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Our mission: Birth Boot Camp is committed to training couples in natural birth and breastfeeding through accessible, contemporary education. Birth Boot Camp is for both mothers AND their partners. You’ll learn to work together to bring your baby into this world as a team.

Why Birth Boot Camp? As with most things in life, you will get out of your birth what you put into it. Birth Boot Camp is the BEST preparation for an amazing birth. You, your partner, and your classmates will learn from a certified instructor who works for YOU, not the hospital. You will receive a complete, unbiased education with resources, videos, and workbooks that are fresh, modern, and updated for couples giving birth in 2017 and beyond.

Fall/winter series begins October 15. Classes will be held Saturday afternoons 10/15-12/17. Contact me with questions or to sign up!

Jill Christianson, BBCI
Bloomington, MN
paisleydoula@gmail.com
701-200-0642

Six things you need to survive your maternity leave

I often hear from working mothers that they could never stay home full-time with their children, the implication being that some mothers have that sort of temperament/patience/capacity for diaper-changing and Dinosaur Train-watching and some just don’t. In my opinion, this belief stems in part from the deplorable job our culture does in supporting and nurturing new mothers, which in turn leads to a negative experience of maternity leave in particular and stay-at-home parenting in general.

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Typically, new parents bring their new baby home from the hospital, and they may have visitors for several days afterwards, but these visitors are frequently the type to bring a gift for the baby, ask to hold the baby, and do nothing helpful at all while keeping the new mother from resting. After a few days, or a week if he’s really lucky, the father goes back to work. The new mother is reeling from her first week of sleep deprivation, the huge hormonal shift that occurs after birth, and, if she’s among the 1/3 of women in the US who have a C-section, recovering from major abdominal surgery. In this state, she is left alone with her baby for 9 hours a day. Not surprisingly, many mothers, while they enjoy their babies, don’t particularly enjoy their maternity leave. In fact, as many as one in four American women experience postpartum depression and/or anxiety. Happy New Baby!

What’s a pregnant mama to do? Instead of focusing on the STUFF your baby needs (which can be boiled down to about 4 things), focus on the PEOPLE that you are going to need. Spend your pregnancy gathering resources and cultivating relationships with people who have the time and skills you’ll need after baby arrives. The DONA postpartum plan is a great place to start when thinking about your needs and who might be able to fill them. The needs they identify include:

  1. Support for rest
  2. Friends with young babies
  3. Nutritious meals and adequate nutrition
  4. Knowledgeable, empowering breastfeeding support
  5. Time to be yourself and/or be BY yourself
  6. Time to be a couple

Rest

You may have heard that new parents are sleep deprived. After my first baby, it really hit home that I was a mother now, like, ALL THE TIME, including all night, every night. I hate to be one of those people who tell pregnant women that they just don’t even know what it will be like, but…you just don’t even KNOW.  Now, there are some things you can do to maximize your rest, including exclusively breastfeeding, co-sleeping, and learning to nurse lying down. Another tip you might find helpful is to determine how much sleep you typically need, and then, once baby arrives,  remain in bed until you have met that need. So for example, if before baby you slept 8 hours a night, and you are up for 2 hours during the night with baby, you must stay in bed for 10 hours (preferably free of screens and other distractions, so that even if you’re not sleeping, your mind is able to rest).

The most oft-given advice to new mothers is to sleep when the baby sleeps. Some believe this to be extremely unhelpful advice, with one blogger even suggesting that people who tell you this be given a quick punch to the throat. But sleep is really that important, and the rest of the adjustments you are making in your life as a new parent will seem so much more manageable if you make sleep a priority. The other big thing that goes along with this is that you must lower your standards for pretty much all other areas of your life for awhile. House cleaning, meal preparation, work tasks, errand running, laundry, personal grooming, most everything can either wait or be done minimally. It may help to officially declare your household to be in bare minimum mode for six weeks or so.

People

It is not healthy for anyone to spend 9 hours a day alone with a baby. Unfortunately, for first-time moms who have been working full-time, nearly all of their friends are likely at work during the day. If you get along with your family and they’re helpful and available, see if you can schedule some regular company in the first few weeks. Even if you’re not much of a people person, breaking up the day with a short visit will be good for your mental health. You might even see if grandma can help out during the “grandma hour” (also known as the witching hour or, by a realist I know, the arsenic hour). This is the time at the end of the day where baby is fussiest and mama is most tired and dinner is most not-cooked. Grandma can help with dinner, then hold baby while you take a nap and a quick walk around the block.

