Ask a Doula

ilovemazzy:

Jacob and I practice attachment parenting. We don’t believe in CIO, we co-slept until Mazzy was 6 months old, and of course breastfeeding and babywearing. She is getting heavy but we still try and use the Bjorn whenever we can. I think the co-sleeping really helped her to be a calm and happy baby. When she woke up in the middle of the night I was right there to feed her and she easily went back to sleep. It felt natural to have her that close to us. She starting sleeping through the entire night at 6 weeks!

Here is some more info on AP from Dr. Sears:

WHAT ATTACHMENT PARENTING IS –THE 7 BABY B’S

Attachment parenting is a style of caring for your infant that brings out the best in the baby and the best in the parents.

7 ATTACHMENT TOOLS: THE BABY B’S

1. Birth bonding

The way baby and parents get started with one another helps the early attachment unfold. The days and weeks after birth are a sensitive period in which mothers and babies are uniquely primed to want to be close to one another. A close attachment after birth and beyond allows the natural, biological attachment-promoting behaviors of the infant and the intuitive, biological, caregiving qualities of the mother to come together. Both members of this biological pair get off to the right start at a time when the infant is most needy and the mother is most ready to nurture

“What if something happens to prevent our immediate bonding?”

Sometimes medical complications keep you and your baby apart for a while, but then catch-up bonding is what happens, starting as soon as possible. When the concept of bonding was first delivered onto the parenting scene twenty years ago, some people got it out of balance. The concept of human bonding being an absolute “critical period” or a “now-or-never” relationship was never intended. Birth bonding is not like instant glue that cements the mother-child relationship together forever. Bonding is a series of steps in your lifelong growing together with your child. Immediate bonding simply gives the parent- infant relationship a headstart.

2. Breastfeeding

Breastfeeding is an exercise in babyreading. Breastfeeding helps you read your baby’s cues, her body language, which is the first step in getting to know your baby. Breastfeeding gives baby and mother a smart start in life. Breastmilk contains unique brain-building nutrients that cannot be manufactured or bought. Breastfeeding promotes the right chemistry between mother and baby by stimulating your body to produce prolactin and oxytocin, hormones that give your mothering a boost.

3. Babywearing

A baby learns a lot in the arms of a busy caregiver. Carried babies fuss less and spend more time in the state of quiet alertness, the behavior state in which babies learn most about their environment. Babywearing improves the sensitivity of the parents. Because your baby is so close to you, you get to know baby better. Closeness promotes familiarity.

4. Bedding close to baby

Wherever all family members get the best night’s sleep is the right arrangement for your individual family. Co-sleeping adds a nighttime touch that helps busy daytime parents reconnect with their infant at night. Since nighttime is scary time for little people, sleeping within close touching and nursing distance minimizes nighttime separation anxiety and helps baby learn that sleep is a pleasant state to enter and a fearless state to remain in.

5. Belief in the language value of your baby’s cry

A baby’s cry is a signal designed for the survival of the baby and the development of the parents. Responding sensitively to your baby’s cries builds trust. Babies trust that their caregivers will be responsive to their needs. Parents gradually learn to trust in their ability to appropriately meet their baby’s needs. This raises the parent-child communication level up a notch. Tiny babies cry to communicate, not to manipulate.

6. Beware of baby trainers

Attachment parenting teaches you how to be discerning of advice, especially those rigid and extreme parenting styles that teach you to watch a clock or a schedule instead of your baby; you know, the cry-it-out crowd. This “convenience” parenting is a short-term gain, but a long-term loss, and is not a wise investment. These more restrained styles of parenting create a distance between you and your baby and keep you from becoming an expert in your child.

7. Balance

In your zeal to give so much to your baby, it’s easy to neglect the needs of yourself and your marriage. As you will learn the key to putting balance in your parenting is being appropriately responsive to your baby – knowing when to say “yes” and when to say “no,” and having the wisdom to say “yes” to yourself when you need help.

MORE ABOUT ATTACHMENT PARENTING

• AP is a starter style. There may be medical or family circumstances why you are unable to practice all of these baby B’s. Attachment parenting implies first opening your mind and heart to the individual needs of your baby, and eventually you will develop the wisdom on how to make on-the-spot decisions on what works best for both you and your baby. Do the best you can with the resources you have – that’s all your child will ever expect of you. These baby B’s help parents and baby get off to the right start. Use these as starter tips to work out your own parenting style – one that fits the individual needs of your child and your family. Attachment parenting helps you develop your own personal parenting style.
• AP is an approach, rather than a strict set of rules. It’s actually the style that many parents use instinctively. Parenting is too individual and baby too complex for there to be only one way. The important point is to get connected to your baby, and the baby B’s of attachment parenting help. Once connected, stick with what is working and modify what is not. You will ultimately develop your own parenting style that helps parent and baby find a way to fit – the little word that so economically describes the relationship between parent and baby.
• AP is responsive parenting. By becoming sensitive to the cues of your infant, you learn to read your baby’s level of need. Because baby trusts that his needs will be met and his language listened to, the infant trusts in his ability to give cues. As a result, baby becomes a better cue-giver, parents become better cue-readers, and the whole parent-child communication network becomes easier.
• AP is a tool. Tools are things you use to complete a job. The better the tools, the easier and the better you can do the job. Notice we use the term “tools” rather than “steps.” With tools you can pick and choose which of those fit your personal parent-child relationship. Steps imply that you have to use all the steps to get the job done. Think of attachment parenting as connecting tools, interactions with your infant that help you and your child get connected. Once connected, the whole parent-child relationship (discipline, healthcare, and plain old having fun with your child) becomes more natural and enjoyable. Consider AP a discipline tool. The better you know your child, the more your child trusts you, and the more effective your discipline will be. You will find it easier to discipline your child and your child will be easier to discipline.

