is motivated to help others create the family of their dreams.

 

March is Surrogacy Awareness Month and the perfect time to learn more about the beautiful gift of surrogacy. Whether you or someone you know are experiencing infertility, here are five things you need about this beautiful pathway to parenthood. 

The Difference Between Gestational and Traditional Surrogacy

Gestational Surrogacy is when the surrogate undergoes an embryo transfer and carries the baby for the Intended Parents. The embryo is created by combining the egg from one person (typically the Intended Mother or egg donor) with the sperm (typically the Intended Father or sperm donor) in a lab (fertility clinic). The gestational carrier does not have any biological connection to the baby. Traditional Surrogacy, on the other hand, is when the surrogate has a biological connection to the baby. In most circumstances, the egg is from the surrogate and the sperm is from either the Intended Father or donor sperm. It is important to note that traditional surrogacy is banned in several states whereas gestational surrogacy is legal in 47 out of 50 states (Michigan being one of the states where it is illegal). 

 

Where to Find a Surrogate 

Matching with a surrogate can be done in a variety of ways. Intended Parents can find a surrogate with the help of a surrogacy agency, a surrogacy consultant, or independently. An independent journey is when an agency or consultant is not used and the Intended Parents manage the entire process by themselves. In these instances, the surrogate is either someone the Intended Parents know or met through social media. The length of time it takes to match with a surrogate can vary greatly depending on the method you choose. Even within one of these options, there is still significant variability in the time to be matched with a surrogate.

You Follow the Law Where the Baby is Born 

Regardless if your surrogate is known (i.e., friend or family member) or someone met through an agency, you will need a legal contract. Since Michigan is a state where surrogacy is not (yet) legal, you would need to find a surrogate living in a “surrogacy-friendly” state. Your legal representation is typically in the state where the baby will be born (i.e., where the surrogate lives). There are some exceptions to this rule, for example, in states where the laws for surrogacy are written favorably, some will try to argue jurisdiction for the state where the embryo transfer occurred. 

The Cost of Surrogacy 

The cost of surrogacy can range from $125,000 to $175,000 based on a variety of factors. Examples include surrogate compensation, whether your surrogate has “surrogate-friendly” health insurance (otherwise the Intended Parents need to purchase her a supplemental policy), type of journey you pursue (independent vs. using a surrogacy agency). There are grants available (pro tip- check out Resolve to find available ones in your state) and financing options to help with the high cost of surrogacy.

Surrogates are Evaluated Physically & Psychologically 

Once you’ve matched with a surrogate, the surrogate will also be evaluated by a psychologist or social worker who is trained in ART.  The exact assessment may vary based on the fertility clinic you are working with and their specific requirements. Most surrogates can expect an assessment that has two components; a session with the psychologist and completing a questionnaire that is part of a more formal measure such as the MMPI (Minnesota Multi-phasic Personality Inventory). 


The Intended Parents’ fertility clinic will review the surrogate’s medical records and schedule a time for her to come to the office for an evaluation. At the evaluation, they will test her and her partner for infectious diseases and undergo a urine drug test. They will also meet with the Reproductive Endocrinologist to review the surrogate’s medical history and discuss the surrogacy process. Lastly, they will evaluate the surrogate’s uterus by either ultrasound or HSG hysterosalpingogram) to visualize the uterus and fallopian tubes.

If you are thinking about beginning a surrogacy journey, we’d love to meet you and learn about your unique circumstances. You can schedule a complimentary consultation here. Not ready to meet but interested in learning more? Download our free surrogacy e-book here.

5 Things to Know About Surrogacy – Guest Blog by Jessie Jaskulsky Read More »

Heidi McDowell headshot

Did you forget something?

Gold Coast Doulas asked Heidi McDowell to guest blog on the topic of preparing your body for childbirth. Heidi is a yoga teacher at Mind, Body, Baby, a doula, a wife, and most importantly, a mama. Her goal is to create a community space for you that feels safe, supportive, and empowering. She holds certifications in Fertility Yoga, Prenatal Yoga, Postpartum Yoga, and Children’s Yoga. She is also a certified Postpartum and Infant Care Doula and a Labor Doula. She is one of two Yoga Alliance Certified Registered Prenatal Yoga Teachers in all of West Michigan. This is the highest credential in the field of Prenatal Yoga.

 

You find out you’re expecting and immediately begin to prepare in all of the ways you know how. You make the doctor’s appointment, the registry list, prep the nursery, hire the doula, and sign up for your childbirth education class. Does it feel like you forgot something? That’s because you did. 

What about your body? You’re preparing to run a marathon aka give birth and you haven’t done any intentional body preparation. And I’m not talking about seeing the chiropractor or getting a massage (do that too). But I am talking about intentionally moving, balancing the tissues, practicing positions, and learning tools to ensure you’re empowered and physically ready to run this race. 

As a prenatal yoga instructor, birth doula, and Body Ready Method trainer I get asked a lot of questions about how to prepare for delivery. As an expecting mom and yoga teacher I thought I had done all of the work during my pregnancy. After 52 hours of labor I was left wondering what I had missed. I never want someone else to feel like they could have done more to feel empowered and physically ready. That’s why my best tips always involve prenatal body preparation. 

Have you heard of your psoas? It’s a big muscle that connects the top of our bodies to the bottom. Did you know it runs over the top of your pelvic inlet on both sides? It is between your baby and your birth canal. In order for spontaneous labor to occur and progress these muscles need to be out of the way of your baby. Sitting, biking, running, lifestyle habits, sports can all contribute to imbalance and excessive tightness of these muscles. An easy way to release this muscle is to stand on a yoga block with one foot and allow the other leg to pendulum swing freely front to back.

How about your sacrum? That triangle-shaped bone in the center back of your pelvis. It’s this amazing trap door that can either get in the way or out of the way when baby is at different levels of the pelvis. If your muscles are restricted in the glutes and low back this bone is likely stuck and unable to move. My favorite release is called a hip hinge. From standing begin to “hinge” at the hips like a broomstick was glued to your spine. Feel the release throughout the entire posterior body.

Tissue takes time to change. You should begin to move your body in intentional ways throughout pregnancy. This will allow your body the ability to open and release your baby when the time comes. Consider preparing your body with low-impact prenatal yoga classes. When practiced with a Registered Prenatal Yoga Teacher classes should be so much more than just yoga modified for a belly. There’s a reason why it is the number one most prescribed form of prenatal movement by doctors and midwives. 

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Pregnancy Loss image for Gold Coast Doulas Podcast

Pregnancy Loss

Remember the story of Pandora’s Box? In Greek mythology, the story goes something like this: Pandora, told she could not open the lid of a box given to her or her husband from Zeus, finally lets curiosity get the best of her and opens the box. Immediately, out comes all the troubles that humanity would ever experience—pain, conflict, war, etc. and when Pandora finally is able to shut the lid, only one thing remains in the box: Hope.

​This story is still used today as a way to explain that even in the midst of complete horror and tragedy, hope still remains. In my motherhood journey, hope has been a positive, calming source that also at times hangs around, making things way more complicated.

​So, let me try to explain my story in brief. My husband and I get married in August 2016 and when we say “I do,” I have already been off of birth control for about three months. Knowing that we were not young kids (I was 34 and my husband was 39), we did not feel like we had any time to lose. I remember saying “I do” and hoping we would have a little one in our arms on our 1st anniversary or at least, one on the way. Months of infertility followed until we went to seek out fertility testing, which led to a diagnosis of infertility with an unknown cause. Infertility treatments followed with me finally getting pregnant on our first round of IVF, only to miscarry shortly thereafter.

After switching doctors, on the 3rd IVF cycle, I got pregnant with our daughter Colette. When I was 21 weeks pregnant, I was hospitalized with a diagnosis of severe preeclampsia, where I stayed until Colette was born via emergency c-section at 24 weeks, 5 days. She spent her very short nine-day life in the NICU before she died. There were no answers, no reason to explain why I had developed preeclampsia and even worse, no real plan as to how to avoid it and to intervene if necessary.

We went back to trying, first naturally and then with another round of IVF which was not successful. After we found out the transfer had failed, my husband was crying in my arms and I strangely felt relief. I was terrified of being pregnant again, still not sure I could trust my body, but desperately wanting a child we could bring home and raise. Eventually, we used a gestational carrier to bring home our rainbow baby, Elliott, who is two years old and absolutely the love of my life.

More recently, after Elliott had turned one, we decided we wanted to have another child and it seemed like everything was again in our favor. Our same surrogate was available and we started the process again, planning to bring Elliott’s baby brother or sister home. But, the stars were not in our favor this time and after failed and canceled cycles and way too many obstacles, we decided it was best for our family to stop and to be happy with our two children, one in heaven and one here with us.

These days, I struggle with what this decision means long term. I worry about Elliott not having a living sibling and if that will affect him personality-wise or if he will feel deprived of the experience. I think about how I will never have a daughter with me here to raise. And the biggest thing that I spend time thinking about is that I will never be pregnant again, I will never know what it is like to experience pregnancy at all past 24 weeks or to experience pregnancy that was not life-threatening after 21 weeks.

The hope that sustained me through our journey, that told me even when I went to the darkest places of thinking I would never be a mom or we would never have a child that was made up of the two of us, is gone. In its place is a hope that I struggle to understand and accept. As much as getting pregnant and going through a pregnancy scare the hell out of me, and believe me it does, there still remains this tiny hope that it will just happen, that when I least expect it, all of a sudden I will be pregnant and that because this surprise, perhaps divine occurrence will make sure that the pregnancy is smooth sailing.

Yet, I know the reality of such occurrence will not magically or divinely ensure that my pregnancy will be fantastic or even healthy or safe or last more than a mere blip of time. I even know that my vision and fantasy of being pregnant is not at all in line with my experience in real life. I hated being pregnant, I hated that everything made me sick, I hated how exhausted I was, I hated that my sense of smell was so strong, I hated that clothes did not fit sometimes one day to the next, I hated that my back hurt and my feet ached. But, most importantly, the same fear that caused me to point our family in another direction and use a gestational carrier is still very much a fear and one that medical science cannot solve at this moment in time. So, I know that accepting the decision to stop trying is best for my health, both mental and physical, for my husband, for our son, and for our daughter, but that little morsel of hope still eats away at me some days and for that, I really wish Pandora had left peace in the box instead of hope.

_________________________

Michelle Valiukenas is the proud mom of her angel Sweet Pea, who she lost due to miscarriage, her angel daughter Colette Louise who she lost at nine days old, and her only living child, her rainbow baby, Elliott Miguel. Inspired by her journey with Colette, Michelle and her husband founded The Colette Louise Tisdahl Foundation, whose mission is to improve outcomes of pregnancy, childbirth, prematurity, and infancy, as well as aid in the grieving process through financial assistance, education, and advocacy. Their flagship program financially assists families dealing with high-risk and complicated pregnancies, NICU stays, and loss. The organization’s ability to help families relies on donations and grants and they are grateful if you are able to donate. Michelle also participates and advocates on issues of maternal health, maternal mortality, infant health and safety, and pregnancy complications. Michelle lives in Glenview, Illinois with her son Elliott, husband Mark, and dog Nemo.​

 

 

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Yoga pose for pregnancy

Top 3 Yoga Poses for 3rd Trimester

Cervical checks aren’t quite the crystal ball some providers make them out to be.  The truth is, we don’t know how your birth will unfold. But by preparing your body you are creating balance in your pelvis and enhancing your baby’s chances of a smoother, more efficient birth! As a labor doula and prenatal yoga teacher I have witnessed how effective body balance work is for my pregnant clients. 

Here are my 3 favorite yoga moves to do to get your body balanced for birth:

Thoracic movement with 360 breathing:

Yoga poses for third trimester

Super simple and often overlooked. Opening the ribs makes space for baby and organs to move up which releases tension in the pelvic floor, the back, and ultimately helps the sacrum have mobility to move out of the way during delivery. Breathing down feel baby lift, ribs expand, heart space lift, and back body widens. 

Rocking Cat / Cow with a kickstand:

Yoga pose for pregnancy

These poses can release tension in the lower back and help maintain mobility of the spine and pelvis. The extended leg is gaining length through the adductors which connect to the pelvic floor – lengthening and relaxing the pelvic floor muscles. From a table top pose extend one leg to the side, rock forward into cow, inhale, and back into cat (almost childspose) exhale. 

Leg Dangling:

You can do this with a book, yoga block, and even a curb. This pose helps release tension in the psoas muscle. The psoas plays a big role in how labor can progress. Since the psoas runs behind and cradles the uterus, tightness can cause an imbalance of the uterus and encourage pelvic misalignments. This would interfere with the baby’s position and descent, and could possibly lead to a longer and more challenging labor. Standing with one foot on an elevated surface, allow your free leg to swing back and forth gently and dangle. Allow the hip to drop. 

You will never regret doing the work that may give you and your baby the best chance at a more functional birth with less interventions. Where do you want to spend your time and energy- in the delivery room or in the yoga studio? 

Heidi McDowell

FOUNDER | MAMA |FERTILITY, PRENATAL, POSTPARTUM YOGA CERTIFIED | DOULA

She/her

Heidi is a yoga teacher, a doula, a wife, and most importantly, a mama.

Her goal is to create a community space for you that feels safe, supportive, and empowering. She holds certifications in Fertility Yoga, Prenatal Yoga, Postpartum Yoga, and Children’s Yoga. She is also a certified Postpartum and Infant Care Doula and a Labor Doula. She is one of two Yoga Alliance Certified Registered Prenatal Yoga Teachers in all of West Michigan. This is the highest credential in the field of Prenatal Yoga.

IG & FB: @mindbodybabyyoga

 

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Lisa Newhouse poses in front of a blue curtain wearing a brown top

Meet our new birth doula, Lisa.

What did you do before you became a doula/consultant?

I had a 20+ year career as an Occupational Therapist. Much of my career as a therapist, was at Mary Free Bed Hospital working in the wheelchair and custom seating department. Approximately 7 years ago, I completed my master’s degree and became an academic advisor. I worked at Aquinas College and Grand Valley State University until the initial months of Covid. At which time, I resigned due to family needs.

What inspired you to become a doula/consultant?

I have always enjoyed professions that allow me to help others. I knew I wanted to do something that would feed my soul a little more, and I also knew that I had a desire to be involved with helping women and children. The doula profession has been on my radar for a while now and the time seemed right to go with my heart and pursue this career.

Tell us about your family.

I have a blended family that consists of four children from my husband’s previous relationship, two children from my previous relationship and one child together. All our children, with the exception of the youngest (15 y/o), are adults and most have families of their own.

What is your favorite vacation spot and why?

My husband and I love to travel and have many favorite spots! I would say that we enjoy traveling internationally and South Africa was one of our favorite trips.

Name your top five bands/musicians and tell us what you love about them.

I really enjoy music, particularly live music, and I find it hard to name who would be my top 5. I can say that I have three artists that I have seen live a few times and every time it has been so fun! The first artist is U2, that I have seen two times. What I love the most about U2 is how they always fill me with hope. A couple other artists that I have seen a couple times is OAR and Michael Franti. I have seen both of them at Meijer Gardens and both artists put on a fabulous show!

What is the best advice you have given to new families?

To always lead with love. At the end of the day, we all make mistakes or can think of something we wished we would have done differently, but I firmly believe that it is always going to be ok if you lead with love.

What do you consider your doula/consultant superpower to be?

I am not completely sure, but I think it would be my ability to anticipate what someone needs in the moment. I have always been good at reading or sensing when someone needs something and responding appropriately.

What is your favorite food?

I am a real foodie! I like just about anything that is local and fresh. However, I do have a real love for ethnic flavors and in particular Mediterranean.

What is your favorite place on West Michigan Gold Coast?

I have two favorite places on the west coast. Saugatuck holds a very special place in my heart because my husband and I were married there! We also love Petoskey, not only is it beautiful, but we have an annual camping trip with friends there every Labor Day. So, we have wonderful memories in both spots!

What are you reading now?

I am a voracious reader! I typically have a stack of 3-4 books at any given time that I am reading. I am in two book clubs, one that primarily focuses on non-fiction and the other fiction. The last couple of books I just read was Brene Browns Atlas of the Heart, love her so much and everything she writes! I also, just read The Sentence by Louise Erdrich.

Who are your role models?

I have always admired and tried to emulate women who have weathered the storms and did what needed to be done. I believe there is nothing more formidable than a woman who is doing what is right and necessary for those she loves.

 

Meet our new birth doula, Lisa. Read More »

Anja's Stem Cell Collection Kit with three babies

Harnessing the Power of Stem Cells Through Cord Blood Banking

Stem cells are special human cells that have the potential to become many different types of cells, such as brain cells, muscles cells, and more. These cells have the potential to treat, or even sometimes reverse diseases that have left patients of the past without effective options. Umbilical cord blood banking provides potential treatments for many of the medical conditions we hope our children and family members never have to suffer through.

What is Cord Blood Banking?
Cord blood banking refers to the freezing and storage of umbilical cord blood and tissues. In the time leading up to delivery, there is a transfer of powerful stem cells and other immune-boosting cells between the mother and fetus. These cells remain in the blood and are often discarded with the umbilical cord and placenta.
Cord blood and tissue banking involve collecting the blood and tissues that contain these cells and freezing them for a later date, when they may be used to treat a variety of illnesses that were previously thought to be difficult to treat or incurable.

Did you know? Umbilical cord blood banking is OB, Midwife, and Doula recommended!
Types of Stem Cells Obtained from Cord and Tissue Banking
There are two main types of stem cells acquired during cord blood and tissue banking: hematopoietic stem cells and mesenchymal stem cells.
Hematopoietic Stem Cells
Hematopoietic stem cells are obtained through umbilical cord blood banking and are approved by the FDA to treat a variety of illnesses, including blood disorders (e.g. sickle cell anemia), immune disorders (e.g. multiple sclerosis, rheumatoid arthritis), and cancer (e.g. lymphoma, leukemia, myeloma). There are also over 1000 ongoing clinical trials examining other use cases.
Mesenchymal Stem Cells
Mesenchymal stem cells are found in the umbilical cord tissue, placenta, and bone marrow. They are powerful stem cells used to treat a variety of chronic and progressive medical conditions, including lung disease, Autism, Alzheimer’s disease, heart disease, and hair loss.

Public vs. Private Cord Blood Banking
While you have the option of receiving cord blood or tissue from a donor via a public cord blood bank, serious side effects may occur. There is a high risk of incompatibility, which may result in a range of significant acute or chronic symptoms.
Since the body is meant to attack foreign bodies it sees as dangerous, a condition called graft- versus-host disease may develop as a result of a stem cell transplant from a donor. This occurs when donor stem cells see the transplant as an immune system invasion. The body rejects the healthy new stem cells, leading to harmful symptoms and sometimes death.
By using stem cells you’ve privately banked that are at least a partial match, you greatly reduce the risk of developing such complications. When banking your cord blood and tissue for future personal use, the cells are always a match for who they came from. They may safely be used as a treatment for family members as well.
Siblings have a 75% chance of being a match, while parents are always a 50% match for their children. Extended family, such as aunts and uncles, also have a probable chance of being a partial match, which could have a significant impact, should they need treatment.

How Can Recipients Benefit From Private Cord Blood Banking?
Significant improvements have been observed in medical conditions with the help of stem cells. These improvements include but are not limited to:
● Reversing Type 1 Diabetes
● Significantly improving symptoms of Crohn’s disease
● Improving motor function in children with cerebral palsy
● Promoting CAR T-cell therapy, an immunotherapeutic cancer treatment
● Aiding in heart failure treatment
● Showing protective effects on hair loss

How To Store Your Cord Blood and Tissue Stem Cells
To bank your baby’s umbilical cord blood, cord tissue, or placenta, order a collection kit before your due date. Store the kit at room temperature and bring it with you to the hospital. When you arrive at Labor & Delivery, tell the admitting nurse that you plan to collect your stem cells. Before birth, tell your healthcare provider that you have the kit ready for collection.
Your collection kit from Anja Health has everything you need and their stem cell banking experts will help guide you through the process.
Use the discount code GOLD to receive 90% off the price of your collection kit!

After the birth of your child, the team at Anja Health will collect your kit from the hospital and take care of everything, including viability testing, optimization, and cryogenic storage in their AABB-accredited, FDA-approved lab in New Jersey.
If the time comes, you’ll be glad to know you have the stem cells to help your child or other members of your family when they’re in need!

 

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Woman wearing jeans, a white tshirt, and a jean jacket sits on top of a desk in her office

Preventing Preeclampsia with Proper Nutrition

Preeclampsia is a prenatal and postpartum condition that is hallmarked by gestational hypertension and the presence of protein in the urine. It occurs in approximately 5-8% of pregnant women and can be life-threatening. Women who have had preeclampsia with a previous pregnancy are at a higher risk of developing it again.

The symptoms of preeclampsia can be varied and confusing. Edema (specifically pitting in the ankles), sudden weight gain, headaches or vision changes are all common complaints amongst patients with this condition, but presentation varies on the underlying cause.

Research has shown that nutritional deficiencies may play a role. [1] There have been several studies linking different nutritional deficiencies with an increased risk of developing gestational hypertension and preeclampsia. In this article I will address the individual nutrients linked in these studies, as well as nutritional principles to get you started.