If your family is far-flung or you don’t get along well, you may need to step out of your comfort zone and find some new people. Reach out to friends and acquaintances who stay home during the day. Size up the other mamas at your childbirth class and consider starting a weekly coffee date before baby, which can turn into a weekly playdate after babies. Attend a La Leche League meeting while you’re pregnant to meet other expectant and new moms. Check with the hospital about pregnancy and new mother groups. A 2009 survey found that 80% of mothers believed they didn’t have enough friends, and 58% felt lonely, so it’s likely that any request to get together will be met with enthusiasm.

Another option is a postpartum doula, someone specially trained to take care of new moms and babies. That includes running errands, cooking meals, cleaning house, doing laundry, PLUS helping with breastfeeding and answering questions about your postpartum self and new baby care. If you have the funds, having a postpartum doula a few hours a day for the first two weeks can make all the difference between thriving and just surviving.

Food

If you are a breastfeeding mother, you will likely be ravenous most of the day (and night). Here again, keep it simple. First, consider setting up a meal registry at a site like mealbaby.com or mealtrain.com. Friends and family can sign up to bring you a meal on a certain day, and you can even make suggestions about favorite foods/restaurants. (Since there are often leftovers, see if you can have a meal brought to you every other day.) If someone wants to throw you a baby shower, suggest a freezer shower, where everyone brings you a prepared meal to freeze for after baby comes.

When you must feed yourself, think fast, easy, healthy, and able-to-be-eaten-with-one-hand:

  • Sandwiches or wraps stuffed with veggies, meat, and cheese
  • Pre-sliced veggies and dip
  • Easy-to-eat fruit
  • Muffins, breads and cookies: if you make them lactation cookies, you will have an excuse to eat a few extra
  • Smoothies: add some chia seeds, ground flax seed, or nut butter for protein
  • Granola or energy bars

For more good info on what and how to eat after baby, check out the book Feed Yourself, Feed Your Family.

Breastfeeding Support

Not so many generations ago, most women breastfed their babies, and families had more children. This meant that girls grew up seeing nursing babies, and when they had their own babies they had knowledgeable support from family and friends. These days, while it’s getting better, breastfeeding is far from normalized enough that you can get good advice and support from just anyone. Your best sources of support are experienced breastfeeding mothers (extra points if they’ve successfully nursed more than one child), certified lactation consultants (IBCLCs), and your local La Leche League leader(s). Get help early and often, and don’t be afraid to contact more than one person if you’re having difficulty – breastfeeding is an art as well as a science, and that third person you talk to may say just the right thing to fix your problem.

Time For Yourself

My sister’s midwife handed out a sheet to each of her clients entitled, “The New Mama’s Guide to the Tender Loving Care of Herself”. It includes the instructions to get a massage once a week for the first four weeks postpartum. This is fantastic advice. Even if massage isn’t your thing, you should make some sort of self-care a priority. One mom I know took a long bath most evenings when her husband got home from work. I liked to hand over the baby as soon as my husband walked in the door and take the dog for a walk. Some moms (including me) get a little twitchy if they’re away from their babies in the early weeks; if that’s you, think about things you can do FOR yourself rather than things to do BY yourself.

A note about fathers: the best way for new fathers to learn how to care for and bond with their new babies is to…actually let them care for their babies. If you can’t help but give pointers on the “correct” way to change a diaper or put on a onesie or give baby a bath, shut your mouth and leave the room. You cannot and should not do everything yourself — let him parent his child.

