C-section Expectations
The expectation of having a surgical birth may cause some anxiety due to the unknown. I hope this overview of what you may encounter during a c-section will allow you to stay calm and trust the process.
The expectation of having a surgical birth may cause some anxiety due to the unknown. I hope this overview of what you may encounter during a c-section will allow you to stay calm and trust the process. Also, it’s a good idea to find out beforehand exactly who can be with you at the birth. Are you permitted to bring your doula and your partner? If not, ask WHY. This may positively affect future consideration for other families.
On birthday, to help you stay confident and relaxed as you await surgery:
Realize that you will be meeting your baby soon!
If you become uncomfortable about anything at all, SAY so. Your care providers are there to provide info and assist you.
Stay relaxed by controlling your breath. Do this exercise with your birth partner/coach: breathe in for a count of 4 and exhale to a count of 8. Release the tension in your face, neck, and shoulders. Focus on relaxing your eyes, tongue, jaw, and hands. Sometimes it helps to do this by squeezing first the face/hands, etc. while breathing in and then exhaling to relax the body part. In addition, try this meditation exercise that is specific to c-sections and can be used in the pre-operative room and even the operating room (OR), if permitted. This meditation is to help you relax and PREPARE for a surgical birth experience.
This is a sweet time to cherish forever.
If you want keepsake photos, typically you can begin taking photos as soon as your baby is born. Be sure to take plenty more photos in the recovery area too since mom may be woozy or a bit out of it. The photos will memorialize the first meeting, feeding, and skin-to-skin bonding time.
In 2018, Birth Photographers from around the world contributed some of their best works to celebrate Cesarean Awareness Month (April) with this lovely compilation. I dare you not to smile, cry, and awe at the beauty of it all.
Questions for your medical care team:
What are your options for anesthesia (epidural, combined spinal-epidural, general)?
Is photography permitted?
Can the baby be placed on your chest in the OR while the surgery is finishing?
Can you have a mirror to watch the birth?
Can a clear drape be used so you can see your baby’s birth?
What postpartum pain management options are available?
Who will go with the baby if he or she needs special care? Your partner? If so, can your DOULA join you in the OR since “only one person is allowed in the OR at a time”?
When can bodyfeeding begin (if desired)?
The baby is born in the first few minutes of a c-section.
The rest of the nearly hour-long procedure is the repair. If your partner goes to the nursery with your baby, you will be alone during this period. Having a doula ready in the wings to step in can prevent you from becoming emotionally overwhelmed or frightened. So if the hospital tells you that only 1 person is allowed to be with you in the OR, you can ask if you may have your doula replace your partner when he or she leaves for the nursery. Your doula can remain with you throughout surgery and in the immediate recovery area.
What to Expect For a Surgical Birth
PRE-OPERATIVE:
After you arrive at the hospital, you will be given many documents to review and sign. About an hour later, you will go into a room or recovery / triage area. You will have blood work done and be given medications to neutralize the acid in your stomach. An IV will be placed in your arm. You may also have part of your pubic hair trimmed, not shaved.
INSIDE THE OPERATING ROOM:
Your abdomen will be scrubbed and the surgical instruments prepared. Drapes and curtains will be placed to prevent infection. Your arms will usually be placed on boards that stick out, away from your body.
SURGERY BEGINS:
The surgery starts by checking to ensure that you're completely numb in the area where the incision will be made. The layers are cut and dissected. These include your skin, muscle, fascia (fat), peritoneum, uterus, and amniotic sac. This part of the surgery is usually fairly quick 5-10 minutes compared to the overall length of surgery.
ACTUAL BIRTH:
You may feel pressure and tugging. Some people may feel briefly nauseated from the pressure or feel pain in their shoulder - this is referred pain. There isn’t much that can be done to alleviate this but it’s still important to tell the anesthesiologist what you’re feeling.
If you want to witness the moment your baby is born, ask that the drape is lowered for the moment your baby is lifted from your abdomen. (Some facilities have clear drapes - just ask.) Your partner and/or doula are usually by your head and can take photos if permitted.
POST DELIVERY:
If your baby is healthy, you can request to have your baby placed skin-to-skin on your chest with warm blankets covering both of you. Your partner, doula, nurse, and/or anesthesiologist can help facilitate this for you. Some babies will latch on in the operating room and others will require some feeding assistance during the first few minutes following their birth. Your partner can go to the warmer while your baby is evaluated. When possible, they will bring the baby back to you after the evaluation.
After the surgery is complete, your doctor will leave the OR and your nurses will move you from the table to a bed. Most people continue holding their baby during this shift, if not, the baby is placed in a rolling bassinet.
RECOVERY:
Your team moves down the hall into the recovery area. Your nurse will monitor you closely and may assist you with breastfeeding if a lactation counselor isn’t present. After 1-2 hours you, your baby, and your partner will move to the postpartum area where you all will stay the remainder of your time at the hospital which is usually 3-5 days.
To avoid blood clots from inactivity, you will be given special braces to wear that will squeeze your legs post-delivery. Your incision will be sore and most women experience great discomfort when first walking post-delivery. While uncomfortable, walking around will accelerate your healing process by increasing circulation and moving the muscles. C-section recovery is usually longer than that of a vaginal birth.
Following a C-section
It may take longer for your milk to come in compared to a vaginal delivery. Put the baby to breast as soon as possible post-surgery and breastfeed often to stimulate milk production. After you’ve returned home should you need breastfeeding help look online for a virtual lactation consultation, support group, or arrange an in-home visit from an IBCLC.
The incision scar is usually about 4 inches and located just above your pubic hairline. It will take about 6 weeks for it to heal. Oozing from your c-section scar should never smell foul, nor should you have red streaks. Ask your nurse how to care for the incision and wear underwear with a high waist that won’t irritate the area.
Bleeding for the first 6-8 weeks following delivery is normal. It is called Lochia (LOW-kee-uh). It will begin as a heavy flow of bright red blood that will gradually get darker and a bit yellowish then back to a normal color of vaginal discharge. Don’t have sex before then and only do so if cleared by your OB at your 6-week postnatal check-up.
