March 3, 2016 by gentlemidwife

Do I Need a Doula if I’m Planning a Homebirth?

So you’ve heard of the advantages of having a doula with you if you’re planning a hospital birth. The positive aspects include such things as: continuous support that doesn’t change shift, possibility of laboring in the comfort of home knowing someone will help you decide when it’s time to go in, someone who can help you and your spouse keep perspective and act as a liaison with the medical staff, a friendly person to call directly with questions during those last days before labor, and the list goes on. All of these things sound good, but if you’re planning a home birth, then you don’t need all this, right?!? You already know who your caregiver will be, you’re staying in your comfy home, your midwife will provide support and perspective, and you can call your midwife directly…which means that a doula is totally unnecessary, correct?!? Well, that’s a question I hear often, and I wanted to take some time to explore how a doula can actually be a great benefit at a homebirth, as well. If you’re trying to decide whether or not you want to add a doula to your birth team, hopefully this post will give you some help, and maybe even answer some of the questions you have.

To get some input on this subject, I contacted several different groups of midwives, doulas and birthworkers, and asked them to tell me from their experience how homebirths could benefit from doula support. Their responses were very helpful, and provided the bases of what I am going to share below.

When it comes down to it, a midwife and doula offer to distinctly different services. While both are attempting to provide women with personalized, professional care, they are coming at it from two different angles. A midwife’s job is to help ensure that mom and baby both maintain the low-risk status. She is concerned with providing a safe, professional and knowledgeable environment to women seeking out-of-hospital births. This means that she must put mom and baby’s safety first-which sometimes means that she will have to stop providing labor support in order to monitor heart tones, for instance. There are also those times when the midwife will need to conserve energy in order to maintain the needed mental and physical alertness needed for the actual delivery, which may mean not being able to constantly apply back pressure for hours on end! For some mamas, especially those who appreciate privacy, a midwife and her assistant may be all that she needs in order to feel supported and cared for, but there are others where this may not feel like enough. As a midwife myself, I seek to provide labor support whenever I can, but I am also always acutely aware of what is going on medically. The role of a doula is that of providing consistent emotional support and physical support. Because she does not have to be responsible for the medical aspects of birth, she is free to focus on helping the couple work together, and helps mom to achieve the space and birth atmosphere that she desires, without distraction.

At a homebirth, a doula can:

Give valuable input and educational support during the prenatal period.
Provide early labor support, and help the couple decide when it’s time to call the midwife to come.
Free dad up to focus on mom by paying attention to other details (like keeping the tub water warm, setting up the bed, changing linens as needed, keeping birth atmosphere tidy, etc.).
Keep mom and dad fed and hydrated.
Help the birth team to remember mom’s preferences-whether it’s the desire for quiet and privacy, or a certain music playing at a certain time, she keeps everyone aware of what mom wants.
Help with comfort measures such as massage, positioning techniques, etc.
Provide positive encouragement about progress and what is happening.
Give mom support during pushing, especially for those families where daddy wants to catch, and mom still needs support by her head that is focused on HER.
Assist with childcare as needed, especially if children are present for the birth.
Help the mom to feel an extra measure of help and support, through extended availability before and after, and checking on mom’s emotional well-being during the initial postpartum period.
Protect and nourish the new family’s space as nursing and bonding are taking place.

A doula is especially beneficial when:

A mom is expecting her first baby or is planning a VBAC. The potential for prodromal labor and/or need for extra physical and emotional support make a doula an especially good choice for these moms! For the same reasons, moms who have a history of long labors may also find a doula an excellent addition to their birth team.
Mom is lacking other support systems. For single moms, or those who have no family or close friends nearby, a doula can be a tremendous asset in providing a consistent, dependable support person during the pregnancy, labor, delivery and postpartum periods.
When using a very busy midwife, or if your midwife has travel plans over the time you are due. If you know there is a good possibility that you may be using your midwife’s backup, then having a doula whom you have already connected with can help make that a smooth transition, as you won’t have to totally “start over” with your birth team.
If your chosen midwife usually practices solo (without an assistant). In these cases, it may be hard for her to provide consistent labor support, as she will have many responsibilities to stay on top of.
When mom knows that she needs extra hands and extra support. Some moms prefer quiet, privacy and extreme “hands-off” during labor, while other moms know that they would relax better when surrounded by encouragement, positive input, touch, massage, etc.
If you’re planning to have your children present at the birth, and don’t have a specific care-giver for them. This can allow dad to spend time with mom or with the other children, and know that no one is being neglected!

So, to tie all of these comments up, you can see that a doula can be a lovely complement to a planned home birth. The moms who have experienced doula care at a homebirth made comments such as “I wouldn’t do it any other way”, “it was the ultimate support group”, “I gained a trusted friend”, “My doula could be someone my midwives could never be (though my midwives were awesome and perfect for me)…All her energy and focus went to me, she had no other obligations”, “she provided a different perspective”, “the little things made a big difference…her doing things that allowed my partner to stay with me was key”. The midwives who have had doulas present at births say, “Doulas are worth their weight in gold, literally!”, “The women who have both feel SO supported”, “Having a doula…helps to share the load, and each individual has something different to bring to each unique situation”, “Doulas provide a different type of connection”, “I think there are some births where there is plenty of work for many hands…and some where there isn’t”.

All that said, I do want to underline the fact that each mother and each birth is unique. While having a doula can make your birth experience even more special, I totally understand that it is not the choice for everyone. For some mamas a more private, intimate and quiet birth environment with as few people as possible is better. And this is totally okay. It’s one of the beautiful things I appreciate about the option of birthing at home…the birth team can be personalized to suit the preferences of the individual mom. Each mom/couple has to figure out what is right for them, as this is what will enable them to relax and give birth in the best way. The goal of this article is not to make you feel like you HAVE to hire a doula! But for those who have wondered if a doula could be beneficial, my hope is that you now have a better picture of how a doula can fit in to your homebirth plans, and how this option can make a mama feel even more supported.

Did you use a doula for your homebirth? Or have you been a doula at a homebirth? I’d love to hear about it! And if you’re looking for a doula, be sure to check out www.doulamatch.net in order to find out about doulas offering services near you! For those living in central PA, I’d be glad to refer you to some excellent doulas who serve the surrounding areas.

February 6, 2016 by gentlemidwife

The Peaceful Birth of Talitha ~ Part 2

Here is the promised second part to Talitha’s birth story. If you want the background leading up to where this story begins, click here.

