International Day of the Midwife!

We are so pleased to be featuring a guest on our blog today! Laura Lawson, CNM, is the owner and midwife of Her Choice Midwifery Services in Bloomington, IL, serving the Central Illinois area with CNM attended home birth.

Laura Lawson photos2

Happy International Day of the Midwife to all my colleagues , midwives, and midwifery students. International Day of the Midwife (IDM) was an idea to honor and recognize midwives around the world. Wikipedia states IDM was first celebrated May 5, 1991, and has since been observed in over 50 nations around the world. The idea was conceived at the 1987 International Confederation of Midwives conference in the Netherlands.

The word midwife is translated “with” “woman”. A midwife comes in all varieties here in the states from a CPM, certified professional midwife, to a CM, certified midwife, to a CNM, Certified Nurse Midwife. We even have male midwives, we don’t discriminate. Midwives practice in the hospitals, clinics, birthing centers, free standing or attached to hospitals, and in homes. In some states it is possible for midwives to be in solo practices/own their own practices. Midwives work with women and their families and generally support and encourage natural childbirth. However, they can prescribe medications. In addition to providing care during pregnancy, childbirth and postpartum, midwives provide well women care.

Regardless of our training, education and practice setting I do feel that midwifery has one common belief and that is to support, guide, educate and empower women. We as midwives specialize in normal and it is our job, passion and role to give to our patients the tools and knowledge to let them make an informed decision regarding their care.

I recently had the opportunity to open my own practice. I named it “Her Choice Midwifery Services”. I truly feel that every woman should have a choice in her care. Informed decision making should happen and be honored.

Laura Lawson photos3

My most recent homebirth was a returning client and she stated the only way she would do a homebirth was with me. Trusting your midwife/health care provider is important.

My patient had a waterbirth & used hypnobabies with her first birth at a local hospital. She was nervous about not being able to have a waterbirth this time around as local hospitals do no offer waterbirths any longer. So when I opened my practice, it only made since to her and her husband to have a homebirth. Her first labor was very short, 6 hours, and this labor was only 4 hours. She was able to have a waterbirth and she used utilized hypnobabies again.

The homebirth was so peaceful and a non-intervention delivery. It was different from the hospital birth as there were less vaginal exams, she was able to have who she wanted there, she was able to eat, move in any position she wanted, less monitoring, no IV during labor, and was in the comforts of her own home. Her baby was also born encaul, born in his amniotic sac. Her wishes were discussed prenatally and honored in labor. Her and her baby boy and family did well. She had a great homebirth and an amazing experience.

 

I am so happy to offer this service to the women in Bloomington/Normal and the surrounding areas. Currently there are only 3 CNMs in central Illinois that are offering homebirth services.

For questions re: midwifery services, homebirths or Her Choice Midwifery Services:

Call 309-585-3535

Bnherchoice.com

Facebook: Her Choice Midwifery Services

Laura Lawson, CNM/ Owner Her Choice Midwifery Services

Crystal’s Cesarean Birth Stories

In honor of Cesarean Awareness Month, we are featuring some great birth experiences from moms who ended up having a cesarean for different reasons and moms who have had vaginal births after a cesarean.

These are Crystal’s Cesarean Birth Stories.

Caleb’s birth: August 2010

We get to the hospital the afternoon of August 25 for our scheduled induction and they hooked me up to the monitors. I was already having contractions about every 3-4 minutes but nothing painful. Pretty soon they started the pitocin, the contractions got a little more uncomfortable but nothing too bad. At about 3:15 that morning, I got up to use the restroom when my water broke! One giant gush. After that the contractions got a lot more uncomfortable and I made it until 6 before getting the epidural (I knew I wanted it!) The epidural was AMAZING. So awesome 🙂 🙂 I couldn’t feel ANYTHING until around 11:45 when I started getting uncomfortable again. Turns out I was at about 9.5 cm–I was at a 3 when my water broke at 3:15 am so I’d say things went quick after that. I started pushing an hour later–they wanted to let me “Labor Down” to see if he would get in place and to help pushing go easier.