melissamedusa:

Garren is getting me a doula! Thanks for telling me about them Celeste!

So… I’m starting my hunt for a Doula, A midwife, A birthing center where I can have a waterbirth, lamaze classes, childbirthing classes, and a prenatal yoga instructor! Pregnancy is KEWL.

Also, to my penpals… or potential future penpals: I am staying in Washington throughout my birth, please respond to the mail I send! I am really enjoying sending out mail and packages right now!

Oh my god! Celeste! I found this place where they do baby yoga, for your freaking baby. It’s so ridiculously cute to see the pictures I can’t even fathom keeping it together while watching babies and toddlers do it!!! AHawkldjnskdgh! I could just piss myself it’s so cute.

It is important to read books that both help you prepare (give you the info you need) and fill you with the confidence, the belief that this is doable, that you need just as much and maybe even more than information to have a great birth experience.

The Birth Partner by Penny Simkin

Birthing from Within

Ina May’s Guide to Childbirth (and if you like that, then her groundbreaking Spiritual Midwifery)

Misconceptions by Naomi Wolf (a bit scarye but really relevant for Americans especially)

The Thinking Woman’s Guide to Childbirth

Dr. Newman’s Guide to Breastfeeding

There are many more, but these are my favourites.

I never recommend What to expect”  in the circles I travel in, it is referred to as “what to expect when you’re expecting a ceasarean”

Look for future posts with movies, childbirth education classes, and websites

ourlilpeshus:

If you want to learn how best to help an expectant mother have a happy and healthy childbirth, The Birth Partner, Third Edition is the only book you’ll need. For almost 20 years, husbands, partners, friends, relatives, and doulas have turned to this book for guidance on being a supportive partner in the delivery room. The expanded third edition includes the most up-to-date information about techniques, devices, and medications for easing labor pain; tests and treatments of the fetus and newborn; strategies to help labor progress; potential medical procedures and interventions; and how best to help the mother during the early days after the birth. And, with its easy-to-use format and new illustrations, the The Birth Partner is the essential guide have on hand in the delivery room.

Dad is currently reading The Birth Partner, but I plan to read it, too. It was lent to us with high praise and recommendation from a lovely couple who delivered their son without an epidural or need for medical intervention.

Using history as her guide, nationally recognized midwife Gaskin explores what she hopes will be a renaissance in natural childbirth, something that she’s been advocating since the mid-1970s. By focusing on how women of ancient civilizations and other modern peoples give birth, Gaskin puts our own hypersensitivities in perspective, uncovering a beautiful, sometimes orgasmic experience rather than a dreadful, painful one. Sure, pain is part of childbirth, but preparing for the pain in a realistic rather than sentimental way—whether giving birth at home or in a hospital—can be the key to a woman’s ability to deal with it naturally. Within the pages of personal anecdotes, some touching, some startling, from Gaskin’s patients and colleagues, every woman is sure to find something to relate to, whether or not she chooses to have a medicine-free labor. The helpful back matter features a glossary, a detailed resource list including advocacy groups and Web sites, and a bibliography that includes periodicals, rounding out an extremely comprehensive and up-to-date guide on the topic

I’m currently reading this book. Ina May Gaskin offers a fair examination of the childbirth options in our country, but focuses heavily on approaching child birth from a woman-friendly—rather than doctor-friendly—perspective. She logically and reasonably explains the body and mind connection, and its role in childbirth. She doesn’t sugar-coat the painful and laborious aspects of giving birth; she knows that having honest expectations of delivery will make it a better experience for the mother and her labor partner(s) regardless of what method(s) the laboring woman chooses.

I wish I could say that this practice is not standard anymore, anywhere.  The unfortunate truth is that some medical professionals still practice episiotomy rather too often.

What  is an episiotomy anyway? It is usually a small incision made at the vaginal opening to make room for baby to come out more quickly.

Why try to avoid an episiotomy?

• Greater blood loss during delivery, since the cut is made through both skin and muscle layers.
• Increased risk of 3rd and 4th degree extension tearing (into the anal sphincter and through the rectal wall, respectively). Thus it causes one of the things it is supposed to prevent. One study found that the repair of such an extension at the time of delivery was inadequate in most mothers, and 50% of these had some degree of anal incontinence (involuntary leaking of stool).
• Episiotomy is of no benefit under usual birth circumstances. It causes pain and debilitation post-partum. In fact, drug companies have found post-episiotomy patients a ready source of subjects for pain relief research.
• Episiotomy may interfere with resumption and enjoyment of intercourse, both short-term and long term.