NUTRIENT DEFICIENCIES ASSOCIATED WITH AN INCREASED RISK OF PREECLAMPSIA

Magnesium: Magnesium is essential for the proper development of the placenta from mid first trimester on. We see significantly lower levels of magnesium in preeclamptic patients. [2] Not only is Magnesium necessary for many of the other nutrients, like Calcium, Sodium and Potassium, to function properly, it is also necessary for the hormone receptors to accept certain hormones. Without proper levels of Magnesium, sodium and calcium build up in the blood causing increased blood pressure and increasing the risk of preeclampsia. Magnesium is a natural muscle relaxant, and deficiency can cause tightening of the blood vessels. The demand for magnesium grows exponentially from 28 weeks of gestation through childbirth.

Calcium: Calcium supplementation in pregnancies at a higher risk for preeclampsia has been shown to reduce the risk of hypertension and preeclampsia [3] as well as reduce the maternal mortality risk due to preeclampsia. Calcium supplementation help prevent dysfunction in the placenta by affecting Nitric Oxide Pathways. [4] Calcium also interplays with a other nutrients associated with an increased risk of preeclampsia, Vitamin D/K/Magnesium.

Zinc: Zinc is an important mineral for hormone development and immune support. It is one of the most essential minerals for pregnancy. Deficiencies are associated with an increased risk of miscarriage, birth defects, and stillbirths. Too much copper or iron can deplete zinc (there is a tricky balance), it is also necessary for proper B6 absorption. Zinc is the catalyst for the millions of enzymatic reactions that are occurring as your baby develops. It is also necessary in protein synthesis (protein is what your oxytocin is going to be made from). Zinc plays a role in the formation of red blood cells, and deficiency can lead to anemia. All things associated with preeclampsia. A 2015 study found lower zinc levels in preeclamptic mothers. [5]

Manganese: A new study, published in 2020, may possibly be bridging the gap among manganese deficiency, oxidative stress, and preeclampsia risk. This study was led by researchers at Johns Hopkins Bloomberg School of Public Health. The analysis found significantly lower levels of manganese in early pregnancy increased the likelihood of the development of both gestational hypertension and preeclampsia. [6] This is the first paper linking manganese to preeclampsia. Manganese makes up a very important enzyme called superoxide dismutase that helps to reduce inflammation in the placenta.

Vitamin D: Vitamin D is a hormone. It is formed from cholesterol in the diet which interacts with the UVB rays to create Vitamin D. It is a fat soluble vitamin in the diet, and there MUST be a fat present for absorption. We do know that Vitamin D plays a significant role in the regulation of the hormones of our body. The role of Vitamin D in hypertension is still not fully understood, but we know there is a connection between low Vitamin D preeclampsia. There is an interesting correlation between winter pregnancies (lack of sunlight) and preeclampsia rates. Vitamin D is necessary in the formation of several enzymes produced by the placenta, which are missing in preeclampsia. Vitamin D is necessary for Calcium and Phosphorus to function. Supplementing with Vitamin D is associated with a decrease in preeclampsia risk. [7] Vitamin D and K work together, and in combination with Calcium, Magnesium and Potassium. Without vitamin K, these nutrients cannot work together correctly.

COQ10: A 2003 study found a marked decrease in CoQ10 in women with preeclampsia. [8] The theory is that increasing oxidative stress “consumes” the CoQ10, decreasing mitochondrial function. Interestingly, this difference is more prominent in women living at altitude than women living at sea level, [9] and with age.

Folate/B12: Homocysteine is a byproduct of the methionine cycle. This is cycle is the “methylation” cycle and is dependent on folate and B12. [10] Homocysteine increases cardiovascular inflammation, and the decrease in proper methylation affects the stability of the placental cells and their function.

Sign up now for our BECOMING a Mother online course! Gain confidence and reduce fear in pregnancy, labor, and early parenting! We’d love to see you there!

HOW TO PREVENT PREECLAMPSIA WITH DIET

The idea that diet influences the onset of hypertension and preeclampsia is a huge component of the functional medicine approach to chronic disease. Bear in mind that the development of the blood vessels between the placenta and the uterus begin early in gestation. In prevention, it is important to begin proper nutrition prior to conception. This doesn’t mean that it cannot develop later, or that severity in symptoms cannot be prevented during gestation. The placenta is growing for several months, as your baby develops, and at any point proper nutrition can be used to grow these blood vessels properly, create healthy blood flow, and relax tense blood vessels and stabilize placental function, all to lower hypertension and preeclampsia risk.

Here are my top guidelines for preventing preeclampsia through diet.

REDUCE PRESERVATIVE SODIUM: Research shows that once you have come into a hypertensive state, you are more sensitive to sodium and will react stronger than you would out of the hypertensive state. Typically, because there is an imbalance in the sodium levels in the cells and out of the cells (in the blood). This imbalance causes a strain on the blood vessels and increases blood pressure. Preservative sodium is different than sea salt sodium, or table salt. This synthetic form of sodium is more difficult for Magnesium to transport and becomes built up in the blood more quickly. Learn to read the labels. Synthetic preservative sodium is found in most packaged products.

REDUCE EXCESSIVE AND ADDED SUGARS: In a natural and balanced diet, our body needs sugars. Fructose is a fuel for the brain, and Glucose is a fuel for every cell in our body. But in excess, or not properly balance, these fuels become toxins. In our society, we consume excessive amounts or processed and packaged foods that are full of refined flours and sugars, and typically lead very sedentary lives. These inactive lives and diets rich in unused fuels causes excessive weight gain, hormone disruptions, and internal damage. Stick to natural sweeteners, such as honey, maple syrup, and fruits and fruit juices when needing to sweeten a recipe. If you are craving sugar, it could mean that you are not consuming enough vitamins and minerals, or you are not balancing with enough fat. When your cells are malnourished, you will crave sugar.

LEARN TO LOVE FAT: Many nutritional fats work as anti-inflammatories in the body. Without a proper level of good fats in our bodies, our hormones cannot function (Our hormones are made from fats!), our brain slows down (over 60% fat), our nerves become hypersensitive to stimuli, and our cells become weak. During pregnancy fats and cholesterols are even more important. They are the building blocks of the hormones that sustain pregnancy.

TASTE THE RAINBOW, AND I DON’T MEAN SKITTLES: What I mean is embrace the rainbow of colors found in fruits and vegetables. Foods that are rich in color are also rich in nutrition. They are also higher in antioxidants. Greens, Reds, Yellows, Blues, Purples, all of these colors are associated with nutrients and antioxidants.

SPICE IT UP: Use herbs to flavor your meals. There is such an amazing array of herbs out there that not only add vibrancy to our meals, but are packed with nutrients, antioxidants, and anti-inflammatory phytochemicals. Garlic, Ginger, Turmeric, Parsley, Cilantro, Oregano, Lemongrass, Curry, Fennel, Dill, Mint, the possibilities are endless. Stimulate your body and your brain with these intense flavors, not added sugar. Many of these herbs are also important sources of pregnancy important nutrients (parsley – Vitamin K), others are specifically known to help treat hypertension (Basil, Cinnamon, Garlic, Ginger, Parsley, Dandelion)

CHOOSE QUALITY NOT QUANTITY: The adage of eating for two is a misnomer. The baby growing inside you, at the most, needs 300 extra calories a day at its biggest. What we do need is more nutrients that sustain the health of your body…not calories. Excessive meals are hard on the system and put strain on the body. Often those consuming poor diets, or nutrient deficient diets, find themselves craving more food, even though they are eating large amounts of calories (well over what they need). This is because the foods they are consuming are nutrient deplete but high in carbohydrates and sugars, and the cells are actually STARVING for nutrition. Choose nutrient dense foods and smaller amounts over large amounts of poor-quality foods. You’ll be surprised at how much your food cravings and excessive hunger go away when your cells are getting the correct amount of nutrients.

STAY HYDRATED: Water makes up the majority of our body (80+%). It is a cooling, and lubricating mechanism. When we are deficient the body can heat up and dry out, causing friction and inflammation. Dehydration also causes an increase in pain perception, and reduction in blood flow to the brain. Over time, chronic dehydration can affect the neurotransmitters of the brain. Even mild dehydration can affect your mood, causing mood swings and depression. During pregnancy, your body is making and filtering amniotic fluid, which is a combination of water Vitamin C, E, and other electrolytes. You need to consume enough for your needs, the amniotic fluid, and your developing baby. The old adage of eating for two, should really be drinking for two, which would be more accurate. A little drink to absorbing more and peeing less…. add fruit, lemon, trace minerals, etc.…to your water. Tap water is lacking in naturally occurring minerals, they are removed during filtering, and processing. Traditional peoples didn’t carry around and fill 32 oz water bottles 2-4x per day…they didn’t have to, the water they drank was more nutritional with little bits of soil and debris which aided in absorption.

Sarah Thompson founded Sacred Vessel Acupuncture in 2012, after years of working alongside western medicine physicians. Sarah has dedicated her practice to those with complicated conditions, and those seeking to improve their health. ​​She brings over 20 years of experience working directly with medical doctors in the fields of Pain Management, Obstetrics & Gynecology, and advanced studies in both Acupuncture and Functional Medicine.

Want to know more? Pick up her new book, Functional Maternity – Using Functional Medicine and Nutrition to Improve Pregnancy and Childbirth Outcomes.

 

Citations

1. Grum T, Hintsa S, Hagos G. Dietary factors associated with preeclampsia or eclampsia among women in delivery care services in Addis Ababa, Ethiopia: a case control study. BMC Res Notes. 2018;11(1):683. Published 2018 Oct 1. doi:10.1186/s13104-018-3793-8

2. Kharb S, Goel K, Bhardwaj J, Nanda S. Role of magnesium in preeclampsia. Biomed Biotechnol Res J 2018;2:178-80

3. Hofmeyr GJ, Lawrie TA, Atallah AN, Duley L, Torloni MR. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochran Database Syst Rev. 2014;6. doi:10.1002/14651858.CD001059

4. DeSousa J, Tong M, Wei J, Chamley L, Stone P, Chen Q. The anti-inflammatory effect of calcium for preventing endothelial cell activation in preeclampsia. J Hum Hypertens. 2016;30(5):303-308. doi:10.1038/jhh.2015.73

5. Ma Y, Shen X, Zhang D. The Relationship between Serum Zinc Level and Preeclampsia: A Meta-Analysis. Nutrients. 2015;7(9):7806-7820. Published 2015 Sep 15. doi:10.3390/nu7095366

6. Liu T, Hivert MF, Rifas-Shiman SL, et al. Prospective Association Between Manganese in Early Pregnancy and the Risk of Preeclampsia. Epidemiology. 2020;31(5):677–680. doi:10.1097/ EDE.0000000000001227

7. Fogacci S, Fogacci F, Banach M, et al. Vitamin D supplementation and incident preeclampsia: A systematic review and meta-analysis of randomized clinical trials. Clin Nutr. 2020;39(6):1742-1752. doi:10.1016/j.clnu.2019.08.015

8. Teran E, Hernandez I, Nieto B, Tavara R, Ocampo JE, Calle A. Coenzyme Q10 supplementation during pregnancy reduces the risk of pre-eclampsia. Int J Gynaecol Obstet. 2009;105(1):43–45. doi:10.1016/j.ijgo.2008.11.033

9. Teran E, Chedraui P, Racines-Orbe M, et al. Coenzyme Q10 levels in women with preeclampsia living at different altitudes. Biofactors. 2008;32(1–4):185–190. doi:10.1002/biof.5520320122

10. Mujawar SA, Patil VW, Daver RG. Study of serum homocysteine, folic Acid and vitamin b(12) in patients with preeclampsia. Indian J Clin Biochem. 2011;26(3):257-260. doi:10.1007/s12291-011-0109-3

 

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Anja's Newborn Stem Cell Collection Kit Boxes

My Personal Journey with Stem Cells | Why Parents Should Bank Umbilical Cord Stem Cells

By Marty Hubbard at Anja Health

It all began in college while on a 19-mile run. I was an avid long-distance runner, and deep into my training I began to feel pain in my right knee. Over several months that pain grew to be a daily problem which hindered me from participating in the sport I loved. It became apparent that no amount of ice or stretching was going to remove this obstacle.

In the following years, I have tried a wide array of diagnostics and treatments, including MRIs, physical therapy, acupuncture, hyaluronic acid, and Cortisone injections. Nothing was ever as effective as utilizing mesenchymal stem cells.

In June of 2021, I had stem cells extracted from the bone marrow in my pelvis, but it was an extremely arduous and painful process. At the time, I wished that I had stem cells banked from my own birth.

Stem cells can be extremely effective in repairing tissue, muscle, and bone damage, so physicians injected my bone marrow stem cells into my IT band, which was believed to be causing the pain.  Now writing this article 4 months later, I am in the best running shape since before the injury in 2016.  Stem cells gave me a new chance at continuing my passion for running.

But, I would not have had to undergo bone marrow extraction if umbilical cord blood banking was common place when I was born.  I could have painlessly undergone a stem cell transplant, and it would not have been nearly as expensive.  So, I’m now on a mission with Anja Health to convey to pregnant parents the importance of stem cell banking and how it could potentially help even young, healthy people like myself.

Anja offers umbilical cord blood, cord tissue, and placenta banking – all of which give parents the opportunity to preserve their child’s stem cells for future use.

Umbilical cord blood is rich with hematopoietic stem cells, which are the origin for cells in the blood, including red blood cells and white blood cells.  These stem cells are FDA-approved to treat 85+ conditions, including cancer, autoimmune disorders, and Leukemia.  There are also numerous clinical trials and studies looking at other use cases, including ulcerative colitis, PCOS, and more.

Umbilical cord tissue (in other words, the cord itself), is rich with mesenchymal stem cells, which are the origin for bones, cartilage, and muscle.  These are the types of cells that saved my knee.  They are being looked at in clinical trials to treat many organ- and tissue-related issues, such as diabetes, liver disease, lung cancer, and sports injuries as mentioned.

The placenta is rich with amniotic epithelial cells, which are being tested in clinical trials, but are currently being used to treat eye conditions and wounds. They can also potentially help the mom in the future.

The best part about banking stem cells is that they can be used for other family members.  Umbilical cord blood stem cells are a 50% match for parents and 75% match for siblings.

The plentiful possibilities that lie ahead with stem cell research are extremely promising.  Stem cells could potentially even be used as an anti-aging treatment, and studies examining stem cell use cases progress every day.  Stem cells have also been used by super stars, including Kobe Bryant, Tiger Woods, Peyton Manning, Rafael Nadal, Christiano Ronaldo, etc. I encourage those interested in stem cell therapy to read more at Healthline.

On a more personal note, I have always been involved in the music industry as well, and similar to how I love to discover artists in their early days and watch them grow, I try to convey to parents that banking stem cells is them getting in early on science that is only going to advance and become more promising.  So, I urge anyone who is pregnant to bank with Anja.  We are the most contemporary, personable, and accessible company in the industry.  Whichever communication method you prefer the most, we’ll meet you there. Whatever level of guidance you’re looking for, we’ll prioritize it.  Bank with Anja.

Check out our BECOMING A Mother course! It’s a self-paced, online series to help reduce fear and gain confidence in pregnancy, birth, and early parenting. With recorded video lessons, monthly live chats, and a supportive FaceBook community – it’s everything we wish we would have known before we had our babies! We’d love to see you there!

Kristin & Alyssa

 

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When to Take a Childbirth Education Class

When is a good time to take a childbirth class and why does it matter?  

We often get asked about the appropriate time to take a childbirth class from students and Gold Coast clients. The answer varies depending on the goals of the individual. I often ask clients if they are first-time parents or new parents. It is also helpful to understand what learning style is best for each individual. Some people prefer hands-on learning and others prefer instructional classes.      

There are many types of childbirth education classes to consider. Some classes are offered on weekends or are shorter in length like our Saturday Series which includes: Comfort Measures for Labor, Breastfeeding: Getting A Strong Start, and Newborn Survival. Our clients are able to select one, two or all three classes in the series based on their unique needs. We would recommend taking these shorter classes closer to your due date, so the content is still fresh in your mind. The Saturday Series of classes are offered every other month, for more flexibility. We also offer private classes if the scheduled class dates don’t work for our clients. A popular private class that we offer is Preparing for Multiples.  It is perfect for parents of twins and triplets.  Private classes are an option with many out-of-hospital childbirth instructors.  

Comprehensive childbirth classes vary in length from five-weeks to twelve depending on the series. They are often two to three hours per class in the series. Some examples of these comprehensive childbirth classes include: HypnoBirthing, The Bradley Method, Lamaze, Mama Natural, Evidenced Based Birth and Gentle Birth.  You will want to factor in your due date when selecting a class in case you deliver early or are uncomfortable closer to your due date. Many classes often have books and workbooks that accompany the learning. The materials may or may not be included in the class fees.    

Gold Coast Doulas offers the five-week HypnoBirthing- The Mongan Method class. The method teaches you to reduce tension and  fear. It is recommended to take the HypnoBirthing series in the second trimester as it offers relaxation exercises to practice throughout pregnancy. We do accept students at any time in pregnancy, however.  

Childbirth classes can be offered in a variety of ways depending on your goals and timeframe.  There are online live classes that take place on a platform such as Zoom. They are still very interactive. Another option is a self-paced online course like Mama Natural. The Mama Natural Birth Course will equip your mind, body, and spirit to help you achieve the birth of your dreams-whether that’s a water birth in your living room, or a gentler and more natural hospital delivery.  

In-person childbirth education classes are offered within hospitals and other professional settings.  These professional settings could vary from an office space to a conference room.  Most classes include both the birthing person and a support person or partner. Many of these in-person childbirth classes offer hands on instruction and guidance with breathing techniques.    

Payment is also a factor when deciding on a childbirth class. Many health savings and flex spending accounts cover out of hospital classes. Insurance can often cover most hospital childbirth education classes. Some classes are self-pay only and some instructors allow for payment plans. Books and materials are often included in the price of the course.   

In conclusion, you can take a childbirth education class at any time in pregnancy. Some classes require additional readings or a longer time investment than others. Look at your schedule and birthing goals to decide the perfect timing for your unique needs. We highly recommend taking a comprehensive childbirth education class as part of your birth preparation.   

For more information about our current childbirth education class offerings visit us at: www.goldcoastdoulas.com 

Check out our BECOMING A Mother course! It’s a self-paced, online series to help reduce fear and gain confidence in pregnancy, birth, and early parenting. With recorded video lessons, monthly live chats, and a supportive FaceBook community – it’s everything we wish we would have known before we had our babies! We’d love to see you there!

Kristin & Alyssa

 

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Comfort Measures for Labor – 8 Tips for a More Comfortable Birth

No matter how you choose to birth, it is important to think about how you can reduce discomfort and fear during labor. There are many ways to prepare for birth, including taking a childbirth education class.

Here are some of my top tips as both an Certified Elite Labor Doula and a childbirth instructor:

1) Rest

Rest and relax in the early stages of labor. Birth can sometimes be a marathon and you want to relax and conserve energy in early labor. Make sure you nourish yourself, so you have energy for the pushing stage. Focus on breathing through each contraction and relaxing areas in your body that are tensed up. Your partner or support person can remind you to release tension in areas that are tight.

2) Environment

Your environment can affect your mood. Consider dim lighting and bringing items from home that are comforting. I am a fan of lining tubs and window sills with LED candles. Some of my clients bring their own pillows or sentimental items from home. You could consider wearing your own clothing rather than a hospital gown. There are also cute labor gowns that you can purchase online. Music and guided meditations can be wonderful tools to utilize in labor. They can help keep you relaxed and calm.

3) Movement

Walking and changing positions are great ways to keep labor progressing. It is sometimes called “labor Olympics” by birth workers. Some positions to consider are swaying your hips in figure 8’s on the birthing ball, getting on your hands and knees and leaning into a birthing ball, and slow dancing. We talk about these positions and more in our Comfort Measures for Labor class, which is part of our Saturday Series of classes.

4) Hydration

Hydration is key. Drink water between contractions. I am also a fan of electrolyte drinks to give you a bit more energy. My favorite option is coconut water if you like the taste. Hydration helps prevent exhaustion and reduces the need for IV fluids. You will also want to empty your bladder every hour.

5) Touch

Physical touch can be wonderful during labor. Birth doulas and partners can apply hip squeezes, counter pressure and labor massage to reduce discomfort. Some birthing persons prefer light touch massage. Touch can be very soothing and grounding to many laboring individuals. It can also be used with position changes.

6) Baths and Showers

Water is calming and can reduce the sensation of pain. Showers and baths before the pushing stage are a wonderful way to provide relief in a hospital setting. Some home birthing clients choose to deliver in water.

7) Hire a doula

Your doula can make sure you are comfortable and supported. The doula can also show your partner some of these hands-on support tools. Doulas can be a wonderful addition to your birthing team. They provide coaching, physical support and informational support.

8) Communication

Communicate your needs to your partner and support team. Listen to your body and know that comfort measures may feel good one minute and be uncomfortable the next. That is normal. Talk to your partner and doula if you have one about how you would like to be supported during labor and birth.

***

Now that you have reviewed these tips, what comfort measures would you like to apply to your birth? Are there any suggestions that are not appealing to you?

For more information about The Gold Coast Doulas Comfort Measures for Labor class, see our full schedule here: https://www.goldcoastdoulas.com/events/.

Written by Kristin Revere, Co-owner of Gold Coast Doulas.

 

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Lee Ann Sotok family photo

Meet Lee Ann, our newest birth & postpartum doula!

