Hello! This is the out-of-date blog for Doulas of Central Pennsylvania, home of State College Doula. Please visit us at www.doulasofcentralpennsylvania.com and on Facebook at www.facebook.com/StateCollegeDoula.

Consumer Reports and Birth Practices

Even the magazine Consumer Reports gets into the wide variation in birth practices across our country!

In some hospitals, a low-risk woman's chances of having a Cesarian birth were 15x that of women in other hospitals. This isn't about a woman or baby needing medical intervention, this is about a certain culture cultivated in those hospitals and the procedures, protocols, and practices of the care providers working there.

One of the biggest things you can do to lower your risk of a cesarian birth is to choose a care provider and place of birth where surgery is only performed when a clear medical need presents itself and where protocols support a woman's ability to give birth, not thwart it. What are your options where you live?


http://news.consumerreports.org/baby/2013/03/advice-to-pregnant-women-choose-your-hospital-carefully.html

How do I know what to trust?

I really love it when women research and come to their own decisions, in conjunction with their spouses and their care providers. But sometimes mothers ask me for sources of information. It's a fine line between providing the best resources I am aware of and sending information that might align with my personal philosophy (because these two things are usually one and the same!) One of a doula's jobs is to provide information. But my goal is not to have women agree with me; it's for them to know as much as they can about risks, benefits, and alternatives, and to make the choice that is right for them as a mother and woman for their unique birth. And I believe the best way to do that is to know about evidence-based birth practices.

So, maybe you found this site looking for information. Maybe you are a client and are already researching. I could provide all the sources, but I'd rather you become aware of where you can begin to look! 

The American Congress of OB/GYns (ACOG) publishes practice bulletins. That is a good place to get an idea of what practices they suggest your care provider follow. The American College of Nurse Midwives also publish articles.

PubMed, The British Medical Journal, and the Cochrane Review database are  huge online sources of scholarly studies and articles. It's where I usually begin my hunt.

Finally, websites such as www.scienceandsensibility.org  and evidencebasedbirth.com are wonderful blogs that work to review the scholarly literature and summarize it in terms that don't require advanced training in statistics. 

Many, many websites exist that give advice. When you're browsing the internet, try to be aware of bias in tone, conclusion, or limited evidence. Make sure the sources for information are listed, and go read the sources or studies yourself!

Happy New learning!

Hypnosis for Birth?

Update! I discovered this website from a on-hiatus Hypnobabies instructor. Her site explains quite a bit, and in a very easy to understand way. Please check it out!
http://birthnaturally.org/frequently-asked-questions.html

Posting again so soon! I just had a conversation with a new mama about what Hypnobabies is, and why I am a big fan of the method.  I used Hypnobabies to have a very satisfying and empowering birth for my second child, and I'm specially trained in how to best support a Hypno-mama. I've spoken to most the the mamas in my life about Hypnobabies, but I couldn't resist posting some information so those of you I haven't met can get an introduction to what it is. I don't receive any kind of compensation for endorsing Hypnobabies--it's just what worked for me!

What is hypnosis? It sounds pretty "alternative."

Hypnobabies is a method of childbirth that teaches many skills including "Eyes Open Medical Hypnosis." This hypnosis is NOT like stage hypnosis, aka "You are getting verrrrry sleeeeeepy." Hypnosis, in medical use, is just a state of the brain where we are very open to learning whatever information surrounds us. It's an actual change in brain wave patterns. We all go into and out of hypnosis many times daily. Hypnosis is the state of semi-awakeness when we are waking or falling asleep, when we are absorbed in watching a movie or staring at the computer, and many other situations. I like to use the example of driving. Have you ever started off on a trip somewhere, then arrived and realized you don't consciously remember the trip because you were thinking about other things? That you "autopiloted" yourself to work? That was hypnosis! Your "subconscious," where you stored the well-learned directions to work, took over and got you there, even while your conscious mind was otherwise occupied.

What does using hypnosis do?

Hypnosis works with your mind to affect your body. Nearly all of the images of birth in our culture are negative: women screaming, dire emergencies, a frantic rush to the hospital. We have everything we have ever heard or seen related to pregnancy and birth stored in our subconscious. Using hypnosis for birth means actively filling the subconscious with positive, empowering visions of birth, and training your brain to respond to the techniques you learn with positive feelings and endorphins. There is a mind-body connection, and it can be used to increase relaxation, peace,and confidence, as well as literally assist your birthing muscles to do their job efficiently, and for many women, without the kind of pain we see depicted in the media.