By this point in the afternoon, the noise from downstairs was almost constant, as Chris was doing his best to finish the basement project up by evening. Lucy had called telling us that their ETA was around 8pm, and just ecstatic to hear there was a good possibility that she might get to be around to see her nieces’ birth (we had told her before that we would love for her to be there, but also told her not to get her hopes up, as there were still two weeks until the due date. I think she prayed pretty hard!). I think it was around 5 or 6 that I went ahead and took a dose of castor oil, hoping that it might help things move along in order to have a baby by morning. We were just getting ready to sit down for supper around 6:30, when Rose arrived at the door-she thought she’d just come hang out, and check in on us! During supper, she noted that I was having to breathe through contractions pretty consistently, to which I replied that “I can still talk through these so I’m trying not to notice them”. She just smiled. Chris ended up clearing out of the basement around 8pm (Joel finally told him he’d better just clear out-he hardly had time to finish the project after waiting so long to start in the morning!), giving us about 20 min. to sweep, dust, and start getting the bed ready, when Daniel & Lucy arrived at 8:15. Lucy assured me that she could make the bed. By now I was starting to notice the contractions, so I took Rose to see where baby things were, and we talked more about where we were planning to do the birth, etc. We opted to “camp out” on the main floor, as Daniel was going to be banished to the basement, and we were hoping the toddlers would sleep through the birth in their own beds upstairs. One huge blessing of home birth is the ability to be flexible with the birth location! (oh, and we became more flexible as the evening wore on…)

At 9pm, I felt that release of pressure and felt the trickle that made me think my water had broken…and sure enough, the next contraction confirmed that! Now THIS felt like the “real deal”, and I knew I didn’t have much time before needing a place relax free from distraction. I told Joel that it might be a good idea for the children to go to bed (they were still super excited about the arrival of their aunt and uncle), and he caught the drift, and hustled them off to bed. Daniel disappeared, and it didn’t take real long for our living room/fireplace room to be transformed into a birthing room! Joel had borrowed a large air mattress which he set up in front of the wood stove, and Rose & Lucy got all the supplies out and in good order. I found it most comfortable to sit on the ball, as it helped to be able to move and relax at the same time.

I had always dreamed about having lovely music playing while I labored, and during my pregnancy had been very blessed by the “Sleep Sound in Jesus” CD by Micheal Card. Joel so sweetly made sure to put it on, and I can still remember how special it was to meditate on some of those lovely songs between and during contractions. The mood of the room was so peaceful, with the lamps turned low, Rose & Lucy quietly chatting in the corner, Joel holding my hand (and not minding my squeezing him…during labor I DO NOT want to be touched, but I sure need his hand to squeeze!), and these sweet songs filling the air. The one in particular that stood out to both of us was “Even the Darkness is Light To Him”…the lyrics that kept repeating in my mind were “so you are safe as the light grows dim, even the darkness is light to Him…The Father above does not slumber or sleep, He wakefully watches our ways, then there’s no reason for you to weep…would not Jesus safely keep…?” Even though it was intense, it was also amazing to me to feel so at peace and at rest, after so many events, activities, responsibilities, etc. that had taken place those last weeks and months.

Time seems to stand still during labor, or at least you lose all ability to gauge time. I think I spent about 45 min. or so laboring on the ball, and feeling grateful that this time I had a chance between contractions to completely relax and prepare for the next one (so unlike my previous birth!), even though they were coming about every 2-3 minutes. Joel would encourage me, Lucy would ask questions about labor and birth, we’d all chat for a little bit, and then another one would hit. Although I have such peaceful memories, I’m also struck with the fact that I vividly remember thinking “this is the hardest work I have ever done in my LIFE…how on earth can women forget how hard it is to have a baby?!” So there is one perspective on the roller coaster of emotions in labor! Another thing, that when I’m not in labor I can laugh about, but the one piece of instruction that stands out the most to me from all my years of working with other midwives and childbirth educators, the thing I remember is “if your lips are loose then your cervix is too”. I can’t remember who said it, but it sure is practical! For some reason, that is a point I can focus on, trying to keep my face muscles loose, and thinking about how it means everything else is loose and open, too.

Sometime between 10:15-10:30, I all of a sudden wanted to go to the bathroom. Once again, you’d think I’d know, but when Rose asked if I thought it was time to push, I told her that surely things weren’t that far yet, and that I was positive this was just a result of the castor oil. She looked skeptical, but being the sweet midwife that she is, she just said to go ahead. As I moved to the bathroom, Joel left to get something in the kitchen. Once I sat down, I felt one massive contraction coming on, and immediately needed his hand. After several extremely intense back-to-back contractions, there was that massive feeling of pressure, and instant change in tone. At this point, Joel strongly encouraged me to move off the toilet…and I’ll admit that inside I was thinking that that was a totally crazy suggestion…lots of babies are born on the toilet…and how on earth can I move now?!? However, Rose had quietly brought in the birth stool, and when I saw it next to me it looked possible to move, which we did as soon as the next contraction was over. I can honestly say that I don’t find pushing enjoyable…it’s like the last sprint in a long race, and I wonder if I’m going to be able to do it…but within 2-3 contractions, our little Talitha entered this world at 10:46pm. Only 1 hr. and 46 min. after my water broke and active labor started-and the castor oil wasn’t even necessary! She seemed a bit stunned, and took a bit to pink up and really cry…I kept rubbing her over and pinching her toes and telling her to breathe…Rose commented that I sure couldn’t quit being a midwife, could I? Once she gave a good long cry I held her close, and was amazed-she was no little baby, and she had a lovely head of dark hair!

Less than an hour old here, I think!

The remainder of postpartum went well…I moved from the bathroom (seems like births have a habit of happening in the tight, small quarters of the house!) and snuggled into the temporary bed set up in front of the cozy woodstove (that night was one of the coldest we had that winter!), then Rose did the newborn exam. Even with all my determination to grow a smaller baby (her brother had been 9#), and all my attempts to eat a strict diet and exercise regularly, this baby girl weighed 8#15oz, and that at a good 2 weeks early! And no, my dates weren’t off! Big

Yoanna meeting her sister

sister Yoanna got to come down and kiss the baby, and her eyes full of awe were so sweet as she gazed on her little sister. After some food, and an absolutely lovely shower, I was packed off to my own bed upstairs. The ladies had the house looking normal again, Rose headed home (by now the snow had stopped, and the snow plows had gone through), and we enjoyed the pampering of Aunt Lucy for the next 4 days. Having her around to entertain the toddlers, cook meals, clean the house, and take care of all the little details was a tremendous blessing, and another gift from God.

Talitha Shalom means “Little Girl of Peace”, and it’s our prayer that she will embody this name as she grows, and that her life can be filled with God’s peace…just like the night of her birth was!

The children meeting baby the next morning

Three little ones to nurture!

Capturing her expressions

Dear Aunt Lucy and Uncle Daniel!

Less than 24 hours old!

Mama has her hands full!

Talitha with baby E-the one I caught just two days before my birth…this was their first time at church!

February 5, 2016 by gentlemidwife

The Peaceful Birth of Talitha ~ Part 1

Note to my readers: I kept thinking I’d get this story written long before now, but I finally finished it just before my baby turns one. How time flies! My apologies on the length…there were so many details that had to be shared to give the background, but if you aren’t interested in those, just wait for the actual “birth story” coming soon!

