Pregnant in a Pandemic? Don’t panic, prepare.

It’s World Doula week and worldwide Doulas are being banned from hospital labour and delivery wards. In some places partners are not allowed in either. Covid-19 is ravaging the planet, and babies are coming into this madness whether we like it or not. Prenatal education is designed to prepare people for the unknowns of childbirth and to help alleviate common fears.  In this current situation, our common fear is the unknown of Covid-19.

I’m getting my information about the effects of this virus on pregnancy and newborns from Evidence Based Birth. Rebecca Dekker and her team are posting the latest information about Covid-19 as it arrives, and it is arriving daily.  What we do know is reassuring – Covid-19 has not been found to cross the placenta and it is not present in breast milk or amniotic fluid. It is too soon to tell if Covid-19 causes birth defects or is responsible for miscarriages. The World Health Organization is not recommending routine separation of Covid-19 infected mothers’ and their newborns, as antibodies against Covid-19 are present in breast milk and it is vital that the baby receives them.

Pregnant women do not seem to be at higher risk than others to contract Covid-19 and the recommendations to avoid it are the same – wash your hands and all surfaces that you and others may have frequent contact with (door handles, light switches, stair banisters, door bells) and stay at home as much as possible. Many women are choosing to reach out to midwives and home birth physicians and changing their birth plan so that they can avoid hospitals, and this is a great option for many people. But if you can’t avoid the hospital, how can you prepare for a birth experience unlike any you have previously imagined?

Step 1) Sign up for Zoom or Skype. If you can’t have your birth team physically with you in the hospital, you can at least have them virtually. Make sure your laptop or tablet is ready to go and the charger is in your hospital bag. Zoom lets you have up to 100 people! This is perhaps too many.  You do not have to have your video on, and you can mute them.

Step 2) Prepare the most awesome music play list imaginable. Shakespeare said “if music be the food of love, play on.” Oxytocin is the hormone of love, and it’s also the hormone that drives your labour. Unfortunely it’s inhibited by stress. When labouring people feel unsafe, the wrong hormones are produced and they put the brakes on oxytocin production. Keep that oxytocin flowing by keeping your eyes closed and your tunes playing.

Step 3) Practice daily self hypnosis. Listening to guided relaxations or visualizations can help pregnant people learn how to relax, and once you’ve mastered the art of deep relaxation at home, it can be easier to get into a deep state of relaxation in the hospital. If your birthing suite has a bath tub available, play your relaxation mp3 and relax in the tub at the same time.

Step 4) Pump up your yoga balls.  Many hospitals provide yoga balls for their birthing clients, but maybe you want to bring yours from home. Get a round one for bouncing on and a peanut ball for helping you labour in bed. Make sure you get the right size, you can find some guidance here.  Peanut balls help your baby progress if you are confined to bed and cannot get into productive, upright birthing positions.

Step 5) Befriend and love your nurse. She continues to show up for work in a world gone mad. She is a superhero, and she has your back.  Describe to her what you had hoped for your birth so that you can say goodbye to it and move forward. If you cannot see her face properly through her PPE, imagine that she is your best friend, your mother or your doula.

Step 5) Be unafraid. Generations of women have birthed their babies without their partner present. You can do this. You are a strong, resilient woman. You can walk into the fire alone and come out the Mother of Dragons. Yours will be the birth story told for years to come. You will survive this and grow stronger. You are surrounded by the love and support of all the generations who came before you. Close your eyes and let them guide you through.

 

17 years!

My very first client was a dear friend, so every year around this time I have a reminder of my first birth when she posts photographs of her daughter’s birthday celebrations. This year she drove off in their car. Today is my son’s birthday, marking 7 years since I was last pregnant. I want to thank all the families who have invited me into their lives.  I feel blessed to have been part of your family’s birth story.

17 years(1)

To celebrate these milestones I’m making some changes in my pricing, something I haven’t done in several years.

My best deal remains the Best Birth package, for those who just want support during labour.  This is a good choice for parents who have family close by to help in the postpartum days, or for people who have taken childbirth ed classes and are feeling pretty confident about their birth choices, or for families who are having their second child.

Package includes 1 prenatal planning session, labour and 2 hours after birth, newly born photography and 1 postnatal visit in the first week. Also includes unlimited texts and emails until 17 weeks.  $870 +HST

The Ultimate Birth Support Package is the Birth and Beyond package, for those who want education as well as labour support. Ideal for busy couples who can’t make it to prenatal class, or for those who are feeling anxious and need more personalized support. This is a good choice for couples who don’t have extended family nearby to help them in the first few weeks.  If your family are coming immediately after the birth you can book your postnatal visits for the time after they go when you may be feeling vulnerable without them. It’s also helpful to book your doula for after your partner returns to work.

