3 Doulas

We've Come a Long Way baby

By jenny Gillespie

Ok, so most of you reading this probably don't remember ever seeing the slogan for the Virginia Slims add campaign: "You've Come a Long Way Baby!".  Well that slogan comes to mind when I think of how far hospital births have come.... 

Gone are the days when newborns were whisked away from their mothers and taken to the nursery so that mom "can rest".  Babies would inevitably be brought back to mom with a tell tale milk mustache, and I am not talking breastmilk!  Twenty five years ago, the nurseries were packed with babies all lined up by the viewng window so that proud dads could show off baby to visiting family and friends.  Today the nurseries look deserted, they are quiet, why?  because baby is with mom, where she belongs.

Gone are the days...

Ok, I am jumping ahead of myself here, I want to go back a step to Labor and Delivery.

Twenty five years ago, when my first baby was born the delivery room was a very different place from what it is today.  A lot has changed since then, and as a doula for over ten years I welcome those changes..Things aren't perfect, but they are much better!

Some differences between then and now:

Then..If I"d hired a doula, the nurse would have told her to wait in the parent's lounge!  "It's too crowded in here! mom doesn't need you, I am here, I have done this for 30 years, she's in good hands"

Now.. "Oh I see you have a doula, hi there! let me show you where the ice machine is" (some things will never change).

Then..If I had given the nurse my birth preferences (typed up on my manual type writer), her response would have been :" Pffft, you don't need this, I KNOW exactly what you need, now hop into bed and be a good girl, I'll be right back with the enema..."

Now.. "Ok these are your preferences right?  Let's go over these together"

Then.. The nurse's response to my tentative attempt at bending the rules: "walk around, oh no no that is absolutely out of the question... a shower, well our delivery rooms don't have those, you should have taken one at home"

Now.. The response goes something like " Let's see how everything goes...Does dad have trunks?  We don't like seeing naked dads around here!  too scary!!"

Then.. The nurse takes baby and says: "I'll be right back with a clean, nice smelling baby!"

Now.."Congratulations Mommy, let's put this little one on your chest, skin to skin is the best thing for both of you"

Anyway the list goes on..But some things don't change... Check in tomorrow to find out what habits are hard to break!!

 

 

The Unconsidered Risks of C-Sections

By: Mandy Schutt

I love cesareans! I mean it, I really love them. I appreciate that they can be done today when a hundred years ago, mothers and babies were dying for reasons that can now be solved by a common procedure. Along with cesareans, I love triple bypass surgery (this procedure saved the life of my grandfather), kideny transplants (this procedure saved the lives of two of my young students when I was an elementary school teacher) and I even love oral surgery (I've assisted with several of these  when doing aide work abroad and seen how much relief they can bring). So, yes I will proudly state that I am a fan of the cesarean.

Here's what I'm not a fan of: The fact that today in America one out of every three births is a surgical procedure. The World Health Organization recommends that the cesarean rate in industrialized countries should be between 10 and 15%. The newest studies find that we are just about doubling that.

What I'm even less of a fan of is how we as a society have bitten into this as being acceptable. Imagine finding out that the rate of kidney removal was double what it should be: wouldn't we ask questions about why this is happening, who's making money from it, and how the problem can be fixed? If double the amount of kidney surgeries were being performed that cut open and manipulate a persons' insides for no reason, we'd be outraged! We'd hopefully be suspicious going in for a routine physical and hearing from our doctor that kidney surgery was necessary. Wouldn't we start doing research? Get a second opinion?

Of course, kidney transplants are extremely necessary in some cases, much like cesareans, but wouldn't we want to be 100% certain of this necessity before we went under the knife?

I could go on and on about the surgical dangers involved in cesareans, but those facts are all relatively easy to find simply by using the google box at the top of your computer screen. In reality, a cesarean IS a major surgery, with risks involved but in all honesty, most women who have them come out alive and eventually physically healhty. In my opinion, it's time for birth activists to lay this approach aside and address cesarean risks from an entirely differrent angle. Let's examine some new criteria that address the other-perhaps lesser explored- down sides of cesarean delivery:

LOST MOTHER-INFANT BONDING:When a woman labors and gives birth naturally her body creates the highest amount of Oxytocin (aka "the love hormone") that it ever has. Remember those butterflies you got in your stomach when your first boyfriend helpd your hand? Or the feeling you got when looking at your soul mate accross a crowded room? That's Oxytocin at work! When a mother is not allowed to hold her baby after a cesarean and when her body has been flooded with drugs for surgery, that precious moment of mother-child bonding accompanied by the Oxytocin high, is lost forever. Most mothers after the surgery are able to see their newborns for mere seconds before they are swept away to be bundled up while the mother is stitched back up. Often it is more than an hour's time before mother and newborn are reunited.