When I sit down to write out the story of Talitha’s birth, the subject that continually comes to mind is that God answered prayer. Seriously. The winter of 2015 was unlike any I have ever experienced to this date, full of stretching in areas physically, spiritually, and emotionally. In order to understand part of the picture of how so many things came together in order to make her birth the peaceful event that it was, bear with me as I give you some background to that cold February night…

My husband, Joel, has served with All-Nations Bible Translation for many years, and earlier in 2014 the decision had been made to build a training base in the State College area, just 2 miles or so from our home. It would take too long to recount the ways God opened doors for a location, permits, funds, etc, but suffice it to say that, as generally happens with construction projects, this one had taken much longer than expected before all the red tape was completed in order to begin building. Which translates into the “crunch” time beginning while I began my last trimester of pregnancy, even though it hadn’t initially been planned that way. While I was not helping with construction J, it was our responsibility to make sure the volunteers had coffee, snacks for break, lunch, and sometimes even a place to stay along with breakfast and supper. Joel had tried to get help in for this, but to make a long story short, nothing worked out-though he was able to get a number of churches and interested individuals to help with some of the food prep, in order to reduce my load. I will admit that these months were HARD. When I’m pregnant, I’m extra emotional, uncomfortable, unsocial, and ready to be DONE. To add hostessing, food prep, and all the effort that goes into that to having two toddlers to care for, all the while dealing with pregnancy issues stretched me beyond what I thought I was physically able to handle. Oh, and I should mention that our small church community (made up of about 7 families) had THREE pregnant mamas, two major moves, a house renovation project AND health issues during the last two months of my pregnancy. But God gave strength, and we pressed on, reminding ourselves that at least the construction project wasn’t something that was going to be repeated!

How the building project looked in January…so much snow that volunteers had to be taken up the lane in a 4 wheel drive vehicle!

Besides the building project, I also was committed to delivering babies! The “last” baby I had on my radar before my own was due the end of January. When I took on this sweet couple, it was with the idea that January would be my “rest month”, as Joel was actively lining up help for the month in order for me to prepare for our baby. I also figured that since there were a solid 5 ½ weeks between this mamas due date and my own, this also should be no problem. Well…sometimes God has other plans in mind! I started getting a bit nervous about how all of this was going to work out when I began having preterm labor signs of my own around 33 weeks. When I realized that I was beginning to dilate, and that baby was settling lower and lower, we seriously reduced my time on my feet, which helped to slow the contractions. I began praying that God would help baby wait at least until this other baby came…and that baby wouldn’t come before we could do it at home. We figured out a workable plan in which I would sit with my feet up after every hour or two of work, which helped to keep things at bay, though I started wondering if we’d be meeting our baby sooner rather than later. But back to babies…the one due in January was not to be my “last” one after all! One of the ladies in our church, who is a good friend, had some things come up which made their family feel like perhaps the midwife they had chosen was not a good fit for them. While I do not normally get involved with a situation such as this (there’s often a deeper reason when a couple and midwife part ways late in pregnancy, and it’s not something to delve into without concern), we had a close relationship with this family, and felt like we needed to help them out. Incidentally, this mama was due the same week as I was, and we had been neck-to-neck throughout our pregnancies, though she was convinced she’d deliver first, as her babies tended to come early. We lined up a back-up, just in case, as there was the real possibility we’d both be in labor at the same time…

Getting things ready for baby sister to arrive!

So all of that brings us to the first week of February. At this point, I’m still having contractions whenever I ‘m on my feet for awhile, and I’m waiting on two babies before my own can come. It’s the kind of situation where you keep saying, “Okay, Lord, let’s see how you’re going to work all this out…” 🙂 In the middle of all this, we started a renovation project in our basement…we had help to do it, and wanted to have the basement ready by the time my mom came to help after our birth, and I didn’t want to be dealing with dirt, dust and noise with a newborn, so we dug in. There were times I cried-like when the heater came on in the basement and spewed concrete dust all through the house…but the guys made great progress throughout that week, and one afternoon a sister from church came over to help me clean. After waiting about 10 days from his due date, the “January baby” came…and I felt like it was a direct answer to prayer to have a clear night for travel (no snow and ice on the road) and a straight-forward, relatively short labor, complete with a healthy baby. I felt a huge sense of relief, too, as that was one more responsibility off my shoulders, allowing me to feel more prepared for my own baby.

By the time the third week of February began, my friend and I were wondering who was going go first. I had reached that point where one is chronically uncomfortable, but so had my friend. That Sunday night she went into labor (just 3 days after moving into her newly renovated house…talk about cutting it close!), and early Monday morning I was called over, helping them to welcome a baby girl within an hour or two of my arrival. Once again, God was gracious, giving them a lovely birth, with no issues that would have been challenging for this very-pregnant midwife to take care of! This week were also trying to finish up the renovation in our basement, as Joel’s sister, Lucy, and her husband were supposed to be arriving that week in order for Daniel to do some trim work at the ABT project. So I napped around construction noise, and felt grateful that meals at the ABT project were being taken care of by another church family who had moved into our community just the week before (remember my mention of two moves over this time?!).

Baby E around 24 hrs old…this was the day before my own baby came!

Another aspect of uncertainty surrounding this birth also had to do with the availability of my own midwife. Our dear friend, Rose, had been involved with our previous two births, and we really wanted her for my midwife again this time. For each birth, God answered specific prayer related to her availability, and this time was no exception! She was working down in Lancaster, and while she had permission from her employer to head our direction when needed, my last labor hadn’t given us a lot of warning-and Joel was not in a hurry to do a solo birth again! I had also been hoping to have my student, Emily, involved, even thinking that at least she’d get some good practice if Rose couldn’t make it in time. But she was already committing to attending her next midwifery class in Maine, which was scheduled to take place the last two weeks of February. So we prayed, and committed the situation to the Lord, knowing that He would work it all out somehow…but not knowing exactly who would be a part of our birth team.

Tuesday night, the 17^th/18^th, I slept fitfully, being awake for several hours with contractions. While intense enough to keep me from sleeping, they wouldn’t get any stronger, and I kept wondering at what point I should be calling Rose to come. When morning finally arrived, I was tired and discouraged. By this time I had experienced many uncomfortable nights with little sleep and lots of contractions, and wasn’t sure how much longer I could survive physically and mentally. After so many hours of consistent, time able contractions through the night, finding myself at only 4cm was so disappointing…surely things should be happening by now! Joel was so understanding, and after giving me time for a good cry on his shoulder, he sent me for a long, relaxing bath, after which he put me back to bed to see if I could sleep. He then proceeded to tell our friend who was working in the basement to wait to come for several hours. I know this seems like an unrelated detail, but it played into the events of the rest of the day! I was able to sleep in the quiet house, and once I woke up refreshed, Joel told Chris to come back-we found out that Daniel & Lucy were coming that evening, instead of waiting for the next day-so we needed the basement for them to sleep in!

I still look back on that Wednesday as a gift. Up to that day, my life had been so full, the schedule so tight, so many urgent, pressing things to take care, running from here to there. No time for reflection, or for that mental preparation that is so helpful when facing something like labor. Even after having had two natural births, I found myself fighting fears of a different type this time. Nightmares of having to be taken to the hospital, because I couldn’t take the pain. Wondering if I could mentally cope with whatever might come in labor. Every time I would voice those fears, my husband would remind me that they weren’t coming for the Lord, and that I needed to trust in Him, and resist those fears. Yet having a day in which to reflect, and be able to gear up mentally for labor was something I needed in order to be prepared. Joel encouraged me to take the day “off”, and he even suggested taking our little family out for lunch. It’s one of those sweet memories I have…our last outing as a little family of 4, enjoying some relaxed time together at the local Chinese buffet. Talking about when the baby might come, and the children soaking up the time with mommy and daddy.

Contractions continued to come and go throughout the day, and Joel (wisely) wondered if it might not be a good idea to touch base with Rose. He really didn’t want her to be very far away if things did start to happen! Rose informed me that she was off work the rest of the week, and was thinking of heading up to her family’s place in order to do some study, and be closer to us in case baby decided to come. I went for a walk in order to get some fresh air and sunshine (though a storm was brewing), and found contractions very strong and intense while walking, though they would slow down again whenever I would sit. Around this time, Joel and I discussed whether or not I should consider taking castor oil. While we didn’t want to interfere with God’s timing of this birth, we also knew that I was physically very run down, and we were concerned about how I would handle more sleepless nights should things continue. After talking with Rose again, and finding out that she was studying at a nearby restaurant, as she felt from the tone of my voice earlier that she should be close by (and a snow storm was predicted for later on in the evening!), we decided to try castor oil if things didn’t move forward on their own. The mind-body connection is amazing, as contractions began to pick up again after just knowing that Rose was 2 miles away!

To be continued….

January 16, 2016 by gentlemidwife

Some Recommended Reading

As we’ve headed into a new year, I’ve been taking the time to update old records/files/paperwork, etc. One of the fun things I’ve updated is my current library list. While the internet can be an excellent resource for many topics, I still enjoy a good book that can stay on my nightstand, or be read while I nurse baby (one of the best things about having a nursing baby is getting guilt-free time to sit and read a book!). This past year I was introduced to a number of books that I had not read before, and I thought it’d be fun to share a few of those titles to you, in case you’re looking for something new to read!

One of the library shelves in my office

Ina May’s Guide to Breastfeeding by Ina May Gaskin: I found this jewel at a thrift store this summer, and picked it up just because of Ina May’s name. It’s a great resource to have on hand if you’re wanting some extra help or information on breastfeeding issues. One thing I appreciated was that she actually dove into the issue of tongue-ties causing nursing difficulties, which is something that many manuals on breastfeeding overlook. Overall, this book was a great easy-to-read book that I would recommend adding to your home library!

Pushed: The Painful Truth about Modern Maternity Care by Jennifer Block: This book is not your “feel-good-warm-and-fuzzy” type, but if you’re in to making informed choice, and understanding the politics and protocols that go on behind the scenes, especially here in the US, this is an eye-opener. Jennifer explores the history behind different changes to the maternity care scene, how insurance companies dictate much of hospital’s protocols, how our lack of understanding our bodies and understanding the normal function of birth contributes to the rise of interventions, the limitations in so many areas of good alternative care options, and more. While it can be a bit depressing at times, it was definitely educational, and helpful in understanding risks vs. benefits of different medical choices.

The Official Lamaze Guide: Giving Birth with Confidence by Judith Lothian: While this one has been around for awhile, I had never taken the time to pick it up and read through it. I found that it really wasn’t all about a particular “method” for birth, but more about understanding how your body works, and how to work with it. Clear, concise information written in an easy-to-read style, with birth stories to boot.

Cut, Stapled, and Mended: When One Woman Reclaimed Her Body and Gave Birth on Her Own Terms After Cesarean By Rosanna Rosewood: This one deserves a disclaimer-while the story was fascinating, I don’t recommend or agree with everything this mama pursued in her quest for a VBAC. However, this book helped me to understand many of the challenges that brave VBAC mothers must make as they recover, heal, and prepare for birth from an emotional, spiritual and physical standpoint. I found it valuable as I seek to help mothers who desire a VBAC without having personal experience.

Besides the mentioned books, I’ve encountered a few new resources that I would heartily recommend:

Spinning Babies DVD’s: The Parent Workshop & Daily Essentials. Gail Tully, the instructor of these DVD’s and the brains behind the Spinning Babies website, has so many tips, suggestions and information to offer-and it all helps to make pregnancy more comfortable, understand your body, and encourage baby to be in good postion…which ultimately helps your labor, birth and recovery to go so much smoother! If you haven’t spent time on Gail’s website, it’s worth looking in to!

VBAC:Know the Facts by Jen Kamel: Jen has compiled an immense volume of research and facts surround VBACs, and presents them in a fascinating seminar that can be taken online or attended live. This 6+ hour seminar addresses subjects such as myths, actual research results, how and why different hopsitals have different protocols, what complications can increase risks (and how to avoid some of them!), and the list goes on and on. If you are considering a VBAC and have questions, or just want to learn more about the subject, this would be a very worthwhile investment. I learned so much from it!

More books…and they don’t all fit here, either!

This past year I had a friend who contacted me-she was newly pregnant, lived in another state, and wanted to know where to start in figuring out what she wanted for her pregnancy, birth, caregiver, etc. What a list of questions! And where do you start?!? So I’ve been on a quest to find factual, evidence-based information to help new moms in making decisions and sorting through all the myriads of opinions and information. If you have a resource that was particularly helpful to you, I’d love to hear about it! Feel free to comment (below), leave a message on the facebook page, or send me an email at: gentlemidwife@gmail.com. I’d love to hear from you!

And if you want to check out my updated Recommended Reading/Library List, feel free to look at it here: https://gentlemidwife.wordpress.com/recommended-reading/ Remember, clients have access to this library as part of their maternity care package!

November 16, 2015 by gentlemidwife

Midwife + Nursing Baby = Crazy Stories!

For a little change of pace, I thought it’d be fun to recount some of the craziness that took place in my life over this past summer. With my third-born arriving in February, I took a break from delivering babies while we adjusted and recovered. As the summer came closer, and the due dates of those fist mamas approached, I’ll admit that I had some misgivings. For starters, it wasn’t like I was getting vast amounts of sleep. 🙂 Then, you add my dear, intense, unpredictable baby to the mix. The plan had been to bring the baby along, and make sure I had an assistant along to help out, should my baby need help while I was unavailable. I had these lovely visions of those “crunchy” midwives that you see doing everything toting their happy baby around on their back…but that’s not reality in my case!

my baby girl when these stories start…

My babies have all been of the “high needs” class, and baby #3 has been no exception. But that adds another dimension to the situation when you’re talking of bringing an extra little person along to something as unpredictable and intense as a birth! Thankfully, I was blessed with very understanding clients, and they were all duly warned beforehand that if I was hired, so was my baby…but I also promised to do my best to keep distractions to a minimum. So here are some tales from this past summer as I toted my little companion with me at all hours of the day and night!