When you are ready to engage in any type of sex, you may spray breastmilk if you’re bodyfeeding. Your breasts may be tender too so be sure to protect and cover them.
Support For The Parents
It’s important for BOTH parents to seek out support from other parents as many new parents will find themselves isolated from family members and friends. Find a postpartum support group NOW so you know who and where to turn to for friendship, connection, and help.
Best wishes for a great birthday and a smooth transition to parenthood.
To your continued health,
Cynthya
How To Create Your Birth Preference Sheet
Maximize your childbirth outcome with these suggestions for an effective birth plan.
A simple birth plan is important for several reasons. First, it serves as a clear communication tool between expectant parents and healthcare providers, outlining preferences for labor and delivery. This helps ensure that the parents' needs and desires are taken into account during the birthing process.
Second, having a birth plan can reduce anxiety for parents. It encourages them to consider various options, from pain management to post-delivery care, fostering an informed decision-making process. A birth plan aims to enhance health results by focusing on you during labor and delivery.
To work effectively, your care providers need to read your birth plan, so keep it short and sweet. Use the following tips to tailor your preferences when creating your birth plan:
Keep it brief. List only what’s most important to you. You can refuse any intervention when it is offered - just ask for the Against Medical Advice Waiver.
Make it easy to read. Avoid small fonts. Use bullet points and leave some white space.
Present it with food/gifts. Nurses work long hours and appreciate snacks. Consider building a small basket or gift bag of reasonably healthy snacks, such as cookies, fruit, crackers, cheese, nuts, etc. Chocolate is always a nice addition. Bring an additional basket for the postpartum nurses, too.
Make it relevant. The nurses don’t need to know that you plan to labor at home for as long as possible, or that you’ll delay newborn procedures until you’ve left the hospital - simply note whether you accept or decline medications and procedures.
Solicit help. Most doctors and nurses are in the health profession because they want to help; however, because they are in the medical profession, many haven’t witnessed an unmedicated birth. They may truly believe that routine interventions such as an epidural, episiotomy, I.V., catheter, etc. are all helpful to a birthing person. Asking for their help in avoiding such interventions may provide a different perspective.
Keep it positive and simple. Try to avoid the words and phrases that include no or don’t.
Finally, a straightforward birth plan can facilitate smoother interactions among the care team. Laying out key preferences clearly helps avoid misunderstandings and allows for better alignment with the medical staff's protocols. While flexibility is essential, a simple birth plan can be a valuable tool for supporting a positive childbirth experience.
Waterbirth Immersion Facts and Tampa Bay Provider Options
If birth givers have a strong desire for waterbirth, and there are care providers who are comfortable attending waterbirths, then at this time there is no evidence to deny this option of pain relief.
Waterbirth is a reasonable option for low-risk birthing people, as long as they understand the potential benefits and risks. If birth givers have a strong desire for waterbirth, and there are care providers who are comfortable attending waterbirths, then at this time there is no evidence to deny this option of pain relief. You can learn more about the current research on waterbirth safety, pain relief, and the reduced rate of severe tearing by reading the attached evidence. - Evidence Based Birth
Most clients do not have access to waterbirth or water immersion during labor because their birthing location does not have a waterbirth program in place. If you'd like to explore the option of waterbirth for your labor, you'll need to find a care provider with privileges to assist you at a location that offers waterbirth. This likely means you'd need to change providers for prenatal care and delivery.
In the Tampa Bay region, consider Morton Plant Hospital in Clearwater. It's a Bay Care facility and you can complete the form on this page to request a physician or Certified Nurse Midwife (CNM) who provide hospital waterbirth access. And because there is Florida State Licensure for Certified Professional Midwives, Tampa Bay has several birth centers offering waterbirth such as Breath of Life in Largo, and Sweet Child O' Mine in Brandon, or Labor of Love in Lutz.
Please reach out to me if I can help you further. I'm always happy to connect with you!
How To Avoid Discomfort and Prevent Pregnancy Complications
Research has found that people who exercise during pregnancy are less likely to have a c-section. As a bonus, pregnant people who exercise are also less likely to get an episiotomy and have a forceps delivery.
When starting an exercise regime during pregnancy, be sure to check with your doctor or midwife to be cleared for exercise first. If you are new to fitness or even a seasoned athlete, you may want to consider hiring a trainer to work with you throughout your pregnancy who focuses on prenatal/postpartum clients. They know what exercises to prescribe and you'll have the benefit of one-on-one attention as your body changes and grows a new life.
When a person has a great trainer, they'll learn how to breathe deeply through the core and diaphragm, which are breathing techniques that will be transferred over into labor and birth.
Many discomforts and pregnancy complications can be prevented or held at bay through proper exercising techniques. a) Gestational diabetes may be lowered, b) Constipation can be lessened because your body is pumping and activating your digestive system, and c) Less leg swelling because blood flow is improved through exercise.
Research has found that people who exercise during pregnancy are less likely to have a c-section. As a bonus, pregnant people who exercise are also less likely to get an episiotomy and have a forceps delivery.
Exercising during pregnancy teaches how to locate, feel, and strengthen the muscles of the pelvic floor, core, and surrounding areas. Not only does it help strengthen these areas, but when a person is properly trained in fitness during pregnancy, they will be taught how to relax those muscles as well. Learning to relax the birthing muscles is key and gives an advantage in how to let go during the birth, relax the pelvis, and allow the baby to move easily through the birth canal without fighting for control.
Extra weight gain and a changing body can negatively affect self-esteem and self-image. Exercising during pregnancy makes people feel good overall about themselves. Exercising during pregnancy is empowering and can lead to and help continue the discipline of exercising after birth. Now is the time to consider prenatal yoga classes in your area, enjoying daily walks outside in nature, or swimming in a pool or at the beach.