What did you do before you became a doula?
Currently, I own my own Health & Wellness business through Isagenix. In addition, I work as an Interior Designer for a company that does home staging for realtors and their clients. Previously I was an Administrative Assistant for Leadership Events throughout the US and Canada.

What inspired you to become a doula?
It was suggested to me by a friend and it resonated with me that this was something I have always wanted to do.

Tell us about your family.
My husband, Jeff, and I have been married for 32 years. We have three adult children – Steve, Shannon, and Griffin. We lived in the Nashville area for ten years and have been in Holland since 1998. In 2019, we added our son-in-law, Ciaran, to the family with a lovely family/friend small wedding in Ireland.

We love to travel and experience other countries and cultures. We have been to Mexico, Peru, Costa Rica, Italy, Korea, Japan, Hong Kong, and Ireland. We like to hike, kayak, ski, boat, golf, and other outdoor activities.

What is your favorite vacation spot and why?
Ireland because our daughter lives there currently! We also love Arizona and Colorado. Honestly, we love just to travel.. All of our trips have been such wonderful experiences and memories.

Name your top five bands/musicians and tell us what you love about them.
Garth Brooks, Adele, Ed Sheeran, Amy Grant, and the Beatles. Honestly, I just love a large variety of music. I love to dance, I love the message of the lyrics. Mostly it is the emotions that music evokes.

What is the best advice you have given to new families?
Breath, enjoy the moments, take things one at a time, and don’t hesitate to ask for advice or assistance. We all need it.

What do you consider your doula superpower to be?
Being a calm presence in an anxious situation.

What is your favorite food?
Seafood and Yellow Curry

What is your favorite place in West Michigan’s Gold Coast?
Lake Michigan, skiing up north, or hiking in our many parks

What are you reading now?
ProDola, Labor Doula Training Manual

Who are your role models?
There are three very influential woman in my life: my mother-in-law (Rosemary), my best friend of thirty years (Juli), and my spiritual coach and treasure friend of twelve years (Trisha).

 

Meet Lee Ann, our newest birth & postpartum doula! Read More »

Woman laying in a hospital bed

Hyperemesis Gravidarum

This post was written by Lauren Utter, a ProDoula trained Birth and Postpartum Doula with Gold Coast Doulas.

Finding out you are pregnant can bring an array of emotions – planned pregnancy or not. Maybe you’re excited because you have been waiting for this day. Maybe you are surprised because a baby wasn’t on your radar. Maybe you’re fearful – of what your pregnancy will be like, how you will look, if the baby is going to be okay, or how you’ll feel.

All of these feelings are normal. Being pregnant causes your body to change. Not just a growing belly, but new hormones, cravings, thoughts, and illnesses. 70-80% of women suffer from morning sickness. At least 60,000 cases of extreme morning sickness, also known as Hyperemesis Gravidarum (HG), are reported (the number of cases is actually higher as many are treated at home). Perhaps you wonder if this is how all pregnant women feel or is it just you? Or maybe you question your ability to handle nausea and pain. Do you feel as though others minimize how you are actually feeling- giving you tips that you have relentlessly tried?

Morning sickness is difficult to deal with; it’s exhausting and frustrating, but there are many differences between HG and morning sickness. Women with HG lose 5% or more of pre-pregnancy weight. Morning sickness doesn’t typically interfere with your ability to eat or drink, whereas HG often causes dehydration from the inability to consume food or drinks. Morning sickness is most common during the first trimester, while HG lasts longer – sometimes through the whole pregnancy. A woman with HG is more likely to need medical care to combat symptoms.

HG is often described as debilitating, making everyday activities like working, walking, cooking, eating, or caring for older children hard to do. Not only are women having difficulties eating and drinking, but taking their prenatal vitamins is often difficult, too, which results in a lack of proper nutrition. Because of severe dehydration and insufficient nutrients, headaches, dizziness, some fainting, and decreased urination can present as greater symptoms of HG.

On top of all the physical signs of HG, secondary depression and anxiety may also be present. There are potential complications that arise when HG is present. We talked about malnutrition and dehydration, but some others include neurological disorders, gastrointestinal damage, hypoglycemia, acute renal failure, and coagulopathy (excessive bleeding and bruising). Fortunately, with effective treatment these complications can be managed or even avoided completely.

While there is no cure for Hyperemesis Gravidarum, there is a variety of treatments including medications and vitamins, therapies (nutritional, physical, infusion), bed rest, alternative medicine, chiropractic care, massages, and more. Not all women and cases respond to treatments in the same way. Caregivers typically believe early intervention, even prevention, is most effective.

Medical providers work with each woman to discuss which treatments work best for them. Common medications offered to women suffering from HG are antihistamines, antireflux, and metoclopramide. Because HG can be traumatic and highly stressful, 20% of mothers experience Post Traumatic Stress Disorder (PTSD) and Perinatal Mood and Anxiety Disorders (PMADs). Early intervention proves to be effective, and your OB/GYN, primary care doctor, or a mental health specialist are fantastic resources for mothers experiencing symptoms of any mood disorder. Along with medical professionals there are many forms of support and resources. There are several Facebook groups of women who are suffering or have suffered from HG. This is a great way to feel supported by knowing you are not alone.

The website Hyperemesis.org is equipped with resources, facts, and blogs from other sufferers and their organization, HelpHer, are leaders in research for HG. The HER Foundation puts on events throughout each year for women and their families to come together.

Another great support system is hiring a doula. Doulas offer support through pregnancy, birth, and postpartum. Through pregnancy we can be there for bed rest support, informational, and emotional support. We provide you with evidence-based resources, and factual information. With this information, women suffering from HG can self-advocate for proper testing and treatment that best suits their pregnancy journey. During the postpartum time, not only do doulas help with infant and family care, but doulas are trained to notice signs of PMADs and will provide you resources that can assist you through recovery.

Doulas want to see you be successful, confident, comfortable, and healthy. I know I can’t be the only one who pushes aside her feelings, physical and emotional, and says “Oh, I’m fine” or “It’s nothing.” Our bodies are designed to “tell” us when something is wrong. Here is a tip: start logging your symptoms, from a single headache to daily nausea and vomiting. This will help your medical provider reach answers. Trust your body and trust your intuition, strive for testing that you believe is necessary, and find your people.

Photo by Andrea Piacquadio from Pexels

 

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A new mom and dad pose in a hospital room with their newborn baby

Virtual Birth Support: Podcast Episode #95

Sam & Justin recently had their baby boy, Judah, in the hospital in the midst of the COVID-19 pandemic.  They describe their experience in the hospital as well as how beneficial birth doula support was throughout pregnancy and then during labor and delivery, even though support was virtual instead of in-person.  You can listen to this complete podcast on iTunes or SoundCloud.

 

Alyssa:   Hi, welcomes to the Ask the Doulas Podcast.  I am Alyssa Veneklase, co-owner of Gold Coast, and today I’m talking to Samantha and Justin, who recently had a baby at a hospital in this midst of this Coronavirus pandemic.  We’re going to talk to you about what that was like.  Gold Coast is not attending births after Governor Whitmer’s declaration that we have to stay at home, and we don’t know when the order will be lifted.  So we kind of just wanted to get a sense of what it was like for you two to go through this whole process.  How far along were you when you hired us?

Samantha:  Pretty early when we found out.  We knew when we were trying to get pregnant that having a doula was something that was really important to us, as well as a midwife and just trying to go that more natural route.  So the minute we found out we were pregnant, it was kind of getting things in plan.  So I would say after the first trimester after we kind of told everybody.

Alyssa:  So you hired pretty early, and that was before all this crazy virus stuff happened.  And you worked with Kristin and Ashley as your birth doula team.  Even before all this stuff happened, what did support look like through the majority of your pregnancy?

Samantha:  It was wonderful.  Being a first time mom, obviously, you have a ton of questions, and I just didn’t want to be the person to be blowing up my midwife all the time, plus it’s hard to get ahold of them.  Our midwife was through Spectrum, so obviously you can’t just pick up the phone and call her.  It’s not as easy.  So being able to have a team of doulas that, any question I had from — I had artisan cheese one day and freaked out thinking I did something wrong.  So to be able to text them things like that and just have that reassurance all the time was awesome, as well as after every appointment, they wanted updates on what’s going on with baby, so it was just that extra support and knowing that they’re there no matter how stupid the question was.

Alyssa:  Well, and as a first time mom, I think we feel like all of our questions are stupid.  Oh, I hear the baby!  Hi, Judah!  So, yeah, obviously, because of this, we’re on speakerphone, and they’re at home and I’m at my home because nobody can go into work.  You guys are quarantined at home with the baby, which is probably kind of a blessing in disguise, maybe.  You can actually kind of hunker down and just focus on bonding and feeding and all these great things without visitors.  But like you said, Grandma comes over and she can’t see the baby!  That’s so hard.

Justin:  It’s been a blessing for dads, I think, especially because I would have had to go back to work today.  I am working, but it’s from home and it’s slower, and I’ve got some time to help support Sam and build my relationship with Judah, too, so it’s kind of a blessing in disguise for — I mean, it sucks, but it’s been nice.

Samantha:  And as a new mom, you’re hunkered down.  I mean, I was planning on not leaving my house for a month, anyway, so it’s kind of nice, especially during this quarantine time, because you’re quarantined anyway with a newborn, so it gives you something to do and keep occupied with.

Alyssa:  Right.  Well, and focus on the positive, right?  Like, there’s so many negatives that we can be focusing on, but you’re stuck at home with a newborn baby.  Boohoo, right?  This is what you’ve been looking forward to for nine months!

Samantha:  Exactly, exactly.

Alyssa:  So your support during pregnancy really would have been the same, Coronavirus or not, because it’s a lot of text and phone calls and emails, right?  It’s all virtual, anyway?

Samantha:  Yeah.  Yeah, that wouldn’t have changed, and like I said, they were available pretty much 24/7, so it was just nice to always have them in our back pocket when we needed them.

Alyssa:  Right.  Tell me about the labor, then.  What happened when you were at home, and how did that support, the actual virtual support after finding out that your doulas can’t support you in person, how did virtual support look then once labor began?

Samantha:  So we came up with a plan that we would utilize anything that we needed.  If we needed to do a video chat, we had my laptop ready to go to bring to the hospital.  But once labor started, we kind of — before I went into labor, we talked over, you know, what are the signs, when we should contact them, how long I wanted to labor at home; all that stuff that we would have done anyway if it was just normal circumstances.  So when I went into labor, it was the middle of the night, of course, and we texted both of them and ended up calling Kristin.  She was the one who answered, and we told her how far apart the contractions were.  She could hear, you know, how I sounded and could tell that they were ramping up.  You know, you can just — moms — everybody says moms have the telltale sign of when contractions aren’t a joke anymore.  So, yeah, she said, yep, sounds like you’re really getting in the swing of labor.  She told me to get something to eat before I went to the hospital and kind of gave us some tips before we — as Justin was packing the bag and getting our bags in the car, some tips I could do before we headed out the door.  And so we did that and then headed to the hospital, and from the moment we got there in triage, I had a couple — well, of course, birth is always unexpected, but I had a couple things come up that I wasn’t expecting to happen.  So from the moment we were in triage, we were in constant contact with Kristin and Ashley, whether it was me or — it was actually mostly Justin.

Justin:  Yeah.  I actually took — like, I would step out of the room a few times just to call her.  There was just a couple moments there when we were down in triage where she was uncomfortable, and the room is a little small.  It was hard to get into that calm state of mind that we were looking for.  So without trying to stress Sam out, I stepped out of the room and just called Kristin.  I was, like,  hey, you know, what are some things I could try to, you know, bring her back into this calm state of mind that we’ve been working on forever.  It was great.  She gave us some positions to try, some things to talk to the nurses about.  Like, she knew there was a tub down in the triage area, so she said to go ask them to use the tub.  So it was good to have them just there — just any questions we had, just to call real quick.

Samantha:  Yeah.  And we had a couple unexpected things, because I wanted to labor naturally, but we had some issues.  I had a LEEP procedure a couple months ago.  Well, not a couple months ago; about a year ago, but that caused some scar tissue that made my labor really difficult.  So we had to have the conversation of having an epidural because my labor was so erratic and my body was under a lot of stress.  So that decision we talked over with the doulas.  And then having Pitocin brought in, which was also something that was on our “absolute no” list, but it was nice to be able to call Kristin.  Spectrum was wonderful, too.  I mean, the nurses and midwives were great as far as giving us all the information we needed and then giving us time to talk it over.  But having Kristin there to be able to call and say, here’s what they’re telling us, here’s what we’re thinking — to have that reassurance from them was huge, especially because our birth plan changed so much, and it was upsetting for me, especially.

Alyssa:  Right.  That’s hard when we get into this mindset of, like, here’s my plan and I’m going to stick to it, and baby or your body says otherwise.  To have an expert to ask those questions and give feedback that’s not — and I think that’s one thing a lot of people thing, that doulas are there to tell you what to do.  It’s more about asking you the right questions so you can figure out what’s right for you.

Justin:  Just having that — just having that information so that we can make our own decision.  Just having them giving us all the proper information we knew everything that was at stake and we could make a better, informed decision.  It was a huge help.

Alyssa:  Right.  Knowledge is power in this instance, for sure.

Samantha:  Yeah, and even the positions.  Once I did get the epidural and Pitocin, we still wanted to do a really low dose of Pitocin to try to have my body naturally ramp up contractions, so Ashley and Kristin sent us a bunch of pictures of positions we could try.  They were always available for Facetiming and virtual, as well, but we never needed to.  But to have that in the back pocket was comforting, as well, that if we needed to virtually see them face to face, knowing that we could do that was very comforting for me, especially.

Alyssa:  So once you actually moved from triage to the labor and delivery room, you said you didn’t actually have to use Facetime or anything.  Was it more of you, Justin, were in contact with them because Sam was in active labor?

Justin:  Yeah.  It was a lot of text messages and a few phone calls.  If it was something we wanted to all talk out together, we’d call, or if it was just a quick question, I’d just shoot them a message real quick.

Samantha:  And I definitely think if I didn’t need — if I wouldn’t have had the epidural, we definitely would have utilized Ashley and utilized some of our HypnoBirthing techniques to help me get through labor and probably would have used virtual face to face more, but just because things moved so fast as far as me needing some intervention, it again changed our plan as far as utilizing the doulas a little bit differently.  But, yeah, it was constant contact throughout the whole labor process, and it was actually nice after I did get the epidural.  I was able to then talk to them and tell them what’s going on and what kind of positions I can try and different things like that.  So the plan changed a little bit, but staying in constant contact with them didn’t.  It was pretty consistent throughout the whole labor process.

Alyssa:  And what about when you got to the point where you were ready to push?  Was there anything they could do to support you during that time?

Samantha:  Well, we planned on having them Facetime for that, but my pushing went very quickly.  I only pushed for about 30 minutes, and we didn’t even — when we started, it was — we texted them saying, oh, they want us to do some practice pushes, and 30 minutes later, we were messaging them saying, well, baby’s here!  So, yeah, we had the whole plan set up for them to help — especially because I had an epidural, they were really going to help me try to breathe baby down, which is what we ended up doing, but to have them face to face so they could see what was going on.  But it just ended up happening so fast that we weren’t able to do that.  But after baby came, we were in contact with them, telling them his birth weight and all that stuff, and once we got up to the room, letting them know how latching was going as far as breastfeeding.  So it was just the best experience possible, especially because I was so devastated, you know, being nine months pregnant and all this emotional — that’s emotional in itself, and then to find out your birth plan is completely blown to smithereens…

Justin:  Two weeks before we even go to the hospital.

Samantha:  Yeah, two weeks before the hospital.  It was just terrifying, but to have them there in that virtual sense was everything because it would have been a very different experience if we weren’t able to have them at all, that’s for sure.

Alyssa:  So let’s say a couple just found out they’re pregnant, and they knew they wanted a doula, like you, but then they have this worry.  They’re going to do the hospital birth; they want a doula, but the doula may or may not be able to be there.  What would you say to a family who’s kind of on the fence about hiring a doula because of the current situation?

Samantha:  I would say, hire.  Hire a doula because, yeah, the situation has changed, but I think even more in this time, you need that extra support more than ever, especially because, in my circumstance, my midwife wasn’t even able to be there.  I had a totally different team because of the way they split up her team, so not only is your birth plan changed, but then my midwife who I’ve been seeing for the last nine months wasn’t able to be there.  So just to have that team, that constant contact, still stay the same even though they’re not there in person, was just a huge comfort and relief for me.  And especially for Justin.

Justin:  I was going to say, for the fathers-to-be out there, I think it’s even more important for them.  We went through a lot of the classes and stuff, and we had good knowledge going in, but you get in the heat of the situation, and you know, her surges and contractions were starting to really hurt her, and I didn’t know what to do in that situation.  So we had this whole plan, and I was doing my best to stick to this plan, and when you get thrown that curve ball, having someone to turn to and just get that reassurance.  I might have made the right decision in that situation, but just to have them say, “Yeah, you did,” or, you know, this is — “Yeah, you did do a good job there.  This is what’s going to happen.  Here’s the outcome.”  Just having that extra sense of security in this very unsecure time is a huge benefit.  Even though they’re not there, it was almost like they were, and it was very helpful, especially for the dads that sometimes might feel a little lost.

Alyssa:  Right, which usually, most of them, I feel like, they do probably feel a little bit lost.

Justin:  Especially the first time.

Samantha:  Yeah, and it takes the pressure off, too, you know, just because I’m telling him one thing, and he’s trying to say, you know, it’s going to be okay, but for him to then reach out to the doulas and say, you know, here’s what’s going on, and for them to not only give me reassurance but him was a game changer, for sure.

Alyssa:  And like you said, you’ve built a rapport with them throughout your pregnancy.  I didn’t know that your midwife couldn’t be there either!  So without your doulas, you would have not had your midwife either, and you would have literally been in a hospital with a bunch of nurses who you’ve never met, and that was it.

Justin:  Right.  Exactly.

Samantha:  And thankfully, we had an amazing team.  Our nurses and midwives that we ended up getting were amazing.  But also, you’re going — it’s your first time.  You’re laboring.  It’s new.  And then you have a whole bunch of strangers, so you’re throwing that mix in it.  So having the doulas there that we’ve had throughout the whole pregnancy, virtually, even though they couldn’t be there, was such a comfort because it just — you had somebody to turn to that you know.

Justin:  One more thing, too, is the hospital — I don’t know about other hospitals in the area, but Spectrum — it was like a fortress.  It was so clean and locked down in there.  We kind of forgot this whole thing we even going on until we left.  I mean, I went down in the cafeteria a few times, and every time I went down there, a whole different section was being completely pulled out and cleaned.  There was no visitors walking around.  There was no one walking around.  I mean, it really did feel like a fortress.  Even getting into the building, we had to go through a couple security checkpoints, so if anyone was worried about the hospital part of it, I think that especially Spectrum, that I know of, I think they’re doing a very good job of keeping everything separated, and the sections of the hospital that need to be cleaned and all that.

Alyssa:  That’s a good point.  For those who maybe have that as a main point of fear for them, delivering in the hospital, they’re doing everything right.  I mean, they obviously want to keep their patients safe and healthy.  It’s got to be weird to walk through that hospital and hardly see anybody because there’s no visitors.

Samantha:  It was weird pulling up because they have the whole security detail, and it was, like, “Why are you here?  What’s going on?”  It was very weird, but like Justin said, it ended up — I almost was sad to leave, just because you’re in this clean, sterile bubble, and like I said, we almost forgot about this whole Corona thing because you’re in — you are — you end up being in the bliss of having your baby, even though it’s such a scary time.  But having — you know, right after he was born, we talked with Ashley and Kristin, and then it was just kind of that blissful — we went up to the room, and they’re doing a very good job.  Obviously, things change, but I think they have it pretty locked down.

Alyssa:  That’s great.

Justin:  They’re definitely out in front of it.

Alyssa:  So then you guys go home, and usually, they do a postpartum visit, but I’m assuming they did that virtually, as well.

Samantha:  Yes.

Alyssa:  Did you have that already?

Samantha:  We did.  From the moment we got home, too, we were in constant contact with them, from them asking how he was sleeping.  I had a couple questions just as far as my recovery and what I could do for comfort as far as that goes, just because as a new mom, you just don’t really expect the discomfort.  I kept thinking, you know, I didn’t have stitches or anything like that, so I thought, oh, I’m going to be good, but you don’t realize what you’ve put your body through.  So it was just nice to have them there so I could say, I’m feeling — you know, what can I do about this pressure that I’m feeling?  I’m having some pain and discomfort here.  To have that support on the postpartum aspect, because, you know, this whole time leading up to the birth, you’re thinking pregnancy and delivery and labor and all that, but postpartum support is also huge, and they really, really helped with that, giving me ideas and tips of helping my milk supply come in.  It was just — they’ve been wonderful.  And we just had our virtual visit with them face to face, and that was great to be able to see them.  They could see the baby.  And then to tell them the birth story, since they weren’t there — I mean, they were there, but they weren’t.

Alyssa:  They got bits and pieces but finally got to hear the whole thing.  That’s great.  Well, is there anything else that you wanted to add or that you think other parents should know?

Samantha:  I just think if you’re on the fence, I mean, nothing — I had this whole — I thought I planned for even the most unexpected in pregnancy, and I definitely didn’t because pregnancy can change in an instant.  But I think that’s why even more now in these times to have that extra support and to have a doula because we plan on having another child, and I’ve already said to them — I said, well, hopefully you guys will be there in person for our next baby!  But I couldn’t imagine going through labor and birth and even through pregnancy and postpartum without having a doula and support, and I think Justin feels the same way.