As it turned out, I didn’t have alot of time to stress over how it was all going to work out, as my first mama went early. When I took the early morning call, I had to think that the timing was beautiful, as I had JUST finished feeding Talitha, and had just gone back to bed. (On another note, it also happened that my sister was staying the weekend, so Joel didn’t even have to babysit the other children!) This meant she was ready to be buckled into the van, where she promptly fell asleep-and she slept long enough for me to arrive at the house, unload, set things up and have my babysitter/assistant arrive to help me out. And it just happened to be my dear friend/helper who can now say she’s cared for ALL of my babies at births over the years. Beth did a great job of playing with Talitha, taking her outside for a walk when she was fussy, and acting as my second set of hands at the same time.

Beth entertaining Talitha

It felt like an answer to prayer, then, when my baby slept in the new baby’s nursery during the birth itself, and for the hour after. She even sat in her Bumbo while we finished cleaning up! With the exception of crying while the mama was in transition (this was when Beth took her for a walk!), she did really well. This made me figure that maybe this whole thing of bringing a baby along wouldn’t be so challenging after all…

Until the next birth! It was that evening that I realized that my baby girl does not appreciate Chipotle’s spicy chicken. I already knew that dairy products caused her stomach to protest, so I had forgone any cheese and sr. cream on my burrito the night before. But the chicken must have been too much. This time, a good friend from my church was along to help babysit, and provide any additional help we might need at the birth. All was well when we arrived, but as the evening wore on, Talitha protested everything…nursing…sleep, you name it. Lynelle ended up walking her up and down the road, and finally baby calmed down and went to sleep. But once she was down, she awoke for her usual night feeding, and blissfully slept through the birth and ensuing clean up. The biggest challenge, then, was getting home when it was her usual time to get up, and now mama wanted to sleep!

Fast forward several busy weeks…by this point, I had two mamas that could technically go anytime. And then at the last minute, I ended up taking over care for another friend, as her midwife had a planned trip out of town (planned well in advance-the hope was that this baby would arrive before she left!), and her baby had decided to take her own sweet time to arrive. Wouldn’t you know, the day this baby decided to come, all of my back-up helpers were either out of town or busy…and my own family was in the middle of helping to host a youth group of 20 from OH, as well as prepare for a big open house that the ministry my husband works for was hosting that evening. Timing can be amazing sometimes! 🙂 It’s also amazing, though, how God can work out all the details…a friend helped

Amy & Talitha

with my older children so my husband could finish his projects for the day, and one of the youth group girls graciously consented to being pulled into a totally unexpected job. Amy ended up not only caring for my baby, but also caring for the laboring mama’s older toddler, as well. The baby came in the middle of the afternoon, once again finding Talitha sleeping during the birth, and we made it back to the open house that evening just as they were ready to ask the blessing on the meal.

I had a couple of weeks to wait, then, as the next babies weren’t in any hurry to come. In fact, I had pretty much given up on being at either of them, as we had planned to be out of town for a weekend (again, this was planned before these mamas started care), and with both of the babies still inside, I figured the chances were slim that they would both wait on my return. But when we returned home from our little trip, both babies were still waiting! The amazing thing was that they also waited until after the following afternoon, when our church was having an ordination that my husband was part of…I wasn’t sure what I was going to do if I had received a call during that time! That evening, after a big, busy day in which Talitha missed a good nap, I got a call-and we decided that this time I should leave her home sleeping (she had just gone down), and hope that either I would be home by the time she got up, or else we’d figure out a plan B. I went on out, and after awhile realized I wasn’t going to be home to feed her, so my babysitter went by my home and brought Talitha to me, around 2am! She looked rather puzzled when she arrived, but after taking everything in, she nursed and went down for a good nap, waking once and needing some attention.

waiting patiently for mommy to finish paperwork

We went on to have a baby, and soon after I got another call-this time from the other mama. Things were happening fast, so after checking things over again, I left my newly-delivered mama in the hands of my assistant Gretchen, pulled Talitha out of bed and tucked her into her carseat, and raced across town. By the time I reached this home, I knew things were moving quickly, and since Talitha was sleeping, she just stayed in her carseat while I went in and joined my assistant (Lynelle) for the birth, which took place within half an hour of my arrival! Once Talitha awoke (about an hour later!), Lynelle brought her in and she was happy as a lark, and she did well the rest of the morning as we returned to the first mama and completed another appointment before we got home.

But the next birth was not so rosy from Talitha’s perspective…I had hoped that if things happened in the night, I could just let her sleep. My usual babysitter was unavailable, and after calling around, I found a friend who was willing to help out, and she brought Talitha to me when it was time for her to eat. Teething was in full force, and my little girlie was not a happy camper. I honestly don’t know what I would have done with out Heidi, who patiently walked her around the neighborhood until she went to sleep…

The last two births of the summer took place about a week apart, and both ended up being similar stories…both took place at some time during the night, both places Talitha protested being put to bed (I have a travel pack n play that would always take with me), and both times once she finished protesting, she went to sleep and was fine.

Sleeping peacefully in her bed

So thus ended the adventures of Talitha joining mommy at births!

As a general rule, I only take on 2 clients per month, as I find more than that very stretching…partly due to demands on family time, partly to the difficulty in sleeping after a birth when you have little ones at home, and partly because I want to enjoy being a mom besides being a midwife. 🙂 So doing 8 births in 3 months time was a record since I’ve been combining midwifery with family life. My husband and I marvel as we look over the summer…there were so many other things going on, besides these births, and yet we’re amazed at the way God directed and orchestrated these events. There is a dear older midwife around here that tells me God always s

eems to work things out in a perfect way…if I could just learn that from the get-go, it would eliminate alot of stress in my life! But this is a little picture of how things came together this summer, from just one perspective-that of having a nursing baby. Now that my baby is getting older, it will hardly happen anymore. On one hand, it looks much easier to not have that additional unpredictable factor included at births-and on the other hand, I’m going to miss my little buddy!

January 21, 2015 by gentlemidwife

Suggestions for a Healthy Pregnancy

Recently I’ve been searching for a short, easy-to-read handout on nutrition and exercise. I was having trouble finding what I wanted…something that hit the high points, but wasn’t so detailed that no one would take the time to read it. Here’s what I came up with, though there is SO much more that could be said. I encourage each of you mama’s to research nutrition, supplements and exercise so that you know WHY you are doing what you’re doing for you and your baby!

During pregnancy, your body faces extra demands and nutritional needs. Making wise choices in caring for your physical needs can help to build a healthy baby, improve your energy levels, experience less complications during birth, and have a more rapid recovery. How is that for motivation?