Time To Be A Couple

Speaking of fathers, staying connected as a couple is also important in the early weeks and months. This does not have to mean a date night out without baby right away, especially if it makes you twitchy (see above). Instead, you might try:

  • Movie night – pick up your favorite takeout, and take turns picking a movie to watch together (and it doesn’t count if one of you is on facebook or playing candy crush during the movie). Also, you must sit right next to each other.
  • Talk to each other for 15 uninterrupted minutes – it may include discussion of the baby’s inputs and outputs, but it better not be the whole discussion. If you need help coming up with something more interesting to talk about, try here or here.
  • Plan a vacation – according to happiness researchers, planning a trip makes people happy. In fact, the planning makes people happier than actually taking the trip. So feel free to think big – a trip you’d like to take for a major anniversary, or when your youngest child leaves home, or when you retire, perhaps?

Book Review: “Expecting Better: Why the Conventional Pregnancy Wisdom is Wrong–and What You Really Need to Know”

I read an excerpt from Emily Oster’s new book, “Expecting Better” in the Atlantic and was intrigued: a pregnancy book written by an economist? What could be better? As a former researcher/number cruncher, any book full of numbers and charts is right up my ally.

After finishing it, I wholeheartedly agree with her approach to making decisions about pregnancy and birth. She believes women should be provided with accurate information relating to their own situation, and then given the opportunity to make informed decisions about their own care and the care of their baby. This seems simple enough, and many women might think, “Isn’t that what my doctor is already doing?”. The answer is almost universally no. Many hospital protocols for labor and birth are not based on evidence, and most doctors provide only advice/recommendations/edicts with little or no information to go along with them.

What about the content of the book? Here are my thoughts:


What I liked

The book is interesting and engaging (especially if you like charts!), and takes a different tack than other pregnancy books I’ve read. I learned several interesting things (did you know a pregnancy test in the 1920s involved injecting a woman’s urine into the ear of a live rabbit, then killing and dissecting the rabbit?). Also, the book included the answer to many questions that I myself have googled either while pregnant or while researching a question for a client.  For example, in early pregnancy, what is the likelihood of miscarriage for each week? (Answer: IF you are seen by your provider at 6 weeks and everything looks normal at that point, your risk is around 11%.  If you are seen at 11 weeks and everything looks normal, your risk is less than 2%.)

The tone of the book is also very measured. She seemed to have few personal biases going into this project and stuck to what the good research studies were able to tell her. For example, based on her assessment of the risks and benefits of an epidural, she opted not to get one. At the same time, she was quick to point out that when she showed other women the same information, some decided the benefits outweighed the risks for them. The data also told her that a doula would be beneficial, so she hired one.

One thing that’s stirring up controversy is her view on alcohol in pregnancy. Studies from other countries have clearly shown that light drinking in pregnancy, especially in the 2nd and 3rd trimesters, has no measurable negative effect. Based on the number of studies and the consistency of the results, she comes to the conclusion that women can feel comfortable drinking up to one drink a day in the 2nd and 3rd trimesters and 1-2 drinks per week in the first trimester.  This, of course, flies in the face of conventional pregnancy wisdom in the US, where you often hear the idea that “well, if you tell women it’s OK to have one drink, they’ll have three!” And that sort of thinking is just what this book hopes to quash — the idea that you cannot give women accurate information and let them make an appropriate decision ALL BY THEMSELVES.

Bones of Contention


There were a few things she didn’t cover that I wish she would have:

  • Artificial sweeteners: many women wonder about the effects, if any, of Diet Coke on their developing baby. Some believe aspartame to be dangerous, so switch to Splenda instead.  Which is safer? Are either of them safe? The FDA recommends limiting your consumption of aspartame during pregnancy — why? What does “limiting” even mean?
  • Ultrasound: it appears Oster had at least three ultrasounds during her pregnancy, and she doesn’t once mention what, if any, research there is to back up the technology’s use or any theoretic or actual negative effects of the test.
  • Gestational diabetes and Group B Strep tests — is it appropriate for everyone to get these tests? Why or why not? What are the false positive rates? What are the current guidelines for treatment of these conditions, and do they have any risks associated with them?
  • C-section: she mentions c-section in passing several times, but (in my humble opinion) doesn’t really hammer home the risks of this major surgery and the potential consequences to future pregnancies.
  • Flu vaccine during pregnancy: How effective is the vaccine? Is it more or less effective when you’re pregnant? What are the most common adverse effects, and how often do they occur? What are the risks of contracting influenza while pregnant?
  • Circumcision and the Hepatitis B vaccine at birth: She had a baby girl, so perhaps circumcision didn’t really cross her mind, but there is some interesting research on the Hep B vaccine that would have fit nicely into this book.