(from better births)  (see JAMA research summary article here http://www.childbirthconnection.org/article.asp?ck=10004 )

How can you best avoid this procedure?

- be vocal with your caregiver prior to labour and in hospital with all care providers

- document your preferance (birth plan, t-shirt, whatever) to strech and possibly tear on your own, give the back up info you have about the lesser degree of tearing and the greater ease of healing with a naturally occurring tear

- Empower your partner, doula, mother, sister, friend who attends your labour with you to advocate for you in the moment

-Do kegels (they apparently do help)

-Do perennial massage (its not very fun, but it can help)

-Learn to relax and trust your body

-Create a birth environment that makes you feel safe

-Deliver your baby in any position but laying flat on your back (ok not standing on your head either)

-Have your caregiver apply warm compresses and light pressure on your perenium when pushing

-Have a slow second stage (pushing), let the baby make room for its entry into the world

-Avoid the snowball(landslide) effect of interventions.  Epidurals often lead to “instrumental delivery” (vacuum or forceps), these often go hand-in-hand with an episiotomy.

-Some people believe evening primrose oil applied to the perenium can help to soften it

- Think “open, open, open”

- Relax your jaw and let your mouth hang open

And remember with either a tear or an episiotomy there will be a period after the birth which is concerned with repair, make sure you and your avocates ask for you to have your baby either before or during the repair… this is an essential time for bonding.  You don’t want to let it pass, or have to wait for it, you and your baby need each other, besides nursing your baby will help decrease the bleeding tremendously.

More details on strategies can be found here http://www.givingbirthnaturally.com/avoiding-episiotomy.html

Feeling well rested is pretty difficult later in pregnancy between the difficulty getting comfy and the “busy brain” chatter that can haunt us.

No doubt you have been recommended that you give yourself ample opportunity to rest, do yoga, take baths, get a massage - these are all fabulous things to do for your body.  I may also suggest some warm milk, a long walk and a visit to the chiropractor along those lines.

The busy brain is somtimes resolved with a peaceful body, sometimes it is not.  Writing or drawing your thoughts, guided imagery, and meditation can help with this. You will want to check in with your natural chemist, naturopath, homeopath, midwife or doctor, but I have found that many moms enjoy some relief from vallerian as a sleep aid and Rescue Remedy as a sort of nerve tonic to settle a overly chatty mind.

The American Heritage dictionary:

A woman who assists another woman during labor and provides support to her, the infant, and the family after childbirth.

Wikipedia

A doula is an assistant who provides various forms of non-medical and non-midwifery support (physical and emotional) in the childbirth process. Based on a particular doula’s training and background, the doula may offer support during prenatal care, during childbirth and/or during the postpartum period. A birth doula provides support during labor. Thus a labor doula may attend a home birth or might attend the parturient woman during labor at home and continue while in transport and then complete supporting the birth at a hospital or a birth center. A postpartum doula typically begins providing care in the home after the birth. Such care might include cooking for the mother, breastfeeding support, newborn care assistance, errands, light housekeeping, etc. Such care is provided from the day after the birth, providing services through the first six weeks postpartum. In some cases, doula care can last several months or even to a year postpartum - especially in cases when mothers are suffering from postpartum depression, children with special needs require longer care, or there are multiple infants.

http://en.wikipedia.org/wiki/Doula

Transition to parenthood

What is a Doula?

Doula is a Greek word for “woman’s servant.”

Birth Doulas (aka Labor Support Doulas)

A birth doula is a supportive companion professionally trained to provide physical and emotional support during labor and birth.

A doula provides continuous support, beginning during early or active labor, through birth, and for approximately 2 hours following the birth. The doula offers help and advice on comfort measures such as breathing, relaxation, movement, positioning, and massage. She also assists families with gathering information about the course of labor and their options. Her most critical role is providing continuous emotional reassurance and comfort.

Doulas attend home births and hospital births; medicated births and unmedicated births, with women whose care is being overseen by doctors or midwives. Doulas may be the only support person for the mother, or may be part of a labor support team including mom’s partner, friend(s), and/or family members.

Doulas specialize in non-medical skills, and do not perform clinical tasks, or diagnose medical conditions.

Doulas do not make decisions for their clients. Their goal is to provide the support and information needed to help the birthing mother have a safe and satisfying birth as the mother defines it.

Postpartum Doulas

There are also postpartum doulas, who provide support after the baby is born. They have knowledge about postpartum recovery, breastfeeding, and newborn care. Their services vary depending on your needs, and might involve anything from a one-time visit for information and advice, to providing overnight care every night for a month.

Proven Benefits of Doula Care

Decreased medical intervention in labor*:

6 weeks after birth, mothers who had doulas were: