Hi, folks! I was recently contacted by the Public Outreach Department at DrugWatch.com to help raise awareness of a serious women’s health issue: pelvic organ prolapse. Below is an informative article, contributed by Elizabeth Carrollton from DrugWatch.com. Please know that the treatments listed below are not listed in order of effectiveness, nor is the list detailed or “complete.” There are a couple of topics not mentioned that I would like to discuss. Like this article states, taking a proactive stance can reduce the number of women who experience pelvic organ prolapse (POP) and pelvic floor dysfunction (PFD). It’s important to know that while a life event like pregnancy may contribute to POP or PFD, it is not necessarily the cause. It is more about the downward pressure in the abdomen and pelvis, rather than a person’s extra body weight or “weak” pelvic floor muscles (that’s why women and men who haven’t birthed children are also suffering from these same health issues, too). Keep in mind that it is not the pelvic floor muscles’ job to carry the weight of a person’s organs—while these muscles play an important role in the big picture of things, it is the person’s ligaments that are to keep organs in place. That being said, if a gal isn’t in tune with how she carries her body on a day-to-day basis and is not focused on proper body alignment, she may experience more troubles. POP and PFD relate to the whole body, not just a woman’s pelvic floor. While kegels can help women recognize how to contract and release certain muscles “down there,” doing them incorrectly may do more harm than good—and you would be surprised at how many people are doing them incorrectly, or doing them waaay too frequently. In fact, Katy Bowman, who has a Masters in Biomechanics and is the creator of the blog “Aligned and Well,” states that kegels may make the pelvic floor tighter, but tighter does not equal stronger. While kegels may treat the symptom, they do not fix the problem, which is why it should not be advised as the only preventative treatment for POP or PFD. One way to prevent PFD or POP is squatting. This isn’t something you would randomly throw into your workout routine while 30 weeks pregnant, nor would you start squatting after being diagnosed with PFD or POP. It is, however, a great preventative exercise to POP or PFD, and it will help with proper body alignment. Having strength in your glutes creates the posterior pull on your sacrum, which makes for a healthy pelvic floor. Bowman not only talks about the overuse of kegels, but she stresses the importance of squats on her blog. You can also find out more information on this topic in Bowman’s interview on MamaSweat, a blog that focuses on fitness and motherhood. POP and PFD are not just pelvic floor issues, nor do they only apply to childbearing women. While it’s good to know how to do a kegel, please do not expect kegels to change your life or fully strengthen your pelvic floor. Does this mean I’m ruling out kegels as a preventative measure? Not entirely. I believe that it’s important to know how your pelvic floor muscles work; however, doing kegels day in and day out will not grant you a stronger pelvic floor. Focus on overall wellness and whole body alignment, and you can’t go wrong!
Pregnancy and Childbirth as Contributing Factors to Pelvic Organ Prolapse
Pregnancy and childbirth are the most dominant contributing factors to pelvic organ prolapse (POP). However, the condition is not usually diagnosed until women are closer to menopause. In fact, approximately 50 percent of women between the ages of 50 and 80 have some degree of prolapse. In most cases, symptoms are nonexistent and women do not require treatment. If other factors are involved — such as smoking, obesity, a genetic predisposition or a traumatic pelvic injury — a woman may be diagnosed with the condition when she is younger.
Symptoms of POP are usually manageable, and POP can be avoided altogether, if women are proactive about maintaining strong and healthy pelvic tissues.
Pelvic Organ Prolapse
Although pregnancy and childbirth set the state for POP, decreasing estrogen levels as women approach menopause further weaken pelvic tissues. Pelvic organs are suspended and held in place by a series of connective tissues that bind organs together and anchor them to the pelvis and sacrum. As these connective tissues become more and more weak, organs can move out of place and/or begin to move down toward the pelvic floor. In mild cases, women may not experience any symptoms. In more moderate to severe cases, women may have seriously uncomfortable symptoms.
Symptoms of pelvic organ prolapse include:
- An inability to insert a tampon
- A tampon's tendency to slide out
- Discomfort during sexual intercourse
- Difficulty beginning to urinate
- A weakened urine stream
- Unusual constipation
- A pulling or tugging sensation in the pelvis and/or lower back
How to Prevent Pelvic Organ Prolapse
Women with more moderate to severe cases of POP often undergo surgical intervention to reverse their symptoms. One of the most common surgical treatments involves a medical device called transvaginal mesh
. This device has now been linked to high numbers of serious health complications. Thousands of women have filed a transvaginal mesh lawsuit
against makers of mesh products after suffering from the sometimes irreversible side effects of vaginal mesh use. The more women do to prevent the onset of POP, the less likely they will be to need surgery to treat their symptoms.
Non-Invasive treatments for POP include:
- Kegel exercises. Kegels can be done daily to keep vaginal and pelvic floor muscles toned and strong. The stronger these muscles are, the less likely a woman is to develop severe symptoms of POP. Women who do Kegel exercises regularly throughout their pregnancy are also less likely to develop incontinence during their third trimester. Pelvic tissues recover faster during the postpartum period if pelvic floor exercises are sustained.
- Pelvic physical therapy. A pelvic physical therapist can work with women who have a higher chance of developing POP to teach them additional pelvic floor exercises to promote pelvic health.
- Postpartum massage. Postpartum massages can increase circulation, reduce inflammation and realign pelvic tissues that have shifted out of place during pregnancy and childbirth. Some of the most effective techniques include Maya massage, Myofascial Release therapy and Shiatsu.
- Vaginal pessaries. While a pessary — a device that is inserted into the vagina — doesn't prevent POP, it can provide support to the pelvic floor and vagina to prevent further organ prolapse. They can help women with more severe cases of POP to avoid surgical procedures.
It is never too early to focus on pelvic health. These non-invasive treatments are also preventative measures that can protect women from risky surgeries later on.
Elizabeth Carrollton writes to inform the public about defective medical devices and dangerous drugs for Drugwatch.com.
World Breastfeeding Week is the first week of August!
Ready for some random breastfeeding facts? Did you know...
- breastfeeding helps your uterus shrink back to its pre-pregnancy size?
- breastfeeding burns calories?
- you don't have to pump and dump?
- breastmilk has healing properties?
- the law requires employers to provide breastfeeding moms with reasonable time and space in the workplace to pump?
- breastfed babies gain weight differently than bottle-fed babies?
- lactation cookies are a totally real and delicious dessert?
- the World Health Organization (WHO) recommends "exclusive breast-feeding up to 6 months of age, with continued breastfeeding along with appropriate complementary foods up to two years of age or beyond."
- you can breastfeed an adopted baby?
- exclusively breastfeeding delays menstruation and can prevent future pregnancies (also known as LAM)?
- all mammals breastfeed? (see pics below)
Below is a little photo album I've thrown together of normal, everyday women breastfeeding. Some women are nursing infants, others are nursing older children. A few are even tandem nursing-- breastfeeding twins or two siblings at once. Breastfeeding is normal, and we need to embrace it in order for moms to have the confidence and proper support to nurse their babies! Special thanks to Weebly and the pictured families for sharing these photos.
(Click on thumbnails to view enlarged photos)
Support breastfeeding mums!
If you have any fun breastfeeding facts, feel free to share them in the 'Comments' section of this blog post. And, of course, if you would like to share a breastfeeding photo of your own, you can email it to me at Blissful.Transition@gmail.com
. Breastfeeding is normal and beautiful. Spread the love, y'all.
If you are showing the positive signs of labor (progressive contractions, water breaking, etc.), then a baby is working on making his/her way into this world! At this point in time, you may be feeling a couple of different emotions:
- With your birth team by your side, the know-how of your body in labor and birth, and the awareness of various positions and comfort measures, you may feel confident, excited, and optimistic about this new journey you are embarking on.
- While you are eager to meet your little one, you may also be anxious to get this show on the road. Different scenarios may be playing out in your head—good and bad. If you experienced a long pre-labor, you may feel exhausted or overwhelmed.
- Know that it is okay and normal to feel a mixture of these emotions. Having continuous labor support and the ability to make informed decisions will benefit you during this experience.
Dad supporting mama in labor
The Realities of Labor and Birth
Do you know what a laboring woman truly looks like? It’s okay if you don’t. Actually, I don’t know if there are a lot of people out there that really do. They may have never witnessed a live birth, or they have only been exposed to birth in the media (SO unrealistic
). Before I became a doula, I was very naïve. I was unaware of the impact of medical interventions on birth. I didn’t know there were moms out there that were opting for natural birth, let alone giving birth in their homes. I had no idea labors could last +24 hours. I didn’t even know doulas existed. I wasn’t aware that when your water breaks, you don’t have to rush to the hospital. And you definitely don’t have to labor in bed or push while lying on your back. If you already knew these things, how powerful was that moment when you were presented with the realities of birth?
Going to my first births as a doula was so eye opening and educational. From my experiences, I wanted to share some general information and tips that can help you better understand and navigate through this process: Childbirth is physiological.
There are so many hormones that come into play during labor and birth. If mom is feeling anxious or tense, adrenaline is released. This hormone can hamper labor progress, causing it to stall or stop all together. Laboring mamas need to feel supported—which will cause a release of oxytocin, the “love hormone.” Partners and support people: be in tune with mom’s emotions. Matching her mood and simply being present will positively affect labor progress. You can read more about the role of hormones in labor here
.Early labor can last a while and feel mellow or chill.
In early labor, distraction is KEY! Engage in regular, everyday activities until you can no longer distract yourself. Do you have a lunch date with girlfriends planned for today but are hesitant because you're in labor? Go ahead out and grab a bite. As one childbirth educator in our community says, you can get pretty fast service if you tell your waiter you’re in labor! ;) But really...take the dog for a walk, call your mom to chat, watch a movie or play some card games with your partner. Do whatever helps to pass the time. Remember that this is the longest stage of labor. If you can manage it, try resting or napping for a period of time. You want to reserve as much energy as possible for the more intense parts of labor. With that being said, eat light foods and keep up your fluid intake. Nourishing your body in the early stages of labor will prevent you from running on empty when you’re pushing your baby out.
Call your doula and let her know you are in labor. She may not meet with you at that very moment, but it’s nice to give her a heads up. By the time you are ready for her to join you and your partner, she will have all of her ducks in a row.If you’re planning a hospital birth, try laboring at home for as long as possible.
This will help decrease the chance of interventions. If you are feeling lonely or unsure, this would be a good time to invite your doula over. She can provide reassurance, perspective, and suggestions. If mom and baby are both healthy, there is no need for continuous electronic fetal monitoring (EFM).
When mom arrives at the hospital, the nurse will want to hook her up to the EFM for about 20-30 minutes. This is just to make sure mom and baby are doing well. Once she assesses mom and baby’s well-being, and everything looks okay, mom will be taken off of the EFM. Typically, the nurse will come in about every hour or so to get a quick reading (subsequent readings are much shorter than the one upon arrival). If labor is moving at a fast pace, the nurse will come in more often. EFM is usually considered necessary when other interventions are introduced, such as Pitocin or an epidural. At prenatal appointments with your care provider, ask for his/her opinion on routine practices and interventions. This may give you a good idea of what to expect once you go into labor. If you find that you are unhappy with the way your care provider handles things prenatally, try switching care providers! Unless you are nearing your due date, it is most likely not too late to switch.Eat to hunger and drink to thirst.
I know I mentioned this up above, but it is just so important to note once again! Most hospitals offer clear foods for laboring women. These include: jello, gummy bears, ice chips, popsicles, broth, etc. I encourage expectant mamas to pack light snacks in their hospital bags. Consider brings crackers, granola bars, fruits and veggies, etc. Not nourishing your body in labor can have adverse effects
on the laboring process. Movement and breathing are powerful coping mechanisms in labor.
Moms will find what works for them in labor, but I always find that breathing techniques and position changes really do the trick. There is no one right way to breathe, but as labor becomes more intense, mom may find that her breathing style changes. Just like transitioning from walking to jogging to running, heart rate and breathing patterns will pick up. Changing positions often will also help with labor progress and baby’s descent. What works in early labor may not work in active labor, and that’s okay! Women typically rely on more than one comfort measure and position to cope with labor pain. Active labor, especially while in the transition phase, is intense!
This is the part of labor that media loves to play off of. I always think of Alison screaming, “GET OUT” when giving birth in the movie, “Knocked Up.” Yes, the moments leading up to full dilation can be very intense, but mom may also turn inward. She may be very to herself, very quiet and focused on each contraction. Don’t be alarmed if she is very primal in her labor. She may be moaning, chanting, keeping a rhythm of some sort (Check out Penny Simkin’s write up on "The 3 R’s in Childbirth Preparation
" to get a better idea of coping rituals). In this phase of labor, support people often hear mom say, “I can’t do this anymore.” Mom may feel defeated and ready to throw in the towel, especially if she is exhausted. She may ask for pain medications or say, “If I could just go to sleep and wake up tomorrow, I could do this.” This irrationality is totally normal. Offer encouragement and remind her of your birth plan. Often times, laboring mamas get so caught up that they cannot see the light at the end of the tunnel. Remind her that you both are getting a baby out of this! It can be hard to keep that in perspective. There is a resting phase.
Before mom enters the 2nd stage of labor, the pushing stage, she may doze off. Support people may be surprised at her ability to relax after such intense and frequent contractions. At this point in time, mom’s uterus is playing catch up and will give her a “break” before she feels the urge to push. Know that this is completely normal, and if mom experiences this lull, encourage her to shut her eyes and rest for a moment. Typically, moms will get a second wind when it’s time to push, but any bit of rest until then will help!Visit the bathroom frequently.
This may sound like a "Duh!" statement, but a full bladder can cause labor to stall. If you feel like you have to pee, go sit on the toilet. If you don't, that's cool. But try out some contractions while you're sitting there. As humans, we have this natural instinct to let go when we sit on the toilet. Really opening up and relaxing may be just what you need to dilate fully. You never know!Mom can use spontaneous pushing to get her baby out.
When mom is fully dilated, she will be encouraged to push. Remind her to wait for that natural urge. Like I stated above, she may not feel that urge right away, and that’s okay. I think it’s said best in “Our Bodies, Ourselves: Pregnancy and Birth:” “Pushing your baby out works best when you do just what your body wants, without external direction. Bear down when you feel the urge. Your pushing efforts will be more effective and powerful if you push when your urge is the strongest. If you have an epidural and cannot feel the contractions well, your care provider and support people can help you identify when to push down.”
To get a better idea of spontaneous pushing, check out this video created by Mother’s Advocate
Last, but definitely not least, I wanted to briefly touch on the topic of informed decision making
. Understand that I offer these suggestions and details to help you decide what is best for you and your family, not to tell you the correct way of handling these events. Giving birth entails so much more than "having a healthy baby," and sometimes the people around a laboring/ new mom do not get that. My goal as a doula is to help moms and partners achieve satisfying birth experiences--whatever that looks like to them.**
When moms and partners are involved in the decision-making process, they feel more informed and empowered than those that do not. Giving birth is something that women do, not something that happens to them! Mamas, please remember that this is your body, your baby, and your birth!
**There is a lot to cover when it comes to talking about the process of labor and birth, and I know I didn't cover all of the details in this blog post. If you're reading this post-birth, what kinds of support did you benefit from during your experience? Were there specific comfort measures, positions, or mantras that got you through? Looking back, is there something you would have done differently? I truly appreciate you taking the time to share your personal stories.
Podcast: Birth on TV and the movies
WombEcology by Michel Odent
Our Bodies, Ourselves: Fetal Monitoring
Restricting Oral Fluid and Food Intake in Labor
The 3 R's in Childbirth Preparation
Get Upright and Follow Urges to Push (video)
Childbirth Connection: Informed Decision Making
In our last blog post, we discussed the ways in which your body prepares for labor. There’s usually a lot going on that we don’t even recognize as “progress.” For example, when you go into the office for a prenatal appointment and your doc says, “I’d say you’re about…one centimeter,” you might be thinking, “That’s nothing, and my due date’s in two days! This baby is never going to come out.” I’m here to tell you that there’s more to it than that. Don’t be too hard on yourself, and have faith in your body. It knows exactly what to do!
In this blog post, I will list the possible, probable, and positive signs of labor. Again, please remember that every woman is different. Some women experience lots of these symptoms, while others don’t even recognize when they’re experiencing pre-labor. It’s typically not until mamas look back, in hindsight, and think to themselves, “Oh…well I was awfully crampy that day, I visited the bathroom frequently, and I went to town cleaning our kitchen.” The symptoms listed below, of course, don’t promise a baby today or tomorrow. BUT the more symptoms that are present, the more likely it is that you are closer to entering the gates of Labor Land :)
Remember those cervical changes we talked about in the last blog post? Although they don’t promise labor to kick in tonight or next week, they are great signs of progress. Before your cervix can dilate, it needs to thin out. Your cervix will also need to soften and move forward in position, too.
You may experience some abdominal cramping, which could feel very similar to menstrual cramps. Sometimes this cramping will extend out to your thighs as well.
This nagging backache is different from the backache you may experience from long periods of being upright or standing. It can come and go, and it often feels like back pain associated with a menstrual period. You may feel like you need to change positions often to get comfortable. A warm rice sock or heating pad can do wonders for lower backache!
Jessica Alba, not fighting the urge to make her nest perfect.
“This house needs to be ready for our new arrival NOW!” says the mama who is nesting. This attitude is very typical for a gal who is nearing her estimated due date. Mamas: As much as you want everything to be perfect, understand that baby will not know the difference between messy and clean house or finished and unfinished nursery. Remember to take it easy!
Loose, frequent stools
This sign can be tied in with backache and cramping (like I stated earlier, this could just feel like you’re about to start your period). And guess what? It’s also related to those cervical changes happening in your body. When the cervix thins out, or effaces, it releases prostaglandins. Increased levels of these hormone-like substances will also make you poop. Although not fun, it’s totally normal to experience an upset stomach and multiple trips to the bathroom before labor begins.
Non-progressing contractions (Braxton-Hicks or Pre-labor contractions)
Many people call these contractions “false labor,” but there is nothing false about it! These contractions may not dilate your cervix, but they help it to efface, soften, and get into an anterior, or forward-facing, position for labor and birth. These contractions are “non-progressing” because they are not longer, stronger, and/or closer together.” Often, they will begin when you’re up and moving and will slow down or completely stop when you change activity. Here’s a great example of a gal experiencing Braxton-Hicks:
“Today, I went out for a walk with my husband. I began to feel a tightening in my abdominal area, which I thought were contractions. We took note of how often they came and went, excitedly hoping this was the real thing. They lasted about 30-40 seconds and came every 10 minutes or so. By the time we got back to our house, I was exhausted. When I climbed into bed for a nap, I noticed that the contractions came less and less...and eventually stopped. I felt a bit disappointed, but after discussing with my doula, we decided I was experiencing Braxton-Hicks.”
Braxton-Hicks may occur on and off for hours or even days before labor really kicks in. Try not to stress too much, and carry on with normal, everyday activities. Distraction will be your best friend in pre-labor and early labor!
Losing your mucus plug/experiencing bloody show
This is exactly what it sounds like. The mucus plug’s purpose is to block the cervix and prevent bacteria from sneaking up into the uterus and causing an infection. When a mama loses her mucus plug, it’s because her body is trying to clear the birth canal and make way for baby’s awaited descent.
The mucus plug is typically clear and may be pink, brown, or blood-tinged in color. Because there is an increase in vaginal discharge in pregnancy, sometimes women don’t even realize that they have lost their mucus plug.
Losing your mucus plug does not necessarily mean you are going into labor right now. But when it does happen, take note and let your care provider know at your next appointment. If you are really excited and want to share the news with someone, call your doula. If she is anything at all like me, she will love this info and share in your happiness! If discharge is bright red in color or there is a great amount of discharge, call your care provider. This could be a sign of complications that need taken care of right away.
I think her water just broke..
Water breaking (leaking or gush)
Are you surprised by this “probable” sign of labor? In movies and television, we often see women go immediately into labor after their water breaks abruptly. They are rushed to the hospital and have a baby in their arms in the next scene or two. Obviously, this isn’t very realistic, although there are women out there that experience fast and intense labors. Actually, only 1 out of 10 women begin labor with their water breaking. This is known as a premature rupture of membranes, or PROM. Typically, a woman’s water won’t break until she’s in the active phase or pushing stage of labor. Sometimes the water won’t even break at all! When this happens, baby is born in the caul
. Pretty amazing, right?
When your water breaks, you may experience a gushing or leaking of fluids. I’ve labeled “water breaking” as a probable and positive sign for this reason: Sometimes, labor may not begin spontaneously, or on its own, after mama’s water breaks. If this happens to you, your care provider will most likely want you to come in for a check-up. He/she may want to induce labor depending on how much time has passed since your water broke. Be sure to address this topic at prenatal appointments in order to better understand your care provider’s protocol regarding PROM.
Progressing = longer, stronger, and closer together. You will need to be experiencing at least 2 out of the 3 variables to label the contractions as “progressing.” As your contractions continue to progress, take notes. Where are you feeling them? How often are they coming? Are the contractions getting longer? These tidbits will help you better understand where you’re at in labor and when you decide to head to the hospital (if you are planning a hospital birth).
Water breaking (leaking or gush)
To add to the snippet above, if your water breaks and you begin to experience progressing contractions, you are in labor! Take note of when your water broke as well as the color and odor of the fluids. Amniotic fluid is usually colorless and odorless. If the water has an odor, it could be a sign of infection. If it is stained, it usually means baby has pooped in utero. This is not atypical for a mama who has gone past her estimated due date, but it could also be a sign of fetal distress. If your amniotic fluid contains a color or odor, it is best to contact your care provider to let him/her know.
If you have any questions regarding labor and birth, contact your care provider and/or doula. While your care provider can provide you with medical support, your doula will be there to offer emotional, physical, and informational assistance.
Stay tuned for the next part of the 'Labor Progress' series, as we will be discussing ways to keep labor moving once it's here!
Let’s talk about labor progress, shall we? I am in awe of how women work with their bodies during labor and birth, especially because of the major changes happening throughout the process. But labor progress isn’t an “all or nothing” type of thing. A pregnant woman’s body can begin to “prep” for labor long before baby signals, “I’m making my way out!” When an expectant gal visits her care provider days or weeks before her estimated due date, the main point of progress discussed is dilation. But there is so much more to it than that! If you want to know more about your baby and the changes happening in your body, think about talking with your doc or midwife about these questions:
| |What position is my baby in?
I cannot emphasize enough
how important positioning is! The position of your baby in utero will influence labor and birth much more than baby’s size. That’s right. All you ladies with small hips and measuring 5 feet tall, you can totally birth a big baby. But what if that big baby is posterior…or breech? That’s where things may get difficult. Getting baby into an optimal position (left occiput anterior
to be exact) can make labor go much more smoothly. I could go on and on about this subject, but it truly deserves to be a blog post in itself! If you’re looking for more information on baby’s positioning, please visit the Spinning Babies
website. What position is my cervix in?
Throughout most of your pregnancy, your cervix will be high and posterior (pointing towards your back). As cervical progress is made, your cervix will eventually move down and take on an anterior position (facing forward). Robin Weiss, Lamaze Certified Childbirth Educator, recently stated
, "Many women can tell when the cervix begins to move around because when a vaginal exam is performed it no longer feels like the cervix is located near her tonsils." :)What station is my baby at?
The station of your baby is based on where the top of baby's head is located. Measurement ranges from a -4 station (high up or "floating") to a +4 station (baby is OUT!). Most of the descent happens during the pushing phase of labor.
| |How soft is my cervix?
Softening, or ripening, of the cervix will help it become more pliable. The softening is caused by a release of hormones and the production of prostaglandins. It is said that a non-pregnant woman's cervix feels like the firm tip of a nose, while a softened cervix feels like an overripe fruit. Fun fact: Semen contains prostaglandins and can make the cervix softer. You can learn more about this, as well as other natural induction techniques, on my friend, Kathryn's, blog post. Is my cervix effaced?
Effacement, also known as the thinning and shortening of the cervix, is measured in percentages. A cervix at 0% is not effaced at all; one at 50% is halfway effaced. A cervix that is 100% effaced is completely thinned out (you may hear of this cervix being “paper thin.”) The average cervix is 1-2 inches in length, but will shorten as it becomes more effaced. How dilated is my cervix?
Dilation, or opening, of the cervix is measured in centimeters (0 cm. being not dilated at all and 10 cm. being completely dilated). Most of us are unfamiliar with the structure or shape of the cervix, so it’s hard to picture exactly what complete dilation looks like. I like sharing this visual guide (below), because it gives you everyday items to compare dilation with.
Keep in mind that these things do not happen in any specific order. While it is nice to be informed of these changes, having one or more present doesn't promise a baby today, tomorrow, or even a week from now. If baby is not ready to greet the world, then it doesn’t matter if mama's cervix is 4 cm. dilated or 100% effaced. Babies don't care about their due dates. When baby has reached maximum growth inside of the womb and the placenta no longer meets her nutritional needs, that's when she will begin to let mama know it's time for her to be born.
Positioning, effacement, softening, and dilation of the cervix are four of the six ways that labor progresses. The first three may happen days or even weeks before labor actually begins. Once you are in labor, your cervix will dilate to completion (10 centimeters), your baby will rotate her head and tuck chin to chest, and her head will mold and descend to be born.
If you are pregnant and nearing your due date, please understand that there is so much going on in your body besides cervical dilation. The process seems complex, but your body knows just what to do. Trust it, nourish it, and be present. Your baby will be here in good time.
Please stay tuned for Parts 2 & 3 of "Labor Progress," as we will be discussing the signs of labor as well as how to keep labor moving once it's here.
Thanks for reading!
Do you have a little something you love throwing together in the kitchen?
The Bloomington Postpartum Doula Collective
(BPDC) is asking families from the Bloomington Area Birth Services
(BABS) community for their favorite recipes and the memorable stories that go along with them. Recipes may be ones such as: your favorite dish during pregnancy, a nourishing meal that was cooked for you in the "fourth trimester" by a loved one, a fun snack you love to create with your toddler, etc. Once the recipes and stories are compiled into one, lovely cookbook, copies will be available for purchase. Profits made will go towards postpartum support for families through the Lactation Center
If you have a story to share, and a recipe to go along with it, please send your contribution to firstname.lastname@example.org. Don't forget to let us know how you would like to be credited (First name only, initials, first and last name, etc.)
The BPDC looks forward to hearing from you!
Our secretary in "the big office building," hard at work ;)
If you've recently found out you're expecting, congratulations! As you enter this new and exciting experience, you're most likely beginning to delve into all things pregnancy. Who will you hire as your caregiver? Do you want to give birth at home or in the hospital? What kind of support will you need after baby arrives? Okay, I know this type of question usually doesn't pop into your head until late pregnancy, or maybe until after baby arrives and you realize you're in a bit of a pinch. But really. You should start thinking about all things postpartum, too!
If you are expecting, I highly recommend hiring a doula. I guarantee you will not regret hiring her. It is her job to support you, to inform you of all options available, and to help you have a safe and satisfying birth and/or postpartum experience. I know, right? It sounds amazing. But how do you go about hiring a doula?
It's very possible that you might not even know where to look first, and that's okay. I don't believe that there are doulas listed in the Yellow Pages (at least not in Bloomington anyways), and we definitely don't all work in one big office building. But, personally, I think that's one of the best parts about doula work-- doulas come from all different backgrounds, bringing personality, compassion, and a diverse set of skills to the birth world.
There are a few different ways you can find a doula in your area. DONA International is the oldest, most widely known doula-certifying organization in the world. You can use DONA's doula locator
to find certified DONA doulas near you. Bloomington Area Birth Services' (BABS) website has a special page
dedicated to doulas who are currently taking clients in the Bloomington community. It is important to note that these doulas are not necessarily affiliated with BABS, although some may volunteer with BABS workshops and classes. You can also check in with the Birth Doulas of South Central Indiana
as well as the Bloomington Postpartum Doula Collective
, two groups of professionals that work with new and growing families in Monroe County and surrounding areas. Lastly, I believe that one of the best ways to find the right doula for you is word of mouth. Talk to your girlfriends, coworkers, and family members. Ask if they've had a doula's assistance for their birth(s), and if so, who did they work with? Why did they choose her? Keep in mind that the doula who was suggested may have been a good fit for that particular family, but she may not be the right labor/postpartum support for you.
Below is a list of questions you may want to address as you interview doulas. Like I said before, finding the doula who is right for you takes time and patience, but it is worth all of the hard work you put forth in your search. I encourage expectant parents to interview lots of doulas in their community before choosing the one that they mesh with the best. Remember that this person will be with you during most of your labor and the birth of your baby, or she may be in your home helping out 3-4 days a week for 2 months. Make sure you feel at ease in her presence; if not, keep searching! If possible, start looking for a doula, whether it be for birth, postpartum, or both, by your sixth or seventh month of pregnancy. This will allow you plenty of time to consider your options and find the best fit!
- Are you available around my estimated due date? I say "estimated" here because it is not set in stone, gals! On average, first time mamas go into labor 8 days after their due date. Please keep that in mind as your due date nears. Instead of only focusing on baby's predicted birth date, pencil in another something special like seeing a new film or going out to dinner with your partner. This will help take the edge off of things when people start noticing you're still pregnant 1 day after your due date.
- For birth doulas: What is your birthing philosophy? For postpartum doulas: What is your philosophy on parenting and supporting families? Note not only what she is saying, but how she is saying it. Is her body language warm and welcoming? Giving birth can be a very vulnerable time for a woman. The doula needs to be a person of trust and comfort. The same goes for those first few days, weeks, or months postpartum.
- How did you get into this line of work? I think it's always fun to hear about this stuff, and there are multiple paths that can lead a person to this work. It also makes you feel more connected to an individual when you know a little more about them other than their occupation.
- How many clients are you working with the month I am due? Doulas usually take on 2 or 3 clients a month. Women rarely go into labor at the same time, so there is a good chance your doula will be completely available for you when you need her. But, things do come up: Illness, a family emergency, and so on. In that case, your next question should be:
- Do you arrange for back-up support? Your doula should always arrange for back-up support! In my private practice, I arrange for back-up assistance in one of two ways: The client interviews multiple doulas, hires me, and then arranges for another favorite to be back-up OR I send out an e-mail to a few doulas in the community who I know and trust and ask them for their availability. My client will then meet the back-up doula sometime before their pregnancy is over. This could be over coffee or at one of our prenatals. It's totally up to the client on how they want to handle it.
- What kind of training do you have? Training will vary from doula to doula. There are multiple doula certification programs out there today (DONA, CAPPA, and toLabor are just a few of them). I would highly recommend working with someone who is at least trained. If she is certified, you should be able to look her up and find that that's really the case. Please keep in mind that if she is just trained but not certified, that does not mean she's not fit for the job. We all have to start somewhere, and trained doulas need the experience to get certified. :)
- How many families have you worked with? Good to know. Talking about her amount of professional experience can lead you to this question:
- Can I speak with a few of your recent clients? You will feel at ease if you chat with a few of her previous clients and hear they had great experiences with her. It's a peace of mind thing.
- For birth doulas: Have you worked with [insert your doctor/midwife's name here] before? Chances are, you're asking this to see if the doula meshed well with your care provider. Or you just want to get an idea of how he performed in labor and delivery. For example, did he stick to your previous client's birth plan?
- What is included in your services? Doula services can be different in many ways, but here are the basics: She meets with you prenatally X amount of times so that you can discuss your birth preferences, practice comfort measures, etc. She is on-call for you for X amount of time. She will labor with you at home or when you arrive at the hospital. She will stay with you until after the baby is born and breastfeeding is established. She will visit with you 1-2 weeks postpartum to see how your new family is doing.
- Do you offer any additional services? A doula may offer additional services or packages along with the basics you just read above. Doulas may provide massage therapy, lactation support, childbirth education classes, belly casting, etc. Ask her if she has any special packages or rates. Think about ways that you can enhance this experience and make it memorable. A cast of your belly on baby's nursery wall would be a nice keepsake, wouldn't it?
- What is your experience with breastfeeding support? It's important that your doula understands the benefits of breastfeeding, for both mom and baby. She can help you to advocate for your family after baby is born. In those immediate moments postpartum, she will remind you to keep baby skin-to-skin, help with breastfeeding positions, and evaluate the latch. She will be your extra set of eyes and hands, especially if your nurse is busy checking on other patients.
- For birth doulas: What is your favorite labor-coping technique? Asking this question can help you better understand the comfort measures and relaxation techniques your doula may introduce in labor. It can also help you understand what you like and don't like (although this can change in labor-- so make sure your doula has a plethora of suggestions :).
- What is your fee? Do you have a refund policy? The answer to this question typically revolves around the doula's experience and location. Postpartum doulas typically charge around $25 dollars an hour for their services; however, those who are still working towards certification may charge a lesser amount. Some birth doulas offer free services, whereas others may charge up to $1,000 dollars per birth. Some doulas may also offer payment plans or gift certificates, which can be a fabulous baby shower gift! Refund policies vary for each doula, so make sure to ask about details regarding her services.
When you feel like you've found the doula that's right for you, your last question will be something along the lines of,
"Will you be my doula?"
Congratulations once again and good luck on your birthing journey!!
Photo credit: Weebly Photos
First, I just want you to take a moment to re-read the title above and realize how awesome it is, period
, a comical blogger, shared with readers the advantages of breastfeeding in honor of World Breastfeeding Week this past August. Of the top 10 advantages, one was “You always win.” She then went on to share an example of this advantage with a fictitious dialogue between her and her husband:
B: What a hard day at work. Let’s watch the game.
Me: It was such a hard day keeping our son alive with my own body. Let’s watch 3 hours of The Bachelorette.
B: (hands over remote)
Laughs aside, this is AMAZING! I think it’s unfortunate that the human body is often underestimated of its capabilities; however, our bodies as females are designed to birth, provide for, and nourish our babies. Side note to expectant parents: let remnants of this simplicity carry over into your first few months of parenting. Your head is probably spinning with conflicting information from the media, family and friends (who usually mean well when dishing out advice), and health care professionals in regards to parenting. Please know that you don’t need lots of fancy things to make your baby happy. Newborns love to be held close and to hear your voice. Keep your baby near, preferably skin-to-skin, and you can never go wrong.
Your Changing Body:
Throughout your pregnancy, your breasts are preparing for your baby’s grand entrance into the world. Hormones such as estrogen, progesterone, serum prolactin, and serum placental lactogen are hard at work, causing growth in your breasts’ ductile network. During pregnancy, your breasts will become larger and your nipples and areolas will change in color or size (Cregan, Hartmann, 1999). Your breasts will also begin to produce colostrum, the first milk your baby will receive, which may or may not leak during your last few months of pregnancy.
Your colostrum will soon change into transitional milk, between 15-45 hours after baby’s birth, and lastly into mature milk, around 2 weeks postpartum (Kent, 2006). Human milk contains many macro and micro nutrients that help to sustain your baby’s energy and promote physical and mental growth and development.
| |Colostrum and it's Quirks:
- It’s available in small amounts. Coincidentally, your baby’s stomach is small, so it really doesn’t need much in order to feel full. The small amount of colostrum per serving also helps your baby learn how to suck, swallow, and breathe at the breast
- It's loaded with living cells that coat your baby’s gut, protecting it against foreign antibodies.
- It helps your baby pass his/her first stool, also known as meconium. Colostrum has a laxative effect. It rids the body of meconium and prevents the development of jaundice.
- Breastmilk made for preterm babies has higher levels of various proteins (IgA, lysozyme, and lactoferrin) that protect baby’s immune system (LLLI, 2011).
| |Breastfeeding can help protect your child against:
- Ear infections
- Intestinal upsets
- Dental problems
- Certain cancers
- Asthma, allergies, pneumonia, and other respiratory problems
(LLLI, Benefits of Breastfeeding
Photo credit: Busy Mommy Media
Breastfeeding can provide pain relief to babies (keep your little one at your breast while newborn procedures are being done after the birth) (Yamada, 2008). Breastfeeding also improves a child's cognitive and language development as compared to children who were not exclusively breastfed (Kramer, 2008).