I pushed from 12:45-2:45 when they decided that it had been long enough. They said I was a great pusher, but he was completely STUCK. At this point I was so exhausted that I was pretty much like “yeah, whatever… C-section… Ok” No fight or anything even though I was ADAMANT that I had wanted to avoid a c-section. I think I was just so exhausted that I didn’t care. Off to surgery we went. And he was STUCK. One person tried to push his head back up and another was pushing so hard on my ribs I thought they were going to break them. It felt like it took an eternity, but they finally got him out, then it was another eternity while they cleaned him up before I got to see him for 30 seconds and they whisked him away.  Turns out his first apgar was only a 2 or a 3 and so they needed to take him and help him. He recovered and his second apgar was a 9.

I ended up having major hemorrhaging–they said was partially attributed to the suction that had developed during pushing and also because he was too big for my body. They “threw everything they could think of” at me and I still wouldn’t “clamp down” (to explain it as the doc did.) I ended up getting 4 units of blood because the bleeding was so bad and they had to put a Bakri balloon in my uterus to try and control the bleeding. Apparently this is very rare and all of the nurses were interested in this procedure. They later told me that if the balloon didn’t do it’s job, it was back to surgery for me with worse case scenario resulting in a hysterectomy.

My recovery from this c-section took a long time, which is not a big surprise considering that it was a pretty bad c-section. Caleb recovered from his first apgar and will be 6 this year!

************************************************************************

Eli’s birth

March 2013

Scheduled C-section

So Elijah’s birth was so much better than Caleb’s! I had to get to the hospital between 5:30-6:00 am. I’m pretty sure I didn’t sleep more than an hour the night before just because I was so nervous about the c-section. I was really worried that I was going to feel it (again) and they would have to put me under. We arrived at the hospital and got checked in pretty quickly. They had me change into a gown and Josh and I just waited in my room for something to happen. Pretty soon the nurses (there were 3 of them that morning and no other patients so they were all helping me out! Plus they knew I was high-risk) came in and started having me fill out the final paperwork and getting me prepped. They put an IV in each hand (normally you just get one but I had to have an extra one in case I needed blood) and then we waited for the doctors to arrive. At this point various team members for the surgery started coming in an introducing  themselves to me, but I don’t remember exactly who all came in!

My surgery was scheduled for 7:30 am but ended up being late. Of course we had some light snow this morning and all of the roads were really slick so the doctors were late! To kill some time, one of the nurses was explaining the procedure for me and when she started talking about the spinal I had a little meltdown. This is also when I found out that they don’t keep Kleenex in the hospital rooms, you have to ask for it!!!

Finally my doctor made it to the hospital, we found the 2nd doctor, and the anesthesiologist came in and started talking to me and explaining the procedure in terms of what she would be doing. They had me walk down to the operating room and asked Josh to wait outside until they had me prepped. I walked in and they had me get up on the table and immediately started prepping for the spinal. I thought I would break down again, but surprisingly I didn’t! The doctor gave me that initial numbing shot and had me “slouch over my baby” to get the spinal in. It took a long time–a lot longer than I thought it would! She said it’s pretty difficult to find the exact spot because they have a very small window to work in and it has to be exact. I had this weird tingly sensation every so often when I think she would hit a nerve…it would make my hips tingle/feel bruised. Very difficult to describe! After probably 10-15 minutes she got the spinal in and they had me lie down (assisted me is more like it.) I could feel my feet and legs getting VERY heavy and eventually couldn’t feel them at all!!!!!! The nurses did their final prep (catheter, I don’t know what else) and then the doctors came in and got started. The anesthesiologist actually tested me this time and we KNEW I was numb–it was awesome! I didn’t feel a thing!!!!!!