This package includes 2 prenatal planning visits, labour and 2 hours after birth, newly born photography and  4 postnatal visits. Also includes unlimited email and text questions for the first 17 weeks. $1177 + HST

If you feel you  have a handle on the labour and birth part but just want additional support when your baby comes home, the Best Start Package is for you. You can pre-book your doula ahead of time to support you when you need it.  This package is also a really good gift to give an expectant family at a baby shower. Booking in advance saves you $40.

17 hours of postpartum visits, minimum 3 hour calls.  First visit in the first week. Unlimited emails and texts for 17 weeks. $387 + HST
Postpartum hours can also be booked more casually. $25/hr + HST, minimum 3 hour call.

For a free consult please click here!

I will be your calming goat.

I just watched Ferdinand with my kids and I just love the character of Lupe. She’s so fun and enthusiastic and a bit vulgar and I’m not going lie, I enjoy that. Being a city girl I didn’t realize that it is common practice to put goats in with the bulls and horses to keep them calm, and I has the realization that goats are basically doulas for expensive livestock. Keeping their anxiety at bay makes it easier to manage the prize race horses or fighting bulls. In pregnancy women quite rightly feel anxious and nervous about the birth to come and hiring a doula can help you feel better about your ability to handle labour.

calming goat

The statistics are clear – just the presence of a calm, confident third party in the birthing room decreases the use of medical interventions and improves satisfaction with the birthing experience, even if all they do is sit there.  What I bring to the birthing room is my belief that birth works. I bring my confidence that you can do this, like so many women have done before. I bring experience of other births, my own included, so I feel comfortable with your movements and vocalizations and nothing phases me. My surety that everything is going to be alright is contagious and it helps relax you and your partner so that you can concentrate on birthing your baby calmly and with confidence.

I will be your calming goat. Keep labouring on and you will get your prize – a beautiful baby.

Click here to book a free consultation.

 

 

Happy Birthday, Baby Girl

Nine years ago my daughter was born, and my life changed forever.

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This journey I’m on now started long before her birth, my obsession with babies started young and I was a seasoned baby whisperer long before I had my own baby, I was a doula before I got pregnant myself.  I was ready to be a mother, ready to experience birth. I was eager for it.

This time nine years ago I was on my hands and knees in a rented birthing tub in my spare room, soon to be the baby’s room. My mother poured water on my lower back with each contraction. My midwives watched from the hallway. My mother wore the apron she usually wore for doing the washing up.  I remember my cat curled up on the stairs, not wanting to get too close to the action but not wanting to leave either. I remember my friend arriving, rather late in the action, and calling to her that she should come up. She was wearing white, perhaps not the best choice when called to a birth but I think it worked out for her and I’m so glad she came.

When you are in labour time works differently. I was in labour for 17 hours, birthing in the late afternoon at 4:36pm. I feel like I was in the tub for most of that time, the tub was magical, but my midwives notes say differently. I thought I pushed for maybe an hour, but apparently I pushed for nearly 4! I remember pushing in the tub and not liking it, trying the birthing stool and then side lying in the bed. My baby was stubbornly OP, meaning she was facing front ways instead of back, and despite all the pushing she didn’t seem to want to come out. I remember the moment when she decided she would be born today after all, feeling her corkscrew from front to back and then it was all a flurry of movement and panting and “don’t push!” and then she cried and I felt so relieved it was over…. and then one of the midwives said “push for the shoulders!” and I thought, how could she not be born yet – I can hear her – and then she really was born and it really was over and I was so tired and she was so small.

And I was different. I was a Mother.

Thank you for making me a Mother, baby girl. I love you today and always.

 

If you want to know more about doula care, click here!

If you want to book a consultation, click here!

 

Five things to register for that no one will ever buy you.

5 things to register for

It’s a little known fact that many department stores will let you complete your registry at a discount, so go ahead and register for these five things that you will really need but that no one will want to buy for you.