As you can see, your baby benefits from breastfeeding in many ways. Not only because of it's protective factors against illness and infection, but because breastfeeding promotes bonding between mother and baby, too! Breastfeeding is not just a way to feed your newborn; it deepens your attachment to him/her as well. When you breastfeed your baby, your body releases oxytocin and prolactin, hormones that help “let down” your milk and deliver it into your baby's mouth. These hormones are also responsible for the blissed-out buzz you get when you breastfeed, causing relaxation and a desire to cuddle with your baby. The release of oxytocin also helps your uterus to contract and shrink back down to its pre-pregnant size. As luck would have it, your uterus isn't the only thing that reduces in size when you breastfeed. Most women typically lose inches in their waistline when nursing their babies (LLLI, 2010). That's right...breastfeeding can help you fit into those clothes you wore back before you were known as “Mommy.”
Okay, not this far "back." And damn you, Carrie Bradshaw, for getting away with wearing this crap.
Melissa Joan Hart, looking healthy many months postpartum.
If you breastfeed your baby exclusively (not providing any other food or drink except breastmilk) and often (remember to watch your baby and not the clock!), your period is not likely to come back for at least six months. This contraception method, known as the Lactational Amenorrhea Method (LAM
), is 98-99% effective when used correctly. When you nurse based on your baby's feeding cues and “empty” your breasts when they feel full, you are following the process of supply and demand. Basically, your baby is removing the milk from your breasts in order to allow more room for new milk production (known as “galactopoiesis”...how about that for your 'Word of the Day?').
So, let's recap: Mom is bonding with baby, losing weight, and not experiencing a monthly period? Pretty impressive, but the benefits don't stop there. Moms who breastfeed are also at a lower risk of developing breast, uterine, and cervical cancer. They are also at a reduced risk of developing diabetes and osteoporosis (LLLI, 2010). New studies
even show that moms who breastfeed actually get more sleep than moms who do not.
Last, but definitely not least, we should stop and take a second to think about how breastfeeding can influence society as a whole. I've often heard many times before, "Breast is best," but I disagree. I know, I know. You're thinking, "Ummm..Lindsey? You just listed one million reasons why breastfeeding is fabulous. Of course you think breast is best."
Actually, breastfeeding is the norm, not "the best." Like I stated earlier, women's bodies are designed to feed their babies. And it's not just about baby's nutrition, but the strong relationship that develops between mom and baby, which eventually spills over into the relationships that exist in our communities. Unfortunately, our society has lost sight of the practicality of women's breasts, focusing more on their sexuality instead. This can make it hard for women to breastfeed in public or even discuss using a breast pump at work with their employer (Pumping moms are allowed time and space in their workplace according to the law
, by the way). If you happen to catch a mom breastfeeding in public, cheer her on. Tell her that she's doing a great job. I believe that we need to embrace breastfeeding in order for moms to have the confidence and proper support to nurse their babies. After all, they're filled with too much goodness to not utilize, right?
And for one last laugh....
Photo credit: Baby Blues
- Cregan, M, Hartmann, PE. Computerized breast measurements conception to weaning: clinical implications. Journal of Human Lactation 15:89-95, 1999.
- Kent, J. Et al. 2006. Volume and frequency of breast feedings and fat content of breast milk throughout the day. Pediatrics 117(3): March 387-395.
- LLLI~ Colostrum
- LLLI~ Benefits of Breastfeeding
- Yamada, J, et al. 2008. A review of systemic reviews on pain interventions in hospitalized infants. Pain Res Manag. 13(5):413-20.
- Kramer, MS, Et al. 2003. "Infant growth and health outcomes associated with 3 compared with 6 month exclusive breastfeeding." Am J Clin Nutr. 78(2); 281-5.
- Wiessinger, Diane, Diana West, and Teresa Pitman. The Womanly Art of Breastfeeding. London: Pinter & Martin, 2010. Print.
- United States Department of Labor
- Doan, T., A. Gardiner, CL Gay, and Lee KA. "Breast-feeding Increases Sleep Duration for New Parents." PubMed. 2007.
1.) Spent time with Baby C on Monday and Friday. She is fighting a cold and is a total snuggle bug. Of course I want her to recover soon, but I don't mind the extra lovin.' I adore that little human. 2.) Attended the second half of my Lactation Specialist course. Took the exam on Thursday. I passed! That's right. I am a Certified Lactation Specialist! I am hoping to blog more about my experience and all that I learned in the near future.3.) Took part in the Volunteer Doula Program training at BABS on Saturday. Loving my fellow doulas and looking forward to helping out expectant families in the Bloomington community! (This program is geared towards providing free birth doulas to women who may not otherwise have access to supplemental support during pregnancy, birth, and the postpartum period). If you're interested in the details of this program and would like to learn more, please email Molly Mendota, the Program Supervisor, at email@example.com.) Put together some festive goodies (including Christmas gifts, 'cause my craftiness blossoms during the holidays), and decorated for Christmas with my sweetie. I know you're dying to find out what I made.
Our Christmas tree in progress! We still need to string on a few more beads and buy a topper and tree skirt..
Newest addition to our ornament collection! Says, "Doulas support your labor of love." Thanks, YourDoulaBag! (www.yourdoulabag.com)
.....Other not so important, yet noteworthy moments:5.) Tried to utilize the powers of my iPhone with voice control. As I'm driving down the road, I push down the button and say, "Call Kelsey." A robotic and monotone voice comes back saying, "Playing-songs-by-TLC." Mission not accomplished while "Ain't to Proud to Beg" plays on.6.) A little boy approaches Kelsey in the cosmetics aisle in Target and states, "My heiny hurts." His mom soon walks up and says, "You don't need to share that with ev-ery-one!" I can't wait to have kids. Or....maybe I can.7.) Had my first experience with Thai food. Awesomeness. My Thai Cafe is bitchin'. Next stop: Esan Thai.8.) Decided that I want a boho chic wedding, thanks to Pinterest. No, I'm not engaged. That's neither here nor there. Floral head wreaths and the outdoors sound perfect. I guess the suspenders wouldn't hurt either. ;)9.) Caught up on all of my tv biz, including American Horror Story. Holy crap, this show is crazy! It's so twisted and bizarre, I just can't stop watching. Oh, and I have this weird crush on Tate...despite the fact that he's deceased, does naughty things in a rubber suit, and kills people. No big deal. 10.) Used our crock pot for the FIRST time in the new house. And by new, I mean we've lived here for 6 months. Didn't have a recipe (lack of eggs, milk, etc. makes finding one online quickly a bit difficult), so I just threw in some noodles, carrots, veggie broth, broccoli, green onions, sour cream, collard greens, and Parmesan cheese. We'll see how it turns out tonight for dinner. What are your favorite crock pot recipes? Would love to hear 'em!