I felt like the surgery went quick once they started. It was maybe 10 minutes or so (I think…I’m not entirely sure when they started cutting) before I felt TONS of pressure and then my doctor said “He’s peeing on me!” After that I heard the other doctor say “That is a BIG BOY!!!!!” and a few seconds later they lowered the drape so I could see him!!!! He was so beautiful, of course I teared up–I think I was relieved it was going so well and overjoyed with my new son. They took Elijah to the room adjacent to us (the door was open) and I could hear him crying while they cleaned him up and weighed him. He had LUNGS!! Caleb didn’t cry at all, but then again his first APGAR was a 3 and Elijah was 9 and 9 (I think…it might have been 8 and 9.) Josh went with while they cleaned him up and they were letting Josh come in to announce just how big he was, so it felt like a LONG time while they were away! I had guessed 9 lbs 4 oz when I saw him and Josh came back and said 9lb 2 oz and 22″!! My doctor made the comment that he would have been 9.4 if he hadn’t peed twice before they weighed him 🙂

After they had him cleaned up and wrapped in a blanket, Josh and Elijah were able to sit next to me for the duration of the surgery! It was soooo awesome and exactly what I wanted 🙂 We admired our new baby while the doctors finished sewing me up. They finished…we took a couple pictures in the operating room with my doctor, and then they put Elijah in my arms and wheeled us down the hall back to my room where we did recovery for an hour (basically, the nurses stayed in the room with me–it was the same L&D room we started in!)

While we were in recovery, I was able to start nursing Elijah! We actually unwrapped him and did skin-to-skin and let him do the newborn baby crawl to my breast. It was SOOO cool to watch him slowly making his way over! One of the nurses got a little handsy and came over and moved him…I don’t think she understood that I was watching him make his own way over (and he wasn’t upset about it, just going slow) so we latched at that point and they covered us with some blankets. The whole thing was awesome! I think we made it back to the room around 10am or so (Eli was born at 8:50am) and did “recovery” until about 11.

We wanted Caleb to be the first one to see him so eventually we called my parents (they were watching him) and said they could bring him up. They were out eating lunch and it took them probably another hour before they arrived. Caleb was so good! I could tell he was intimidated by the hospital setting, but it was amazing to watch him come in and give his new brother a kiss. He seemed to “get it” too–that this was the same Elijah who was living in my belly. We had told him that we were going to the hospital and Elijah was going to come out of mommy’s tummy and come home with us. I think he understood! Caleb gave Eli a blanket and a security animal and Elijah gave Caleb a bag full of new cars (Cars movie toys and matchbox cars) and Caleb still will pick up the cars from Eli and say “Eli gave me this!!!!!!” It’s adorable.

The pain has been so much more bearable this time. The worst part–one of the nights we were there, I was sleeping and so the nurse didn’t wake me to give me my pain meds overnight. I had no idea when I could have them again so I was waiting and waiting for them and I was in a TON of pain by the time she came in. I had asked to keep on top of the pain meds, I didn’t want to get behind because I didn’t want to be in pain! After that I made sure to ask how long between pills and call them if it seemed to be getting close. I’ve already been out walking and am feeling great.

Ashley’s HBAC Birth Story

In honor of Cesarean Awareness Month, we are featuring some great birth experiences from moms who ended up having a cesarean for different reasons and moms who have had vaginal births after a cesarean.

A HBAC is a Home Birth After Cesarean. This is Ashley’s HBAC Birth Story.

My first birth, was a long homebirth turned c-section. I call this my Rainbows and Unicorns HBAC because it was as ridiculously perfect as a birth can get. I don’t know how I got so lucky.

My water broke Monday morning, but I had no more than 2 or 3 contractions in a row over the next 24 hours, despite my best efforts to get labor started naturally. So Tuesday afternoon I took castor oil, which worked pretty quickly. 2 hours later I was in labor, starting off with contractions 2 minutes apart. It was pretty intense skipping the early labor part, and getting my oldest out of there and everything (well, the pool) set up was a bit stressful. Contractions did eventually space out, thankfully, but they were strong. I went from 3cms to 10cms in about 3 hours.

The thing about progressing that fast is I was afraid I wasn’t doing it. With my first, labor was strong and long, but somewhat irregular and I had lots of back labor. This time it was strong and regular with a bit of back labor. I was dealing with things ok, but it felt like I was progressing quickly and I was so afraid I wasn’t. That sounds a bit convoluted, but hearing my dilation progress so quickly with so little trauma (I was dealing with it much better than the first time around) really upped my confidence.