#1 – A Squatty Potty – any step stool will do but this one is specifically designed to hug your toilet and when used it puts you into a perfect squat position. The toilet wasn’t really designed very well, and this little stool puts your body into a much better position for emptying your bowels. If you are suffering from constipation during your pregnancy this will really help stuff slide right out. Also, squatting frequently helps stretch and strengthen the pelvic floor, which will result in an easier childbirth. You can even use this when you are labouring at home to support you in a squat position and help the baby move down and out.

#2 – A donut pillow. Not a very glamorous gift but since even the most uneventful birth will result in some swelling and discomfort in your vagina, a donut pillow gives you somewhere to sit where you will not have to deal with any pressure on your delicate parts. Put an ice pack or a bag of frozen peas in the hollow and relax. These are also great in late pregnancy to take the pressure off your tailbone and pelvic floor and help you remember to sit up straight in your office chair.

#3 – Maxi-pads you can see from space. No one is going to buy you these, but if your department store has a drugstore section, why not? You will need these even if you have a C-section as it’s normal to bleed for several weeks after having a baby, and you can’t use tampons or a cup at this time (which for me, was the worse part of bleeding for several weeks). Always Maxi Overnight with wings get my vote. They are enormous but do the job well. Some women like to wear Poise or Depends in the first few days but personally I didn’t enjoy the feeling of wearing a diaper, and I found a product designed to absorb blood rather than urine just did a better job at handling the lochia. Register for a bottle of witch hazel too and prep some padsicles to enjoy in your first few days postpartum.

#4 – A sitz bath. This little insert for your toilet will be your best friend if you suffer from postpartum hemorrhoids. Fill it with warm water and Epsom salts and sit (well, squat since you have a squatty potty) with a magazine for a blissful ten minute break. Helps heal your perineum and gives you a well deserved time out. A good opportunity for your partner to figure out how to handle a new baby while you take care of yourself. Self-care is a vital part of surviving new parenthood, find little moments of solitude wherever you can.  Your days of using the bathroom alone are numbered.

#5 – A waterproof mattress pad. While most women don’t have their water break spectacularly like you see on TV, it does happen and you need to protect your mattress just in case. It’s more likely that you will leak milk or your newborn’s diaper will fail when you are lying in bed together. Register for that mattress pad- those suckers can be expensive but not as expensive as a new mattress.

Baby Ready can help you set up your registry with the things you really need. Contact us here for a free consultation!

Gift the gift of a doula!

Gift of doula

Some partners are concerned that having a doula will mean they will have no role in their baby’s birth. This is not true! A doula can help give you the confidence to be a fantastic supportive birth partner. Your doula can reassure you that your partner’s labour is progressing normally and help keep you both calm if it is not. Your doula can teach you comfort techniques that will your partner will come to depend on during her labour. You will be as involved as you want to be for the entire labour and delivery. And if you need to step out, you can feel confident that your partner is being taken care of in your absence. Give the gift of doula support – and get it for yourself too.

 

Don’t be a martyr, you’re a mother now!

It’s really hard, after a lifetime of pretending everything’s fine when it’s really not fine, to stand up and advocate for yourself. I understand that. Women are socialized from birth to be polite and nice and do as we’re told. I’m trying hard to raise my daughter to question this. I want my kid to ask questions, get the information she needs and do what she believes to be right without concerning herself with being nice, whatever that means. When we’re pregnant there’s a lot going on in our bodies that feels different and new and even strange, and you will have things come up that you need help understanding. If you feel like you’re bothering your obstetrician or midwife with your endless questions and concerns, then perhaps you have the wrong caregiver. Helping you understand what’s going on in your body and mind is their job. As your doula I can help answer some of your questions and concerns, but I am not a medical professional and I want you to go over my head and feel comfortable doing so – your doula, your doctor (or midwife) and your partner should work as a team and not get in each other’s way. Pregnancy is not an illness and while you may feel uncomfortable you shouldn’t be suffering. If you are in pain, if you feel sick all the time, if you spike a fever these are potentially signs of preterm labour and you must contact your caregiver right away.

Check my handy postcard size hand out for the warning signs that you should not ignore.

3rd Trimester Discomforts

Hire a doula to help you plan your pregnancy, birth and postpartum recovery!

 

click here to contact us!

The Uncomfortable Feminist

 

I am a birth worker,

arguably the most woman-centric job on the planet. I work with women at their most vulnerable, most powerful, most female. Giving life is something only we can do. It is beyond awesome. And yet, women in childbirth are subjected to disrespect, abuse, and downright misogyny on a daily basis. I am confused by the number of hospital staff I have encountered on the maternity floor who do not seem to like working with women. Perhaps a career move should be considered?