Think about the feelings of nervousness you might have before a big job interview: your palms sweat, you feel unsettled, you might be nauseous. If your friends and family had spent the previous months telling you how THEIR job interviews were horrible, how scary the interviewer was, how they never got the job, how might that affect how you felt? How you feel mentally affects how you feel physically.  Now imagine how you might feel if everyone you knew told you how capable you were, how you were perfect for the job, how they knew you would succeed! You really can use your mindset to affect how you experience something. For many women, birth is made much more comfortable and even enjoyable!

Is hypnosis New-Agey?

There isn't any agenda to the hypnotic suggestions, except to help you have a safe, empowering birth. It is fully compatible with any belief system; in fact, you can tailor it to your faith by adding some of your own suggestions, prayers, or passages.

How do I learn more?

There is no local Hypnobabies instructor, so I decided to order and use the Hypnobabies Home Study Course. It is a 6 week course, so it is best to start around week 32, though there is no reason you could not start sooner. I practiced my hypnosis skills daily from week 18, and had a safe, swift, comfortable and easy birth. If you're interested, you can check out the home study course here~https://www.hypnobabies.com/self-study/hypnobabies-self-study-course

If you want to get an idea of what hypnosis is like, they have a free Mp3 for you to try! It is exactly like the hypnosis scripts in the program, so it's a great way to try it out! I suggest listening to it daily for a week, then see how you feel. They also have a Mp3 that explains more about hypnosis than I have written here. Check them both out at https://www.hypnobabies.com/about-hypnobabies/experience-hypnobabies

I hope this introduction to using hypnosis in childbirth was enlightening! If you have any other questions about using Hypnobabies in your birth, please email me!

War Songs

An excerpt from http://babygooroo.com/2012/08/how-other-cultures-prevent-postpartum-depression/

"Three months after the birth of her child, the Chagga woman’s head is shaved and crowned with a bead tiara, she is robed in an ancient skin garment worked with beads, a staff such as the elders carry is put in her hand, and she emerges from her hut for her first public appearance with her baby. Proceeding slowly towards the market, they are greeted with songs such as are sung to warriors returning from battle. She and her baby have survived the weeks of danger. The child is no longer vulnerable, but a baby who has learned what love means, has smiled its first smiles, and is now ready to learn about the bright, loud world outside.

What American mothers experience
In contrast, American mothers often find that people are more concerned about them before birth. While a woman is pregnant, people may offer to help her carry things or to open doors or to ask how she is feeling. Friends will give her a baby shower, where she will receive emotional support and gifts for her baby. There are prenatal classes and prenatal checkups, and many people wanting to know about the details of her daily experience.

After she has her baby, however, mother-focused support rapidly declines. Typically, a woman is discharged from the hospital 24–48 hours after a vaginal birth, or 2–4 days after a cesarean section. She may or may not have anyone to help her at home—chances are no one at the hospital has even asked. Her mate will probably return to work within the week, and she is left alone to make sure she has enough to eat, to teach herself to breastfeed, and to recuperate from birth. The people who provided attention during her pregnancy are no longer there, and the people who do come around are often more interested in the baby. There is the tacit—and sometimes explicit—understanding that she is not to “bother” her medical caregivers unless there is a medical reason, and she must wait to talk to her physician until her six-week postpartum checkup. There probably are resources in her community that can help, but she has no idea where they are and feels too overwhelmed to seek them out for herself. So she must fend for herself as best she can."

Mothers should be supported long after they've had their babies.  Emotional, physical, and mental changes continue for weeks after the birth. In this town, people often don't have family living locally, so you have to build a support community for yourself. Friends, coworkers, people from a place of worship, and postpartum doulas, as well as family, can all help. 

The first days and weeks after your birth are precious and fleeting. This is YOUR time. Ask that anyone who visits bring a meal, or expect to wash some dishes or run some laundry. Make a list of chores that visitors can do.  Accept any and all offers of help so you can spend the majority of your time getting to know your newborn, resting, and working on breastfeeding if you plan to nurse. 

And, take it easy on yourself.  Motherhood is anything but perfection, so if you have a messy living room or don't feel like doing your daily yoga routine, don't feel guilty. Those things can come later. You and the baby deserve every bit of pampering and attention you receive. You deserve  your war songs to be sung.

What about my partner??