There were also several things I wish she had covered differently or in greater detail:

  • Prenatal testing: Oster’s mantra as an economist is that more information is always better, so she is generally in favor of any and all prenatal testing. However, because many prenatal tests have very high false positive rates (which she does mention), women are subjected to worry and stress they could have avoided by simply avoiding the test. And when the test in question (such as routine ultrasound) has not been shown to improve outcomes, there are some serious moral questions about its continued widespread use. Because of her bias here, the question she and her husband ask first is “Which test should we start with?” rather than first asking “Is any testing necessary?”.
  • Cost: as an economist, she has surprisingly little interest in the cost of maternity care in this country, particularly the costs of  tests, procedures, and care providers that have not been shown to improve birth outcomes (i.e. most prenatal testing, ultrasound in low-risk women, care by an obstetrician for low-risk women, continuous fetal monitoring, elective repeat c-section, etc.)
  • Midwives: Oster hires an OB to attend her birth but does not go into why. She mentions midwifery briefly in her chapter on homebirth, but doesn’t delve into the research that shows that the midwifery model of care results in better outcomes for both moms and babies when compared to OBs.
  • VBAC (Vaginal Birth After Cesarean): Oster states that that there are no randomized studies of VBAC safety, but that the studies there are show an increased risk of “serious infant complications and a greater likelihood of maternal hemorrhage”. She does not go over the risks of repeat c-section, and her recommendation is that VBAC might not be a good idea. Many organizations disagree with her, including, of all groups, ACOG. (For a fabulous read on this topic, see this post from Midwife Thinking.)
  • When the research runs afoul of hospital policy: I want to scream when I hear pregnant women say, “I wanted to do X during my birth, but my provider wouldn’t let me.” I especially want to scream when ‘X’ is something like “drink juice” or “birth in a position that isn’t on my back in stirrups” or “not be induced unless there is a medical indication”.  Oster frequently states in the chapters on labor that her biggest fear was that her provider would “make” her have an induction. I wished she would have stated more clearly that birthing women have the right to refuse any and all procedures during labor and birth, particularly those that are not evidence-based. This leads me to:
  • Birth as a time to “vote with your feet”: Oster is an economist, not a revolutionary, and I can hardly fault her for not issuing a battle cry to all of womankind to demand respectful, evidence-based maternity care. However, she starts the book being irritated by the misinformation she’s given, then doesn’t switch providers OR challenge her doctor on nonsensical policies like ‘only clear fluids during labor’ and requiring continuous fetal monitoring. Why not? She lives in Chicago, where there are presumably many places to give birth and many providers to choose from.

In the end, I will add this book to my library because it makes pregnancy seem less scary and gives women (mostly) good information about some common questions. I will also attempt to fill in the holes I think she left with future blog posts; stay tuned.

The New Mama’s Guide to the Tender Loving Care of Herself

Below is a postpartum plan similar to what my sister’s midwife gave her after the birth of her second baby (and my very first doula baby!). New mothers should aim to have enough help (from her partner/family/friends/postpartum doula) so that they CAN follow this plan if they wish. Feel free to modify the plan, or ask your healthcare provider for her or his recommendations. Note that this is for after an uncomplicated vaginal delivery; if you had a c-section, consider following the first-week plan for at least a couple of extra weeks. birth boot camp twin cities

First Week Postpartum

Enjoy your baby
Limit visitors
Get a massage
Total bed rest
Short nap in the morning
Long nap in afternoon
Eat and drink well
No leaving house

Second Week Postpartum

Rest in bed and in other parts of house
Long nap in afternoon
Eat well
Get a massage
Light chores like folding laundry

Third Week Postpartum

Begin gentle walking beginning with 5 minutes a day and working up to 20 minutes
Nap every afternoon
Eat well
Get a massage
No errands, shopping, cooking, or cleaning

Fourth Week Postpartum

Regular walking
Nap every afternoon
Eat well
No more than one errand per day
Join activities that bring you into contact with other mothers

Now you just have to take things on one at a time.

Know your limitations.