As a doula it is my job to support my client. It is not my job to speak for my client, and sometimes I have to sit and listen and hold my tongue while others try to knock my client down. As a doula I have no power, but I try to make my client feel powerful, powerful enough to stand their ground and say “I’m doing this my way” when faced with pressure from those who feel the need to run the show. Sometimes I feel very uncomfortable.

As a doula I am a witness to a lot of underhanded stuff.

As a feminist I want to scream. “Don’t talk to her that way!” “She is an adult not a child!” “You are her doctor not her boss!” I want to say, “He’s not right.” “He doesn’t have the right” “She’s impatient; her agenda is not the same as yours.” I want to say “a healthy baby is not the only important thing. “  I will be misunderstood. A healthy baby is important -but what about a happy and healthy mother? What about an empowering birth experience?

What about respecting the woman as well as the child?

I am a birth worker, and a feminist.  But I rely on my husband’s income to support our family. If giving birth is not respected, how can I expect birth work to be respected either? I believe in the work I do, but my belief doesn’t put much food on our table.  I am told to charge what I’m worth, but if the birth experience is not respected, the worth of a doula is not clear.

I am a doula and a feminist.

I love my work. I do it because I believe choice in childbirth is a feminist issue. I never wanted to be political, but I will fight for this. We were all born. How can we not respect the one thing that we all have in common?

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To Test or not to Test

During a rare quiet moment the other day I stumbled upon this article in the Toronto Star: ‘Over-testing can have a serious downside’. Written by Dr Sacha Bhatia, it’s a quick sum up of a phenomenon we are more than familiar with in the maternity care industry: that more tests and procedures do not equate to better outcomes. His article led me to the website for Choosing Wisely Canada, a new campaign by the CMA and the University of Toronto.  They are encouraging Canadian patients to think for themselves and ask their doctor 4 simple questions:

  1. Do I really need this test, treatment or procedure?

  2. What are the downsides?

  3. Are there simpler, safer options?

  4. What happens if I do nothing?

This is exactly what I encourage my clients to do – use their brain and ask intelligent questions. Think of a simple procedure like the Nuchal Translucency ultrasound most women have around 12 weeks and ask the 4 simple questions.

  1. Do you really need this procedure? This is a test that screens for Down Syndrome and other chromosomal abnormalities. For most women this is the first chance to have a look at their baby and they jump at the chance to do so. But do you really need this procedure? Will you abort a baby with Down Syndrome? If the answer is no then this is not a necessary procedure for you.

 

  1. What are the downsides? If the test indicates abnormalities, you will undoubtedly feel anxious and worried about your baby. The test generally used to confirm any issues is the amniocentesis which is a much more invasive and painful procedure with higher potential risks. So if you agree to the non-invasive NT test, you may find yourself in a position where you are forced to choose to undergo an amniocentesis to alleviate the stress brought on by the first test.

 

  1. Are there simpler, safer options? This test is already pretty safe and simple.

 

  1. What happens if you do nothing? If your baby is fine, then he will continue to be fine. If your baby has chromosomal abnormalities, he will continue to have chromosomal abnormalities.  So this test only affects your peace of mind. It’s up to you to decide if knowledge is power or if you would prefer to stay ignorant.

 

 

So you can see the Choosing Wisely Questions are pretty easy to apply to most maternity tests and procedures.  Take Continuous External Fetal Monitoring in labour:

  1. Do I really need this procedure? This monitors your baby’s heart rate continuously during labour. The research shows that continuous fetal monitoring holds no benefits over intermittent fetal monitoring, and in fact often creates problems. So no, you don’t really need this procedure.

 

  1. What are the downsides? The downside for you is that EFM limits your mobility and forces you to stay in bed or at least in your hospital room. If your hospital has portable wireless units you will have a little more mobility but you will still be expected to stay in range. Being tied down during labour is not ideal. It also steals your thunder, meaning that your caregivers will concentrate on what the monitor is telling them and ignore you.  Sometimes the information on the monitor will indicate fetal distress when there is none. Obstetricians err on the side of extreme caution, so any momentary irregularity in the tracing will cause them alarm.  The research shows that CFM does not actually catch things that IFM does not –but it does appear to cause distress in healthy obstetricians.

 

 

  1. Are there simpler, safer options? Yes, the simpler, safer option is intermittent monitoring with the EFM or even a Doppler.