It is common and understandable when expecting mothers (and dads) wonder if a doula will take over the job of their birthing partner or spouse. It might initially sound like an intrusion to have someone else in the room. But women who have used a doula overwhelmingly find that the doula is a great help for them AND their spouse, for many different reasons. Doulas are never there to take the place of the loving partner with whom the woman has a deep and lasting relationship. They provide a calm presence, knowledgeable skills, and support for the partner to allow them to be there for the mother without worry. 

I've collected some quotes that showcase how women feel about doulas and their spouses! Enjoy!

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Our doula was a huge support- no surprise there.  However, she was a support in a way I didn't expect.  My labor was long and intense.  Our doula allowed DH to be human.  Because she was there, he took breaks, ate, slept, etc.  I know he was only able to do this knowing I wouldn't be alone.  While our doula was supportive of me too, having her there eased DH's mind and gave him respite. 

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My first time to have a Doula was w/ baby #3. And husband and I both agree that we will never birth w/out a Doula again!

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My husband is not reading and not super involved. He told me "you dont need me there, you got your crew" or doula and midwife. I explained to him our doula is my interpreter. She interprets what I need (my fourth child with him, fifth in all) and he's never looked at me and got something without my saying "I need this." She interprets my needs and communicates with me in a way that's productive (men don't always communicate productively during labor). She then involves him or can direct him what to do. That way husband can wind up a rock star but isn't expected to, well, be a doula. She can help him in his involvement.

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When we finally got moved to a room I was in transition. I was sitting Indian style on the bed and she and my husband pushed on either side of my hips to get me through contractions. It helped soo much.

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My hubby says he always feels very helpless in labor, but I need him there. My husband did say it helped him to have the doula, she offered suggestions and reassured him that things were fine.

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I found a doula! This is a huge relief to me and my husband. He is looking at a back surgery in the next month and we have no idea how this will affect him at the time of our sons birth. Husband wants to be very active in the labor, he is my coach after all. We are using the Bradley method. We also live out of state from our families so the doula will be a great comfort to us. 

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Please know that you can have both a doula and a hubby and not be neglecting your husband.

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My husband honestly just does not have time to research, learn with me, etc.  I know, I know, "You make time for things that are important to you," But honestly, There wasn't time (for him, besides a little bit of listening).  I really wanted him to be knowledgeable, but I also knew it wasn't going to be possible with all our other commitments, so I just let him do his thing.  He was soooo helpful during labor.  The only time I was mad was when I was nearing transition and baby was posterior and I could not get comfortable even between contractions and he fell asleep!  I really wished I had a doula then.  I didn't hire one because my other labors had been really, really fast.  That one ended up being 24 hours.

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A husband is not a doula. A doula is not a husband. And all for good reasons!!

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My husband went with me to long childbirth classes and read and learned a lot. He was absolutely prepared to be my protector and my coach. That said, he was amazing how helping me to relax, which we had practiced a lot. He helped me coast the wave of each contraction, and I didn't necessarily want to be touched otherwise. But there were certain things I think I needed that only someone who has been through births would have known to do for me. I needed more vocal encouragement, and my hubby isn't a talker. I think a doula could have changed the experience for the better.

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My  husband read Dr. Bradley's book and the Birth Partner. After reading those he realized that although he could be a coach to me, it would be nice to have someone there so if he needed a break, he would be able to without feeling guilty or leaving me alone.

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My husband was never opposed to having a Doula. He told me we could do whatever I needed. But, he admits now that he never appreciated the role of a Doula until we had an awesome one at our last birth. He LOVES her and LOVES Doulas now! He is 150% supportive of Doulas!

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A lot of husbands fear that a Doula will replace them. But, actually, a Doula is there to advocate for you and your husband and the baby. She will help your husband know how to best support you. She will help you through labor when that may be hard for hubby b/c he's emotionally invested in you and doesn't want to see you in pain. A Doula will free him up to just love on you and dote on you and do whatever he can to get you through the delivery!

Family-centered Caesarean Section

Caesarean sections, or C sections, are performed for a variety of reasons, the vast majority of which should be for medical necessity. When a C section is planned in advance (for things like pre-eclamptic symptoms or uncontrolled gestational diabetes) many things can be done to make the birth more enjoyable and provide more benefits to mother and baby. This video beautifully demonstrates how making small adjustments to what has been done as a "standard" in the operating room can make a  Caesarean birth more family-centered.