If visitors ask if they can do or bring anything, don’t hesitate to make suggestions:

  • Bringing over a meal
  • Running an errand on the way to/from your house
  • Washing dishes, sweeping the floor, throwing in a load of laundry, etc.

You may start a regular exercise program 2 weeks after your last drop of vaginal fluids.  If your discharge starts turning red again, that is a sign that you’re doing too much and need to rest.

Listen to your body – it is wise.

Three ways to survive being 10 months pregnant

My fourth child was born 11 days past his estimated due date, which was 6 days longer than I had ever been pregnant before. Each of those days seemed like an eternity, and since then I have been on a quest to help women enjoy the end of pregnancy just a little bit more, especially if those last days stretch into the 42nd or 43rd week. Here are three of my favorite ideas:

  1. Plan something fun and/or useful every day. Once you get close to your due date, make a schedule. You might want to:
    1. have coffee with a friend
    2. go to a movie
    3. go to prenatal yoga
    4. buy some yarn and learn how to knit a baby hat on knittinghelp.com. (Or ask me. I’ll even let you borrow my needles.)
    5. get a massage
    6. buy a new book that does not include baby, birth, expecting, or pregnancy in the title
    7. plan a walking date that includes ice cream at the end
    8. go shopping for something you can wear post-baby (not new skinny jeans: think lounge pants, scarves, shoes, hats, or a new cardigan/robe you can wear while holding baby skin-to-skin)
    9. make freezer meals for those first weeks postpartum
    10. attempt something crafty you saw on Pinterest. Even if it doesn’t turn out, you can be content with the fact that you’re so crafty, you make PEOPLE.
  2. Start pre-spending the baby’s birthday and/or Christmas money. This was the “natural induction method” I finally settled on with aforementioned baby #4: At 41 weeks, 2 days, I decided I would get to spend $50 per day on whatever the heck I wanted until he was born. I thought this should have started at 41 weeks, so I purchased a new quilt for our bed that counted for three days. The next day, I bought the matching pillow shams. By that evening, I was in labor! (Note: it is NOT effective to attempt to bribe the child to come out: I distinctly remember offering our daughter $500 if she would come out by a certain day; no dice.)
  3. Have a progressive baby shower. This idea was brought to my attention by a doula friend, and is probably nicer than spending your kid’s birthday money (though technically my son has gotten to enjoy the quilt and shams for the majority of nights over the past two years). Here the idea is that you choose a gift for yourself for each day past 40 weeks. You actually RECEIVE the gift that falls on baby’s birthday. The gifts get progressively better/more expensive, starting with, perhaps, a baby bath/lotion set at 40 weeks and ending with something like a new car or $1 million if you make it to 42 weeks or beyond. Have friends and family pitch in if you wish, either by signing up for a particular day or just chipping in some cash for the prize pot.

For more on enjoying the last days of pregnancy, see this wonderful article.

How Not to be a Whiney Primey

Whiney Primey: (noun) “a first-time mother-to-be who comes to the hospital over and over, mistakenly thinking she’s in labor”

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First step: if you hear your care provider or nurse utter this term, fire them immediately. If you wouldn’t be surprised to hear this term come out of your provider’s mouth behind your back, fire them immediately. For a one-day service that costs somewhere in the neighborhood of $10,000-$20-000, you shouldn’t have to deal with condescension.

Second step: Fear of eye-rolling nurses shouldn’t keep you from getting the care you deserve. If you have a question or concern, big or small, talk to your provider. If your question isn’t answered to your satisfaction, or if something just doesn’t feel right, do not be afraid to go straight to the labor and delivery floor of your hospital.

Now, all that said, let’s say you would like to do your laboring mostly at home. Or you would like to avoid the extremely disheartening scenario of  being told you’re not in labor yet and getting sent home. Or you’d like to avoid the cascade of interventions that can start with a first-time mom and a slow-to-get-going labor. How will you know when it’s time to get yourself to the hospital?