Diet Recommendations:
There are many varied suggestions out there as far as pregnancy diet goes. While it is important for you to do your research and make the best choices for your particular situation, the following are a few principles to go by when it comes to what you eat:
– Major on high-quality protein. Protein helps to give you sustained energy, builds good skin integrity, and keeps your blood sugars in check. Some ideas include: Greek yogurt, cheese, nuts, nut butter, chia seeds, eggs, meat, and seeds.
– Consume a variety of vegetables, preferably organic whenever possible. This helps to provide you with more fiber, and the multitude of natural vitamins and minerals that vegetables contain.
– Add quality oils to your diet. Recent research has proven that quality fats are good for us, contrary to what we used to be told! Coconut oil, olive oil, and butter (esp. if it’s grass fed!) are examples of good fats to be consuming.
– Reduce your intake of carbs-especially simple carbs. While carbohydrates are good in moderation, they shouldn’t be considered the foundation of your diet. Carbohydrates tend to elevate blood sugar levels, as well as adding extra pounds to you and the baby during the last several months of pregnancy. When eating carbs, do your best to make sure they are made of whole grains whenever possible, which provide you with fiber and a slower sugar release. Using a variety of organic grains (such as oats, spelt, rye, etc.) are better choices than only consuming wheat products.
– Stay away from artificial sugars, and limit your intake of refined sugar. Try using maple syurp, honey, coconut sugar or other more natural-type sugars when you need something sweet!
– Try to limit fruit juices, and eat whole fruit instead.
– Keep healthy snacks on hand, so that it’s easiest to make good choices when you’re hungry!
Supplements:
Ideally, your nutritional needs should be met through a healthy, balanced diet. But most of us can still use a bit more help!  The basis of your supplements should include a high-quality prenatal vitamin, one made from natural food sources instead of being chemically engineered. Seeking Health, New Chapter Organic, and Thorne Research are good brands, but there are more out there. Most moms are also lacking in sufficient calcium and magnesium, and I recommended taking a minimum of 1000 mg. of calcium each day. This can also help you to sleep better at night, and experience less muscle cramping and discomfort. Other supplements are normally suggested and added as needed, and we can discuss your particular needs during our prenatal visits.

Exercise:
In preparing for your labor and birth, it’s good to keep in mind that it is similar to preparing for a marathon. No one decides to run a marathon and then does it the next day-it takes lots of preparation and training for the big event. It’s much the same with giving birth. The more prepared and equipped your body is, the better able you’ll be able to handle the challenge and the easier your recovery will be. I highly recommend the following:
– Take a brisk walk at least 3 times each week, trying to go at least 1 mile in distance.
– Incorporate some type of exercise program (even just 10 min. long!) into your daily routine, and make it happen at least 3 times a week. There are many different 10 min. pregnancy workouts on youtube, and many other options you can take advantage of. A routine that incorporates lots of squats and leg-strengthening moves can be especially helpful in getting your body prepared for birth.
– Visit the “spinningbabies” website for information on daily exercises that encourage good alignment for mom and good positioning for baby. I have an excellent DVD on this subject that I encourage each of my clients to borrow and watch.
– Consider visiting a chiropractor during the last trimester to ensure your body is ready for birth!

November 24, 2014 by gentlemidwife

Frequently Asked Questions

If you are considering a home birth, perhaps the following are questions you have wondered about. Don’t hesitate to contact me with any specific questions…I’d love to help you in any way I can! Please note, these questions and answers pertain specifically to my practice here at Gentle Delivery Childbirth Services, and may not apply to other midwives and practices.

Q. At what point in my pregnancy should I contact you?
A. You are welcome to contact me at any time-with preconception questions or as soon as you find out your pregnant. A free no-obligation consultation where you can ask questions and see my office can occur at any point, but I typically schedule your first actual appointment once you are between 10-12 weeks along, as that allows the baby to be mature enough to hear the heartbeat. The earlier you are in touch, the greater chance I will have an opening over the time you are due, though it’s never too late to talk with me about your options, either…we can begin care late in the pregnancy when necessary, too!

Q. What does a normal prenatal look like, and where does it take place?
A. Prenatal appointments normally take place in my home office, usually on Tuesday and Thursday afternoons, although other times are possible. I generally expect to take anywhere from 30 min. to an hour, with the goal being able to spend enough time to answer any questions or concerns a couple might have, as well as including education regarding exercise, nutrition, positioning, childbirth, etc. At each visit a urine sample is checked, weight is recorded, BP is taken, and baby is listened to, measured, and palpated to see his or her position. Other testing and/or procedures will be performed as needed. The normal schedule for visits is every month until 28 weeks, followed by bi-weekly appointments until 36 weeks, and weekly visits thereafter. A home visit is performed at 36 weeks, in order to give myself and any other birth attendants a chance to see your location in normal daylight hours! 

Q. Do I need to see a doctor besides seeing you for prenatal care?
A. That honestly depends upon your personal preferences. The prenatal care I give would be similar to what you would receive from a doctor, including labs and referrals for things like sonograms. Most of my clients do not see a doctor while receiving care from me, as it keeps costs down and keeps them from multiple prenatal care visits. If your OB office is open to co-care, it can provide you with a seamless transition in case of transport, especially if it is covered by your insurance provider. If care with an OB is covered in full by your insurance provider, you may benefit from continuing care with them in order to have the costs for your labwork and other testing covered completely.

Q. Will my insurance cover your services, or how can I afford it?
A. Sadly, many insurance companies do not cover home midwifery care, though it is always worth checking into thoroughly. I would be happy to provide you with some information on how to best discuss this with your insurance company, and I am also willing to give you a written statement complete with insurance codes to submit to your insurance company. In order to keep my own costs down, I do not file insurance, but I do try to make care accessible to all families by charging a sliding scale fee based upon your family’s income. Keep in mind, too, that when using insurance, you will have a co-pay, and for some people the cost of my services are either similar or lower than the co-pay amount you would be paying with a hospital delivery.

Q. I notice you have a student working with you. How does that influence my care?
A. When a student is interning for midwifery training, their level of involvement varies according to where they are at in their studies. A student midwife begins by observing all aspects of midwifery care, and applying the academic knowledge she has already received to practical, hands-on situations. As her experience expands, so do her opportunities-she assumes more responsibility depending upon her level of experience and skill. Students are always grateful for any opportunity afforded them to learn, and would love to be as involved with your care as you feel comfortable with. I always strive to make sure the client feels completely comfortable with any care provided by a student, whether that is allowing the student to feel for baby’s position and fundal measurement, or whether it is as extensive as allowing the student to participate in a high level of care during delivery. Whether you prefer lots of involvement or minimal involvement, a student generally acts as my birth assistant during the actual labor and delivery, helping to provide labor support, take notes, and in general act as my second set of hands. 

Q. Who will attend my birth? Is is okay to invite others to be present in addition to the birth team?
A. Normally I attend births with one or two qualified assistants. These ladies are usually either skilled students or birth attendants, and enable me to know you are getting the best care possible, allowing both baby and mom to be cared for in case of emergency. Besides this, whomever else you choose to have present at your birth is up to you. I’ve been at births where it was the bare minimum of people, and I’ve been to births where there was a crowd! The main issue is that you feel totally and completely at ease and comfortable with whomever is present, as that can majorly impact your experience.