Consider working with a Pelvic Health Physical Therapist during pregnancy to prepare you for safe exercise and how to give birth without causing harm to your pelvic floor. Your therapist will be able to assess how your muscles are functioning and can guide you. The pelvic floor is the “floor of your core.” By keeping this muscle strong and functioning well, it will help you stay injury-free.
Resources:
http://americanpregnancy.org/pregnancy-health/effects-of-exercise-on-pregnancy/
https://www.fitpregnancy.com/exercise/prenatal-workouts/33-reasons-exercise-now
https://www.ncbi.nlm.nih.gov/books/NBK430821/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084336/
Why Hiring a Birth Doula-Photographer is the Best Choice for Capturing Your Special Moments
Birth Photography IS NOT the NAT GEO shot! (It can be IF that’s what you want.) Photographs of labor encapsulate the journey of bringing your child into the world. They show the bond of the parents, their anticipation for meeting the baby, and the fleeting memories of the baby’s first birthday.
As you prepare for the miraculous journey of childbirth, you may find yourself contemplating whether to hire a birth doula-photographer or just a regular photographer to capture those magical newborn moments. While both options have their merits, hiring a birth doula-photographer offers unique benefits that can truly enhance your labor and birth experience. Here's why:
1. Expertise in Birth Photography:
Birth is an incredibly intimate and emotionally charged event. It requires a skilled photographer who understands the dynamics of labor, the importance of timing, and the ability to capture those raw, beautiful moments seamlessly. Birth doula-photographers have specialized training in capturing the essence of birth, ensuring that every precious detail is artfully documented. They possess a deep understanding of the birthing process and can adapt to any situation, allowing them to capture the most powerful and heartfelt images.
2. Knowledge of Labor Support:
Birth doula-photographers are not just photographers. They are also trained birth doulas who offer emotional support, physical comfort, and advocacy during labor. This dual role allows them to intimately understand your birth preferences, anticipate your needs, and capture the moments that truly matter to you. Unlike traditional photographers who may be unfamiliar with the birthing process, birth doula photographers are well-versed in the intricacies of labor, enabling them to capture authentic and meaningful images.
3. Seamless Integration:
Hiring a birth doula-photographer offers the convenience of having two professionals in one. Instead of coordinating with a doula and a separate photographer, you can entrust your birth experience to one person who is committed to capturing the moments while providing continuous labor support. This seamless integration ensures a harmonious experience, allowing you to focus on bringing your child into the world while knowing that your memories are being beautifully preserved.
4. Respect for Your Privacy and Boundaries:
Birth doula-photographers understand the importance of maintaining privacy and respecting boundaries during such an intimate event. They have built strong relationships with their clients, cultivating a level of trust that allows them to be present without being intrusive. They know when to step back and give you space, ensuring that you feel comfortable and in control of your birth environment. With a birth doula-photographer, you can rest assured knowing that your birth journey will be respected and documented with grace.
Pros of Hiring a Birth Doula-Photographer
1. Preserves precious memories:
Birth is a profoundly transformative and emotional experience. The presence of a birth doula-photographer ensures that every precious moment, from the anticipation and labor to the first cry and the initial bonding, is captured in beautiful images that can be cherished for a lifetime.
2. Provides a unique perspective:
Birth photography captures intimate and awe-inspiring moments that might otherwise be forgotten or overshadowed by the intensity of the experience. The photographs offer a fresh perspective for both the birthing person and their family, enabling them to relive and appreciate the journey from a different vantage point.
3. Supports parental empowerment:
Birth can be a physically and emotionally challenging experience. Having a birth photographer present can provide an added layer of support and reassurance, helping the birthing person and their partner focus on the process while knowing that someone else is capturing the story.
4. Normalizes birth:
Birth photography, when shared with consent, helps normalize the reality of childbirth. By showcasing the strength, beauty, and vulnerability of the birthing person, birth photographs can educate and inspire others, promoting a greater understanding and appreciation for the journey of bringing new life into the world.
5. No additional cost:
Hiring a separate birth photographer can be an added expense to an already costly process. For families on a tight budget, the desire to document the birth through professional photography may not always align with their financial priorities.
6. Facilitates healing and closure:
In cases where birth doesn't go as planned or complications arise, having photographs can assist in the healing process by offering a visual record of the journey and providing an opportunity for reflection, closure, and growth.
Capture the Magic of Parenthood with a Birth Doula Photographer
I’ve attended over 600 birthdays, combining my skills as an experienced labor doula and a professional birth photographer. I’ll provide you with an unparalleled experience, capturing the raw emotions, tender moments, and joyous milestones of your journey into parenthood.
Nothing compares to the emotional impact of looking back at the photographs that encapsulate the journey of bringing your child into the world. Having these cherished memories shared with your child as they grow creates a powerful bond and a beautiful legacy for generations to come.
I'd love for you to review my photography portfolio.
If you’re in the St. Pete / Tampa area, schedule a free phone consult today about the combined service of doula support + birth photography for your BIG day.
How to Protect Your Mental and Physical Health During Childbirth
In the moment of bringing a new life into the world, a deep connection is etched in the hearts of all those who share in this sacred experience. It is a time of celebration, love, and boundless joy, as the world welcomes a new soul, and a family embarks on an enchanting journey of parenthood.
Birth teaches us to be flexible. After over a decade of doula work, I’ve helped hundreds of clients hone in on what their biggest preferences are for their baby’s birthday. Over the years, I’ve reviewed all sorts of birth plans. Which are the most effective I’ve found so far? The one that is most specific - written by the client who has prepared ahead of time on potential interventions and common procedures, but can turn to a trusted advisor and discuss plans B and C. In birth, the best plan is one that informs the birth support team on how to help you succeed.
Learn evidence-based options for childbirth. Get my help in preparing your birth partner to become the advocate and hands-on support person that you will need to succeed and enjoy Birthday. I’ll share my sample birth plans and a simple easy guide to writing your own. Our first prenatal meeting will afford you plenty of time to raise any concerns about the upcoming birth with your care providers, discuss options for labor and delivery, and get answers to your specific questions.