 

  1. What happens if you do nothing? If your baby is in distress then no one will know. In this case occasional monitoring is the better choice over continuous monitoring or no monitoring.

 

So it’s wonderful that the CMA are on board with this initiative to stop overuse of unnecessary testing in medical care, but what is not wonderful is that

The Women’s Health section does not have a single word about maternity care.

Not a one.

So what’s up with that?

Now, Choosing Wisely had their inaugural meeting at the end of March, 2016, so I guess I should be a little kinder and give them a bit more time, but in the mean time if you feel like I do that there should be a large section on Obstetrics on their website, please visit their site and give them feedback! And please let me know what you said in the comments section below.

Practice Defensive Birthing

Defensive birthing

Nowadays hospitals are practicing defensive medicine – which basically means they feel they have to use all their tools and interventions to prove that they’ve done everything they can to produce the best outcome.  But their idea of the best outcome starts and ends with a healthy baby. Sometimes the Mother gets lost along the way.  Mother friendly hospitals acknowledge that the mother’s experience is also important –a traumatic birth experience can result in poor bonding between Mother and Baby which can effect breast feeding success and cause postpartum depression. There are ways to optimize your birth experience even in the most intervention – happy hospitals.

Here are a few tips to help you negotiate these common road blocks on the way to your best birth:

 

speed bump

Childbirth is not an area where ignorance is bliss. You wouldn’t leave on a road trip without checking a map, don’t go blindly into labour. Go to prenatal classes, read books, decide what kind of birth you want and write a birth plan. For tips on how to do that, check here.

 

 

slow

 

Transfer to hospital can slow down or even stop your labour. If you show up too early the hospital may feel the need to ‘do something’ to speed you up. Stay at home as long as possible.

 

 

do not

Well meaning nurses undermine your determination to have a natural birth by offering drugs every 2 seconds. Get the nurses on your side. Hit the drive through on the way to the hospital and pick up a dozen donuts. Print out a sign that says “We are trying  to have a natural birth! Please don’t talk about epidurals! I’ll ask for one if I want one.” Stick it on the donut box. Print another and stick it to the door.

traffic lightsUnfamiliar places make relaxing into labour difficult. Treat the hospital room like a hotel room. Don’t be afraid to open all the cupboards and check the place out. Use all the blankets and pillows, don’t be shy. You are paying for this room, make it yours. Find the light switches and turn them off!  Bring your bedside lamp from home or some battery powered candles and dim the lights.

 

picnic-areaYou need to eat and drink to keep your strength up – but do not expect the hospital to provide you with decent food. Bring a picnic and choose your snacks wisely. Nothing too smelly! Some old school nurses still believe you should restrict food and drink in labour, even though the research doesn’t support this and even the American Society of Anesthesiologists has stated that it’s okay.

 

pedestrian_crossing_vector_sign_9603The bed looks really inviting  but it’s best to stay upright as much as possible. If you must be monitored insist on sitting upright preferably on a birthing ball to keep your hips open and flexible.  Play music to calm and soothe you, or get you up and dancing. Moving your hips is a great way to get baby to move down and out. Dance and sway and walk around the floor.

 

car-wash-When you are beginning to think you can’t do this anymore -use the facilities! Seriously, if there’s a tub you want to get in it. And here’s a little secret – those pillows can totally go in the water. They’re designed to clean up after all kinds of bodily fluids, so if you need a bath pillow just grab one off the bed and use it. Hydro therapy can be very effective and if you are feeling like you might want an epidural, try the shower first.

 Bring a supportive pit crew. Your partner, a doula, a RMT, pit crewyour best friend. The more support the better.  How nice it can be when one person is rubbing your feet and another your back while a third is bringing you a drink of ice cold water. Your birthing suite should be like a 5 star resort with a spa, and you should be treated accordingly.  Unfortunately this isn’t usually the case, so you must bring your servants with you. If you find you prefer solitude when labouring, park your people at the door to keep it closed.

stop sign

Don’t let anyone tell you what to do. I’m not saying ignore doctor’s advice, but if you feel like you’re being bullied, you are. You can tell your doctor to change his attitude or get out. You can tell your nurse to shut the f up. You are in labour, dammit, and you can get away with anything! And have your pit crew back you up. A chorus of “she said no” is helpful to remind the staff that consent is actually required before they do anything.

 

wiggle road sign

 

Try to enjoy the journey. Your labour may seem endless while you are in it but soon it will be over and your baby will be in your arms. And then the real trip begins!

 

 

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