  1. Know that many first-time mothers (FTMs) get sent home at least once. First labors are often long, and FTMs have no frame of reference for what active labor feels like. Also, laboring women are prone to “magical thinking”: being at the hospital means you’re at least physically closer to where your baby will be born, which can feel the same as being actually closer to your baby’s birth.
  2. Take a comprehensive childbirth class: Birth Boot Camp students have watched videos of real women in labor and giving birth. They’ve seen what sounds and positions might signal that labor is becoming more active. They’ve also been equipped with MANY different ways to cope with labor and have had practice getting into a good labor rhythm with their partners’ help.
  3. Hire a doula: A doula is like having everything you learned in your childbirth class in a handy, portable format. Plus, she brings you drinks and presses on your back in just the right spot. She will not, of course, determine for you when it’s time to go the hospital, but she will be a very helpful sounding board and source of information about when’s a good time to go.
  4. Ignore labor as long as possible. Midwife Gloria Lemay even suggests keeping early labor signs “a secret“. If it’s nighttime, keep sleeping (or at least resting with the lights off). If it’s during the day, keep yourself busy and/or take a nap. Remember that your labor will likely cause you to miss at least one night of sleep, so don’t waste a precious ounce of energy getting worked up over contractions that are fifteen minutes apart.
  5. Consider throwing out the “5-1-1” rule: your hospital likely has a rule of thumb about when to go in based on your contraction pattern. Most common is 5-1-1 (contractions five minutes apart, lasting at least one minute, and they’ve been like that for at least one hour). Sometimes it’s 4-1-1 (four minutes apart, one minute long, for at least one hour). Usually, a first-time mother with this contraction pattern will still be in early labor, and will be discouraged when she gets to the hospital and is told her cervix is 2 or 3 centimeters dilated. Some midwives are a fan of the 3-1-2 rule for first-time mothers: contractions 3 minutes apart, lasting one minute for at least two hours. This is likely much closer to active labor for most women.
  6. Watch for other signs: the shift to active labor is often accompanied by increased bloody show, shaking, nausea, vomiting, or burping. Your water might break as well (unlike in the movies, most women are far into active labor or even pushing before this happens). Any of these signs, accompanied by contractions that you are unable to walk or talk through, probably warrant a trip to the hospital.

Note: as with anything having to do with birth, there is a WIDE range of normal. One of my first doula clients started vomiting with her first contraction, and they started less than five minutes apart (she gave birth 24 hours later). Last year, a client had been laboring on and off for two days, and contractions were FINALLY 5-7 minutes apart. She wanted to head in, and when they called, the hospital told them it was probably too early but they could come if they wanted. When we arrived, she was 8 cm and had her baby a couple of hours later. The one and only rule that applies to everyone is that you will not be pregnant forever.

 

Four things you can do now to shorten the length of your labor

couple tub (1024x683)Lots of people think that a fast, easy labor happens mostly by the luck of the draw, and that there’s nothing much you can do to influence it during pregnancy. Several recent studies, however, paint a different picture. Put each of these four things together and you could shorten your labor by about 25%:

1. Yoga – one study of women who practiced prenatal yoga found that their labors were 2 1/2 hours shorter on average.

2. Watch your weight – Excess weight gain during pregnancy was associated with an active labor that was 1 1/2 hours longer, according to researchers at the University of North Carolina. They believe this may be due to extra fat deposits making the birth canal narrower plus increased baby size.

3. Hire a doula – a large review of available research on professional labor support found that having a doula at your birth decreased the length of active labor by 40 minutes. Other benefits included a reduced risk of c-section and reduced need for pain medication.

4. See a midwife – Care by a midwife or other provider with low intervention rates has been associated with better outcomes for moms and babies, lower cesarean section rates, and shorter labors. One study showed an even greater reduction in length of labor with the continuous presence of a midwife during active labor.

What about the epidural? 

Depending on whom you ask, epidurals either increase the length of labor and increase your risk of cesarean, or have no effect on length of labor or cesarean rates. If you are planning to get an epidural (or decide to get one once you’re in labor) there may be some benefit to waiting until active labor (5-6 centimeters). The four factors listed above, however, will likely have a much larger effect on your labor, particularly your choice of provider.

Of course, time is only one aspect of labor and birth. If an informed, empowered birth is important to you as well, you may wish to sign up for a comprehensive childbirth education class as well.