Also, compared to Evie’s, it didn’t hurt that much. Sure, it hurt, but it wasn’t that bad. At no point did I have the burning sensation in my bones that sent me running to the hospital with Evie. I never even went through transition. I’ve talked to so many moms and read so many stories about reaching the point when you feel you’re going to die, or that you can’t do it, or that you’ll split in two; it never happened.

The hardest part was pushing against a cervical lip, and then my midwife holding it back. It took something like 10 contractions with her fingers in there to move past it, which sucked, but once it was gone everything changed. The urge to push felt great, but it wasn’t overwhelming and it wasn’t uncontrollable. I just really wanted to push. Not pushing during a pushing contraction sucked, even when it was only long enough for me to stop a push, catch my breath, and start another one. And those contractions were LONG. The joy of homebirth is that you don’t have people yelling at you how to push, but I was still doing something like 4-5 pushes per contraction. Also I’m apparently a stealth pusher. It wasn’t until the 2nd or 3rd in a series that I made any noise at all.

Pushing took an hour and a half after that lip was gone, and it was hard work. Having had a c-section I wasn’t totally confident that I could do it, and for a long time I wasn’t making much progress. This was probably when his head was molding and it was normal, but I felt that hour and it was a long hour. Then, suddenly, he was coming through. Crowning was amazing. The ring of fire was nowhere near as bad as I feared, though it was intense. Yay water birth. The truly amazing thing was I knew I’d birth on my hands and knees, and I saw myself catching, but I didn’t know how that’d work out logistically. Well, for the record, it was on my knees, face on the side of the pool, and hands reaching down to feel his head come out.

Pushing a head into my hands was the single coolest experience of my life. Feeling his hair THEN his forehead THEN his ear (as opposed to Evie’s forehead and ear coming first), his cheek all slide out of me was amazing. That was when I realized there was a real person in there, and he was almost out! I felt him kick and turn, which was really unpleasant, then pushed out the shoulders and chest and pulled him out of my body myself. That moment was incredible, I don’t think I can explain how amazing it was.

His apgars were probably 8 and then 10, and he was so calm after birth. It was just this amazing ecstatic peaceful entrance. Literally, I had my ideal birth.

Tavian Miles Alexander
4/3/12
9lbs 13oz 22″ long 14″ head
And no stitching needed!

Karee’s Cesarean Birth Story

In honor of Cesarean Awareness Month, we are featuring some great birth experiences from moms who ended up having a cesarean for different reasons and moms who have had vaginal births after a cesarean.

This is Karee’s Cesarean Birth Story…

When I got pregnant with my son in late 2012, I never entertained the idea of ever needing a c-section. I was very used to pregnancy, babies, and even birth when my mother had a home birth when I was 16 and my sister made me an aunt at 11 years old. My sisters and my mom never had any real birthing issues, so why would I? I also felt like I knew enough about pregnancy, labor, birth, etc (and saw The Business of Being Born like twice) before I even got pregnant. So I planned a home birth and also had check-ups at Carle Hospital as it was my first pregnancy and wanted to be sure everything was checking out. And it was. Until that 20 week anatomy scan.

Something was very wrong with my cervix. At barely 20 weeks along, I only had 1/2cm of cervix left when you’re supposed to have between 3-6cm. Up until this point my pregnancy was completely uneventful and nothing ever felt off or like it wasn’t a typical pregnancy symptom. It was a bit of a shock when the doctor told me I needed to go up to Labor and Delivery immediately and get a cerclage suture placed (to more or less sew up my cervix). I called my midwife first who confirmed I should get the cerclage placed and was confused as to why a perfectly healthy first-time pregnant 22-year old would have an Incompetent Cervix. She had seen the condition before, but only with women who had a large number of miscarriages and/or D&Cs.

The cerclage was placed and the next 4 weeks were spent on strict home bed rest. My cervix was almost non-existent and the internal cervix was starting to open, dropping baby right onto my paper thin cervix. By 23 weeks, I was 100% effaced. My OB had little hope I would continue to carry, and was surprised every week I came back in still pregnant. I was admitted onto hospital bed rest at 23 weeks and there I laid for the next 4 weeks wherein nothing happened. I never had a contraction, or bleeding or leaking fluids or any pain (except the aches that bed rest caused).