Justin:  Absolutely.

Samantha:  It’s like having your best friends to be able to talk to, and it’s such a comfort, especially —

Justin:  But a best friend who’s also very knowledgeable!

Alyssa:  Your best friend who’s knowledgeable and judgment-free and can give you all the best support.

Samantha:  Yeah.  And especially because my birth plan changed so much in the sense of having to have interventions, which I didn’t think I was going to, so that was even more unexpected, and to be able to — you know, you’re in the rush of the moment, and I was really upset, and, you know, you get down on yourself as a new mom thinking you’re failing in some aspect.  To be able to have them — obviously, Justin can sit there and tell me all day that I’m doing the right thing, but to have somebody else who’s not only gone through that experience but seen other women and giving me advice and telling me what I’m doing and the decisions I’m making are right for me and my baby was such a relief and such a comfort because it’s such an emotional time, and when things aren’t going already as planned, and then you throw in more wrenches into the mix, it can overwhelming.  So to have them as support was just everything to me.

Alyssa:  Thank you so much for sharing!  I wish that I could see little Judah, too.

Samantha:  I know!  I know.

Alyssa:  It’s really hard!  But, yeah, focus on bonding with that little guy.  How’s breastfeeding and everything going?

Samantha:  Breastfeeding is going good.  We’ve had to supplement a little just because he’s such a peanut, but, again, they’ve helped with that, as well, just because that can be hard as a mom.  You know, you think, oh, breastfeeding is going to be this simple thing, and it’s hard.  Being able to talk it over with people — they’ve given me some great articles, and I had a virtual meetup with some new moms that Kristin suggested, a team that I should join in on, and that was really helpful.  I got some great tips from that, and to not only see new moms who delivered around the same time as I had, and that was all virtual and really cool to be able to hear from them.  You know, they might not be going through the same issues as I am, but to hear they’re also having questions and not knowing what to do was really reassuring because you can get stuck in this loop of, why is this not working for me?  What am I doing wrong?  Why is it so easy for everybody else?  And you don’t realize other moms have, you know, if not the same issues, then different issues.  It’s all different for each person.

Alyssa:  Yeah.  It’s not easy for everybody else.  It just seems like it is.

Samantha:  It does, and it’s easy to get down on yourself and think, oh, you know, woe is me, why is it not working for me?  But to be able to have not only doulas but then give me other resources to be able to reach out to was also great, as well.

Alyssa:  That’s awesome.  Thank you for taking the time to share your story!

Samantha:  Of course!  Thank you

 

Virtual Birth Support: Podcast Episode #95 Read More »

Coronavirus (COVID-19)

COVID-19 Reduce Your Risk!

 

Reduce Your Risk by Megan Mouser, NP.
March 31, 2020

STATISTICS COVID-19
With statistics regarding the novel coronavirus changing daily (and even hourly), the most up-to-date information can come from Michigan Department of Health and Human Services as well as the Centers for Disease Control. To date, at the time of this publication, there have been over 163,000 cases in the U.S. alone with over 2,860 deaths. Michigan appears to be an emerging epicenter for COVID-19, making our efforts to reduce the spread of this virus even more emergent.

WHAT ARE WE SEEING? WHY SHOULD WE BE CONCERNED?
Locally we are beginning to see an increase in cases. Today there are 108 presumed positive tests with 119 tests pending. You can find local updates for Kent County on the Access Kent website.

With coronavirus being a new (novel) virus, very little is known about best practices. This is why you are seeing information and decisions varying day to day. The clinical picture for those suffering from this virus can range dramatically from very mild symptoms (including some with no reported symptoms) to severe illness resulting in death. Current treatment options are fairly limited, however new therapies and studies are emerging. Even with recovery from the illness, long-term consequences are possible. Coronavirus is also very easily transmitted, even without an individual ever presenting with symptoms. This is why socially distancing and practicing preventative measures is so important! In regards to healthcare resources here in West Michigan, we are preparing for a large influx of possible patients from this virus which will put a strain on our healthcare resources if we do not slow the spread. We are already beginning to see this in the metro Detroit area.

GENERAL RECOMMENDATIONS
We cannot stress enough the importance of washing your hands often with soap and water for at least 20 seconds (if not available, use hand sanitizer with at least a 60% ethanol or 70% isopropanol alcohol content), covering your mouth and nose with your elbow when coughing or sneezing, avoid touching your face, cleaning “high touch” surfaces daily, limiting your contact to only people in your household, and practicing social distancing by remaining at least 6 feet apart from anyone else if you absolutely must go out.

I also think it is important to recognize that this is a very stressful time for many of us and it is important for our overall health to make sure that we are taking care of ourselves including getting adequate sleep, regular exercise, eating a nutritious and healthy diet, getting out for some fresh air (while maintaining social distance), reaching out to our support systems, and allowing yourself some “slack” regarding loss of control and frustrations.

In regards to specific populations, this virus does pose a higher risk to people who are older or have other serious chronic medical conditions such as heart disease, diabetes, or lung disease. Women who are pregnant are also considered at increased risk, however to date limited data is available regarding this illness during pregnancy. Coronavirus has not been shown to cross into amniotic fluid or into breastmilk at this time. However, if a pregnant woman became ill with the virus, additional precautions would certainly need to be taken at the guidance of your healthcare team. While on the topic of pregnancy, we can rest assured that healthcare providers and hospital staff are working diligently to reduce the risk and spread of COVID-19. While locally there has been visitor restrictions in place at the hospitals, your support person (as long as healthy) will be able to support you through delivery and hospitalization at this time.

Infants are also considered to be more at risk for not only COVID-19, but illness in general due to underdeveloped immune systems at birth. I would encourage all new parents to continue to practice not only standard precautions (including hand washing, cleaning surfaces, avoiding sick contacts, etc.) but also to continue to restrict visitors to the home after delivery to only members of the household. While this is certainly a time to celebrate your new addition, our primary goal is a healthy baby and family!

As for older children and teenagers, we know that this is very challenging time with the cancellation of schools or daycares and changes to routines and schedules. The risks for these age groups from coronavirus continues to be present, therefore as difficult as it can be to enforce and practice social distancing, it is imperative for parents to not only model this behavior but to also help our children understand why this is necessary. In a time of uncertainty, parents can continue to lessen anxiety in children by discussing together as a family, remaining calm, and continuing to offer love and support.

As a community we all share responsibility to continue efforts to reduce the significant risk from COVID-19!

Reputable Resources:
Centers for Disease Control and Prevention
Michigan Department of Health and Human Services 
World Health Organization

Megan Mouser is a board certified Family Nurse Practitioner serving the Grand Rapids area since 2014.  Born and raised in the Upper Peninsula of Michigan, she completed her Bachelor’s of Science in Nursing through Northern Michigan University and went on to obtain her Masters of Science in Nursing through Michigan State University.  She has over a decade of experience working with infants and children in the Neonatal Intensive Care Unit, and most recently seeing both adults and children in her outpatient family practice office. She also volunteers her time teaching graduate students as an adjunct clinical faculty member with Michigan State University School of Nursing’s graduate program.  Megan is passionate about preventative medicine and creating strong relationships with her patients and families in order to provide personalized, high-quality healthcare. Megan resides in Grand Rapids with her husband Matt and two golden doodle rescues “Max” and “Marty”. In her free time she enjoys spending time with her family and friends, traveling, being in nature, cooking, and gardening.

 

COVID-19 Reduce Your Risk! Read More »

Alyssa Veneklase and Kristin Revere sit in an office while podcasting together

Coronavirus Update on Doulas: Podcast Episode #94

Kristin and Alyssa, Co-Owners of Gold Coast Doulas, give an update on doulas and the coronavirus.  How is this affecting birth doulas in the hospital and postpartum doulas in the home?  They also talk about virtual classes such as Mama Natural Online to help new parents stay prepared while social distancing.  You can listen to this complete podcast episode on iTunes and SoundCloud.

Alyssa:  Welcome to Ask the Doulas.  You are here with Alyssa and Kristin, and today we’re going to talk a little bit about the coronavirus.  I’m going to let Kristin do most of the talking just to kind of update our friends and clients on the current status.

Kristin:  Yes!  So we are happy to share the protocol within Gold Coast on how we are keeping our doula team, our childbirth educators, and our clients healthy.  We are recording this on March 17th, so things are changing daily, and by the time you listen to this, the information that we’re giving you may be a bit different.  But we did want to respond quickly and have notified all of our clients about our safety protocols.  With birth doula clients, we are doing all our prenatal, our free consultations, and our postpartum meetings virtually.  So our clients now know that they are talking to teams by phone or Zoom meetings or Facetime, whatever the preferred method is.  We’re still giving you that same time and attention; just keeping you safe and healthy during this critical time.

We had been working with area hospital administrators and with the governor’s office to make sure that we were able to support our clients in person, and again, this may change by the time you’re listening to this, but we had a day yesterday where we were told birth doulas would not be able to support in the hospital.  So we contacted all of our clients and made a plan to support in the home before and support virtually in the hospital.  Through work with the governor’s office and area administrators, we were able to obtain entry into area hospitals.  So starting today, that is not an issue.  With the executive order from the governor’s office, a partner and a doula are allowed to admit into area hospitals.  There will be a health screening, and we’re going through credentialing processes with every hospital having different requirements, but we plan to support our clients.  This is as of today, and again, if the outbreak continues, we may need to rely on virtual support.  Because Gold Coast has a big team of birth doulas, we will monitor symptoms of coronavirus and the flu, as we have always done, to assure that a healthy doula will be attending the birth.  We’ll be doing the best we can to isolate our team.  We’re staying home with our families.  We’re not going out into the public unless we need to get provisions.  Going from there to ensure that we’re able to support our clients during this time when they need the emotional and physical support of doulas now more than any time.

Alyssa, I know that in postpartum support, we have made some accommodations as well, and part of that is some of our clients had contracts that were about to expire, and we’ve talked to them about delaying support, and with our postpartum doulas, who our clients want us in the home, we are of course making sure that the doulas are healthy.  We’re using sanitization methods.  If we’re doing cleaning, we’re cleaning doorknobs and handles at our clients’ homes.  We’re coming in with clean clothing, taking our shoes off, as we always do, and using whatever precautions our clients want us to in their home with caring for baby and caring for the mother.  And, again, with our postpartum doula team, we have a lot of doulas.  So if a doula has any symptoms of coronavirus or the flu or even a cold, we are sending in a healthy doula to replace the scheduled doula.  Do you have anything to add to that?

Alyssa:  No.  I mean, nothing’s really changed in that regard.  All of our clients get that same kind of care.  It’s just extra — I guess maybe an extra added step at this point.

Kristin:  And as a sleep expert, part of what we do as postpartum doulas, both daytime and overnight, is allow our clients to rest.  Now, with your sleep certification, I know you focus on newborns and toddlers and so on, but let’s talk a bit about the importance during this time to keep your immune system strong and getting sleep for families.

Alyssa:  Yeah, the problem with sleep deprivation is your immune system starts to decline, and more than ever right now, it’s important to keep your immune systems healthy.  So that means still going outside and getting fresh air, getting exercise.  But you also need sleep.  And with a newborn and/or a toddler at home, that can really be trying.  So the beauty of my sleep consultations is that I don’t need to do it in person.  We can do it via phone and text.  So if that is an issue, you can call me still for that.  But regardless, you just have to focus on sleep.  You have to get your required amount of sleep, and your kids need to be going to bed on time.  I know this feels like a big vacation for them, but you need to have a set bedtime and awake time.  I mean, if we’re going to be in this situation for three to six weeks, they are going to become sleep deprived.  They are going to become little monsters.  It’s going to make your days even harder, but then again their immune systems could start to decline.

Kristin:  Right.  And, again, we do offer sibling care, so we can help with snacks around the house, and we have noticed that a lot of West Michigan families tend to have family support of grandparents or other family members, and now with some of the guidelines for keeping the elderly safe and away from children, I know my kids are being distanced from my parents due to my father’s heart condition and so on.  And so we can come in when you are relying on your family right now and take some of that burden off of you and your partner.

Alyssa:  I have canceled all family functions.  A birthday party, a sleepover.  You know, my parents called and offered to help, and “thanks, but no thanks.”  We’re stuck at home anyway.  There’s nowhere I can go, nothing I can do.  So, yeah, we’re just kind of laying low at the house.

Kristin:  Yeah.  And so people are obviously isolating, canceling things, and we’re able to — we do offer bedrest support, so we are able to do virtual bedrest support if that is something that a client is interested in.  Or, again, support in the home with childbirth education.  We can do mini classes virtually or in home and provide sibling care for our clients who are on bedrest and need to feed their other children, especially now that daycares are closing and schools are closed at least through April 10th, if not longer.  And so we’re adapting as best we can and keeping our team safe.  For clients who are not part of our current childbirth series that has now gone virtual, our Hypnobirthing class started out in person, and due to the coronavirus, we’ve turned that into an online class with our instructor.  But we are an affiliate for Mama Natural, so we wanted to talk about that as an option for clients who are not able to take a hospital childbirth class or take Hypnobirthing or a different child preparation method.  You can go onto our website and sign up for our online affiliate program through Mama Natural and take the class online. We’ve gone through the class.  I personally went through the entire curriculum, and my clients have used it and have had success, so that is a great option during this time when we need to isolate and be at home and still want to prepare our clients and have our clients feel like they’re ready for this birth.

Alyssa:  And Kelly Emery, our lactation consultant, also offers an online pumping class and a breastfeeding class.

Kristin:  Perfect!  So there are some things you can do, and again, things are ever changing, but as of right now, all of the area hospitals are limiting visitors to one support person, so your partner or family member and a doula who is credentialed in area hospitals.  So in the postpartum units, you are not able to have siblings visit or family at this time.  Everything is limited to protect the health workers and the patients.  So it is good to have these conversations with family members.  I always tell my birth clients at prenatals that now is the time to express whether or not you want visitors in your birth space, and now knowing some of these plans have changed, if you have family members flying in, you may want to delay, or if you have older family members or immune-compromised caregivers, then now is the time to have these discussions rather than having disappointment at your due date if you’re due this spring.

Alyssa:  Yeah.  They won’t even be able to come in, and probably family members can’t even fly in at this point.  We’re getting close to that.

Kristin:  Yes.  Domestic travel is limited and could be delayed indefinitely.  So we’re just taking things day by day.  But we want you to remain calm and positive about this and go with the flow, so try not to take in too much negative media and use this time to focus on connecting with your baby.  And if you have other children, reach out to us if we can help.  We’re here for you.

Alyssa:  I think it reiterates the importance of an agency like Gold Coast Doulas being professional and certified and insured and, like you said, credentialed so that we can get into the hospitals.  The hospitals trust us.  They have a list of our certified doulas’ names.  They might ask for a federal ID number.  They might ask for certification; proof of certification.  These are all really important things to consider when hiring a doula anytime, but especially right now.

Kristin:  Yes!  Stay well, everyone !

 

Coronavirus Update on Doulas: Podcast Episode #94 Read More »

Birth Photography: Podcast Episode #92

Photographers Kris and Autumn of The People Picture Company answer questions about birth photography, what a photographer actually does in the delivery room and how the process works for hiring a photographer and talking about birth plans.  You can listen to this complete podcast on iTunes or SoundCloud.

Alyssa:  Welcome to the Ask the Doulas podcast.  I am Alyssa Veneklase.

Kristin:  And I’m Kristin Revere.

Alyssa:  We are co-owners of Gold Coast, and we are here today with Autumn and Kris from The People Picture Company.  We wanted to bring you in because you do a lot of birth photography and a lot of our clients use you, but I know a lot of people are cautious or maybe don’t understand quite what the role of a photographer is in the delivery room, and I think it might be weird for people to say, you know, there’s going to be this stranger with a camera photographing my private parts.  Like, I don’t know this person!  Can you ease people’s fears and maybe tell us what the whole process looks like?

Kris:  Of course!  It all starts with a prenatal consult.  So this is where we get together and discuss your birth plan and what you want your birthing experience to look like.  This helps give us an idea; like, okay, are you doing a hospital birth or a home birth or a birthing center?  All of these things kind of factor into it.  We exchange phone numbers and all the information there, too, and then pick packages.  But it’s really a time for us to get together and to get to know each other because it is a very personal, private, intimate experience, and we’re going to be there with you, so we want to be able to know you and have you be comfortable with us.

Kristin:  It’s almost like when you do weddings and you have a shot list.  In your prenatal, I’m sure you go over, okay, this is what’s acceptable, and this is what I don’t want.

Kris:  Exactly.  We also go through and we show off some of the other births that we’ve done that the mothers have completely agreed that it is okay for us to show.  We have a couple of photos on our website, if you go into Maternity and Birth.  But when we go into a consult, you get to see a little bit more in depth.  These are ones that are, like, you know, actually during the birth experience.  So sometimes there’s nudity because you might get really hot when you’re giving birth to your child.  Sometimes people want that crowning photo.  I’m not going to put that online, but if you want to see what that looks like or a photo of your placenta where your baby lived for a while, then I can show you those during the consult so you get more of an idea and a feel of what you can expect from your birth photos.

Alyssa:  So it’s kind of like, if I were to say I want birth photos, but I don’t want any shots of boobs; I don’t want any shots of vaginas; I don’t want a butt.  Then you would know that going in, saying, okay, we need to crop this out or I’m not going to…

Kris:  Not going to photograph it.  If you want the photos of your child coming into this world but you don’t want that crowning photo, I don’t have to be right where the doctors are.  We can be right up by your shoulder.  In fact, that’s how it was with my photos.  I don’t have any crowning photos of my son coming out, but I have some great photos from over my shoulder, and you can see him just emerging into the world.  It’s so magical because you can ever see everyone that’s in the room and my husband and my doctors and everyone, and it’s just so magical.  Especially because most of that, I had my eyes shut, and one of my friends was, like, no, open your eyes.  Open your eyes!  You have to see this moment!

Autumn:  I think a part of it, too, is during the consult, you are getting comfortable with each other, and there’s a moment where you kind of think past the nudity, you know?  We’re basically capturing the emotional experience between you, your baby, your family.  That is something that is bigger than the nudity sometimes.

Alyssa:  Right!

Kristin:  And I love that you’ve also supported surgical births and shown the beauty of that as they’re getting prepped to go into the operating room and so on.  Some of those pictures are amazing.

Kris:  Yeah!  With the Cesarean births, we’re not allowed in the operating room for those, but we are allowed in the prepping areas and as you’re walking down the hallway or being wheeled into the operating room, we can do all of that and we can do the couple of hours after the birth, as well.  It’s just that for those we’re not actively allowed in those rooms for the surgical process.

Kristin:  I’ve loved attending births with The People Picture Company because you really do capture the emotions of the couple and the intimate experience that they have, as well as, obviously, meeting their new baby or babies for the first time and really, you have a way.  That’s why we have you photograph our team and a lot of the events we do.  You really capture that moment so perfectly and the beauty of birth, the raw and realness of all of it.

Autumn:  And no birth is the same, no two births.

Kris:  No.  But they’re all emotional.  I cry at every one.

Kristin:  For sure.  They are.  It’s an honor to be in someone’s birth space.  I don’t take that lightly as a doula.

Alyssa:  So you’re essentially on call; that’s why you exchange numbers.  So how does that work from your client’s end?  You exchange phone numbers, and then when the due date approaches, you just kind of — they know that your phone’s going to be on next to the bed all night?

Kris:  Yep.  My phone is on next to my bed all night.  It is turned up as loud as it possibly can be, and in case I’m asleep, my husband is a very light sleeper, so if he hears it, he’s definitely going to be waking me up.

Autumn:  You’re pretty amazing.  You wake up, and you’re there, and it’s magical.

Kris:  It’s so funny because almost all the births that I’ve been on have been in the middle of the night where we’re getting a call.  Hey, we’re starting to have some contractions.  Okay, great.  Keep us informed.  Let us know when your water breaks, and we’ll be there, wherever you’re going to be having your birth.  We’re very flexible, so if you were originally going to be doing a home birth and then something is weird and you need to go to the hospital, then just have someone let us know.  It doesn’t matter who it is.  Just put our number in your birth plan, and we’ll be there.

Alyssa:  That’s what a doula’s good for.  We can call you and let you know.  By the way, we’re headed to the hospital.

Autumn:  And the greatest part is we have a whole team, so during that time when Kris is on call and she needs to be ready whenever, anything that she has going on, we’re there to kind of help take care of that so we free up her time to be available to be at the birth no matter what.

Kris:  Yeah.  I block off your due date for sure.  That entire day is completely reserved.  I won’t schedule anything.  And then for a week or so before and a week or so after, because babies come when they want to come, I have those listed as on-call, which means that if someone else needs to take one of my other sessions that I have prebooked because you’re going into labor at that point, then they have that.  I have a bag packed and with me wherever I am, so I am ready to go and meet you as soon as I get the call.

Kristin:  Sounds just like what I do as a birth doula!  And most of my calls are in the middle of the night unless it’s a planned birth.  Or early morning; I sometimes will get a call.  They’ve been laboring at home in early labor, and then they want my support early in the morning.

Kris:  Babies just love coming at night.

Autumn:  They do!