Avoiding Overwhelm While Staying Safe and Healthy
Expecting a baby during a pandemic is concerning, to say the least. Taking the necessary precautions to keep you and your family safe is paramount. But how does one prepare for the unknown?
Take some of your classes online. These include CPR through the American Red Cross, as well as a breastfeeding course. Be sure to enroll in a class that is LIVE and small so you can be sure to ask questions as they pop up.
Eliminate all unnecessary visitors for several weeks prior to and after birthday, especially if visitors must travel to you by plane. Make use of FaceTime, Facebook, and the good ol’ USPS to send notes and keepsakes.
Ask family and friends who wish to lend a hand in preparing for life with a new baby, to cook casseroles, bake breads and hearty soups, etc. so you can freeze these and use them as needed.
Have your resources on speed dial and don’t hesitate to call on them. These people include your doula, lactation specialist, pediatrician, therapist, bestie, and MOM. People truly want to help but don’t wish to give unsolicited advice so reach out should you need a shoulder or sage advice.
Stock up on baby items now. Have diapers in many sizes and/or some cloth diapers on hand just in case. Wipes, creams, soaps, etc.
Order your breast pump and make sure you have storage supplies now. Include bottles and pacifiers too. Get a few maternity/nursing bras and shirts, as well as pads, nursing pillows, and the like.
Request all care providers wear a mask when they are in the same room as you. This request should also be included in your birth plan to advise hospital employees of your wishes.
Be sure to carve out some time to enjoy your hobbies to unwind and have fun. May I suggest learning a new language? Baby sign language is easy to learn and teach to your baby. You’ll be amazed by the vocabulary they develop well before they are ready to use words and it helps minimize tantrums!
In the moment of bringing a new life into the world, a deep connection is etched in the hearts of all those who share in this sacred experience. It is a time of celebration, love, and boundless joy, as the world welcomes a new soul, and a family embarks on an enchanting journey of parenthood.
I’d love to help you along the way. Set a free consult with me now.
Placentophagy: Encapsultation, Smoothies, Truffles, oh my!
There's no current evidence that ingesting the placenta will provide any health benefit. The CDC advises against ingesting placenta in any form.
It's purported that ingesting placenta via encapsulation or chocolate truffle, fruit smoothie, or alcohol-extracted tincture, may naturally promote milk production, prevent postpartum depression, and speed healing. There's no current evidence that ingesting the placenta will provide any health benefit. If you are unsure if this long-time practice is right for you, keep your placenta on ice at the hospital and deep freeze it as soon as possible. You can encapsulate your placenta up to one year after its birth.
The CDC advises against ingesting placenta in any form. Placentophagy can be harmful to you and your baby. Here's a link to more info on their site. Right now, we don’t know if placentophagy has any effect on postpartum depression, and if any effect that it may have, maybe due to the placebo effect. More info is posted here in the National Library of Medicine.
Afterbirth Anywhere provides a clinical approach to placenta encapsulation services that protect the integrity of the placenta throughout the process. With trained specialists and a dedicated workspace designed solely for placenta encapsulation, their services are efficient and can process a placenta in less than 20 hours. Their specially designed workspace allows for better sanitation than an at-home kitchen, it also protects the placenta and those in the mother's family from unintended exposure to contaminates in a busy home.
Afterbirth Anywhere uses temperature-controlled equipment to ensure the placenta is not degraded by exposure to high temperatures or variations in temperatures. Their encapsulation process ensures that each capsule has a consistent amount of finely ground placenta to allow for proper dosing. It’s important to note each pill should contain pure placenta with no herbal additives that may cause unexpected side effects rendering the pills unusable.
For more information and to make your purchase, please visit Afterbirth Anywhere, a partner provider of The Happiest Doulas. We have chosen to partner with Natural Afterbirth due to their efficiency and professionalism. For your safety, we strongly advise you to research your placenta processing options and choose a well-known and respected company such as Afterbirth Anywhere and we'd appreciate your telling them that we referred you.
Episiotomy, Tears, and Perineal Support
Learn how to keep your perineum intact during the pushing (second) stage of labor with these recommendations. A video is included to help you safely use warm compresses.
Vaginal births are often associated with some form of trauma to the genital tract, and tears that affect the anal sphincter or mucosa (third- and fourth-degree tears) can cause serious problems. Perineal trauma can occur spontaneously or result from a surgical incision (episiotomy). Different perineal techniques are being used to slow down the birth of the baby's head, and allow the perineum to stretch slowly to prevent injury. Massage, warm compresses and different perineal management techniques are widely used by midwives and birth attendants.* Read the evidence here.
In an article by Evidence Based Birth about optimal birthing positions for the second stage, a recent 2017 Cochrane review and meta-analysis, Gupta et al is referenced. The analysis combined the results of 32 randomized, controlled trials that included more than 9,000 birthing people in hospital settings. In comparison with non-upright positions, people who were randomly assigned to upright positions in the second stage of labor were:
25% less likely to have a forceps or vacuum-assisted birth
25% less likely to have an episiotomy
54% less likely to have abnormal fetal heart rate patterns
More suggestions to limit tearing during the second stage of labor
Support your skin throughout pregnancy. Avoid processed foods, focus on nutrition, and eat a well-rounded diet.
Plan on a waterbirth or water immersion for a long period of time right before delivery. Explore what underwater birth can offer and seek out medical facilities and care providers that offer inflatable tubs or birth pools for labor and delivery. For further reading on waterbirth, checkout this article from Evidence Based Birth.
Get off your back for the pushing phase. Squat, kneel, stand or lay on your side.
Breathe the baby down and focus on completely relaxing your pelvic floor. Bear down gently when you feel the urge to push at the peak of a contraction. Use mind-body relaxation techniques such as guided meditation (hypnosis).
If an epidural is used, you likely will not feel an urge to push with contractions and must be directed how to push and how long to do it for. This is called purple-pushing or Valsalva pushing, and increases your risk of tearing and/or for the need of an episiotomy and perhaps later on, other issues such as urinary incontinence.