One night I went to bed unusually uncomfortable. (How much more uncomfortable can you get when you’ve been on strict hospital bed rest for almost 1 month?) I was just sore and achey everywhere. But I fell asleep around 11 p.m. and woke up at 5:30 a.m. to use the bathroom. I came back, got in bed and started having what could only be contractions. They didn’t really hurt much, but the pain came and went every 1-2 minutes. That’s when I started bleeding. Quite a bit. I finally convinced the nurse to get a doctor (like no really go get a doctor) and the doctor came in and did a manual exam. I was 26 weeks, 3 days. I was also 6cm dilated and she told me the baby was “right there.” Basically baby was “falling out” which is common with Incompetent Cervix.

Baby was breech though. He had been breech and happily dancing on top of my paper thin sewn up cervix since about 21 weeks. The doctor wanted to do an urgent c-section. I stopped her though and asked Why? My water hasn’t broken, shouldn’t we just wait? That was a no go. Baby was already coming and she was worried about his cord prolapsing. Plus, I guess it’s not the best way to birth a 26 weeker.

I was whisked away to a room in L&D, prepped, given shots and then taken into the OR. I was glad at that point that I had been on hospital bed rest! Looking back on my birth story, my c-section was the most insignificant part, and I guess that’s a good thing. Sometimes I have to remind myself that I had one. It was kind of a walk in the park, and the least of my worries.

I was given an epidural, and was awake for the c-section. I remember arguing with my husband over baby’s name. We didn’t know the gender and he wanted to name her Violet Lynn but I vetoed that multiple times saying it sounded too much like violin and that Violet Gwendolyn was better. Our arguing was in vain though, as to my extreme delight, we ended up with a boy just a few minutes later. I saw him distantly, briefly, before he was wheeled away to the NICU.

Recovery was excruciating. Of course I was out of it, and God bless nurses. Especially the ones who have to push down hard on recently c-sectioned abdomens. I’m sure I asked why they were doing it, and I’m sure they had a good reason. But Lord, I just had a kid and this was the worst pain in my life! Anyway. I was immediately given a breast pump, in the recovery room. They told me to get milk flowing, I had to start pumping immediately. I loved their sense of urgency! About an hour after being in recovery, I was wheeled up (in my bed) to the NICU to see my son. He was 2lbs 7ozs and breathing very well. I was worried that being born via c-section would decrease his chances of breathing well, but that was one thing he was always good at.

I pumped every 2-3 hours and my milk came in very quickly, though never at a huge volume. At any rate, during my son’s 15 week NICU stay, he was given my breastmilk the entire time barring the first week where he was additionally given a special human-based milk formula for micro-preemies.

I went home 2 days later and was incredibly happy to start walking again after 2 months on bed rest. They say walking is one of the best ways to heal up after a c-section, and boy, did I do a lot of it trekking back and forth from home to NICU. By 2 weeks post-surgery I felt great and by 3 weeks post-surgery I felt almost completely back to normal.

Today the scar is a reminder of my son’s awful but victorious birth. He will be 3 years old this summer and has never had a single medical issue after being released from NICU after 103 days. And we still nurse. 😉

 

Melissa’s VBA2C Birth Story

In honor of Cesarean Awareness Month, we are featuring some great birth experiences from moms who ended up having a cesarean for different reasons and moms who have had vaginal births after a cesarean. This particular story is from a mom who had a vaginal birth after 2 cesarean births.

This is the story of the journey I took to have a VBA2C (vaginal birth after two cesareans).  Prior to getting pregnant, I read a book entitled Supernatural Childbirth by Jackie Mize. So I know how to stand in faith and have a healthy pregnancy. I am thankful to God that I have such enjoyable pregnancies, without morning sickness or complications. The only other book I remember reading during my first pregnancy, a recommendation from a friend, was Natural Childbirth the Bradley Way by Susan McCutcheon. I skipped the chapter on Cesarean Surgery – I definitely wasn’t having one of those.