Five Things That Only Doulas Get Excited About

Doulas are a special breed. We get super excited about stuff that probably, at best, does not interest the general population and, at worst, disgusts them. Let me give you a few examples:

Doula shoot-113

  1. Bloody show: this is one of the many phrases that I am forbidden from uttering at the dinner table. This can mean that labor is starting, or, later in labor, that the cervix is continuing to dilate (I’m also not allowed to say ‘cervix’ at the dinner table). This means that THE BABY IS COMING!
  2. Vomit: if a woman is shaking and burping and vomiting, I start smiling. I can’t help it: that typically means that things are really moving and THE BABY IS COMING!
  3. Nakedness: this actually seems to interest a lot of people, but it interests a doula for probably a different reason. When a woman uses the bathroom and doesn’t bother to put her pants back on, or when she gets out of the tub and doesn’t seem to notice or care that she is not wearing any clothes, that is another good sign that THE BABY IS COMING.
  4. Amniotic fluid: If a woman’s care provider doesn’t break her water, she has about a 70% chance of getting to full dilation with her bag of waters still intact. Which means, if a woman is in active labor and all of a sudden there’s a splashing sound, there’s a good chance the very next thing she utters will be:
  5. “I have to poop!”: when a woman says this in labor, get ready. You know why? Because THE BABY IS COMING.
  6. Actual Poop: when a woman is pushing her baby out and she poops in the process, this is very exciting — that means she is moving the baby’s head down and moving anything else in the way along with it. Which means (you guessed it) THE BABY IS COMING!

As I was writing this list, I started contemplating why I get so excited about vomit and poop. There’s the obvious excitement about getting to see a new human enter this world, and watching parents meet their new baby for the first time. But there’s also a more mundane reason that’s specific to doula work: you see, I love my job more than is probably fair to love a job, but sometimes labor is long. Picture this: Imagine you were supposed to work until 5pm, but sometimes the time clock slows WAY down, and sometimes it just stops altogether. For, like, eight hours. THEN imagine how you would feel if, all of a sudden, the clock started spinning around like crazy towards quitting time. THAT’S HOW IT FEELS TO A DOULA WHEN A BIRTHING WOMAN TELLS YOU SHE HAS TO POOP.

Happy World Doula Week to all of my favorite doulas! May your clients’ labors be smooth and your shoes be washable.

 *NOTE! I am now a retired doula looking back fondly on the days of holding em bags for my laboring clients. If you are pregnant and in need of a doula in either the Fargo-Moorhead area or the Twin Cities, please contact me and I can recommend some excellent ones!

The Marathon and the 5K

Some people bristle at the idea that Birth Boot Camp marathonrequires its instructors to have had an unmedicated birth before training. (This is not typically students; it is mostly other doulas and childbirth educators who teach a method that does NOT have this requirement.) Here’s an illustration to help understand why this requirement was one of the things that drew me to Birth Boot Camp as an instructor, and why I think I can serve my students better because of it.

Let’s say you decide you want to run a marathon. You start looking around for training programs and find a class that’s for people running their first 5K. You find another class about running in general and another about triathlons. Finally, you find a class for people who are training for their first marathon. Which class would you sign up for? Would it matter to you if your trainer hadn’t ever actually run a marathon herself?

A good marathon training program is not going to spend a lot of time telling you that running a 5K is perfectly acceptable if you’d like to just do that instead. They’re also likely not spending time explaining why people who run marathons are better than people who run 5Ks. And they’re definitely not telling you that you shouldn’t make any plans when it comes to marathon running because it’s unpredictable. They will assume that your goal is to run a marathon, and they will prepare you to RUN A MARATHON.

Birthcurly purple Boot Camp is for couples who have decided that a natural birth is important to them. They want to know how best to achieve their goal. To that end, I focus on all of the different things couples can do to get there:

  • prenatal nutrition and exercise
  • choosing a great care provider and birth location
  • relaxation exercises
  • positions and comfort measures
  • support from partners and doulas
  • potential variations of normal labor
  • common interventions and potential side effects
  • postpartum rest and recovery.