Read about natural tearing when pushing verse a midline or medio-lateral episiotomy. The degrees of lacerations are explained and photos are posted.
Since the current evidence shows there may be a benefit to applying warm compresses to the perineum during the crowning phase/second stage of labor, you may wish to discuss this option with your care providers. Many people looking to use this technique will have to apply it themselves. (Another role for your partner.)
The below video explains how to use warm compresses safely. Discuss this method with all of your care providers before labor begins. During labor, talk to your nurses (and later, the OB or midwife) about using warm compresses (wet washcloths) to support the perineum during the crowning phase. Compresses are used during contractions and many washcloths will be needed as well as an electric kettle and a large bowl. While the hospital can provide several washcloths to you, MANY will be required. I suggest you purchase a few bundles of pre-cut cloths made from a soft material, which will be disposed of after use.
Resources:
https://www.cochrane.org/CD006672/PREG_perineal-techniques-during-second-stage-labour-reducing-perineal-trauma
https://evidencebasedbirth.com/evidence-birthing-positions/
https://www.dona.org/blogacog-supports-limiting-interventions/
Labor Tips for Birth Partners
Doula tips for labor: As your due date approaches, your partner may be feeling some anxiety over how to best support you during labor. The following seven points are what I typically suggest to worried partners.
Labor and Birth Tips From a Doula
As your due date approaches, your partner may be feeling some anxiety over how to best support you during labor. The following seven points are what I typically suggest to worried partners.
My most common suggestion to clients during late pregnancy is to stay informed, rested, and positive. Create a bubble of peace around you! I suggest self-care by relaxing with music, hypnosis, aromatherapy, and hydrotherapy.
While a client is at home during early labor, I typically suggest that she enjoys a long, warm bath to relax her muscles completely so she might be able to sleep between contractions when she returns to bed. It is important for her to rest and allow labor to advance on its own. Skip the shower until you’re at the hospital - it may both comfort you and speed up labor. Keep reading for more tips and reminders for an optimal perinatal experience.
1. Learn to time contractions.
Download an app to your smartphone to accurately time contractions. I like the Full Term app but anything will work, even a kitchen timer and notepad. To get the hang of it, practice before labor begins.
When I'm called to help at a labor, I ask how far apart the contractions are currently (frequency), how long each contraction lasts (duration), and for how many hours the timing has been recorded. I often ask for screenshots too.
2. Know the stages of labor.
The Birth Partner is an excellent guide for anyone supporting labor and birth. It covers the role of each member of the birth team, medical interventions, and natural approaches, and what to expect in the event of a necessary c-section. Labor is divided into four stages:
Stage ONE is further divided into three phases:
Phase I: Early labor also called the latent phase.
Phase II: Active labor (5cm or 6cm dilation to 8cm)
Phase III: Transition (8cm dilation to 10cm or "complete")
Stage TWO: also called the pushing stage.
Stage THREE: the birth of the placenta.
Stage FOUR: the hour after birth.
3. Don't take anything personally.
People communicate with their whole body during labor and swatting a hand away, etc. is common! I once witnessed a partner getting his face “palmed” and pushed away so his partner could continue making eye contact with me. We all laughed about it later and nobody had hurt feelings.
4. Keep relaxed, rested and nourished.
Provide water, decaf tea, or diluted fruit juice and nibble on easily digestible foods. Play music, suggest several long baths, and between contractions, give a foot massage or two. Stay positive and remember true labor will progress on its own without taking long walks to "get things moving." Labor is a time to conserve energy and to sleep between contractions; every bit of accumulated sleep helps to combat fatigue for active labor and transition.
5. Be supportive and present.
Binging on shows during early labor can be a necessary distraction for the person in labor but avoid watching TV by yourself or using your smartphone unless it is being used to time contractions to track labor. Focus on your partner and assign a trusted family member the task of updating friends/family on the day's progress.
6. Get support for the immediate postpartum period.
Any help is appreciated when a new baby arrives! Postpartum doulas are trained to facilitate the bond between parents and baby and recognize the signs of postpartum depression. Such doulas or infant care specialists will assist your family with light housekeeping and meal prep, providing a much-needed extra pair of helping hands!
Have the contact info of a local Lactation Consultant on hand. Let's face it, breastfeeding can be difficult and new parents need expert help at a moment's notice. Ask your doula, OB, or midwife for a referral.
7. Know the signs of postpartum depression.
Here’s a list of symptoms of postpartum depression and anxiety. Educate yourself and take action before a problem embeds itself - call a therapist and schedule an appointment immediately when you suspect help is needed.
Give Gentle Reminders and Trust The Process
It is intuitive for a person's body to move throughout labor and to test multiple positions to strike the perfect balance of comfort and progress. To keep the body loose and limp throughout contractions, focus on the wonderful breaks in between. As a break ends, take a deep cleansing breath, drop the shoulders, and wiggle the jaw or open the mouth. If standing or using a birth/balance ball, keep hips swaying or circling. Movement, open-pelvis positions, and a relaxed body help the cervix open faster and shorten the overall length of labor.
The positions shown here facilitate the normal, natural process of labor. Keep in mind that you'll want to encourage a position change every hour to stretch (unless the coveted nap takes hold.) I also suggest clients empty their bladder every hour or two and labor on the toilet for 10-15 minutes each visit.
I'd love to show you how I can positively impact your pregnancy and childbirth experience. The next step toward having a happy birthday is to request a free consultation. For the best birth outcome, secure doula service - virtually or in-person if you’re local to Tampa. I'd be delighted to help you.
Want to see the evidence on doula support for labor? Take a look at this handout from Evidence Based Birth.
Online Class: How To Prepare Your Partner For Labor
The Institute of Medicine says it takes on average 17 YEARS after new research is published for medical professionals to change the way they practice.
Attribution: Lamaze International
The Lamaze Healthy Birth Practices are the foundation of Lamaze. These Birth Practices are designed to help simplify your birth process with a natural approach that helps alleviate your fears and manage pain. Regardless of your baby's size, your labor's length and complexity, or your confidence level, these care practices will help keep labor and your baby's birth as safe and healthy as possible.