Q. Are children welcome to attend the birth?
A. It’s your birth, so you get to decide if you want your children present or not! If you are planning on having your children attending, I strongly recommend you having an extra person handy whose sole responsibility is caring for your child(ren) so that you can focus on the delivery.

Q. Do you do waterbirths?
A. Yes! Laboring and delivering in the water are both options. For many people, their home tub is comfortable enough, but if you’re wanting to use an actual “birth pool”, I can put you in touch with rental possibilities.

Q. I had a cesarean with my previous delivery, does that rule out a home birth?
A. I am happy to help women VBAC whenever possible. For most women, a VBAC at home is statistically safer than a repeat c-section. Make sure you get a copy of your previous medical records, and we can discuss your particular situation in person in more detail.

Q. What birth positions are options at home?
A. There are about as many options as there are women! One benefit to delivering at home is the flexibility to figure out what works the best for you…whether that is squatting, laying in bed, standing in the shower, or wherever you are the most comfortable. I have a traditional “birth stool” that I bring along to births which gives you the option of a low squat, but most women instinctively find a position that works the best for them.

Q. Are you prepared for possible emergencies?
A. Yes. I maintain current certification in both neonatal resuscitation and CPR, bringing along emergency equipment in case of a baby with breathing difficulties. I also carry equipment to assist with stabilizing a mom in the rare case of hemorrhage. It’s my goal to make your home birth experience as safe as possible, which includes careful monitoring of both baby and mom during and after labor, so as to catch any concern that is out of the scope of “normal”. Consistent prenatal care combined with healthy, low risk moms lowers the chance of emergency procedures drastically, but your birth team stays alert for any signs of possible surprises. We can discuss this question in more detail during your consultation if you wish.

Q. So, laboring at home sounds nice, but what about the mess that comes along with birth?
A. Most people are surprised at how little mess is involved. I have families purchase disposable underpads (available at most drugstores) and a cheap shower curtain, which we use to protect surfaces such as the bed and carpet for the actual birth. These things get thrown away afterwards, and myself or my assistant will start laundry before we leave your home. We also make sure to tidy things up so that you aren’t left with clean up!

Q. How do I go about getting documentation for my child?
A. I will file all needed paperwork with the state, which includes the official birth certificate and request for a social security number. I also perform the newborn screening test on your baby during the home visit which occurs 24-48 hours after birth.

Sweet baby feet as baby is being weighed during the newborn exam!

July 26, 2014 by gentlemidwife

Preparing for your birth…

This information is written specifically to give first time mothers and first time VBAC moms suggestions for how to improve their chances at achieving a natural, easier delivery. But that doesn’t mean this is just for them! All of these suggestions can help ANY mom as she prepares for an optimal birth! Pregnancy and childbirth is such a special and exciting time, and it is also something to be prepared for ahead of time. It is good to keep in mind that a woman’s body was designed to give birth, and that, normally speaking, your body does know what to do to get the baby out. On the flip side, though, is the fact that this is the first time your body has ever experienced this process. Because of this, labor can sometimes last longer, and be more physically demanding, as your body takes the time it needs for all of the muscles and bones to work together and stretch to allow your baby to enter this world. If you have invested time and effort into preparing ahead of time, your body will benefit, both in the labor and recovery processes. Just think, you wouldn’t run a marathon without giving adequate training and preparation-and so it is with childbirth. You must condition your mind and body to give you the best results.

Throughout the pregnancy:

– Read and educate yourself! Take childbirth classes, together with your husband. This will help you both to be informed about the physical and emotional processes, and allow you to discuss ideals, hopes, and dreams before labor begins. I believe that education can also help to reduce the level of pain, as it helps you to understand what is going on in your body, instead of fearing the unknown. The more you can find out ahead of time, the more able you will be to relax, knowing your body is doing what it was intended to do. There are many books, DVD’s, and classes available-talk with me if you need suggestions!

– Eat a healthy diet. A diet full of good, healthful foods (vegetables, protein, and complex carbohydrates), and low in sugars, fats and simple carbohydrates, can help you in several areas. One, it doesn’t build a huge baby. A smaller baby is easier to push out! Secondly, it allows your body to be able to function at it’s optimal ability, as your energy level is increased. Thirdly, good nutrition can build better skin integrity, which decreases your chances of tears.

– Exercise regularly. Exercise is an extremely important factor, as labor and birth are very much physical events. Stretching, and building up your endurance level throughout the pregnancy will enable you to persevere if your labor gets long and tiresome. Throughout the last few weeks, walking briskly (until your pelvis hurts!) for at least 45 min. every day, can help to encourage the baby’s arrival to happen sooner rather than later.

– See a Chiropractor-if your body is not in alignment before labor, this can really slow things down and keep the baby from descending. While having regular adjustments can be helpful, it’s an especially good idea during the last 3-4 weeks, as it can help your body to relax and get the baby into the best possible position before labor begins.

– Visit http://www.spinningbabies.com and try some of Gail’s suggested techniques for helping baby to achieve the best position. Regularly implementing techniques such as inversions and belly sifting can help to reduce your overall labor time by helping your body to stay aligned and encouraging good position of the baby!

– Practice relaxation. If you can learn to relax, go limp, and let your body work before labor begins, then the better able you will be to do this during labor. Remember, fighting pain and discomfort works against you during labor-you must open up, let go, and relax in order for your uterus to function the most efficiently. And the more efficiently it works, the easier it will be on you! In practicing, pick times of the day when you can work on letting each area of your body go limp. Find out what helps you to relax: water, music, massage, etc., and then have these available during labor.

During the last 5 weeks:

– I encourage moms to take the following supplements:

Gentle Birth Formula ~ this is a specially formulated blend of herbs in a tincture form that work to help prepare the uterus for the upcoming birth. You begin at 35 weeks by taking 2 dropperfulls a day throughout the first week, and increasing the amount to 2 dropperfulls 3x/day for the remaining weeks. Mothers who take this herb usually have more “warm-up” contractions, which help the cervix to begin dilation and effacement before actual labor. This tincture can be purchased through In His Hands Birth supply at the same time that you order your birth kit.
Super Primrose Oil or Borage Oil ~ this supplement is in a soft-gel form, and you begin taking 1-2 capsules orally beginning at 35 weeks. Around 36-37 weeks, you may begin inserting one capsule vaginally at night when ready to go to bed. The high GLA content and natural prostaglandin that these oils contain helps the cervix to soften, making dilation easier. It’s a great way to give your body a head-start towards dilation!

In closing, remember to keep yourself hydrated, rest often, and take care of yourself. And when labor begins, try to get some rest before getting excited. You need to conserve the energy for later. So think about some activities that provide fun distraction (games, movies, going out for supper, etc.), and try to focus on other things until the contractions become consistent and strong enough that you can’t be distracted through them….

May 22, 2014 by gentlemidwife

Helping Baby Achieve the Best Position…a little report on my day at Spinning Babies!