Now, let’s say you completed your marathon training program. There are a few possible outcomes on race day:

  • You complete your first marathon! Yay!
  • You run well, but just bonk at mile 18 and require assistance to get to the finish line
  • You run well, but don’t realize you accidentally signed up for an ULTRA marathon instead of a regular marathon and require assistance to get to the finish line
  • You roll your ankle during the race and require surgery

If you didn’t reach your goal, you might feel disappointed. That’s completely understandable. Or you might realize that the circumstances warranted a change of plans, and you’re totally ok with that. You likely will NOT blame your training program for setting unrealistic expectations. Nor will you come away believing that marathon enthusiasts are “setting other people up for failure”. You probably also won’t be angry that you wasted all that time training and eating right and now are in really good shape.

So it is with birth: I trust that women and their partners can make decisions about their own birth. As a Birth Boot Camp Instructor, my goal is to help couples achieve THEIR goal of a natural childbirth. We definitely spend time scenario planning for when a deviation from their goal is appropriate and how to deal with that both logistically and emotionally. But the bulk of the class is on getting them what they want out of their birth. And Birth Boot Camp graduates love it.

More reading on the subject:

Natural Birth Isn’t About Earning a Medal from Country Bumpkin Birth Services

The Science of Suffering from Fargo Doula

Selfish Women and Their Silly Birth Experiences from Improving Birth

How I Chose Birth Boot Camp

…and why you should, too!

curly purple

In 2014, I decided to add childbirth education classes to the services I offer my clients. At that time there were exactly zero options for non-hospital-based childbirth education in Fargo-Moorhead, and expectant couples in this area deserved better.

So I set out to research my options — what kind of class did I want to teach? How long would the class be? Did I want to train with a certain organization? Become certified? If so, which organization? Did I want to be affiliated with a particular method, or did I want to choose my own curriculum and materials?

 

I sorted through websites and talked to other doulas, midwives, and childbirth educators in person and online. Ultimately I came to the following conclusions:

  1. I wanted to educate couples about birth, but not just that: I wanted to give them enough information and preparation to actually change their birth experience for the better.
  2. I found that couples who had taken longer classes were the most vocal about loving their experience. I also heard again and again about friendships formed and support systems gained in the context of a more intensive class. Partners felt more confident about their abilities to be a comfort and support to the laboring mom.
  3. I wanted a class that moms AND dads would love.
  4. I had a lot of experience as a doula, midwife’s assistant, La Leche League Leader, and mother of four, but I was smart enough to know that I needed training as a childbirth educator.
  5. Making my own curriculum sounded appealing at first, but I quickly realized that experienced childbirth educators had probably already come up with something better than I could put together on my own. No reinventing the wheel for me.

With those lessons in mind, I narrowed down my search to just two options: The Bradley Method and Birth Boot Camp. Both programs were longer than most other options (24 hours for Bradley; 25 hours for Birth Boot Camp). They both covered topics that would truly make a difference in couples’ birth experiences, including nutrition, fitness, comfort measures and techniques for partners, and breastfeeding and postpartum care. Digging deeper, however, I began to see differences:

  1. Bradley is a “method”: it encourages a particular way for laboring women to act and sound. Birth Boot Camp is not a method: it provides couples with many tools, trusting them to choose the ones that work for their birth.
  2. Bradley is “husband-coached couple tub (1024x683)childbirth”: the husband is encouraged to be the only support for his wife during labor. Or, they talk about doulas as if you can only choose one: either the husband OR a doula; not both. While Birth Boot Camp recognizes that husbands/partners know the mother best, they also believe that the couple’s experience is exponentially enhanced by a professional doula who knows birth. Together with her care providers, they provide a team that can meet all of the mother’s needs.
  3. Birth Boot Camp has an extensive required reading list for its instructors, updated student handbook and videos, and a commitment to keeping their materials and birth statistics up-to-date. Bradley, on the other hand, relies on just a few books for its teachers, one of which hasn’t changed much since it was published in the 1960s and another that hasn’t been updated in almost 20 years.

BirthBootCamp_Color-LBirth Boot Camp was the clear winner. After completing the certification, including four days of training in Dallas with the incomparable Donna Ryan and Sarah Clark, I am more convinced than ever that expecting couples in Fargo-Moorhead will LOVE this class. (Update: Now that I’ve moved, couples in the Twin Cities can also LOVE this class!) Contact me if you’d like to get together and take a look at the class materials, or sign up today for an upcoming series!