Alright, I'm off to prep for a prenatal. Hope you all have experienced a wonderful start to December! Hugs to you!
Mama breastfeeding and wearing baby
Pregnancy, childbirth, and becoming a new parent present times of challenge and development, whether it be for the individual or the family. Annemarie van Oploo once shared, “Childbirth is a time when a woman’s power and strength emerge full force, but it is also a vulnerable time, and a time of many changes presenting opportunities for personal growth” (Schwegel, 2005). A new addition to the family requires extra physical, educational, and emotional support. A postpartum doula provides this care by offering a helping hand, a listening ear, and a plethora of resources. Her presence is invaluable and truly makes a difference in the lives of many new families.
There are multiple benefits to hiring a postpartum doula for the first few months after baby’s birth, a time also known as “the fourth trimester.” Research indicates that those who hire a postpartum doula make an easier transition at home after baby is born, which ultimately affects family members’ physical and emotional health. These individuals also experience greater parental satisfaction and fewer mood disorders (DONA, 2002). More specifically, families who acquire the help of a postpartum doula experience greater success with breastfeeding, greater self-confidence, and a smaller incidence of postpartum depression (DONA, 2002). The postpartum doula not only “mothers the mother,” but she also tunes into all family members’ needs. In fact, when the postpartum doula “mothers the father,” he is better able to take care of his partner so that she can adequately provide for and nurture their baby. For example, a large factor in breastfeeding success is a supportive partner (Giugliani, 1994). Simple acts such as partner providing snacks, extra pillows, and words of encouragement aid mothers in achieving successful breastfeeding relationships with their babies.
It is crucial that women and their families receive postpartum support, especially in North America. Our culture highly values independence, which in turn may lead many individuals to think they must handle their personal issues alone. Unfortunately, this matter carries over into the postpartum period and influences our society’s ideals of the “perfect parent.” The postpartum doula fills this void and prevents isolation from occurring. She becomes a crucial asset in certain situations: The family having no friends or family nearby to help, the mother experiencing a difficult birth, the mother giving birth to a premature baby or multiples, etc. The doula helps to foster a support system that families can utilize in the present and future.
According to DONA’s Standards of Practice, the postpartum doula provides support after the baby’s birth as well as up to three months in the family’s home. Certified postpartum doulas affiliated with DONA have completed a 27-hour workshop training, read an extensive list of books pertaining to the postpartum period, and created an informative list of local and national resources. They understand newborn characteristics and basic care, help with breast and/or bottle feeding, assist with light household organization and meal preparation, and provide sibling support if applicable. Their services have been evaluated by at least three families as well as a healthcare professional. Although she does not provide medical assistance, a postpartum doula can make referrals for other professionals if needed. A doula is a generalist, but she has the power to connect families with other experts in the community, helping families to feel cared for and educated.
According to DONA’s Code of Ethics, every woman who desires to have a doula should be able to have one. Doulas should set reasonable fees when working with clients. If a doula is not available for a mother who requests postpartum assistance, it is that doula’s responsibility to refer the mother to other doulas who are available (either through local resources or DONA). Follow-up with new moms is crucial in order to ensure they get the help that they need and deserve. When a doula decides to work with a client, she must demonstrate dependability. This involves creating and sharing a contract that discusses services provided, back-up support, refunds, fees, etc. Doulas should always maintain confidentiality when working with their clients. This simple action illustrates respect of privacy and will allow a mother to feel more secure in the care of her doula.
Bringing a new baby into the home not only presents physical challenges, but emotional and mental ones as well. Yes, all moms will have to recover from childbirth and experience sleepless nights, but they, along with other members of the family, will have to adjust their roles, too. Women are now mothers, men are fathers, and the only child is now a big brother or sister. Luckily, this transition will not be as unsteady with a postpartum doula’s guidance. Doulas steer new parents in their new roles as caretakers. When the doula models, demonstrates, and explains certain behaviors and techniques, parents (and siblings) receive concrete instructions and develop coping skills for working with the new baby (Kelleher, 2002). In this way, family members learn how to bond with and integrate baby into their family unit. By providing a nonjudgmental outlook, reassurance, and evidence-based information, the doula fosters independence and confidence in new parents. She helps them to feel empowered and adequate for this challenging yet rewarding new responsibility. Every family will benefit from a postpartum doula’s practical, yet special touch. A doula truly makes the difference!
*All content written and compiled by Lindsey Rupp. Please contact me before using anything found here. Photo Credit: Weebly Free photos.*
Dad & baby skin-to-skin
"DONA International – Code of Ethics for Birth Doulas." DONA International. 2005. Web. 20 Oct. 2011.<http://www.dona.org/aboutus/code_of_ethics_birth.php>.
"DONA International – Standards of Practice for Birth Doulas." DONA International. 2005. Web. 20 Oct. 2011. <http://www.dona.org/aboutus/standards_birth.php>.
Giugliani, E., Vogelhut, J., Witter, F., & Perman, J. (1994). Effect of breastfeeding support from different sources on mothers' decisions to breastfeed. Journal of Human Lactation, 10(3), 151-161.
Kelleher, Jacqueline. Nurturing the Family: The Guide For Postpartum Doulas. Xlibris, 2002. Print.
Kelleher, Jacqueline and Penny Simkin. The Postpartum Doula’s Role in Maternity Care: A DONA International Position Paper. 1998. A publication on the value of birth doula support.
Schwegel, Janet. Adventures in Natural Childbirth: Tales from Women on the Joys, Fears, Pleasures, and Pains of Giving Birth Naturally. New York: Marlowe &, 2005. Print.