DIFFICULTY BREASTFEEDING: When a mother exits surgery, she has been heavily drugged and has several tubes attached to her on various parts of her body. This makes mom groggy, often sleepy (I've seen mothers so sleepy, they can hardly keep their eyes open to take in the beauty of thier new baby), and unable to confidently feel or control their arms enough to hold thier child while attempting to breastfeed. Additionally, the hormones that create the milk ejection reflex, have been interfered with through medication necessary for surgery.

NO SKIN TO SKIN CONTACT: After a cesarean section, a mother is still in surgery. She is not able to hold her infant. Instead of receiving that wonderful skin to skin contact, we now know is so important, the child is instead taken out of the mother's sight (most often, out of the room) and is in the hands of unfamiliar nurses.

The above cesarean risks are rarely discussed when women are contemplating the pros and cons of a cesarean. While a mother may be able to come to grips with the idea of a longer recovery, hightened chance of infection, and even surgery for herself, when she is made aware of the additional psychological and physiological risks that can affect her newborn, she may not be as obliged to go under the knife. Certailny, there are situations when a cesarean is an appropriate, life-saving measure, but true emergency c-sections are few and far between.

I encourage every woman of child-bearing age to sincerely educate themselves on the risks and appropriateness of cesarean sections BEFORE you are in labor and on the spot to make an uneducated decision that will not only affect your baby, but your future birthing options as VBACs are becoming more difficult to come by.  A great place to start this research is at ICAN's site dedicated to cesarean awareness.

 

Newborn Sleepy-Time Tip

By: Mandy Schutt

 

Before having their own babies, many moms imagine staying at home with their newborns to be a relatively easy gig. The imaginary mothering scenario goes something like this:

1. Nurse baby.

2. Baby falls asleep.

3. Put baby in bassinet.

4. Have a couple hours of time to sleep/make dinner/work from home/email/etc.

Many moms instead find the first few months after giving birth to be anything but easy. The realistic mothering scenario can often go like this:

1. Nurse baby

2. Baby falls asleep

3. Put baby in bassinet

4. Baby wakes up crying.

5. Nurse baby again

6. Baby falls asleep

7. Baby wakes up crying.

Repeat from step one and then add in step 4b: "Mom joins baby in crying" 

As a postpartum doula, I’ve seen this scene time and again. As the hours, days, weeks, drag on mom’s exhaustion escalates creating for a rough postpartum experience.

There are some times when the baby’s crying is caused by a larger problem ranging from colic to gas bubbles to rash. But most of the time when I am with a mom on the verge of tears, I am able to help her solve the problem by a few pretty simple techniques that which recreate the womb environment. We must remember that newborns are called newborns for a reason; they are newly born and used to being inside warm, calm, bouncy tight-quarters (aka “the womb”).  Recreating this familiar environment for an infant can be most comforting.

A snug swaddle can work wonders with a fussy infant. Be sure that Baby is in a clean diaper, is not over or under dressed (sometimes in hot CA days, a baby may benefit from being almost naked under the swaddle), and then swaddling the little one in a proper-and I repeat, PROPER- swaddle. A swaddle is not just a quick burrito wrap in a blanket. Many moms think they are swaddling but in fact are wrapping the blanket just tight enough to annoy the baby and create a sort of tactile over-stimulation, which is exactly opposite of what a good swaddle should do.

Here’s a helpful video of a dad (I find dad’s are usually pretty awesome at swaddling once they learn technique) swaddling a 5 day old…and don’t get me started on how deliciously gorgeous the baby model is in this video. A. DOR.A. BLE. In the video, the dad mentioned “The Happiest Baby On The Block”. Personally, I’m a fan of most aspects of this program and use it often while working with new parents.

Most of the time babes are not crazy about the swaddling process so I tell parents to take a deep breath right before doing it, to continue talking to their baby, explaining what they are doing, “Mommy is just making you all cozy in this swaddle, it’s just going to be a little longer and then we can cuddle again…”and NOT rushing through the process. If swaddling is a new skill, this is especially important to remember. While it may seem that you need to move fast to get through the steps faster, this usually results in a sloppy swaddle and in the end is much more frustrating.

Once baby is swaddled, bouncing is helpful. To do this easily, parents can hold baby while sitting and bouncing on an exercise ball or jauntily walking. Bouncing is often much more effective than rocking.

Keep in mind that it usually takes time for an infant to fall asleep. Most babies need at least twenty minutes of comforting and lulling before they are in a deep sleep. This can seem like forever to an exhausted parent, but hang in there. Once Baby is no longer twitching, and their eyes have stopped fluttering, they are in a deep state of sleep and can usually manage to be put down for a snooze…parents should follow suit if at all possible.

For more information on how to perfect the swaddle as well as other baby-calming techniques, check out The Happiest Baby on the Block program. If you are interested in a Happiest Baby class or consult, contact Mandy Schutt.