"Birth Plan" at your own risk

So I was with a couple in the hospital, as they were approaching the birth of their 2nd child. The mom had arrived in transition (about7-10 cm dilation), progressed quickly and was starting to push.
Not surprisingly their OB was not on call, so the doctor who'd signed off on the birth preference sheet was not their to see that their wishes were carried out.
No problem! I remind the OB who is present that this couple has indicated that they would like to practice expectant management for the placenta delivery (as opposed to the hospital protocol of giving synthetic oxytocin as the baby is being delivered as a preemptive protection against hemorrhaging. In expectant management you let nature take its course and would only give a synthetic oxytocin if the mom actually hemorrhages). They want this in conjunction with a desire for delayed cord clamping/cutting (as research shows that leaving the cord pulsing for 2 extra minutes boosts iron reserves in the baby for up to 6 months).
However, it became clear that this young doctor had no idea how to permit nature to simply run its course while watching carefully (she repeatedly asked me for guidance on when to clamp, when to cut, when or if to put traction on the placenta etc.). I'm just the doula, not the OB! That's your job isn't it!?!? Apparently not. If you wishes fall outside the protocols the doctor has been trained within, I guess you may run into them not knowing how to behave in any other way.

Not an aspect of helping people create birth preferences that I ever imagined I'd encounter.

Maternity Experience Report

According to the Maternity Experiences Survey conducted by the Public Health Agency of Canada only slightly more than half of Canadian women felt their birth experience was "very positive".
I don't know about you, but I think it's pretty sad, that the birth of one's child isn't amongst the most positive days in your entire life.
I wasn't surprised to note that nearly 3/4s of the women who had midwives as their primary caregiver report the experience as "very positive".
Coincidence - I think not :)
The survey seemed to be very extensive. I'm sure anxious to read further summaries of the findings when they're published in the Journal of Obstetrics and Gynaecology in the spring of 2008.

Busy Month of September!

WOW! My first month as a full time doula. 4 births .... obviously left me with too little time to post blogs.

First was a 6 pound girl, then a bunch of big babies followed: a 9 pound boy, a 9 pound girl and an 8 pound boy!

All lovely, all special, all unique. Each birth had its ups and downs. All the mothers were brave goddesses.

I am thankful to each family that allowed me to share in these special moments of their lives.

Cochrane Database Review concludes women should have labour support

The Cocharane Collaboration has just published a review of Continuous support for women during childbirth. Following is part of the abstract:

ABSTRACT

Objectives:
Primary: to assess the effects, on mothers and their babies, of continuous, one-to-one intrapartum support compared with usual care.
Secondary: to determine whether the effects of continuous support are influenced by: (1) routine practices and policies in the birth environment that may affect a woman’s autonomy, freedom of movement and ability to cope with labour; (2) whether the caregiver is a member of the staff of the institution; and (3) whether the continuous support begins early or later in labour.

Main results:
Sixteen trials involving 13,391 women met inclusion criteria and provided usable outcome data. Primary comparison: women who had continuous intrapartum support were likely to have a slightly shorter labour, were more likely to have a spontaneous vaginal birth and less likely to have intrapartum analgesia or to report dissatisfaction with their childbirth experiences. Subgroup analyses: in general, continuous intrapartum support was associated with greater benefits when the provider was not a member of the hospital staff, when it began early in labour and in settings in which epidural analgesia was not routinely available.

Authors’ conclusions
All women should have support throughout labour and birth.

You can read the whole 72 page review by downloading it from the Childbirth Connection; a great source of pregnancy and childbirth information.

LOADS of breastfeeding information!

WOW, there are some fabulous questions and tonnes of great answers and info in the Globe and Mail's Dr. Jack Newman breastfeeding Q&A.

Dr. Jack Newman answers breastfeeding questions

My mother was (and still is!) a La Leche League leader. While I was growing up, I remember hearing the one sided conversations of my mom offering telephone support to other mothers with breastfeeding concerns.

I surprise myself when, as a doula, I'm asked for breastfeeding support and I hear those memories pop into my head "..... get naked with your baby and climb into a warm bath..... " How many times did I hear this advice!? How much of what I know about breastfeeding is simply an innate knowledge I acquired as a child while attending La Leche League meetings, conferences, family potlucks and picnics, etc. I an unusual and lucky in this culture that my knowledge of breastfeeding and solving it's minor hurdles is second nature to me. You can take a peek at my Breastfeeding BirthFAQ on my website.