At the end of April, I had the special opportunity to take the Spinning Babies workshop taught by Gail Tully at the Midwifery Today Conference in Harrisburg. While the day was packed with information, I enjoyed every minute of it…I honestly felt excited about the prospect of having another baby myself after learning so many practical tips on how to promote optimal fetal positioning for both the baby’s sake and the mother’s comfort. Gail has a wealth of information at her fingertips, and I think I’d have to take the class several more times before I could really retain it all (even though I took lots of notes!), but I wanted to at least give a few pointers from things that I learned. Visit her website at: http://spinningbabies.com/ to learn more yourself.

To begin with, Gail showed a diagram about the structure of the uterus, and how it is covered in fascia, just like all of our other muscles. When the fascia is pulled or stretched in an unnatural angle, it is going to affect the way that the baby is positioned in the uterus. This is one reason why it is important to watch your repetitive movements…do you carry a child on your hip? bat a baseball? If the muscles and ligaments are too tight, too loose, or twisted, the baby will NOT be able to settle into the correct position. The balance of your soft tissue can be more important than your pelvic size. Thus, doing specific exercise techniques throughout your pregnancy (and during labor when needed) in order to help align these muscles can make a big impact on what position the baby settles into. When the womb is symmetrical, the baby will naturally assume a more flexed position.

When it comes to the “perfect position”, the place to aim for is having baby settled on the left side. The tendency is for baby to settle on the right side, as our uteri have a natural propensity towards this direction. However, the shorter, curved left side encourages the baby to flex his head and assume a “C” type position-his physiology is actually enhanced by this flexed position, as well as this position providing more consistent, even pressure on the cervix, which in turn encourages dilation. When the baby is on the mom’s steeper right side, the baby naturally wants to assume a more “military presentation”, where the head is not flexed-this causes uneven pressure on the cervix, and can really reduce progress in preparing the cervix for labor, and stalling progress during labor itself.

Demonstrating how the different muscle layers work to support or constrict the uterus

Another interesting aspect Gail brought out is how thyroid malfunction can cause the baby to assume a negative position. A root metabolism issue can affect the way in which the uterus operates, as well as causing it to be more susceptible to twisting. Making sure your entire body is working optimally can help prepare you for a better pregnancy and birth! The fact that we spend so much time sitting both in the car and in a reclined position also contribute to a asymmetrical uterus. Women used to be encouraged to sit “like a lady” with good upright posture, which can also help to promote good posture of the womb.

In presenting exercise techniques, Gail focused on three separate types of exercises that she calls the “3 Sisters” to provide balance and room for mom and baby. Each of these exercises helps the mom to relax, and thus in turn helps to relax the fascia of the uterus, which then helps to provide the balance to help the uterus to become more symmetrical. She would encourage pregnant mamas to do these exercises at the minimum of once a week, but once a day would be even more ideal! Besides encouraging baby to engage in a good position, these exercises can also help to improve mom’s comfort by relaxing the muscles that receive so much strain during pregnancy. In labor, these techniques help to promote descent of the baby, and can be done multiple times. Rather than try to explain these techniques myself, I’ll point you in the direction of where you can find instructions on her website:
– First, encourage deep squats and calf stretch. Then move on to the “3 Sisters of Balance” http://spinningbabies.com/techniques/activities-for-fetal-positioning/423-the-3-sisters-of-balance- :
1. Rebozo sifting: helps relax the broad ligament and get the mother loose and relaxed herself. http://spinningbabies.com/techniques/activities-for-fetal-positioning/rebozo-sifting
2. Forward Leaning Inversion: This is best for resolving a transverse lie, and helps to encourage healthy circulation. http://spinningbabies.com/techniques/the-inversion
3. Side Lying Release: Helps relieve pressure on ligaments.

Once these techniques have been performed to help achieve balance, your next goals are Gravity and Movement-especially to help during a pause in labor.

During labor, you can use these techniques to help whenever you reach a point where progress is being stalled. Gail encouraged us to rethink the usual question of “what is dilation?” and instead think “where’s the baby?”. If the baby isn’t descending, then something needs to change, regardless of what dilation is. And depending on where baby is at, different techniques are needed to get the baby to descend. For any stall, she recommends trying the “3 Sisters of Balance” in order to relax mom and balance the uterus.

As you attempt the three above techniques, consider where baby is: If he is stuck at the brim of the pelvis (characterized by a long latent phase, or start-and-stop labors for days), then the baby needs to flex his head in order to enter the pelvis. Tight round ligaments can prevent baby from descending. At this point it is much more important to get the baby to enter the pelvis, rather than trying to get labor to become more regular. Dilation won’t do any good if the baby isn’t in the pelvis! Trying Gail’s Abdominal Lift and Tuck followed by Walchers, can help to flex that little guys head and get him to descend. http://spinningbabies.com/techniques/activities-for-fetal-positioning/abdominal-lift-and-tuck http://spinningbabies.com/techniques/activities-for-fetal-positioning/walchers

If baby is stuck in the mid-pelvis (right at the ischial spines), labor tends to stall around 5-7cm. This can often be caused by a tight pelvic floor, and special attention to the side-lying release technique can help to relax those tight muscles. Trying a lunge, and the “Shaking the Apple Tree” techniques can also help to get the pelvic floor relaxed and help baby to descend.

When labor stalls around 9-10 cm (think anterior lip, etc), realize that you must address the root cause, not just push back the lip. Trying positions that open up that part of the pelvis can provide more room (deep squat, McRoberts, hip press, toilet, etc.). Sometimes putting pressure on the sacrotuberal ligaments can help them release and provide more room for birth. If there’s not an urge to push, try to rest, and wait until the body is ready-sometimes mama just needs a break!

There were many, many more things that Gail taught and shared…not to mention all the stories of different complicated, stalled labors where these techniques were used. If you ever have a chance to sit in on one of Gail’s classes, I would highly recommend it! Much of her information is located on her website, as well, which is an excellent resource for both midwives and mamas alike.

Where is baby’s position in relation to the mom’s pelvis? How can we use that information to help us decide which technique(s) to try?

April 29, 2014 by gentlemidwife

Pictures from the “Office Project”

Today I’m taking a break from educational and informative posts…I finally had a chance to take some pictures of my newly finished office, and thought it would be fun to let you all take a peek! When we moved into this house, I was excited about one room that had built in counters and cabinets, plus a little desk that faced a window. The room had alot of potential, but it also badly needed lots of work and paint! It was one of the big projects that my husband and I tackled this winter, and as usual, it took longer than what I was anticipating. 🙂 But now that it is finished, we are both really pleased with the results! So here’s a little peek, along with an updated family picture that my sister took this weekend…

My favorite corner-it’s perfect for studying, sewing, paperwork and so many other things!

The lovely tree that my mom painted while she was here visiting

The “baby wall” with many pictures of babies that I’ve either delivered or given care to

The beautiful exam table that we just purchased…it even matches the color scheme!

More of the “tree wall”-the angles in this room make it hard to get good pictures

Another side of the room

Our little family – April 2014

Gentle Delivery Midwifery Services (Centre Co. PA)

"…He shall gather the lambs with his arm, and carry them in his bosom, and shall gently lead those that are with young." Isaiah 40:11

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