Prenatal Education at Quinte Midwives

I am thrilled to announce that, beginning in April, I will be teaching regular prenatal classes at Quinte Midwives in Belleville. These classes are open to all expecting moms and their partners (or other support person), not only those who are clients with the midwives there. This course is designed to help you feel confident, calm and prepared as you approach your birth and new parenthood. It will also provide your partner with skills and knowledge that will aid them in supporting you during labour and birth, as well as postpartum.

Details of the first course:

Tuesday evenings, from 6 pm to 8:30 pm
5 weeks, beginning April 22nd, 2014
$200 per couple ($50 deposit due upon registration)
Quinte Midwives, Belleville

Topics for the course will include (but will not be limited to):

  • natural pain management and coping strategies for labour
  • the physiology of labour and birth
  • positions for labour and birth
  • risks and benefits of common interventions (including pain medications)
  • breastfeeding
  • postpartum care
  • newborn care and characteristics

To register, please fill out the contact form after the jump. Continue reading

Prenatal Education in Cobourg!

photo credit: Zixii via photopin cc

photo credit: Zixii via photopin cc

I am excited to announce an early spring weekend prenatal course at House of Wellness in Cobourg! This is a two-day intensive course designed to help you feel confident, calm and prepared as you approach your birth and new parenthood. It will also provide your partner with skills and knowledge that will aid them in supporting you during labour and birth, as well as postpartum.

Continue reading

MamaViews: How to Get the Most From Your Relationship With Your Doula

While I’m working on part two of my post about prenatal exercise, I thought I’d share something with you to tide you over! The lovely folks over at MamaViews recently asked me to contribute to their article, How To Get The Most From Your Relationship With Your Doula. Check it out by clicking on the badge below!


Exercise in Pregnancy Part One: It Does Your (and Your Baby’s) Body Good!

As a fun addition to my doula and childbirth education work, I have recently been training to become a pregnancy fitness educator. Pretty soon I’m going to start offering classes for moms who want to stay fit and limber during their pregnancies, and who want a little guidance, as well as a group to join, in order to do it. All of the reading that I’ve been doing as part of this training has made one thing abundantly clear – exercise during pregnancy is (for the vast majority of women) a good thing. Today I’ll be talking about the physical benefits of exercise for mom and baby (mom may be doing the exercise, but everybody wins!) and then in part two of this post I’ll delve into the less well-known, but equally important concept of body trust and why it matters for pregnancy, birth and the postpartum. Continue reading

Warm and Fuzzy: New Client Testimonial

Another testimonial from a wonderful client. There’s nothing like the privilege of being invited into someone’s birth experience.

We looked at a number of Doulas before selecting Heather. She provided exceptional care and support throughout our unexpected excessively long labour. Her skills and wisdom, especially in regards to pain management were especially helpful. Over four days she became part of our home and helped us to welcome our little girl into the world. We would highly recommend Heather as a Doula, she offers exceptionally good value, especially considering her extensive knowledge base.

 

Birth Without Fear

'They felt comfortable knowing that they had two knowledgeable and experienced midwifes and a doula to support them,' explained Ms Dives

Photo credit: Jackie Dives

I came across a beautiful set of photographs this morning, in the UK Daily Mail and wanted to share them with all of you. Check out the full article and photo series here.

Taken by fellow doula, Jackie Dives, these pictures really capture the beauty of a home birth. There is a level of bliss that seems only attainable in birth when a woman is truly comfortable, cared for and respected. It’s a pretty hard thing to achieve in a hospital setting but I see it every single time at home.

Obviously, home birth is only right for those who really want it – in other words, if you’ve done your research and you feel you’d be more comfortable in a hospital, then that’s where you should be – but for those who prefer it and who work with their midwives and are deemed good candidates for home birth, let no one call their choice “wild or erratic” again.

To learn more about home birth and the studies that have been done to determine its safety, check out my post (Home)Birth. Is. Safe.

Plan Schman?

I recently came across a blog post on the subject of birth plans and whether it’s worth writing them. (Full disclosure: I now can’t find the original post, or I would link to it here…). As a doula, I have always encouraged my clients to write birth plans and I believe that there are very real benefits and little to no risk, as long as you recognize why you’re writing it and acknowledge both your hopes and your fears while doing so. Continue reading

The Motherbaby Dyad: Can maternity care ever truly be ‘baby-friendly’ without first being ‘mother-friendly’?