If you weren't lucky enough to grow up with your own breastfeeding guru, don't worry, Canada has one of the world's best breastfeeding experts at their disposal. Dr. Jack Newman co-authored one of my favorite breastfeeding books.

In May 2007 the Globe and Mail initiated an online Q&A with Dr. Newman and they were swamped with the number of questions they got. So they're doing it again. Write in with your questions now and watch for the answers on August 16.

Midwifery in Alberta

Midwifery has been a registered and legalized profession in Alberta since the mid-90s. Unlike all other provinces in Canada with regulated midwifery, our province failed to carry through with supporting the fully funded integration of midwifery into the public health care system. To this day Alberta couples pay $2500-$3300 for midwifery care.

There have been many instances in the past when consumers and lobbyists have become excited at the suggestion that public funding would be forthcoming. So I hate to get my hopes up , yet again. However, this recent letter from the Executive Vice President of the Society of Obstetricians and Gynaecologists of Canada, addressed to Alberta's health Minister is a powerful endorsement. I really hope it holds strong political sway.

Low Birth Weight Babies and Cesareans

More babies across the country are being born underweight, and our country's caesarean rate is approaching double of what the WHO recommends as safe.

Some of this can be attributed to more women putting off their childbearing years to later in their life. Some of this is yet another consequence of the obesity pandemic. Some of this can be attributed to an increase in multiple births as reproductive technologies are more widely used.

But a good deal of this can be attributed to the medicalized shift in obstetric care. Ask your mothers and your grandmothers. Who delivered their babies? Family doctors, General Practitioners, Midwives. Only a generation ago a woman in Edmonton would have paid out of her own pocket to see an OB for her normal pregnancy. Our healthcare system would not have paid for such a specialized professional to care for healthy, normal pregnancy.

We can't make light of the fact that the vast majority of Canadian women are cared for by a surgical specialist while she's pregnant; is it any wonder our surgical birth rates are climbing?

Trust yourself, trust your body, trust your baby, trust birth - avoid unnecessary obstetric intervention .... it has a price, it may be your baby's health.

Introducing "With Woman Birth Doula Care"

After lots of learning on the part of my "webmaster" (aka my husband) version2.0 of my Doula website is up and running!

Please check out With Woman Birth Doula Care and pass the link along to anyone you think might be interested.

Keep coming back to the site to learn about new services as I add them - prenatal classes, Mother's Blessings, and more.

Echinacea in Pregnancy

I've, personally, started using echinacea a lot more when I feel a cold or other symptoms of infection creeping into my body. Some mothers wonder at the safety of taking this herbal extract during their pregnancy.
Most main stream health care providers seem to err on the the side of caution. They'll point out that without controlled studies indicating a lack of negative side effects, it's safest to avoid such herbal preparations all together.
Hopefully this research will put more caregivers and mothers at ease in choosing echinacea as one possible line of defence against infections during pregnancy.

Edmonton's Baby BOOM!

Edmonton is booming. Housing prices are through the roof. "Help wanted" ads front nearly every business. There are a lot of people in this city ..... so of course there's a LOT of babies on the way. With a shortage of staff and a surplus of patients, it's not surprising that Edmonton women are increasingly less satisfied with the care they are receiving at Edmonton hospitals during childbirth. Check out this recent CBC news story

"One of the nurses said that the level of education that they're able to give people isn't the same anymore, and they're basically just checking vital signs and just hoping that everything goes well."

All the more reason to hire a doula for your birth. You will need a doula to rub your back, help you to the bathroom, find you an extra blanket, bring you ice chips, and ensure a satisfying birth. Every couple deserves a doula who will happily give her time providing education.

I am looking forward to all the couples I will be able to support towards a joyous birth.

Doula business will be booming too!

Welcome to my doula blog!

Bear with me as I grow accustomed to this new (for me) world of blogging. I want to be able to share with you my experiences as a doula; stories about births, interesting articles about pregnancy and childbirth and my thoughts about my life's passion ... BIRTH! I'm told - by my computer guru (aka husband) that this is the way to do it .... he's guided my technological growth pretty successfully up until now so I'm gonna trust him and go with it.