Kris:  My son came right after midnight, and our birth photographer, Bree — she’s one of our team.  She actually doesn’t shoot anymore, but she picked up a camera for me.  I think I was her last session that she did.  And she came — she was so sweet.  She came at — oh, gosh.  I don’t even know what time.  She came pretty early.  Probably about 7:00, I think, is when my water broke and everything, and she was there until about 1:00 in the morning when I finally kicked her out.  You need to go home; you need to go to sleep.  We got our photos; we’re great.  We got our few things that we wanted afterwards.  Go home and sleep.  But that also leads me to the photos of after the birth, like how long we get to stay for that.  That’s actually a really good segue there that I hadn’t planned.

Kristin:  And I know some clients can hire you just for that first hour or that time of bonding and not the actual labor if their preference is to not be photographed during the birth itself.

Kris:  Definitely.  It’s still all the same thing.  We’re still on call and everything, and the way our packages work, we have two different ones.  They both include up to two hours of post-birthing, and that covers the first moments of your child’s life.  So if you want us in there for the birth, then that can include the cord cutting and such.  If you want us there for the first little bit afterwards, it can include the first time you’re nursing your child if that’s what you end up doing.  If you’re doing skin to skin contact; the weight, height, and head measurements, the footprints, and the first family photo of you all together in that blissful moment.  And then also if you have any family members that are coming to meet the newest addition, so if you have an older child that’s coming to meet the younger sibling for the first time, or you have some grandparents that are being grandparents for the very first time, we can be there for that, too.

Alyssa:  How does it work — let’s say a client gets induced and says, hey, I’m going to the hospital, but then it ends up taking two days.  How do you — or have you had a client like that where you’re there for a really, really long time?

Kris:  We’ve had one where we’ve been there for —

Autumn:  We’ve had to do switch shifts.

Kris:  Yeah.  I’ve done some switch shifts before where we kind of tag out.  Okay, I’ve been here for, like, 12, 13 hours.  I need a momentary break.  I need a little cat nap, but we don’t want you to have to worry about us missing it.  So then we just kind of tag out with one of our other team members, and then we swap for a little bit.

Alyssa:  So there’s no price difference?

Kris:  No.

Alyssa:  It’s just whatever birth you have, whether it’s two hours or two days?

Kris:  Yep.  Your kid comes in the time when your kid wants to come, and we’ve got to be flexible with that.

Kristin:  Right.  And even with inductions, there can be some sweet moments where they’re on the birthing ball or moving around the room, and you can capture – again, if it is a couple, you can couple the intimacy with the couple, or if there’s a doula supporting…

Autumn:  Well, the greatest part is it’s not just one single moment with the birth.  It’s the entire process, and being able to capture that for basically the entire family is so special because we literally see the moments before, where they’re on the ball and they’re trying to get them out, and then they —

Kris:  It’s the whole story.

Autumn:  It literally is the story.

Kris:  And going back to personal experience, I was induced for my son because he was a week late and didn’t want to come.  And there are times, because it was a long, emotional, hard birth, that don’t necessarily remember.  But because I had my photographer there and I made a book later on, I’m able to remember and to kind of — not necessarily relive, because I don’t remember the pain, thank God, but I do remember the joy, and I remember thinking – like, for me the birthing ball was bad, and all I can remember was saying, “Ball bad!  Ball bad!”  But I remember that because I have the photo of me with that ball and then the ball completely on the other side of the room because I didn’t even want to see it.

Kristin:  Listening to your body is key!  That’s what I say.  That’s part of it!

Alyssa:  So once you get into the labor and delivery room, what does that look like?  Are you kind of like a fly on the wall trying to stay out of — like, you don’t want them to even know you’re there, or are you talking to them and —

Kris:  It kind of depends on the couple or on the mom and what they want, and this is why we do the prenatal consult.  We usually try to help out if we can, like either be a gopher — like, so if mom is really sweating but doesn’t want her partner to leave and needs a wet washcloth or something, then we will do that.  If you need some ice chips or something, we can go and do that for you so that your people don’t have to leave, although of course if you have doulas, then they usually end up helping out that way, too.  So we help out where we can, but otherwise, it’s usually very intimate, and the couple is pretty much in their own world.  We just kind of capture that and stay out of the doctors’ way.  After you have your baby, we know that you’re really excited to show the photos of your new little baby to friends and family and all your loved ones, and so instead of sending cell phone photos that can look a little weird, we do sneak peeks so we’ll provide you with a handful of photos that are completely ready to send out to friends and family.

Alyssa:  Like the next day?

Kris:  Within 24 hours.  Usually less than; it’s usually one of the first things that we do when we leave the birthing room.

Autumn:  She gets really excited.  She gets back to the studio, and she’s, like, “I’m doing this!  I’m really excited!”

Alyssa:  You always do.  Every team photo, you’re, like, okay, give me a couple weeks.  And then two days later, you’re like, “They’re ready!  I was just too excited.  I had to go through them.”

Autumn:  Well, I mean, it’s our work, and we get so excited about it, and we can’t wait to show it off because what is the point of just sitting on it when we can share it with everyone?

Alyssa:  In my past life, I was a photographer, and it was the same thing.  While it’s fresh in my head, I wanted to go through them.  It’s exciting to see what you just created.  So I get it.

Kris:  You’ll get a handful of photos the same day, usually within a few hours, so you can send them out.  And then the final photos, we say two weeks, but it’s usually sooner.

Kristin:  And certainly, I feel like birth is a major rite of passage, and as wedding photographers, you understand how much time, money, and preparation is involved in planning for that rite of passage, but really, when you look at minor investments in the birth and postpartum time for a family, hiring a birth photographer or doing newborn shots doesn’t even compare to the investment in a wedding photographer, for example.

Kris:  Oh, yeah, no.  It’s a fraction.

Kristin:  Can you explain a bit about what your fees are so people who aren’t familiar with birth photographers — as you talk about being on call and longer lengths and so on?

We have a couple different packages when it comes to the birth, and they each include high-resolution images for you to share, to do whatever you want with.  And then you also get an album to create for our highest package, which is a 20-page lay-flat album.

Kristin:  You’re saying a digital album?

Autumn:  No, a photo album.  So you get digital files, high-resolution, and then our highest package, you get a 20-page album to share and have it on your table so you can show it off.  And plus like Kris said, you get to relive the moments because sometimes you just don’t remember, and having that printed album is so important because you can’t have all of your images live on digital because you don’t know how long they’re going to last.  We always want everybody to print things.

Kris:  Which is why we provide you with the high-resolution images, too, because those are good quality for printing.  So you’re welcome to print them yourself or you can print with us.  We have a la carte print packages, too.  So the first package, like Autumn was saying, it’s $850.  It includes everything: the prenatal consult, the on-call availability, the two hours after birth, and then 100 or more, however many, high-resolution images, and a 20-page 5×5 print photo album.  And then our second package, which is our base package, is $500, and that includes 30 to 50 high-resolution images, so that’s if you need just a little bit; just a little reminder, not the whole big coverage of everything.  And then because we want to see you guys again and provide you with a really good first family photo that’s not right after birth, we include 10% off your newborn session if you get either of these two packages because, yeah, your first family photo — yeah, it’s great to have one in the hospital, but let’s get one where your hair and makeup are actually done, too.

Kristin:  And I know you do documentary-style or more of the posed family shots, depending on preference and price and so on?

Autumn:  Absolutely.  We actually prefer doing newborn sessions in the home because it’s where you’re going to be the most comfortable, and then you also don’t have to worry about packing up the family and moving them to our studio, which can be a hassle sometimes.  Our goal is to make everything hassle-free, so we come to you, and we can document your entire family as you are, and we can also get some posed shots that would be printed and put on the wall.  The documentary style also work well if you do an album.  Plus, it’s more realistic.  It’s you in your zone.  It’s where your family is.  And if you have other kids, it’s also really fun to see how they interact with the baby, also.

Kris:  Some of the documentary ones that we’ve done are within your nursery, so if you’re changing your baby on the table or nursing them in a rocking chair or something like that and then you get a photo of the entire nursery in this environmental setting, too.

Kristin:  It’s nice.  You did that with a twin client of ours.

Kris:  Yeah.   They were so sweet.  They were adorable, and we had grandma in there, too.

Alyssa:  So if anyone is interested in birth photos or family photos or baby photos —

Kristin:  Or maternity photos.

Alyssa:  Yeah, maternity photos — what’s the best way for them to reach out?

Kris:  Probably our website would be the best.  We have all our packages listed on there.

Kristin:  And you also have a page on the Gold Coast Doulas website.

Kris:  We do, so you can just go to the Gold Coast Doulas website and go into Birth Photography and find us that way, too.  And then we have all of our packages listed and a handful of images to show you, just kind of a portfolio of examples to see if we’re your flavor of photographer or not.

Autumn:  And the best way to find out is just reaching out and setting up a consult to get to know us, really.

Kris:  Yeah.  You can do that straight from the website.  We have contact boxes.  You can email us.

Alyssa:  And probably depending on the time of year, as long as it’s not wedding season, you could do it last minute.  Like, hey, I’m 38 weeks and I just decided I want a photographer.

Autumn:  Oh, absolutely.

Alyssa:  As long as you’re not in the throes of wedding season, you might be able to say yes?

Kris:  You know, as long as you’re not a Friday or Saturday, chances are really high.

Alyssa:  Cool.  Well, thanks for joining us.  Is there anything else that we didn’t cover?

Autumn:   I did want to point out that another thing after birth – one of our favorite things to do is follow you through the first year.  What we have is a package that basically is dedicated to capturing your baby at several stages in the first year.  So then you can do the three, six, nine months and then the one year, so you can also print that out and get it on the wall to see how much they’ve grown.,

Kris:  They change so much in that first year.

Autumn:  They really, really do.  It’s amazing.  They go from literally —

Kris:  Tiny squishes to little humans.

Autumn:   Yeah.  It’s amazing.  And it’s really fun for us, especially somebody like Kris who’s there during the birth, probably the maternity session, and after with the newborn, and then we get to follow you through and literally watch your family grow.  It is so much fun.

Kris:  It’s awesome watching them grow.

Autumn:  Yeah.  Because our goal is to become lifelong friends, not just the photographer one day.

Kris:  Yeah.  We want to get to know you and become friends and tell your story.

Kristin:  I love that.

Alyssa:  That’s cool.  Thanks!

 

Birth Photography: Podcast Episode #92 Read More »

Birth story

When Your Baby Doesn’t Follow Your Birth Plan

Have you ever set out to accomplish something life-changing? How did you prepare for it? Did you research it online? Did you read a how-to book? Did you seek advice from those you trust? Would you ever show up for the big day without preparing ahead of time?

Back in November of 2017, I finally saw those two blue lines on a pregnancy test.  I was unbelievably excited, but yet filled with fear and anxiety. After over a year of trying to conceive and a devastating miscarriage, my husband and I were blessed with the opportunity to try it again.  For anyone that has experienced a miscarriage you know that each cramp, test, and Dr. appointment is filled with intense emotion and fear.

The fear and anxiety wasn’t completely gone after our 12 week ultrasound, but it definitely became a background noise that I could drown out with our baby registry, nursery decorations, and my efforts to create the perfect environment for my baby for the remainder of the pregnancy.

During my first trimester, I was gifted The Mama Natural Week-by-Week Guide to Pregnancy and Childbirth by Genevieve Howland (highly recommended by the way, even if you’re not a super crunchy mama) by my sister who unknowingly would become the trail blazer that would go before me by about 12 weeks and share all her child rearing wisdom with me.  This was new for me as an OLDER sister, but her recommendations and personal experience were pivotal in creating an empowering childbirth experience for me.

Fast forward to the third trimester where it really started to sink in that I was going to birth this tiny human inside me.  This is the part of the story where I realized I was going to experience something life-changing that I knew very little about.  After reading the best books, talking with seasoned mamas and investing in a bomb childbirth course (Mama Natural’s once again!), I decided that my ideal birth plan was to have a vaginal delivery with as few medical interventions as possible.  I did the research to get the facts and my husband was very supportive (but also a rookie) so I wanted some reinforcement to help me achieve my dream birth story. This is the part where my very wise sister recommended talking with Gold Coast Doulas about how they could help me reach my goals.  She had just accomplished a successful, low intervention vaginal delivery so it didn’t take much convincing for me to call and get matched up with doulas that were a good fit for my birth goals.

At 41 weeks and 3 days, it became apparent that my son had not read my birth plan and despite my best efforts was coming out on his own terms.  In the midst of my research, I learned that induction could be intense, unpleasant, and ruin my plans for an unmedicated birth; unfortunately, my OBGYN had decided this was the best option for me. My husband and I walked into the hospital like a couple headed to Baby-Mart to pick-up our baby.  I had not experienced one real contraction to this point, was dilated to 1cm (I still think this was a pity centimeter) and I had shed many tears as I realized how little control I actually had over this birth experience.  I prayed God would help me surrender to His will for this birth.

As if this was the moment my son had been waiting for all along, I felt my first real contraction minutes after being hooked up to the fetal heart monitor before beginning the induction process.  I finally stopped feeling sorry for myself about my “ruined” birth plan and regained my confidence knowing this was MY birth plan and no matter how it ended, it was the perfect plan for me!

Contractions continued to come, and they recommended that I receive a dose of Cytotec to soften my cervix. Thankfully labor continued to progress on its own without any further doses of cytotec or pitocin.  Several hours after contractions started, I peed the bed… or so I thought. After 2 trips to the bathroom and continued “leaking” I realized my water had broken. My cervix continued to dilate and my husband was now recruited to help me through my increasingly more intense contractions.  My nurse was amazing and encouraged me to change positions by kneeling and leaning forward on the bed and rolling from side to side with a peanut ball between my legs to encourage continued progression of my labor. It’s funny because I knew this movement was important, but in that moment, all I could think about was how it made my contractions hurt worse and that I didn’t want to move at all. Turns out that’s the point! You want to intensify contractions, progress labor, and get that baby in your arms!

As the hours progressed my husband continued to ask if we should ask Mary, our doula, to join us (she’d been checking in with him periodically) and I continued to say no. I guess I had heard too many stories about long labors because I was convinced we still had a long way to go.  When my attentive husband noticed the signs of transition he quietly vetoed my decision and let Mary, along with family, know that we were getting close and it was time to come to the hospital. When Mary arrived they were wheeling in delivery equipment and it was go-time. She reminded me of the breathing techniques I had practiced and was available to help with whatever comfort measures we needed even when it was silence.

There was no mistaking when it was time to push as my fetal ejection reflex kicked in.  I was thankful that my provider let me stay in a side-lying position to push while my husband and Mary held legs and hands (focusing on my needs) allowing the doctors to focus on our son. My husband excitedly updated me that they could see his head, but he just didn’t seem to want to move past that point. Despite my best pushing efforts for about 40 minutes, our baby’s heart rate was dropping, and I was now needing oxygen. At this point, my OBGYN highly recommended an episiotomy to deliver my son quickly. This was not part of my birth plan, but I agreed knowing everyone’s goal was to deliver a healthy baby. As his head emerged and the OBGYN quickly freed him from the umbilical cord around his neck, he launched himself earth-side and to this day has not stopped moving and wiggling.

It’s crazy to think that at 8 pm on Sunday night we walked into the hospital with a space in our hearts we had no idea even existed and by 8:30 am on Monday morning our hearts were overflowing with love and connection with someone we had only just met.  Childbirth was unknown, exciting, and challenging.  The experience was so very empowering and the outcome was undeniably life-changing. My piece of advice for expecting moms is to go into labor and delivery prepared, supported and believing in yourself knowing that your body was made to do this!

Written by Dr. Nicole Bringer, DPT
Owner of Mamas & Misses Physical Therapy
www.mamasandmisses.com 

 

When Your Baby Doesn’t Follow Your Birth Plan Read More »

pregnancy physical therapy

Physical Therapy During Pregnancy

Maternity clothes✓ Registry✓ Hospital tour✓ Doula✓ Photographer✓

What could you possibly be forgetting? What about getting YOURSELF prepared?

Likely from the moment you found out you were pregnant you have been focused on the tiny human growing inside of you. While prenatal vitamins, nursery preparations, and choosing the perfect name are all very important parts of preparing for the birth of your baby, so is preparing YOUR body to birth this baby!

Hopefully in the midst of your nesting you have decided to create a birth plan.  As you consider what positions you want to labor and deliver in and what interventions you feel comfortable with during your birth experience, I would challenge you to consider what you are doing to achieve those goals.  Hiring a doula and recruiting a rockstar support person is a great place to start, BUT there is more!

Research has shown that the percentage of first time moms that experience perineal tearing during delivery is somewhere between 80-90%. Research also shows that 66% of women that deliver their babies in sidelying have NO perineal trauma and 61% of women that deliver on hands and knees have the same TRAUMA-FREE experience.  (Simarro 2017, Walker 2012, Soong 2005, Shorten 2002) Instead of crossing your fingers and hoping for the best when it comes to your perineum, what would it look like to practice different delivery positions with your partner BEFORE you go into labor? What about the evidence that says perineal massage 1-2x per week starting at week 35 can DECREASE your risk for tearing and episiotomies? Have you been taught how to perform this technique and are you taking the time to do it? (Seehusen & Raleigh, 2014) With my first son, I totally missed the boat on perineal massage. I ended up with a nasty episiotomy. You better believe I’ll be making perineal massage a priority this time around!

Our bodies become a temporary home for our babies during pregnancy. Our mama bear instincts have already kicked in, and we want to make sure we are creating a healthy and happy environment for our babies to grow within. Exercise and intentional movement is a great way to foster this type of environment for our little ones. Did you know that exercise helps prevent or manage gestational diabetes, high blood pressure and preeclampsia? Exercise also helps us sleep better,  reduce our stress levels, and minimize back pain.  If your pregnancy is non-complicated and you do not have activity restrictions, you should be exercising! The American College of Obstetricians and Gynecologists recommend exercising at a moderate intensity 3-5x per week. Sometimes we become paralyzed when we’re not sure where to start and what’s safe.  Trainers, instructors, and Physical Therapists with certifications and experience working with women during pregnancy are great resources for mamas hoping to create safe exercise habits.

Let’s not forget about investing in our pregnant bodies to make life easier for ourselves in the postpartum.  During your pregnancy your belly is doubling or even tripling in size.  As we gain 25+ pounds, we expect our pelvic floor to step up to the challenge and make sure we don’t pee our pants when we sneeze at the grocery store. There are two studies that give us good reason to keep our pelvic floors strong during pregnancy.  The research found that women experienced less urinary incontinence at 35 weeks gestation, 6 weeks postpartum and 6 months postpartum when they did pelvic floor exercises DURING their pregnancy compared to women that DID NOT do pelvic floor exercises. (Boyle et al., 2012, Price et al., 2010) Sidenote: sometimes the phrase “pelvic floor exercises” is confusing. Does that mean kegels? Yes and no. Clear as mud I know! Kegels are pelvic floor exercise where we lift and squeeze our pelvic floor muscles, but it’s also important for our pelvic floors to have the ability to relax and lengthen. Sometimes women experience pelvic pain and incontinence because of overactive pelvic floors (need help relaxing) and sometimes it’s because they have underactive pelvic floors (need more strengthening). Even if you have excellent pelvic floor strength and no concerns about incontinence, it’s still helpful to create a mind-body connection with your pelvic floor.  During labor and delivery the goal is to relax and open your pelvic floor while pushing so that your pelvic floor remains healthy even after childbirth. Bonus points if you practice your breathing and pelvic floor relaxation while pregnant in the positions you hope to deliver your baby in.

I’ve been a mom in your shoes, running around with my To-Do list trying to check off all the boxes before my baby arrived.  As you prioritize your list and consider your baby budget, remember that your body IS this baby’s home.  The way that you prepare your body WILL make a difference on the day that your baby decides to make its grand entrance.  Exercise, pelvic floor awareness, perineal massage, and labor positions are all important pieces of the pregnancy puzzle.  It’s tempting to become intimidated or overwhelmed at this point because you’re just not sure where to start.  Start by consulting a Women’s Health Physical Therapist.  Now that you know what your goals are, you have some great questions to ask them!  Physical Therapists should be another member of your prenatal team, and we want to help you make your planned Birth Story a reality.

My practice is Mamas & Misses, LLC and we offer In-Home Physical Therapy sessions for women local to West Michigan as well as phone or video consults for those who live further away.  One of our missions is to provide knowledge to mamas that will empower you during your pregnancy and postpartum experience; therefore, we have lots of FREE info on our YouTube channel as well as our Instagram account @mamasandmisses_pt.  

Dr. Nicole Bringer, DPT
Owner of Mamas & Misses LLC
Email: nicole@mamasandmisses.com
Phone: (616) 466-4889

 

References

Boyle, R., Hay‐Smith, E. J., Cody, J. D., & Mørkved, S. (2012). Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews, 10, CD007471. doi: 10.1002/14651858.CD007471.pub2

Price, N., Dawood, R., & Jackson, S. R. (2010). Pelvic floor exercise for urinary incontinence: A systematic literature review. Maturitas, 67(4), 309-315. doi: 10.1016/j.maturitas.2010.08.004

Seehusen, D. A., & Raleigh, M. (2014). Antenatal perineal massage to prevent birth trauma. American Family Physician, 89(5), 335-336.

Shorten A, Donsante J, Shorten B. Birth Position, Accoucher, and Perineal Outcomes: Informing Women about Choices for Vaginal Birth. Birth. 2002;29(1):18-27.