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Most people now acknowledge that close physical proximity between mothers and babies during the first hours, days, weeks and even months of life is ideal for both. We know that being skin-to-skin encourages the baby’s oxygen levels to remain stable, that it regulates her temperature, that it encourages bonding between the two, that it stimulates milk production in the mother’s breasts and that babies held skin-to-skin for long periods tend to cry much less often (and have lower levels of stress hormones as a result). We know that breastfeeding on-demand helps both mother and baby adapt to life after birth; that room- and even bed-sharing helps everyone get more sleep, can prevent SIDS and make breastfeeding easier; that picking up a crying baby rather than letting them ‘cry it out’ keeps stress levels low and tends to lead to less anxiety later in life. Basically, the goal in all of these things is to allow the newborn to live outside of the womb in a manner that resembles life in the womb as closely as possible. Human babies are born essentially premature when compared to other mammals. While the calf can walk at birth and the baby chimp can cling to it’s mother’s back while she climbs, human babies are still essentially foetal. Why? Simply put, we walk upright, which affects the size and shape of our pelvic bones and we have big brains, which require large skulls to keep them in. In order for our human skulls to fit through our human pelvises (which they do very well, thank you very much – remember, as Ina May says, “Your body is not a lemon.”) we must be born early relative to other mammals. This works out ok, as long as we are prepared to care for what is essentially a foetus living outside of the womb. Doing so is even more demanding than pregnancy and requires support systems, maternity leaves, lots of encouragement and the ability to pick oneself up again time and time again (i.e. self-compassion). I have written before about the importance of community and social support systems for new parents but today I am thinking about the process of labour and birth and how they affect both mom and baby (or, motherbaby as many people are now referring to newborns and their moms to signify the importance of caring for them as a single entity). We accept that what happens after birth affects both mother and baby, but the evidence also shows that how a mother is treated prenatally and during labour and birth affects both individuals as well. So what does it mean for a hospital to be considered “mother-friendly” or “baby-friendly” and why are these two separate sets of considerations? Continue reading

Late Summer Weekend Prenatal Classes

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I am offering another weekend prenatal course in Toronto in August. This is a two-day intensive course designed to help you feel confident, calm and prepared as you approach your birth and new parenthood. It will also provide your partner with skills and knowledge that will aid them in supporting you during labour and birth, as well as postpartum.

Join me on Saturday, August 17th and Sunday, August 18th, 2013 from 10am to 5pm at the Centre for Social Innovation (Annex – 720 Bathurst St.).

To register, email register@labourdoula.com with the following information:

  • your name and your partner’s name (if applicable)
  • your phone number and email address
  • your expected delivery date and expected place of birth

This course is ideal for those expecting a baby between September and November. The course is $240 per couple. Discounts are available for doula clients.

Topics for the course will include (but are not limited to):

  • natural pain management and coping strategies for labour
  • the physiology of labour and birth
  • positions for labour and birth
  • risks and benefits of common interventions (including pain medications)
  • self-advocacy/informed decision-making skills
  • breastfeeding
  • postpartum care
  • newborn care and characteristics

Wondering why you should take an independent class instead of one offered by your local hospital? 9 great reasons here.

photo credit: peasap via photopin cc

FAQ Friday: Pain in Induced vs. Spontaneous Labours

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Following up on last week’s inaugural FAQ Friday post, in which I responded to the question, “how is a doula different from a midwife?“, this week I will be addressing a question that was posed to me by a reader: “what is the difference between pain experienced during a natural childbirth and during… an induction?”

A little background to start us off, in case you aren’t familiar with the term “induction”. An induction is when, instead of waiting for labour to begin on its own (or, ‘spontaneously’), measures are undertaken to force the body to go into labour. Usually when we refer to an induction we mean a medical induction, where various steps are taken by medical practitioners in order to cause labour onset.

The word induce is a verb meaning “to bring about or give rise to”. While a medical induction is certainly the most aggressive and surefire way to make labour start, there are many non-medical techniques that women have traditionally used when they want to hurry things along a little. These may include acupuncture, eating certain foods (such as spicy things or pineapple), having sexual intercourse involving both female and male orgasm, or taking homeopathic and/or herbal remedies. Castor oil is also commonly ingested to bring on labour, though many women report unpleasant side effects, so this should only be tried as a last resort (i.e. to avoid a medical induction) and with the blessing of your healthcare practitioner. A medical induction may involve three steps:

  • if the cervix is not yet ‘ripe’ (i.e. it is not yet softening, shortening or opening) a synthetic prostaglandin gel is applied to the cervix directly in order to encourage it to soften and dilate (one of the reasons that sex involving male orgasm is helpful is that semen contains prostaglandins)
  • once the cervix has dilated a little bit, an amniotomy is performed. This is more commonly known as when a doctor or midwife “breaks your water” (aka AROM – artificial rupture of membranes). This is done using an amnio-hook, which looks a little bit like a crochet hook. The hook is inserted into the opening of the cervix and the bag of waters is punctured.
  • sometimes immediately following AROM, but sometimes after a period of waiting (in which labour may start on its own), Pitocin is administered. Pitocin is the brand name for synthetic oxytocin. Oxytocin is the hormone that is secreted during labour, which causes uterine contractions (here is where the female orgasm is handy – our brains also release significant amounts of oxytocin when we have orgasms…also when we kiss, hold hands, sing in chorus…). Pitocin is administered by an IV and the amount is increased gradually until contractions are happening frequently and with enough intensity to cause the cervix to open fully.

As you can probably gather from the above description, a medical induction is a way of simulating the natural processes that typically cause spontaneous labour onset. As with almost any intervention, each stage has some risks or drawbacks, including increased likelihood of a Caesarean section, in the event that the induction fails (a Bishop’s score is a means of assessing the likelihood that an induction will succeed in advance).

One of the biggest drawbacks to inducing labour is what the original question alludes to, that is, increased contraction pain. While every birth is different and some women experience more or less pain than others (indeed, many women experience no pain at all in labour), it can be said in general that an induced labour is significantly more painful than labour that begins on its own and proceeds without augmentation (augmentation is the use of Pitocin in 1st stage labour when it is felt that labour is not progressing rapidly enough).

Why is this? There are a couple of reasons. First, because Pitocin is not your body’s naturally produced oxytocin, but a synthesized form, it affects different people (and their uteri) differently. This makes it difficult to know how much to administer from woman to woman in order to get labour going gradually they way it most often does when it occurs spontaneously. One of the reasons that women who are induced are required to wear continuous electronic foetal monitors is because of this. One monitor shows how strong the contractions are (though not always accurately) and the other shows the baby’s heart rate (again, not always accurately). This is important because babies are affected by the contractions of the uterus and if they are too intense, this can cause foetal distress.

In addition to dosage issues, Pitocin is a substance that is being introduced to the body from outside, rather than being released from within the body as a part of a complete system. Oxytocin is only one of the hormones produced in the body during childbirth. When labour happens on its own the body is responding to prior hormonal secretions (such as melatonin) and subsequently causing others to be released (such as endorphins). When labour begins spontaneously, it usually does so somewhat gradually. The most definite sign of ‘true’ labour is contractions that progress – that is, they become stronger, longer and closer together over time. As they become more intense, longer and more frequent, the body begins to release increasing quantities of endorphins, which allow the woman in labour to cope more easily with the contractions themselves. Endorphins can reach a potency that is significantly stronger than morphine. These hormones (melatonin, oxytocin, endorphins) have a synergistic relationship to one another – that is, they enhance each other’s effectiveness in the body. Because Pitocin is synthesized and administered artificially, the body’s ability to respond with appropriate amounts of endorphins is compromised. It can’t keep up. It is important to note, that the release of endorphins can also be compromised by the release of stress hormones – catecholamines – such as adrenaline. This means that any interruption that causes stress, fear, humiliation, etc. in a woman has a direct impact on her physiologic ability to cope with the sensations of labour. These stress hormones can also interfere with the release of oxytocin, which then may lead to augmentation with Pitocin because contractions are slowing or stalling. For many people, simply being in a hospital is a stressful thing, which may be one reason why statistically speaking, hospital labours tend to be longer and tend to lead to a greater number of interventions, such as augmentation or pain medication, even when they begin naturally.

When you look at naturally occurring contractions on a monitor, they look like hills that have a slow incline, a rounded peak and a slow decline. As labour intensifies, the slopes on either side become more extreme and the peaks get higher. Contractions caused by Pitocin on the other hand, tend not to have very gradual slopes and have much higher peaks, earlier on. They look spiky, rather than hilly. In other words, induced labour hits women much harder, faster, instead of allowing for a gradual ‘easing in’. Add to that the fact that your body’s pain ‘medications’ – endorphins – don’t work as effectively when the system is circumvented, and it’s no wonder that women who have experienced both induced labours and spontaneously occurring labours say that the former are much more painful than the latter.

Do you have a question you’d like me to answer? Maybe you’d like to know more about induction, or maybe your question is on another topic altogether. Anything goes! Leave it in the comments and I’ll be happy to tackle it next week.

photo credit: Fire Engine Red via photopin cc