Get Evidence-Based Information for Childbirth
The Institute of Medicine says it takes on average 17 YEARS after new research is published for medical professionals to change the way they practice. Don't get stuck with outdated practices for your baby's birthday! Whether you plan to deliver naturally or have medication during labor, this private class will help you be prepared when you walk through those hospital doors. You'll learn:
how to get evidence-based care to optimize your birth outcome
labor comfort measures and positions for progress
how to reduce your risk of a c-section
relaxation practices and other labor tools for partners to use
Access to the online Learning Center
Get my tips collected from years spent helping clients throughout childbirth. Aim to take this birthing class between the 32nd and 38th weeks of your pregnancy so you have time to prepare your preferences for labor and delivery. The online class is NOT pre-recorded, which means that you’ll be able to get immediate answers to your questions.
Continuous labor support is an essential component of safe, healthy care during labor and birth.
All women should be allowed and encouraged to bring a loved one, friend, or doula to their birth. This is difficult during Covid as many hospitals have new policies in place restricting additional support people with bans altogether or limited visiting hours. In response, I’ve provided many people with birth coaching throughout labor with remote guidance. Let’s explore this option together during a free consult by phone. Schedule this at your convenience here.
To ensure that you (and your partner, if you have one) have a healthy birth experience that you will positively look back on for years to come, learn your options for childbirth. I’ll show you how to prepare for labor with evidence-based information and positions for comfort and progress. You’ll increase your confidence and knowledge of how to handle any obstacle that may come your way on birthday.
Vaginal Exams Don't Predict Labor
A cervical exam may show that you are 3cm dilated but it could still take weeks before labor starts on its own. Some clients experience latent labor for days (or prodromal labor for weeks) following an exam - they cramp and bleed with mild contractions that keep them awake at night but doesn’t result in labor beginning.
It's important to remember that you have the right to decline a vaginal exam if you don't feel comfortable with it. Simply staying dressed or politely saying "No, thanks" is enough to assert your choice. Always prioritize your comfort and autonomy during prenatal visits, and seek more information if needed to make informed decisions about your care.
Cervical exams during pregnancy, particularly in the later stages, are often seen as a routine part of prenatal care, but they can be uncomfortable and sometimes lead to unnecessary stress or interventions. These exams can introduce bacteria, and lead to an infection, as well as cause premature rupture of the membranes (breaking the waters).
Many women can feel pressured by their healthcare providers to undergo these exams, even though they may not provide significant information about when labor will begin. For instance, being told you are 3cm dilated doesn't necessarily mean labor is imminent; it could still be weeks away! Additionally, some women experience discomfort or even complications, such as cramping or bleeding, after an exam.
"Clients often misinterpret the residual symptoms of a vaginal exam for signs of labor starting on its own." - click to tweet!
Unless you are in labor or about to be induced, knowing your dilation or effacement is not too helpful. The exam may even hurt, or cause later issues. So why do many endure this highly inaccurate assessment? They felt pressured by their care provider. Often times I hear, ‘I know it doesn’t tell us much, but I just really wanted to know how dilated I was.’
Once upon a time, a client called me in tears stating that during an exam at her 41st week appointment, her OB stripped her membranes without her permission to get things going. Ouch!
A cervical exam may show that you are 3cm dilated but it could still take weeks before labor starts on its own. Some clients experience latent labor for days (or prodromal labor for weeks) following an exam - they cramp and bleed with mild contractions that keep them awake at night but don’t result in labor beginning.
Ultimately, if you don’t want to have a cervical exam, you don’t have to explain your reason for declining one. My tip to you is to stay dressed at your next visit or simply state “No, thanks” when offered - no one will force you into an examination. For more info on prenatal cervical checks, watch the video below and read on.
Labor is divided into four stages
No one can predict when your body will begin to labor. Here’s more info on the stages of labor listed below:
Stage ONE is further divided into three phases:
Phase I: Early labor also called the latent phase.
Phase II: Active labor (5cm or 6cm dilation to 8cm)
Phase III: Transition (8cm dilation to 10cm or "complete")
Stage TWO: also called the pushing stage.
Stage THREE: the birth of your placenta.
Stage FOUR: the hour after birth.
For an overview of labor and birth with suggestions for progress and comfort, keep this webpage linked from your phone.
Stay in the know
The Happiest Doulas maintains a Pinterest board, Labor & Birth Support; Tips from Doulas, Midwives, and Educators. Follow it for more labor and birth tips from trusted resources around the world. Happy Pinning!
Strengthen Your Body For An Easier Labor and Quick Recovery With These Tips
Proper exercise can help new moms avoid future pregnancy complications like back-aches, carpal tunnel, Diastasis Recti, and reduce the risk of needing a c-section due to a tilted uterus and/or pelvis and the dreaded, "failure to progress in labor." To achieve optimal perinatal comfort and health, we suggest the following tips.
Our modern lifestyles, with little or no balanced, proper movement, are not conducive to the complex nature of an ideal, healthy birth experience. Proper exercise can help new moms avoid future pregnancy complications like back-aches, carpal tunnel, Diastasis Recti, and reduce the risk of needing a c-section due to a tilted uterus and/or pelvis and the dreaded, "failure to progress in labor."
Strengthen your body through targeted movement and breathing exercises to prevent or treat Diastasis Recti (abdominal wall separation). To achieve optimal perinatal comfort and health, I suggest the following:
Pregnancy
0-4 MONTHS
In addition to your regular exercise routine, start building up your endurance and improve flexibility. You'll want to work one-on-one with us to avoid Diastasis Recti.
5-9 MONTHS
Walk daily, consider joining prenatal aquatic and/or weekly yoga classes. Continue your training with the tailored exercises that will strengthen your abdominal wall, back and pelvic floor.
Postpartum
0-3 MONTHS
This is a sacred time to heal and nourish your body while adjusting to parenthood. When you feel up to it, walking while pushing a stroller is the ideal exercise to return slowly to physical activity. Increase the pace and distance gradually.