Simarro M, Espinosa JA, Salinas C, Ricardo O, Salavadores P, Walker C, Schneider J. A prospective randomized trial of postural changes vs passive supine lying during the second stage of labor under epidural anesthesia. Med. Sci. 2017, 5, 5. doi:10.3390/medsci5010005

Soong B, Barnes M. Maternal position at midwife-attended birth and perineal trauma: is there an association? Birth. 2005;32(3):164-169.

Walker, C., Rodríguez, T., Herranz, A. et al. Int Urogynecol J (2012) 23: 1249. https://doi.org/10.1007/s00192-012-1675-5

 

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Rise Wellness Chiropractic

Symphysis Pubis Dysfunction with Rise Wellness Chiropractic: Podcast Episode #90

Dr. Annie and Dr. Rachel talk to Alyssa about Symphysis Pubis Dysfunction (SPD), how to prevent it, how to treat it, and things every pregnant and postpartum woman should be doing!  You can listen to this complete podcast episode on iTunes or SoundCloud.

Hello.  Welcome to another episode of Ask the Doulas.  I am Alyssa, and I’m talking with Dr. Rachel and Dr. Annie again of Rise Wellness Chiropractic.  How are you?

Great!

So I got asked by a client about symphysis pubis dysfunction, and I’m not even exactly sure what that is, but you knew.  Right when I told you, you knew.  So can you tell me?

So SPD — sometimes people think of sensory processing disorder, which is with older kids, but in relation to pregnancy, it’s symphysis pubis dysfunction.

And what the heck does that mean?

It’s a mouthful!  So basically, where your two pelvic bones meet in the front is called your symphysis pubis, so that’s where the two bones meet together.  There’s cartilage in between there, and that area widens for birth.  So usually late second to third trimester, we’ll see some women will start having pain.  That can be related to the relaxin that’s in their system that’s helping the ligaments loosen and helping that area separate, but what we usually find is it’s more due to pelvic imbalances.  Usually one side of the pelvis is higher than the other or something like that or it’s rubbing in a weird way.  That’s usually what causes that symphysis pubis dysfunction.

So it’s strictly for pregnancy?

Yes.

And are there any ways to not get it?  Avoid it?  Treat it?

Get adjusted!

Yeah, just because if it’s caused from a misalignment —

Exactly.  Yeah, if it’s caused from pelvis imbalances, then that is directly a chiropractic issue.  It’s biomechanical.  That’s something that we can address through adjustments.  And then we also have stretches that you can do, and there’s also a Serola belt which is like an SI  belt.  It goes around your sacroiliac joints, and it’s just a low belt.  It doesn’t really do anything in terms of — it’s not like a belly band or something that you would wear to support the baby, but it does help to support the SI joints and keep everything together.  Really, it’s hypermobility in that joint that’s causing that pain.

It’s too mobile?

It’s too mobile.  Yeah, so we usually see it with not first-time pregnant moms but usually second or third, especially if they’ve had some kind of fall or something like that while pregnant.  They can injure their pelvis, and that’s usually what brings those things up.  I actually had a patient a couple weeks who came to us for SPD, and under care, she was doing great.  All her pain went away.  But she had fallen during her first pregnancy, and then during her second pregnancy, she started having all this pain and stuff come on. 

So falling during pregnancy; it’s not just like a random fall at any time in your life that could affect this?

It could be.  Pregnancy is really good at exacerbating existing issues or past issues.  Like if you’ve had any pelvic imbalances in your past and then you’re pregnant, just that relaxin is going to kind of flare things up.  Typically, what we see is pain with putting weight on one leg.  Climbing stairs is when your pelvis is moving the most, so that’s usually when a lot of the pain is flared up.

Walking; something that you don’t have to do very often.

Yeah!

Sounds horrible!

But sitting is not good for it either.  It’s one of those things that nothing is good for it.

Laying hurts; turning while you’re laying.  Like that’s not already hard when you’re in the third trimester!

Does it actually cause any more pain or discomfort during labor and delivery?

It can.  It depends on really, like, what the pelvis — because if you think of the pelvic bowl, if there’s imbalances in the pelvis, it’s not just affecting the bones.  It’s also affecting your pelvic floor muscles.  It’s affecting all of your stabilizer muscles.  So it can potentially affect how things go during labor.  I don’t know if it creates more pain, necessarily, or if it would be, but any pelvic imbalance is going to effect, probably, the efficiency of your labor.

Plus, it doesn’t necessarily clear up after.

That was my next question.

Yeah, it’s not like you deliver the baby and then it’s gone.

Because you still have that imbalance?

Exactly.

Exactly, yeah.

So then what do you do for that?  Just keep getting adjusted?

Well, it should clear.  If you’re getting adjusted, it should help clear it up while pregnant.  So I guess what we’re saying is, you should get checked if it’s happening.

I mean, it’s definitely like you have to retrain that pelvic imbalance somehow, and you do that through chiropractic adjustments or through exercises, through physical therapy, sutff like that.

Yeah.  PT floor rehab, yeah.

Probably a combination of both, right?

Right.  If you do it all, then you probably have best outcomes. 

Yeah, I don’t think we understand how important the pelvic floor is, and all we’ve learned is Kegels.  That’s not necessarily even a good thing to think.  When I saw a physical therapist for pelvic floor issues specifically, I was, like, that makes so much sense!  Even just the way we breathe; I didn’t know that my diaphragm was part of — what would that be?  The top?  The diaphragm is the top of your pelvic floor?

Yeah.  It’s the top of your —

Like the space?  I guess I can’t say top of the floor.  Your pelvic floor is the floor.

Your intrabdominal space.  So it’s like the lid, and then your pelvic floor is the bottom.  But it’s a big airtight balloon, pretty much, so when you breathe, it affects everything.  But pelvic floor is an issue that we don’t talk about, really, with women in birth, but it’s a huge thing.  Every woman who pushes out a baby has pelvic floor issues.  Every woman who has a C-section has pelvic floor issues because those are attached to your abdominals, too.  So, really, every woman should be getting some kind of rehab on pelvic floor after birth.  That’s my soapbox!

I’m in these group exercise classes, and every woman is, like, oh, jumping jacks.  I’m going to pee my pants!  I had one friend who was, like, I was working out and I didn’t know if it was sweat or I had peed my pants!  Yeah.  I get it!

Well, pelvic floor and core strength, too, are both things that get overlooked with women after pregnancy, and then we see women with back pain later, and it’s because their core is so weak.  So, really, we’re just promoting physical therapy pelvic floor rehab.  It’s what needs to be done.

And chiropractic care.  Retraining all that neurology is important.

I think even just learning about it!  I’ve done yoga classes forever, and they will say, like, during this pose, tighten your pelvic floor.  I’m, like, what the hell are they talking about?  What?  How do I do that?  But now after learning that even breathing is different and the feeling of — I hate saying Kegel because it’s not even what it is, but I guess that is the feeling of what you would do to stop your pee, but doing that during certain exercises is a whole different feeling, but I think now that I’m conscious of it, I’m, like, oh, that makes sense.  Oh, I can do that here.  Okay.  It’s gotten a lot better, but I still can’t do jumping jacks.

See?  The jumping jacks!  I don’t do them either.  They’re like, do jumping jacks to warm up, and I’m like… No.

I do the ones where I just put my hands up.  I just kick my leg out.  I’m fine with it!

It’s what everyone’s doing!  They call those jumping jills.

Is there anything else pregnant or postpartum women need to know about symphysis pubis dysfunction?

It’s not something that you need to suffer through.  There’s a lot of chiropractic studies where it helps in a lot of case studies, but also, biomechanically, it makes sense.  You don’t have to feel like you can’t walk up the stairs or sit or that you have to be in a lot of pain when you’re trying to sleep.  Find out you’re pregnant and get under care.  That’s really what we tell people. 

Tell people where to find you!

We are in East Town in the Kingsley Building right next to Gold Coast Doulas, or you can find us at our website or on Facebook and Instagram.  You can message us on those platforms.

Well, as always, thanks!  We’ll have you on again soon!

 

Symphysis Pubis Dysfunction with Rise Wellness Chiropractic: Podcast Episode #90 Read More »

Spectrum Health Midwives

Baby-Friendly Hospital Initiative: Podcast Episode #89

Today we speak with Katie and Becky from Spectrum Health in Grand Rapids about what it means to be a designated Baby-Friendly hospital. You can listen to this complete podcast episode on iTunes or SoundCloud.

Kristin: Welcome to Ask the Doulas with Gold Coast Doulas. I’m Kristin, co-owner, and I’ve got Alyssa here. And we’ve got special guests joining us today from Spectrum talking about the Baby-Friendly initiative. So welcome, ladies! Introduce yourselves and tell us about your background!

Becky: My name is Becky Crawford, and I’m a nurse manager at Spectrum. My background is in postpartum and labor and delivery nursing.

Katie: And I’m Katie. I’m the project specialist for women and infants at Spectrum Health. My background: I am an RN, and my background is high risk OB and postpartum nursing.

Alyssa: Awesome!

Kristin: Fantastic! Thanks for joining us! Tell us about what baby friendly means and why it’s such an intense process to go through certification. Fill us in!

Katie: The Baby-Friendly hospital initiative was actually created back in the early 90s, and it’s an international organization to promote, protect, and support breastfeeding practices. Spectrum Health Butterworth was designated Baby-Friendly initially in October of 2014, and we just went through the redesignation process and were redesignated at the end of May of this year. There are ten steps for Baby-Friendly that each support breastfeeding practices, and we can talk through some of those steps, as well. You have to be proficient in all of those ten steps to receive the designation, so you really have to show breastfeeding excellence, and it’s a really strict and rigorous process to go through.

Becky: I think overall, the way I describe it to patients is that we’ve created a culture that’s supportive of breastfeeding and of moms that want to breastfeed. So it’s not that we force anyone to breastfeed. Our goal is just to educate moms, support them, and help them be successful if that’s the option they choose.

Katie: Absolutely. As nursing professionals, part of our responsibility it to make sure that best practice and current research reaches our patients and that they’re educated on all of those best practices. Breastfeeding is best practice, but it’s also about informed choice and supporting our patients with whatever choice they make. While Baby-Friendly is primarily about breastfeeding and supporting breastfeeding, there is a formula feeding option there, and we support patients in that option, as well. It should never be about pressure. It should just be about education and informed choice.

Kristin: That is a question that I get from doula clients. If they choose, whether for medical necessity or personal choice, to formula-feed, how they can navigate the system with Baby-Friendly hospitals.

Alyssa: That’s what I was going to ask, too. Do you think that designation scares a mom who knows she doesn’t want to breastfeed? Does she think shes going to come into this hospital and you’re going to try to force it? What does that look like for a mom who doesn’t want to?

Becky: We do hear that feedback from moms that haven’t delivered with us, that they’re just nervous. Having to talk about breastfeeding, even, can be an uncomfortable conversation if they know that’s not the choice they want to make. So our approach with our staff is to educate the patient on all the options, let them choose, and then support. So it should be a one-time conversation. We’re going to talk through all your feeding options. These are the great benefits of breastfeeding. If you choose not to do it, okay. Then let’s talk about formula feeding, and we’ll focus our education there. So making sure they know their options, they understand the benefits, and then support.

Katie: And, you know, nurses educate on a lot of topics, right? It’s not just about breastfeeding. But the other topics we educate on, it’s the same sort of informed choice, right? Breastfeeding is such a personal decision. It’s such an emotionally charged topic. I think that while we need to educate our patients on breastfeeding and why it’s great, we also need to acknowledge the fact that it is a really personal choice, and it’s okay if you choose not to, as long as we’ve given you all of the information.

Kristin: And so your labor and delivery nurses, your postpartum nurses — everyone is specially trained to support the initial latch and continued breastfeeding through their stay?

Katie: Yes.

Kristin: And that’s something that we always stress as doulas is that you have support from your nurses as well as the board-certified lactation consultants who do rounds in the postpartum time.

Katie: Actually, one of the ten steps is staff education. All of our nurses receive 20 hours of dedicated breastfeeding education. Of that, 15 hours are classroom education and then 5 of those is clinical, practical breastfeeding education hours. Every one of our nurses; it’s built into orientation for any women’s nurse, so everyone from labor and delivery to postpartum gets this education. There’s also a requirement for providers, so nurse midwives as well as physicians, to receive additional breastfeeding education, as well. Per Baby-Friendly, they’re required to receive three hours of breastfeeding education.

Becky: We also have a team of lactation consultants that offer further help for any mom that’s struggling, but I’m also bringing in more peer counselors, too, just to round on every patient and offer every mom some support, ever with those first few times they’re latching, just so they can hear that they’re doing a great job. It’s really just to address the breastfeeding concerns of all moms, not just the moms that are struggling, just to really walk them through it.

Katie: And we do have quite a few nurses that are certified breastfeeding counselors, so they have received additional education as well as the education that they received for Baby-Friendly.

Kristin: How are you able to support moms with babies that go to the NICU initially with their breastfeeding goals?

Becky: Well, actually, we get them pumping right away. If your goal is to breastfeed, we like to have them pump within two hours of delivery to start establishing that supply. Our nurses will come in and do education, and the lactation consultants will see them, also, and just talk about the importance of pumping to build up that supply. They’re also going to skin to skin. There are some lactation consultants that are dedicated just to the NICU and these moms, so there’s a lot of support there, too.

Katie: The providers in the NICU are very, very supportive of breastfeeding, and they encourage and educate moms on the importance of breastfeeding, as well, so there’s good collaboration between our OB teams and our NICU teams regarding supporting those moms in breastfeeding and being successful.

Kristin: That’s what my clients tell me, that they get a lot of support, even over at Helen DeVoss, as well as in their rooms with lactation. As far as other elements of the Baby-Friendly designation, what else encompasses those ten standards?

Becky: There’s a lot. We start right at delivery, with the golden hour after delivery. We place baby skin to skin immediately after delivery, and we avoid all unnecessary care for that first hour. Any exams or assessments would all be done while the baby is skin to skin on mom. We try to give them that time to bond and establish that first feeding.

Kristin: And if the mom can’t do skin to skin, I have dads ask me all the time about the benefits of them doing skin to skin with baby. So that’s something that’s encouraged, as well?

Becky: Absolutely. We’ve had lots of dads do skin to skin. We like to bring them in on the process whenever possible.

Kristin: That’s fantastic. And then delayed cord clamping is now a standard policy?

Becky: Yes. And we also room-in, so babies stay with their moms 24 hours a day unless mom requests otherwise. But that’s what we try to encourage and do all procedures at the bedside to keep the family together 24 hours a day.

Katie: I think that rooming in is another hot topic when you’re talking about Baby-Friendly and breastfeeding, and the literature does tell us that rooming in does help moms to be more successful breastfeeding. I think that it’s important that patients understand that we’re going to allow you to keep your baby with you. We’re going to be able to take care of mom and baby together. You’re going to learn your baby’s feeding cues. You’re going to learn all those little nuances. We’re going to help you learn that in the couple of days that you have with us. There is space where if you wanted your baby to go to a nursery, we could do that. We’re supportive of that, as well, but again, we are going to educate, and then we’re going to honor choice.

Becky: Exactly.

Kristin: And then there’s delayed bathing and other procedures beyond that?

Katie: Yes.

Alyssa: What’s the thought behind all the delayed cord clamping, delayed bathing? Why? What are the benefits?

Katie: The delayed bath is sort of about the transition from being inside mom and then outside and regulating temperature. So we wait at least twelve hours. We like to wait closer to 24 hours to do that first bath. We’re, of course, not going to hand you an ooey gooey baby. We do a little wiping off, but it really does help that baby transition to life outside of mom and regulate. It also allows you to go immediately into skin to skin so the baby can help regulate not just the temperature, but the heart rate and the breathing. And, again, that’s evidence based. In fact, there’s a pediatrician out in Massachusetts who really pioneered the Baby-Friendly initiative in the hospitals out in Massachusetts, and she did a study on delaying the baby bath, as well. That’s the literature we have for it; it’s all about maintaining stability for the baby.

Kristin: That’s awesome, Katie.

Becky: For the delayed cord clamping, that just gives the newborn a little more blood volume, and, actually, it’s better for baby. There’s no reason to cut the cord any sooner, unless the baby is having a respiratory issue and would need resuscitation, so that would be out of the norm. But otherwise, we do wait and delay so the baby can have more blood volume from the placenta.

Alyssa: How long?

Becky: Our standard is a minimum of one minute. I know a lot of moms request —

Alyssa: So this isn’t like it’s for an hour —

Becky: We’re not saying 10 minutes or 20 minutes. Generally, the cord stops pumping within five minutes. So some moms request to please wait until it stops pulsating, and we can do that, too. Generally, we wait about a minute, and that’s probably close to when it stops pulsating. But we’re not talking about an hour or anything like that.

Kristin: Yeah, some of my clients want to see it actually turn gray and stop pulsating before it’s cut.

Alyssa: And I didn’t want to see mine at all.

Becky: I didn’t either, personally!

Alyssa: My husband did accidentally and was like, oh, my God, an organ just fell out of you!

Katie: I love all of that stuff. It’s so fascinating!

Kristin: As far as additional steps that you take to get recertified, tell us about that process and why it’s important.

Katie: You will see in our women’s and infant services department that OB triage is on A level, and then all the way up to the 8th floor in that tower, you’ll see the 10 Steps for Baby-Friendly posted. It’s just showing our support of those ten steps. We have to show that patients receive prenatal education in our clinics regarding breastfeeding. We have to show that all of our staff receive the education. The people that come out to do our survey — the interview staff.

Becky: And patients.

Katie: And patients and providers, so they will go in patient rooms to see that they receive the education about breastfeeding and that they’re being appropriately supported for breastfeeding. So they look at our exclusive breastfeeding rate.

Kristin: And then you have support groups, as well, when mothers go home and need additional support. They can go to free support groups and seek help through their OB or midwives or pediatricians?

Katie: Absolutely. I think a lot of our pediatricians have at least one pediatrician who is an IBCLC, so a lactation consultant, as well. I know that our DeVoss clinic has two pediatricians that are lactation consultants.

Becky: And our pediatrician who is an IBCLC actually oversees the residents, and so she’s the one working with them and training them. It’s kind of keeping that mindset forefront for all of them, too, and helping them learn the Baby-Friendly system.

Katie: So while nursing took this on and rolled it out, there is a lot of support from providers, as well. Of course, our nurse midwives receive, as part of their education, breastfeeding, but our pediatric providers are all very supportive of breastfeeding, as well.

Alyssa: Is there anything that you think is a misconception for this Baby-Friendly Initiative? Is there anything that it isn’t? You told it what it is, but what isn’t it?

Becky: Yes. I think the thing we hear most is that, I’m going to be pressured to breastfeed if I deliver there. And there is nothing further from the truth. Our goal is a culture supportive of breastfeeding, not a culture of pressure. So our goal is to educate, let moms make decisions, and support them. So there’s no pressure. I think the other big misconception is about rooming in. Sometimes you have a mom who, let’s say, has had a C-section and she’s exhausted, and she just needs support for a couple of hours. We will accommodate that. We’re all about supporting moms. So although we do encourage rooming in, and there are a lot of benefits to it, in certain circumstances when it’s not best for the family, we support what is.

Katie: I think that it’s the 80/20 rule. There’s going to be exceptions to every rule, and it’s just important that we support our patients through that. I think that Becky and I have probably both taken care of those moms that have had long labors or C-sections, and they come up to the floor, and they just need rest. You have to take care of yourself.

Becky: They’re crying. The baby’s crying. Everyone’s hit a wall. And it’s like, why don’t I just cuddle your baby for an hour. You take a nap, and then let’s try again. Sometimes just 45 minutes of sleep can change the entire situation.

Katie: I remember after my second one, I got two hours of sleep. Like, two consecutive hours. And it was the best two hours ever!

Alyssa: I’m thinking about my situation. It was fairly quick. Yeah, sure, I was tired, but I did choose one time in the middle of the night to have them take my daughter to the nursery so I could get — it was about two hours. But I felt so amazing. But I wasn’t in this dire circumstance. So today with — this was before the Baby-Friendly. So today, would I have to prove to you that I need the sleep?

Becky: No.

Katie: No!

Alyssa: It’s just, would you take her for a couple of hours? You’re not going to say, well, you don’t check these boxes, so she won’t go.

Becky: No. I think the goal is when moms come up to the postpartum unit to talk to them about, well, babies room in 24-7, and we keep you together and care for you together. However, if you have a need to send your baby to the nursery, we’ll accommodate that. So our goal is to not educate the mom at 2:00 a.m. who’s exhausted and crying about how she should room in with her baby. That’s not really the time to have that conversation, and it probably wouldn’t be well-received. So we want to educate them when they first come up so that at that point, at 2:00 a.m., if you decide to make that decision, it will be more like, okay. I’ll bring her back for her next feeling.

Alyssa: I didn’t think I wanted to, but now I do.

Becky: And that is common. Okay, I just need a little bit of a nap, and then I can keep going.

Kristin: Yeah, we’ve had clients hire us to help out in their postpartum room when their partner had to go home to tend to another child or had a job to get back to. We’ve loved that role of being in the hospital, as well as later on in the home, to support them and help them get sleep and also learn baby cues and feedings and help support breastfeeding.

Alyssa: Basically, be their postpartum doula in the hospital as well as at home.

Becky: We would welcome that support, definitely! I’m sure our nurses would love to partner with you on that!

Alyssa: For those moms who don’t want to send — maybe they desperately want the sleep, but they don’t feel comfortable sending their baby to the nursery. Your doula sits in the rocking chair and holds your baby.

Becky: What a great option!

Alyssa: Yeah, it’s been really kind of life-altering for a few of our clients who are a little bit more on the — you know, a lot of moms just have anxiety, especially first-time moms.

Katie: I think that so much of the focus goes to the baby, but we’re taking care of mom, too, and that needs to be in the forefront, as well. There’s two patients there.

Becky: And be aware of her self-care and her needs in the moment, too, because what I always try to tell my patients is, you need to take care of yourself so you can take care of this baby. And if that means a short nap, then I think we need to do that because it’s going to make you a better mom in the morning when you’ve had a little bit of sleep.

Kristin: Exactly. What other hospitals in the area within the Spectrum brand are Baby-Friendly? We have clients in a 50-mile radius of Grand Rapids, so we work with a lot of your smaller hospitals, as well.

Katie: So Spectrum Health Butterworth just received redesignation, like we talked about. Spectrum Health Zeeland.

Becky: They’re newly designation last September.

Katie: And then Spectrum Health United Memorial up in Greenville. They were designated five years ago, and they’re going through the redesignation process right now.

Alyssa: So is it every five years?

Katie: Yes. And then Spectrum Health Big Rapids is going after designation, as well. We have, as a system, Baby-Friendly requires us to have an infant feeding policy, and we have standardized that infant feeding policy across the system for all of our regional hospitals, as well. So you’re going to see a piece of Baby-Friendly in all Spectrum hospitals. And the reason for that is that it’s evidence based and it’s best practice, so even if they’re not designated Baby-Friendly, these are practices that we should all be doing.

Becky: Right. They’re probably practicing very similar to Baby-Friendly, even if they don’t officially have that designation.

Alyssa: That’s great. Anything else you want to share before we sign off?

Kristin: What resources, if any of our listeners want to learn more about Baby-Friendly or some of the work Spectrum has done — where can they go online to get more information?

Becky: I think just going to the Baby-Friendly website will give you a lot of information about the 10 Steps and about what we’re focused on as a Baby-Friendly hospital. So you can really start just researching Baby-Friendly, and we are following that to a T, so that will tell you how we’re practicing.

Katie: Our provider offices also have education and information about Baby-Friendly, and then —

Becky: Our childbirth education classes.

Katie: Yes, at Spectrum Health Healthier Communities. They have information, as well.

Kristin: So the educators can fill their students in with any questions they have?

Katie: Correct, yes.

Kristin: And then is there anything special with the hospital tours that our clients go on before delivery? Do you incorporate Baby-Friendly or answer questions based on that? I haven’t been on a tour in a while.

Katie: I don’t think that they specifically talk about Baby-Friendly, except that —

Becky: The practices, probably.

Katie: Yeah. They likely don’t highlight the nursery like they used to. Our nursery — we don’t have babies lined up in the nursery like we used to. They’re with their moms, so you can’t go to the maternity floor and look through the window of the nursery. There’s no babies there.

Becky: I do think they talk about some of our practices, about how you room in and we keep babies together. And I think the other thing is maybe some of the practices, like the skin to skin after delivery. Things that might be different than other hospitals, just so they know what to expect; that we would never supplement a baby unless it was medically necessary, and we’re not handing out pacifiers unless somebody requests it. So it might be slightly different than other hospitals that are doing deliveries in the area.

Katie: Our childbirth educators are pretty passionate about breastfeeding and supporting breastfeeding practices, as well as supporting natural birth. They give the whole gamut of the birth experience.

Kristin: Well, thank you for joining us and sharing so much!

 

For tips on how to make your hospital room feel cozy for birth read Creating A Cozy Hospital Birth Space in First Time Parent Magazine by Kirstin Revere.

 

Baby-Friendly Hospital Initiative: Podcast Episode #89 Read More »

HypnoBirthing Story

Maddie’s Birth Story: Podcast Episode #83

Our listeners love hearing a positive birth story.  Today Maddie, a previous HypnoBirthing and Birth client, tells us all about her labor and delivery as well as her experience in the hospital right after having her baby.  You can listen to this complete podcast episode on iTunes or SoundCloud.

Kristin:  Welcome to Ask the Doulas with Gold Coast Doulas.  I’m Kristin, and I’m here today with my former birth client, Maddie, and we’re here to talk about her personal birth story.  Welcome, Maddie!

Maddie:  Thank you.  I’m glad to be here!

Kristin:  So we talked a little bit about why you chose HypnoBirthing in a previous podcast, so tell us about your birth story.  How did you know you were in labor?  Give us all the details.  I was lucky to be there!

Maddie:  Yes, it was wonderful to have you there!  I went into work on a Wednesday, and I was due July 18th, and it was July 13th.  For some reason, I just kind of thought, oh, I’ll know.  It’s not going to happen yet.  I went to work; I had a normally-scheduled weekly appointment with my midwife.  I went at 10:30, and I had been kind of grouchy all day and just felt a little off but did not think about it at all.  I’d been having practice labor for a few weeks, so I really wasn’t noticing anything different.  I went to my appointment and sat down, and she said, how are you feeling?  And then I started bawling. I said, “I just feel so confused by my body!”  And she was like, well, let’s just take a look.  How about we just take a look, and so she did an exam, and she said, girl, you’re six to seven centimeters!  And I was like, what?!  And I started crying again, and then I said, but what does that mean?  Even though I’d been through HypnoBirthing; I knew what it meant, but it was just so unexpected.  I was so far along already.  She was fantastic; she was so wonderful, and she said, well, it means you’re going to have a baby today.  Go have some lunch.  So I called my husband.  He was working, and I told him I was six to seven centimeters, and he said, well, what does that mean?  And I called my mom who was coming, and she said, but wait; what does that mean?  So we were all pretty taken off guard because it wasn’t like I had woken up and said, oh, you know, I think something’s happening.  No one was really prepared.  Hey, I’m six to seven centimeters.

Kristin:  Right, I couldn’t believe it when I got the call.  I was like, what?!

Maddie:  Yeah!  I went and got some lunch and drove myself to the hospital and parked on the fifth floor of the parking structure and waddled in.  You showed up; you were the first one, and we went up to the room.  Fortunately, since I’d already had the exam, I didn’t have to go through and wait for 20 minutes for them to monitor me or anything.

Kristin:  That’s so nice to skip triage and go right up.

Maddie:  We went up the room, and it was not bad for a really long time.  You know, my body was doing a lot of the work as far as maybe turning the baby or getting more effaced.  Having done HypnoBirthing, I knew that dilation is not the only factor that you need to pay attention to, so I was able to just kind of relax and say all right, it’s going to happen when it happens.  You were there; you did a lot of hip squeezes for me, which was really fantastic for that counter pressure, because I was having back labor.  My husband is not able to do those with his wrists, so that made a huge, huge difference.  And we just kind of hung out, and I listened to my HypnoBirthing, and I listened to some relaxing music.  My appointment was at 10:30, and he wasn’t born until 10:45, so it was a while, but…

Kristin:  But for a first-time mom, it was pretty quick, and it’s one of the few calls I get in the daytime hours.  Most of the time, I get a call at 2:00 AM or 11:00 PM.

Maddie:  Right!  Things started to get ramped up some, and then I started noticing it more, but none of it was overwhelming.  One thing that we talked about in HypnoBirthing was breaking the amniotic sac.  That’s protection for baby, so I didn’t want to do that; didn’t really feel like there was any reason to.  The contractions really weren’t bad.  The surges weren’t overly painful or overwhelming, and so my midwife worked her full day at the office and then came in.  She checked me again quite a bit later, and then she did accidentally break the amniotic sac, and then after that, things got pretty intense.

Kristin:  Yeah, that can intensify a lot!

Maddie:  Yeah! I think from the time my water broke until the baby was born was about 2 hours and 45 minutes, so doable.  I spent a lot of the time in the tub, and that felt really great.  My husband was able to just use the hand shower, and having that, the different points of pressure, I think kind of helps take your mind off of it to some extent.  The water makes it a little less intense.  I really liked to be in there.  Then we got out, she said she wanted to check me, and I was Group B Strep positive, so they wanted to do another round of antibiotics.  That had been one thing that, when I found out, I was super devastated, because I wanted to labor at home for as long as possible.  I didn’t want to have to come in before six centimeters, and we had me the plan that if I came in and I wasn’t six centimeters, I didn’t want to know what I was at.  But I would just not go home.  You could know; my husband could know, and then we could make the decision.  Let’s walk around a little bit or just not be admitted.  But because I was already six to seven centimeters, when I was checked, we went right in after I got lunch.  We went right in and got admitted, so I was able to get those antibiotics in.  Once she checked me again and broke my water, it got intense.  It was really just — I felt very internal.  You know, it was not a lot of talking, and it was — I think right after it broke, I kind of got to that point where I was like, oh, no.  I can’t do this!

Kristin:  Which most women go through with unmedicated births.  Transition!

Maddie:  Right.  However, as soon as I had that thought — I have a distinct recollection of, oh, no, I can’t do this.  No, wait – that means I’m really close.  That means I can do this.  And so then I really tried to just focus on my breathing, because we’d talked about that and learned and practiced about getting those breaths in.  And I did end up struggling with that, but having you, having my husband, having my midwife all saying, all right, this is the birth you prepared for.  You can do this.  Just take those big breaths.  Breathing and focusing on those voices helped me to kind of get back on track, get it under control.  We tried a lot of positions for delivery, which that was one big thing.  I had changed providers pretty early on from an OB who said you’re only allowed to birth on your back, and I said, I want the freedom to do whatever position feels comfortable for me and for my baby and my body.  And so I ended up doing a lot of my laboring and pushing leaning over the back of the bed on my knees, and that definitely felt like the best position for me.  We tried on the side with the peanut ball.

Kristin: I remember trying a lot of different positions, and it’s all about listening to your body.

Maddie:  Right, and my body was saying, this does not feel good!  Don’t do that!  So I spent a lot of time there, and then I got to a point where I just remember feeling so hot and just, you know, put as many ice-cold washcloths on me as possible.  I was so hot, but I was just kind of getting right there to the end.  It was right at the end, and then my midwife had said, okay, I want to check you after this next surge, and so I want you to roll over.  And I already knew I was crowning, but I couldn’t really explain it at that point.  I’m like, no, no.  He’s there.

Kristin:  Right.  I feel him!

Maddie:  He’s right there!  So I did end up flipping over, and that was okay on my back, and that was fine.  What was helpful was the nurse that was there; she had said, do you want a mirror?  And I had said no, no, I don’t want a mirror.  And then she said to reach down and feel your baby.  When I could feel — he’s right there.  More than just oh, I feel it with my body, but actually touching it with your hand — he’s almost here!  That kind of gives you a little reinvigoration.  I’m right there at the end!  So I was able to catch my baby and put him right on me and do optimal cord clamping.  It was fantastic, just beautiful.  He was born on July 13th at 10:45 PM, so about 12 hours from when I figured out that I was in labor until he was born.  And it was being just relaxed about the whole process and recognizing it’s going to happen when it happens, and your body is going to do it, and trusting your body.

Kristin:  Exactly, trusting your baby and your connection with your own body and your baby, because it’s the two of you working together along with, of course, your partner and support team.

Maddie:  The very first thing I ended up saying after Charlie came out was, good job, buddy!  He was a part of it, too.

Kristin:  Exactly, babies work so hard!  They have to turn in the canal and — yeah, they’re exhausted.  You’re exhausted.

Maddie:  Exactly, there’s a lot happening.  It was beautiful!

Kristin:  It really was.  It was an honor to support you.  How did it go with the skin-to-skin time and breastfeeding as a first time mom?  Let’s talk about some of that and how you felt bonding in that first golden hour.

Maddie:  That was fantastic that I could do skin-to-skin right away.  I didn’t feel pressured to stop.  That was super important.  I did have some postpartum bleeding, and so while all of that was being taken care, not being separated from my baby was so big so I could just focus on him.  That part was wonderful.  We got all cleaned up.  The breastfeeding definitely was more difficult.  I have one side that’s inverted normally, and so baby really struggled to latch on that side, but he also struggled on the other side.  I was fortunate that Spectrum has IBCLCs on staff 24 hours a day, and so they were able to come in at 3:00 AM and focus on what’s going on, why is baby not latching.  We did end up using a nipple shield, and that was pretty demoralizing for a while.  We used it until six weeks, and I went to some Le Leche League meetings and things like that.  It really was important to have those contacts ahead of time and know where the meetings are; know when the meetings are; know an IBCLC that’s recommended in case you are having those issues so you’re not having to try to figure that out when you’re exhausted and you’re feeling downtrodden and things aren’t working.  It’s really hard to try to find that when you’re already struggling.  So having figured that out ahead of time, I was able to go to a meeting, go meet with a lactation consultant again.  We did stick with it, and then at six weeks, which is pretty common, he just kind of got it.  We got in the tub where it was warm and kind of womb-like and got rid of the nipple shield, and it worked.

Kristin:  That’s amazing that you were so persistent and it paid off!

Maddie:  Yes!  We just weaned at 2 years and 11 months.

Kristin:  Oh, congrats!

Maddie:  Yes, that was exciting.  We had a fantastic nursing journey.  If you really stick with it and arm yourself with that support system, you can do it.  I feel like so many women don’t have that support system.  My mom nursed; my sisters nursed all of their children.  Having that support system makes a huge, huge, huge difference.

Kristin:  Yeah, and like you said, just taking advantage of lactation while you’re in the hospital, even for moms who have a great first latch, to just have someone see your holds and answer any questions you might have — it’s a resource that I highly recommend anyone take advantage of, if they’re birthing in the hospital, of course.

Maddie:  Right.  That was important that they did come in.  They came multiple times to check on us and did work on holds and really understanding, you know, here’s another technique.  Here’s another hold to try if this one isn’t working, so you have those skills in your toolbox to pull out.  Okay, this isn’t working; let’s try this.  That definitely was helpful for me, as well.

Kristin:  Great!  Well, thanks for sharing your story!  Do you have any parting words?

Maddie:  I would just say to do your research.  It’s easy to just say that my doctor is going to do what’s best for me.  This is what happens.  This is how it goes.  But it doesn’t have to be.  You can be such an advocate for yourself, and you can surround yourself with other people to advocate for you so that you can get the type of birth that you want so that you have the support that you need.  Even if you have a partner that’s not able to be there in the way that you need, you can get a doula.  You can have a midwife who births in the hospital.  It’s really not different.  I know people that really think, oh, they’re not a doctor.  That’s totally different.  Just really doing your research and asking other moms who have been through it.  Moms are very willing, good or bad, to give you their advice, so get as much information as you can so that you can make your own informed decisions.

Kristin:  Yes!  Thank you for sharing your story because other women want to hear personal, especially positive, stories.  I feel like when it comes to birth, you here the dramatic or tragic.  Everyone likes to tell negative stories, and there aren’t enough positive, and a lot of women in pregnancy want to surround themselves with light and positivity.  We really appreciate you coming in!  Thanks so much, Maddie.  Thank you, everyone, for tuning into our podcast.  Remember, these moments are golden.

 

Maddie’s Birth Story: Podcast Episode #83 Read More »

Birth Stories

Gaby’s Birth Stories: Podcast Episode #77

Gaby is a local business owner in Grand Rapids and talks to Alyssa about the birth stories of both of her children. You can listen to this complete podcast episode on iTunes or SoundCloud.

Alyssa: Hi, welcome to Ask the Doulas podcast. I am Alyssa and I’m excited to be here with Gaby today. How are you?

Gaby: Hi, I’m great, Alyssa.

Alyssa: So we met a couple of months ago?

Gaby: Yes.

Alyssa: Was it the Mom Brain meet up?

Gaby: We did, yeah.

Alyssa: Yeah, and we got to talking about your lovely little bridal shop. I shouldn’t call it little, we’ll talk about that in another episode. But you have three children?

Gaby: I have two.

Alyssa: Two children.

Gaby: And a fur baby!

Alyssa: But you didn’t birth that one!

Gaby: Yeah, no.

Alyssa: I just wanted to talk about your stories. So our moms who are pregnant love hearing positive birth stories and it’s not to say that even though your birth story – the outcome may be positive, but there weren’t crazy things that happened along the way.

Gaby: Yeah.

Alyssa: I think there are so many people telling you, oh, just wait until… You know? And they tell you negative things about pregnancy, about labor and delivery, about postpartum, and then every year as your kid grows, oh, you just wait until… So I like to give our listeners some positive stories. So tell me about your kids. How old are they now?

Gaby: I have two kids. My oldest, Aurora. She’s going to be six this year. And my youngest, Andreas, he’s going to be three this year. They’re a good amount apart, but still kind of fighting the ages right there.

Alyssa: Yeah. What was it like having a three-year-old and a newborn?

Gaby: She had just surpassed the age of needing me 100% of the time. She was starting to be independent and she was very involved and loving, but there was still that balance of like, she’s still not 100% independent. But I like that space. I wouldn’t personally go any closer. I know I have friends and moms that are like, I just like to have my babies super close so that I’m having babies all at the same time. And I’m like, that sounds very overwhelming!

Alyssa: I think it’s very overwhelming in that stage. I was actually just talking to a girlfriend today who did that and she was like, It was so overwhelming! I don’t even know how I made it through. She goes, “But now, it’s so easy. They’re all within the same age range and they’re all independent. And they all just go play outside for two hours together.” So I can see the beauty of both ends, I guess.

Gaby: Yeah and now since she’s a little bit different, she’s still kind of interested in what he’s interested in, and can also watch him a relative amount of – you know, she’s kind of on the lookout a little bit. So she’s enjoying that responsibility of like, I’m in charge and don’t do that.

Alyssa: Oh yeah, my daughter’s six and she would love to be a big sister.

Gaby: Yeah. She’s like, don’t do that. Or she’ll run inside like, “Mom!” Okay, let’s go through the emergency levels here. Not everything is 100% red flag, our house is on fire, emergency.

Alyssa: So how were your deliveries with both of them? Were they pretty similar or completely different?

Gaby: They were relatively similar. I like to talk a look at all the possibilities and when I originally was planning to get pregnant and got pregnant, I was like, gve me all the drugs. Let’s set a date for the delivery, just give me all the drugs, and it’ll be quick and simple, and I’ll be in and out, and I’ll look great. You know, in a week I’ll be fabulous.

Alyssa: Instagram perfect, right?

Gaby: Yes! It’ll be fabulous! And that’s when I started reading up more on it and because of my tendencies already – so for example, my back has always kind of been sore, in pain, or more on the delicate side, and I started seeing the complications with medications and where they go and how they go and how they affect you. I started to explore a more natural way, more hands-off, with still keeping in mind, If I need it, that’s open. So not ever being like, I don’t want it no matter what. But just being like, I want to go in with the mindset of as much hands-off as possible. And then with the nurses and the doctors, because I trusted them if it really needed to be done, or if I needed medication or an intervention, then I was okay with doing that. And it was relatively – the pregnancy itself, I was sick! Sick, sick, sick, sick, sick! I think I lost weight until the last couple of months. And she was right on time and it was a relatively – I don’t know if it’s long, but it was almost like 12-20 hour from start to finish. But I think the active labor was maybe 6 hours? I was in a lot of pain. It seemed like, I can’t even tell you how long it was, but the active labor wasn’t that long.

Alyssa: Did you end up begging for an epidural?

Gaby: No, I didn’t. What ended up happening is they gave me Stadol at the last stages because I was refusing to sit down, to lay down, because it just hurt so much more. So when the contractions started they put me in a little tub, but as it started to get more intense I just couldn’t be sitting down. So most of the labor my partner and I were just on our feet. So I would be on my feet and then the contraction would come and I would obviously just collapse and he would just kind of hold me. Like underarms hold me through the contraction. Then the doctor’s like, you need to rest! You’ve been on your feet most of the labor. And I was like, I can’t, it hurts! They’d try to lay me down and I’d be like, “No!” It was just not good. It definitely helped me rest once I took the medicine and I don’t want to say it took the pain away, but it definitely helped ease the transition from standing up and the anxiety of like, If I lay down, it’s going to hurt more. She came and it was everybody focus! Don’t talk to me, focus! And she was delivered. There weren’t any complications. She came out great and everybody in my family waited until we were in the other room to come in.

Alyssa: Yeah, I was going to say, who was in the room with you?

Gaby: Just my partner at the time. Yes, I was very adamant about that. In fact, my grandmother tried to come in a couple of times and she was like, do you need anything? And I’m like, There’s nothing you can do! Please, I need some space. And I think it really helped me focus in the moment and just continuously tell myself, your body is meant to do this, to go through it, don’t panic. I just had to be like, don’t panic, just breathe in. You’re supposed to do this. If something were to go wrong, someone’s going to tell you if something’s wrong, they’re going to intervene. But as long as they’re just like, hey, everything’s okay! I’m trusting my environment and my body that this is what it’s supposed to do.

Alyssa: So was that intentional decision to only have you in your partner in the room for your first baby?

Gaby: Yes.

Alyssa: Because you wanted to focus.

Gaby: Yes and I feel like I would get distracted. And my mom, I love her to death, she’s great. She actually works in the emergency room. She’s an interpreter. But when it comes to family emergencies, she gets really panicky. And at that time with my daughter, she was actually in Florida, so it wasn’t too bad. It was just my grandma kind of coming in. And I think after the second time, I was like, I will see you when it’s done. Please, I’m fine. There’s nothing really. I guess in my head it’s kind of like, what can you really do? And I have friends that have everybody in there. Like a photographer and the neighbor. They’re great, they love it. They just want all the hugs and kisses and I just want everyone like, we’re here to work. We’re here to get from A to B, but we’re going to do it. So I told everybody, you cannot be out until I’m in the next room. And for the most part, they listened.