MONTH 3 AND BEYOND
1. Sculpt, tone and reshape your postpartum physique with compound movements. You'll gain strength while encouraging your body to return to its peak performance. Be sure to select an exercise routine that will avoid exasperating the condition of Diastasis Recti (abdominal wall separation.) NO PLANKS or CRUNCHES!
2. Improve posture, correct foundation problems and repetitive injuries, with the targeted training included in the packages. We will guide you through strengthening your pelvic floor muscles and abdominal walls allowing you to move through parenthood with ease. This will help you avoid future pregnancy complications like back-aches, carpal tunnel, Diastasis Recti, and reduce the risk of having a c-section due to a tilted uterus and/or pelvis and the "failure to progress in labor."
This list of suggested items that may aid your postpartum recovery. And this post on easy recipes shares a few ideas to help you thrive during the first months following birthday.
Try These Simple Moves to Prevent Pain in Pregnancy and Create Space for Baby to Move
The Psoas (so-as) is the lesser-known birthing muscle, which is often overlooked in pregnancy and birth. Using these tips and movements can help get you on the right track to prevent pain and build a stronger core for your healthy and happy vaginal birth.
The Psoas (so-as) is the lesser-known birthing muscle, which is often overlooked in pregnancy and birth. Using these tips and movements can help get you on the right track to prevent pain and build a stronger core for your healthy and happy vaginal birth.
The psoas muscle is one of the most functional and crucial muscles our body has when it comes to movement in everyday life, and especially during pregnancy and postpartum. It is the deepest foundational core muscle to our bodies. The Psoas is attached to and down your vertebrae, then through your pelvis and end at the top of your femur bone.
With the psoas, we are able to bend at our hips in flexion, but it also keeps our trunk and spine stable during any other type of movement. Most importantly in relation to birth, the psoas helps to keep our pelvis open and free to move in the way our body needs, it stabilizes. If your psoas is tight or short, it could tilt your pelvis forward, if your psoas is stretched too far or weak, your pelvis could be tilted backward, causing low back and leg pain. In either situation, it can become a snowball effect in pregnancy, and could possibly lead to a C-section if a doctor does not feel your pelvis is in the right place to get the baby through the birth canal.
3 Tips to Strengthen This Neglected Muscle That can Weaken Your Chance of Having a Vaginal Birth:
1. Try not to sit for extended periods of time. Get up and move every 30 minutes or so, as you walk maybe throw in a couple of lunges;
2. Perform Pelvic Tilt exercises as seen in the below video:
3. Do this Lying Psoas March to strengthen your core and hip flexor:
Activate your Psoas to relieve pain, open your hips, and strengthen your core
Understanding the psoas muscle gives us the foundational knowledge we need to change the way we move. It’s important to activate our psoas so we can:
Locate the muscle in our body;
Loosen our hips to help relieve pain (especially in pregnancy);
Strengthen and stretch it properly to keep our lower back and body stabilized in all movements during pregnancy;
Open our pelvis to help create more space for the baby to move around and get in the right position for birth to have a more comfortable and shorter labor.
1. Try this psoas activation test:
2. Perform these stretches to continue activating the psoas and then loosening tight hips:
When we deliberately engage our psoas muscle, we are giving our bodies the chance to correct unhealthy movement patterns. When we move in an unhealthy way, our bodies tend to compensate by pulling on other muscles or ligaments to adapt to the movements we are trying to accomplish (i.e. walking, sitting, bending over, getting up), thus creating pain because it is unnatural. Instead, when we choose to activate our psoas, our bodies start to move naturally again and eliminate pain. Even better, if we engage with our psoas before we start compensating, we can prevent compensations and pain.
It starts with a single step.
Alleviate Fears of Childbirth and Manage Labor Pain
These healthy practices are designed to simplify the birth process in order to alleviate fear and manage discomfort. No matter what type of labor, the length of your labor, or your confidence level, these practices are key to keeping you and your baby as safe and healthy as possible.
Supported by research studies that examine the benefits and risks of maternity care practices, these 6 birth practices are the foundation of Lamaze childbirth classes taught around the world. These healthy practices are designed to simplify the birth process in order to alleviate fear and manage discomfort. No matter what type of labor, the length of your labor, or your confidence level, these practices are key to keeping you and your baby as safe and healthy as possible.
Attribution: Lamaze International
Evidence-based care means using the best research about the effects of specific procedures, drugs, tests, and treatments to help guide decision-making during labor and birth. This is the gold standard for maternity care worldwide. Yes, hospitals and medical care providers such as your OB and midwife are often well aware of the latest research and recommendations based on these findings. That's great until you consider the fact it takes - on average - 17 YEARS for medical professionals to change the way they practice!
I am a Professional Member at Evidence Based Birth, where I receive frequent continuing education on the best practices in the field. I love to pass this information on to my doula clients and students of my private childbirth classes, which are available LIVE (not pre-recorded) both online and in-person. This lesson is tailored to meet the specific needs of each of my clients.
Keep reading to learn how each of these 6 practices can help you optimize birth outcomes, then sign up to take my intensive Labor Lesson. You'll learn tested strategies for labor comfort and progress, gain insider tips from my time working at your birthing facility and alongside your OB or midwife, and easily prepare for your transition to parenthood.
What are the Six Lamaze Healthy Birth Practices?
1) Let Labor Begin On Its Own
A. In pregnancy, labor will start only when all the players - your baby, your uterus, your hormones, and your placenta - are ready. Every day of the last weeks of pregnancy is vital to your body's (and your baby's) preparation for birth. Should you choose to induce labor, know it is a medical event and proceeds quite differently from spontaneous labor.
B. Induction has a higher percent of cesarean rate associated with it. So while a cesarean is not definitive with an induction, ask yourself if the potential benefit truly outweighs the risks.