Alyssa: Minus grandma, twice.

Gaby: Minus grandma! I think she was just – you know, I think it’s definitely shocking. Your loved ones want to like, how can I make it better?

Alyssa: Well how did your partner react? Because often times they’re the ones who, you know, I want to fix this. I want to help and there’s nothing I can do.

Gaby: We had been together for a while and I definitely have a – in my life in general, when I’m sick I have the same kind of reaction. So he kind of knew that I was going to need specific help and we kind of were like – he knew. And he knew that if I needed something I would ask or that for example, really he was just there literally as a support because I was on my feet. And then the next time he was just there to make sure – I was like, I just need you to make sure that if I cannot vocalize what I want, this is what I want. That we have decided together. And he was just kind of there, vigilant, just checking, which kind of also brought me a little bit of peace of mind. Like, I have someone that isn’t trying to deliver a baby. I think they were 7.8 and then my other one was like 8.7.

Alyssa: But in your head, you were probably like, this must be a 12-pound baby.

Gaby: Whatever is coming out, I’m doing it and he’s not and he can say, go through the checklist.

Alyssa: Right!

Gaby: I’m very – I like to take charge and so at that point, there was only one thing that I was going to be able to focus. We had talked about it and I think he definitely – I have a very like, don’t get close to me unless I need it kind of vibe when I’m in pain. But again, I just kept thinking, this is something that happens. That’s supposed to happen, that you’re meant to happen. Like, you’re body’s prepared for even though you’ve never personally gone through it before, but it’s supposed to kind of go this route.

Alyssa: So how did that affect baby number two knowing you’ve been through this before, you knew your pain thrthreshold did that help?

Gaby: I actually thought I was not as far along than I actually was. With both of them! So don’t time your contractions in your head. Make sure you’re using an actual timer. With my son, when I got in they were like, do you want medication? Do you want some Stadol right now? I was like, Oh, no! I still have time. I’ve only been here a couple ho ofurs. With my daughter, I was here, it wasn’t until like midnight or you know, until I got Stadol, so I still have a couple hours of labor.

They didn’t say anything, they were like, okay, fine. You don’t want medicine right now, we understand. And then when it started getting worse and I was like, okay, I’m ready!

Alyssa: Give me some!

Gaby: And they were like, you’re too far along. And I’m like, wait, what do you mean? It hasn’t been that long. I had already labored outside of the hopsital longer and I must have been dilated much faster, obviously, because it was my second.

Alyssa: Right.

Gaby: So it was kind of a shock to me like, wait, I’m not – this is going to happen without anything. So with my son, I didn’t have any medication. And he just kind of – I don’t think the doctor was a little – she didn’t even have time to put gloves on. ‘Cause when they were like, you don’t need medication, you’re far along. I’m like, oh. And then a little bit after that, like less than 30 minutes, I was like, it’s time! You have to wait until you feel pressure. I’m like, yes! I’m checking it off, yes. And they’re like, no, it’s going to be a little bit. And then the doctors come in so relaxed. They’re so relaxed. And I’m like, ma’am. You should probably move along. And she sits on her little stool and I’m just kind of watching her like, she shouldn’t be this calm because I’m feeling it. It’s coming. She’s coming. And she literally turns around and she’s like, let me put my gloves on. And I’m like, nope! And she’s like, what do you mean? And she’s like, oh my God. And she just – she’s like, okay. And she catches him – he comes out.

Alyssa: No gloves? No time.

Gaby: She didn’t have time for gloves.

Alyssa: Oh my gosh.

Gaby: Yeah.

Alyssa: So I mean it kind of was a totally different experience. I mean, very quick.

Gaby: Yeah.

Alyssa: You probably wouldn’t call it painless, but it was a lot less drawn out.

Gaby: No. It was a lot less drawn out pain and I don’t know if I was – I don’t want to say I was used to the pain. I was in pain – like the muscles on the inside of my legs had decided they were too sore the whole pregnancy, so I was in a lot of pain consistantly. Kind of like jolts of pain. I don’t know if I was used to pain and then it was a faster delivery and he was just kind of like, I’m ready. And he just slid right out.

Alyssa: Do you think that as first time moms, since we don’t know what to expect, our brains kind of tell us that it’s going to be worse than it is?

Gaby: I think it definitely contributes to that and sitting down and talking to friends – the stories are not there for us. Like my friends and I are not like, I wish somebody would have sat down and talked about the actual labor. Honestly, not in a, I’m going to scare you. Not in a warning, not in a, don’t get pregnant because then labor’s painful. But in a, let’s go through everything, compare notes. So that you can be at least aware of what actually happens. Be prepared for the pain. As women, we have pain every month. Some of us more than every month. I think we’re much more capable, but we have this background fear of labor and delivery.

Alyssa: What are a few of those things that you would say to a new mom who has no idea?

Gaby: I think that mostly would be educate yourself with actually facts. Educate yourself in how you yourself react to pain in just your everyday life. Are you squimish? Are you not squimish? How your partner does that? How are you going to communicate? Some people can’t communicate when they’re in pain. Does that need to be talked about beforehand? You can bring your $200 ball to sit on, but I could not sit on the ball. It wasn’t mine. I didn’t pay for it, so I was grateful that I didn’t invest in a birthing ball that I didn’t need. So there’s going to be so many switches. Just kind of learn to be a little bit more go with the flow, ‘cause in the end – I want to say it’s like the baby in your body that’s going to be in charge of what happens. I just kept telling myself like, just breathe. Breathe through it, not because it’s going to minimize the pain, but because it’s going to help focus where I’m going out of the pain.

Alyssa: Sounds like you could have benefited from our hypnobirthing class. It’s like learning physiologically what’s going to happen. You know, what’s going on in your body, what’s happening during a contraction, what’s happening during active labor, but then like you said – so you’re ahead of most knowing that, let’s talk about how I deal with pain and how I process things. Do I like to be touched? Do I not like to be touched? Do I hold all my tension here? So knowing that and talking to your partner about that ahead of time is a big part of what the hypnobirthing class is about. Let’s focus on these things and practice how are we going to deal with that when we’re in this situation.

Gaby: Yeah and you definitely have to – we work so hard in preparing the room, and the baby, and all the stuff, but that moment is so small comparatively speaking, but it’s so intense. And it can leave such a big mark if it gets too complicated. So I feel like being prepared for a lot of stuff makes the load a little bit lighter. ‘Cause you already have the answers and you know what to expect. I didn’t realize that my doctor wasn’t going to be there until the very end. This whole time I’m like, I want my doctor. I’ve known her for a million years and we’re best friends. They didn’t call her until the end. Then when I realized, the nurses were just fabulous. They’re the ones that are going to take care of you. So it’s great to have a great relationship with your doctor, but going into where you’re going to give birth and seeing the support and the nurses – the support staff, I guess depending on where we give birth, they’re going to be there for the long run. They’re really invested in you because they’re there with you the whole time.

Alyssa: Yeah. Labor and delivery nurses are amazing.

Gaby: Yeah, yeah. I was kind of worried that – because I wasn’t going to be in a hospital, they were going to be like, we’re going to wire you up and we’re going to put all the juices in you. And I was like, I don’t want -. But it wasn’t like that at all. I didn’t feel forced into a certain way that they were doing things.

Alyssa: Well, is there anything else that you would love to share?

Gaby: I just wish we would trust our decisions more and be more confident in what we can handle, as far as labor and delivery. Again, if you want that support group there around you, and you know you need it, and that’s how you’ve been your whole entire life like you want mom, and aunt, and everybody, and the dog, that’s great. But if all of a sudden because you’re giving birth everybody wants to sign up and come and take pictures, don’t do it. It’ll be a good first start to parenting and being with family. It’s not about you not loving or caring, or that you don’t want them involved ever in the life of the baby, but that is such a critical moment that you can’t have extra people that you’re really not going to ulitize or that you’re going to feel like you’re trapped in that room for a long time.

Alyssa: Yeah, so often family members can make us feel – like guilt us into doing things that we don’t feel are right. And this is, like you said, the first step in a very long journey of parenting where you have to do what’s best for you and your family and not everybody else.

Gaby: Right. I probably would have been mad to see my sister on her phone while I’m mid contraction.

Alyssa: Right! You better not be posting anything to Facebook.

Gaby: Yeah. Like, how can you be relaxing? I’m mid contraction! You know, let’s not get angry. Let’s just focus on that.

Alyssa: I did the same thing, so I totally understand.

Gaby: People are so hesitant to say – They don’t want to hurt anybody’s feelings and I think it’s – now that we’re learning a little more emotional tintelligence, think we can put responsibility on both parts. One to say no and the other part to understand. Hopefully everybody understands if you want to draw that line.

Alyssa: Well, thank you so much for sharing.

Gaby: You’re welcome. Thank you for having me.

Alyssa: We will have you on again. I want to learn a little bit more about your business and what it’s like. I love talking to moms who are business women as well.

Gaby: Yeah, I can’t wait.

Alyssa: Thanks, everyone for listening. You can find us on iTunes and Sound Cloud. Again ,this is Ask the Doulas. You can find us at goldcoastdoulas.com, Instagram, and Facebook. Thanks for listening.

 

Gaby’s Birth Stories: Podcast Episode #77 Read More »

Woman wearing neutral colors lays on a white bed cradling her baby bump

HypnoBirthing Baby – Wesley

We love getting birth stories from clients! This is a beautiful story from one of Ashley’s HypnoBirthing students. Through all of the unknowns of labor and delivery for a first time parent, this mom describes her birth experience and how relaxing and keeping calm throughout eliminated any room for fear.

Wesley Thomas Sarazin was born 9-2-18 (13 days prior to EDD) at 5:02 pm. At 4:30 am on 9-1 was laying on the bed at my cabin and felt a pop/jolt feeling and thought my membranes released, but I stood up and no fluid was coming out. I went to the bathroom and had instead lost my mucus plug. I laid back down with my husband and had 2 contractions 20 minutes apart, but decent intensity. Since the cabin is about 1 hour and 15 minutes from home, I knew I wouldn’t feel comfortable laboring there and wanted to go home. Chris started to drive, and about 15 minutes before getting home I started to vomit. I got out of the car and fluid gushed. Surges were 6 minutes apart and lasting about 1 minute, with lots of back labor.

We got home and I took a shower, grabbed our hospital bags, and contractions were now about 5 minutes apart. I had wanted to labor at home for a while, but felt that I needed to head into triage because I was doing more vomiting and I felt like I needed to poop so I was afraid to try not knowing what my cervix was doing. I was 1cm and “soft” with baby’s head pretty low at the appointment just over a week prior. We got to triage around 9:00 am. I was still only 1-2cm but surges seemed quite intense and still no more than 5 minutes apart. They confirmed I had released my membranes and I was taken up to L&D by 10:00. I had some high BPs initially but they came down and stayed around 135/85 so they weren’t really concerned about pre-e. I was GBS neg.

Krista, my first nurse, was awesome. She has been in the field for 25 years. I’m a nurse so I wanted an IV in up front, because I don’t have great veins. I got in the tub right away and labored there for about 2 hours. I did not have to do continuous monitoring. They took an initial 20 minute reading (wireless in the tub) and then just traced me for 2 minutes each hour with the portable one. I purchased a bath pillow on Amazon and that made it more comfy. I listened to Rainbow Relaxation and some other YouTube/Amazon playlists that I had ready. I got out and dried off, and did some squatting. I hated the ball. I hated leaning forward; the sensation in my abdomen when leaning forward was less tolerable than the back labor. I had lots of rectal pressure the whole time, probably my least favorite part.

I had them check me at around 1:30 pm, and I had made it up to about 5.5cm and 90% effaced. I continued to labor, now mostly side lying with a peanut ball and some standing/squatting and rocking hips. Krista, the RN, told me to try to get through 4 surges in 1 position and then switch to another position; that it would help time go by, and for me it did. I would do about 3-4 surges and then switch. It gave short term goals to get through. Kind of like when you’ve got 10 more minutes to run but you think of it in five, 2 minute sections, just get through the next 2 minutes.

My husband, Mom, and sister took turns applying heat or ice to my back and some counter pressure. I also held heat or ice over my pelvis as it just felt like menstrual cramps. Between surges, I would tell myself to be “loose, limp, relaxed”. I continued with either Rainbow Relaxation or a really great birthing affirmations track that I had found on Youtube. My favorite affirmation was “My surges are not stronger than me because they ARE me”. Baby did have some late decels but was overall ok.

The first 5 hours I was barely monitored but had to be watched more closely at the end. About 2 hours later I was having natural expulsion reflex and I was about 7.5cm and 100%.

Doc finally came in and I was relieved when she didn’t leave, which encouraged me to know that things were likely happening soon. She was fantastic. Even the nurse commented that she has a very midwife-like approach and I felt totally comfortable with her. She put a warm wet towel on my perineum and did counter pressure during my surges. She told me to keep doing the natural expulsive pushing if it was happening even though I was not 10cm because baby was coming down well, at +1 station and tolerating it. She said, “You’re not going to rip through your cervix, your body knows what it is doing.”

After 20 minutes of active pushing, I was struggling to breathe because my urge to push was so strong it was hard to breathe in as much as I’d like. They threw a mask on me and had me push with 1 leg up through 2 surges and then switch and lean the other way to get baby to keep rotating. They got a little aggressive with how they had me push but at the time I was ok with it because I wanted him out ASAP! His head came in and out through several surges and once I popped that head through his body came all at once, such a relief.

During transition I almost asked for some nitrous oxide, but with knowing that the end was in sight, I just kept completely relaxing between surges. I didn’t have any drugs aside from IV fluids. The Doctor did do a pudendal block right before I pushed which I had never even heard of but am super thankful for. I didn’t have the “ring of fire” feeling that some people talk about.

I didn’t get post delivery pit, and had no issue with bleeding. Baby did about 2 minutes of delayed cord clamping, and then I donated the rest. He wasn’t pinking up well and neonatal needed to come. He had lots of fluid/mucus in his lungs and got deep suctioned. H also had to go on CPAP. Once he was looking better, they put him on my chest again, but unfortunately after a few minutes his color was not looking good and we had to call neonatal back for more CPAP and suction. He was threatened with the NICU and I told him to get his act together so he could stay and snuggle with me. I just kept talking to him from across the way. My husband and mom were right by his side as well. The 3rd try to my chest worked. He had mild signs of respiratory distress but his color was looking better.

The next hurdle was hoping his blood sugar was ok since he couldn’t try to latch until his breathing was stable. Luckily that was good!  The only thing I would change about the whole process would be to slow down on the pushing because I think that would have minimized my tearing and maybe the baby wouldn’t have had as much fluid in his lungs.

We are in mother baby now, doing fine. He has been latching pretty well. He still is borderline tachypnic so Dad and I are taking turns holding him because he does better that way. No bassinet for him tonight.

I had my Husband, Mom and sister in the delivery room and am so glad they got to witness our awesome birth. The labor and delivery was hard but honestly not as hard as I thought it would be. It was different I would say, in regard to the back labor and rectal pressure. My husband called me a “gangster”. He said, “I don’t know how to say this the right way, because I know it wasn’t easy, but you made it look easy. It didn’t look like you were uncomfortable.”

Before labor and birth, Chris was a lot better than me about trying to use the HypnoBirthing lingo and shut down any negative birth stories that people would tell. We had several people (who are honestly GREAT people, so it surprised me) say to us, “Oh you’ll see once you get into labor, you’ll want an epidural,” or “You don’t get a trophy afterwards.” After a few of those statements, I just stopped telling people that I was going to try for a natural birth. Fortunately, my mother delivered 4 children without medication, so I had her encouraging me and my husband fully believed I could do it, more than I did.

I should say that the reason I took HypnoBirthing was because I believe that our bodies are made to do this. One of my friends, who’s biggest fear about labor was that she would go too fast and not be able to get an epidural, had read the book – Ina May’s Guide to Childbirth and she gave it to me when she was done. That book further ingrained the message that our bodies are made to do this and a birth without fear will hopefully progress as it should. I think that is the most important part of preparing yourself for natural childbirth. I can honestly say I was never fearful at any point and had a beautiful, exciting, experience.

Most, if not all, of my preferences were met and I am so happy with my experience. I was up to the bathroom and walking around the room less than 2 hours after he was born, and I’m really not having any pain. Bleeding is appropriate without the dose of pit. Just trying to get some rest but being extra attentive though this first night because of my little guys breathing.

 

HypnoBirthing Baby – Wesley Read More »

Trusted birth team

Your Trusted Birth Team

We all know that becoming a parent is difficult, but most first time parents don’t really have a full understanding of how hard it will be until they’re in the midst of it. They may encounter fertility struggles or miscarriages; they realize that planning during pregnancy takes a lot of work; they have to find an OB or midwife they trust; they may hire a doula; and it takes time for new parents to put a postpartum support network in place.

Add on to that the stressors of guilt, living up to “social media standards”, unwanted advice from friends and family, fear of failure, and lack of confidence. It’s overwhelming and can leave parents feeling defeated before they even begin.

With information at our fingertips, how do we discern what’s evidence-based and what’s junk? What’s worth worrying about and what’s not? How does a parent today make an informed decision?

Luckily, our West Michigan families have so many great health care professionals to choose from and tons of options for support. We’re going to tell you how to begin this journey on the right path so you don’t go through this alone. If you are supported by a trusted team throughout, you are more likely to have a positive birth experience.

Let’s talk about some myths. It’s important to talk about the misconceptions the public has on every area of the support team. Let’s debunk those!

Doula Myth #1: Doulas only support home births.
At Gold Coast Doulas, over 80 percent of our births happen in a hospital. Our clients are seeking professional, experienced doula support in the hospital setting.

Doula Myth #2: Doulas only support parents who want an all-natural delivery.
Gold Coast Doulas supports any birth and respects all birth preferences.

Doula Myth #3: Doulas catch babies.
Definitely not! We are not a replacement for any medical staff, we are an added member of your birth team, there to offer informational, emotional, and physical support throughout pregnancy, labor, and delivery.

Doula Myth #4: Doulas only offer birth support.
We have antepartum doulas that offer support for mothers on bed rest, are high-risk, or for any reason need additional help while pregnant. We also have postpartum doulas that support families once a baby, or babies arrive. They offer in-home care, day and overnight. They are like a night nanny and infant care specialist rolled into one!

Hospital Birth Myth #1: You can’t have an unmedicated birth in a hospital.
This couldn’t be further from the truth. Many of our birth clients prefer an unmedicated birth in the safety of a hospital setting. Our West Michigan hospitals have many different options for a laboring person.

Hospital Birth Myth #2: An induction leads to a cesarean.
This is not always the case. In many cases, labor induction leads to a successful vaginal birth.

Hospital Birth Myth #3: You can’t move around during labor. 
As long as you don’t have an epidural, movement is encouraged. Even with an epidural, there are many possible position changes in bed that your birth doula can help you with. You won’t be lying on your back the entire time. Most hospitals have walking monitors for those who wish to move around during labor.

Midwife Myth #1: Midwives only support home births.
We have many local midwives that do support home births, one midwife that delivers in a birth house, and there are plenty of Certified Nurse Midwives that practice in hospitals! There are midwives in West Michigan for any kind of birth preference you have.

Midwife Myth #2: Midwives only support women during pregnancy and birth. 
Many midwives also offer well-woman care (annual exams).

OB Myth #1: They aren’t supportive of vaginal births after cesareans (VBAC) and it’s best to attempt one at home. 
This is often based on the hospital’s policy rather than preference of the doctor. Many hospitals are supportive of VBACs.

OB Myth #2: They do not work with doulas.
This is not the case. Many of our clients see an Obstetrician and most are very comfortable with professional doulas. Our team is always willing to accompany clients to a prenatal appointment if the provider is not comfortable with working with a doula.

OB Myth #3: They don’t like birth plans.
While this may be partially true just because many “birth plans” are eight pages long. Many things patients put on their birth plan are already protocol at most hospitals (skin to skin, delayed newborn procedures, etc). Knowing that providers have to see many patients in one day, it’s important to keep in mind that they cannot read through an eight page plan. Give them the information that is specific to you. “I want dimmed lights and music.” “I don’t want to be touched when I’m laboring.”

Millennials are over 80 percent of the pregnant population right now and they want answers! They want a relationship, and they want a team they can trust. Our parents and grandparents had one doctor who did everything. They trusted anything the doctor said and definitely didn’t go searching for answers on their own.

Medical care is different today, and families expect a different approach to their healthcare. Oftentimes they don’t even realize they need something more until they are expecting a child. It’s probably one of the biggest unknowns to ever happen in someone’s life. Having a trusted team by your side through the entire process can relieve the stress, pressure, and oftentimes unnecessary anxiety that comes with planning and preparing for pregnancy, labor, and postpartum.

If you are pregnant or even just thinking about starting or growing your family soon, reach out to us. We can offer local resources and our doulas are here to be your guides when you are ready.

In the meantime, here are some trusted online sources we recommend. Try your hardest not to get information from individuals online (mom groups, Facebook, etc)!

The American College of Obstetricians and Gynecologists (ACOG)

The American Academy of Pediatrics (AAP)

March of Dimes

Evidence Based Birth

 

Your Trusted Birth Team Read More »