C. All the hormones that play a part in labor (oxytocin, endorphins, catecholamines, and prolactin) are important. However, there are studies that show now just how important those same hormones are to both mom and baby when spontaneous labor occurs. For example, the naturally-occurring oxytocin surge in the pregnant person’s body that precedes labor is thought to have a neuroprotective effect on the baby, while higher levels of the synthetic version (Pitocin) produced the opposite effect. Catecholamines are vital to readying the baby’s lungs for air-breathing after birth, and fetal catecholamines increase a few days before spontaneous labor. Knowing that due dates are often off by at least a few days, even inducing at 40 weeks can lead to issues if the baby isn’t ready.
To learn more about this healthy birth practice, read our post, Weighing Benefits v Risks of Induction.
Labor Tip:
If you wake up in the middle of the night feeling contractions, try to go back to sleep. Maintain the quietness of the night and don’t wake your partner right away. Remember they need adequate rest in order to provide you with support when labor really gets tough! If contractions keep you awake, try taking a long, warm bath, then go back to bed and doze between contractions. Let the early phase of labor build the natural cascade of hormones; each one signaling another in perfect harmony allowing for your body to help itself and your baby to birth in the safest way possible.
2) Walk, Move, Change Positions
A. Pregnant people who move around and use upright positions during labor have shorter labors, less intervention, report less severe pain, and describe more satisfaction with their childbirth experience than women in recumbent positions.
B. Changing position frequently moves the bones of the pelvis, helping the baby find the best fit to come down.
C. Moving around can also help prevent c-section by reducing the chances of a stall of labor or shortening the amount of time a stall lasts; especially in early labor.
To learn more about this healthy birth practice, read the post by The Happiest Doulas - Make Labor Productive with Positivity, Positions and Personal Support.
Labor Tip:
If you're experiencing pain in your lower back during labor, hang your belly underneath you as much as possible. Try kneeling on all fours or sitting backwards on a chair or toilet. Ask your partner to press on your sacrum or squeeze both your hips at the same time. Also, moving your hips/pelvis in a hula-hoop or figure 8 motion may help the baby rotate off your spine into an optimal position.
3) Continuous Labor Support
A. This is not a new concept. Ancient art depicts women giving birth surrounded by other women. This is how birth occurred in many civilizations for many years until about the 20th century when doctors moved birth to a hospital.
B. Having someone who is knowledgeable and able to help you and/or your partner can greatly help the entire birth experience by reducing risk of cesarean, shortening the length of labor (by helping you with positioning and movement), and the ability to cope with labor by offering comfort measures.
Your partner is an essential support person for you to have by your side. However, your partner will need to eat and use the bathroom at times. Also, most partners have limited knowledge about birth, medical procedures, or what goes on in a hospital. Doulas and partners work together to make up a labor support team.
To learn more about this healthy birth practice, read the post, When Childbirth Moved Into Hospitals Labor Support Was Left Behind.
Labor Tip:
Having a baby is akin to running a marathon – laboring people need adequate nutrition and hydration to keep going. Some ideas: small amounts of cheese (1 oz), fruit, veggie pieces, rice cakes, honey sticks (can often be found at Farmer’s Markets). Stay away from heavy foods that may cause GI upset or nausea. Partners need to make sure they are eating and taking care of their needs as well so they can provide adequate support.
4) Avoid Routine Interventions
A. Interventions are like dominos. Often times, one intervention will lead to another and then another. Example: Using Pitocin (artificial oxytocin augmentation) means having an IV, constant monitoring, and often times, an epidural...which adds frequent blood pressure checks, urinary catheters, etc.
B. Most U.S. births today are intervention-intensive. A majority of people surveyed for Listening to Mothers experienced one or more of the following interventions during labor:
Continuous electronic fetal monitoring (EFM)(93%)
Restrictions on eating (87%)
IV fluids (86%)
Restrictions on drinking (66%)
Episiotomy (35%)
Epidural anesthesia (63%)
Artificially ruptured membranes (55%)
Artificial oxytocin augmentation (53%)
Labor Tip:
Although research shows that routine and unnecessary interference in the natural process of labor and birth is not likely to be beneficial - and may indeed be harmful - many people give consent to routine procedures such as vaginal exams, INT/hep lock/IV ports, and continuous monitoring. While each of these routine interventions are sometimes necessary, you may wish to ask WHY you are being offered such interventions. We recommend you consider the benefits, risks, and available alternatives (acronym: BRA) to any proposed intervention.
To learn more about this healthy birth practice, read the post, How To Avoid Routine Medical Interventions.
5) Avoid Giving Birth on Your Back and Follow Your Urge to Push
A. Spontaneous pushing allows baby to get more blood flow and oxygen than the typical coached pushing for 10 seconds long. Pushing should not go for more than 8 seconds at a time to allow for optimal oxygenation of the baby.
B. Use gravity! Giving birth on your back reduces the size of your pelvic outlet and fights gravity. When you feel the urge to push with a contraction, pay attention to what your body tells you. Do you want to stand up or get on your hands and knees to push? If so, go for it.
Labor Tip:
You may request a bar for support while squatting during the pushing stage. While in a squat position, there is maximum room for your baby to exit the pelvis and travel through a shorter birth canal.
To learn more about this healthy birth practice, read Benefits of Upright and Spontaneous Pushing and How to Get Support For What You Want.
6) Keep parent and Baby Together
A. Ask that your baby is placed on your abdomen "fresh out of the oven" immediately following delivery. Your baby’s natural “crawling” movements as she makes her way to your breast can help expel the placenta naturally, as well as putting pressure on your belly to help minimize bleeding. Also, once the baby latches onto the breast, you begin to naturally produce more oxytocin, which further helps your uterus to shrink down and prevent postpartum bleeding.
B. Any care that needs to be done immediately after birth can be done with your baby skin-to-skin on your chest.
Labor Tip:
Bruising may be seen on various places of the body such as the face, or sometimes on the back. Childbirth can be pretty rough on babies, too – not just laboring person!
To learn more about this healthy birth practice, read The Happiest Doulas’ blog post, Keep Parent and Baby Together.