As it turned out, I did have a c-section. My water broke before labor started, and I only dilated a centimeter or two. Because of recent research, my doctor did not recommend pitocin. After a few hours, the baby showed signs of distress. My doctor’s recommendation was c-section. I didn’t really want to have a c-section, but I didn’t know what to say otherwise. I put all my trust in his knowledge because I didn’t have any of my own. Looking back, there were many things I could have done to help the situation including: changing position, getting off my back, walking around, sitting on a birth ball, showering, nipple stimulation, or simply waiting (we were not in an emergency situation).  My lack of knowledge made the whole process seem scary. It wasn’t a good way to start motherhood.

For my second pregnancy, I switched providers and was going to have one of those VBACs. My doctor said she would allow me to attempt a VBAC. When I was at 40 weeks, she scheduled a c-section. I tried to stand up for myself, but I didn’t really know what to do. I decided to have a c-section with my provider, who I had developed a relationship with, on a Friday. If I waited and went into labor over the weekend, I would not see my provider until the next Tuesday. I didn’t want to attempt a VBAC with a provider I just met.

After the second surgery, I was determined to NOT have another c-section. I did LOTS of research between my second and third pregnancy. I met and chatted with a doula. I met and interviewed a VBA2C–friendly provider in another town. I picked up pamphlets at a local Labor Day Rally to Improve Birth. I attended an ICAN (International Cesarean Awareness Network) meeting.

As soon as I was pregnant, I started digging even deeper into the world of childbirth.  Educating myself was very empowering.  I learned the facts about c-sections and VBACs (vbacfacts.com). I chatted with another VBA2C mom. She gave me several book recommendations including The Thinking Woman’s Guide to a Better Birth by Henci Goer and Silent Knife by Nancy Cohen and Lois Estner. She also introduced me (not personally) to Ina May Gaskin. I devoured Ina May’s Guide to Childbirth.  I enrolled in Shannon Morber’s Birth with Boldness class. In this class I was encouraged, empowered, and emboldened. I found my voice. I learned how to make informed, quality childbirth decisions while becoming aware of the physiological processes of labor and birth. This was very important to me because even though I was on my third pregnancy, I had not actually experienced labor. Another vital part of my success was finding a doula. We clicked immediately, and −bonus− she was a VBAC mom.

Finally the time came for baby #3 to be born. I was in early labor on and off for 4-5 days. I think the hardest part was I didn’t get much sleep during that time because of the discomfort. I finally thought it was “time” so we drove the 1hr, 10 min drive to our provider. It wasn’t “time”. There had not been any change since a doctor’s visit two days prior. This was discouraging because I thought I had started active labor. I decided I did not want to drive back home so we got a hotel room, and I labored through the night. I made tremendous progress during the night. I didn’t sleep. I was under nearly constant pain, stress, and tension. I couldn’t eat. On average, my contractions were two to three minutes long. My body was working very hard, and I got to the place mentally where I was thinking about another c-section. Around 7:30am we left for the hospital. It was a relief to get such good news when I learned that I had dilated 4-5 cm. I knew that I was going to deliver naturally at this point (!). I continued to labor at the hospital that morning. My contractions were still three minutes long. Finding comfort was not always easy. But it was important to me that I receive very little intervention, so I just kept moving around, changing positions and sitting on a birthing ball. The nurses read my birth plan so they knew I wanted to be up and moving. I requested intermittent monitoring. They were very helpful making that happen.  Early afternoon, my provider suggested breaking my water. She explained it would speed things up, and baby was doing great. I had labored long enough without sleep or food. I consented to this intervention. It was a good choice. Within 30 minutes, I progressed the rest of the way (2-3 cm) and started feeling the urge to push. The pushing stage lasted about 30-40 minutes. When they placed the baby on my chest it was the sweetest, most satisfying feeling in the world.

Erin’s Ceserean Birth

In honor of Cesarean Awareness Month, we are featuring some great birth experiences from moms who ended up having a cesarean for different reasons.

Erin said writing her birth story out was very therapeutic for her. Has anyone else felt this way?

I had a very easy, healthy, low risk pregnancy.  I exercised regularly and did prenatal yoga.  My husband and I took all the childbirth education classes Presence offered.  I had a birth plan and I thought I was prepared to have a baby.  I felt great at 41 weeks and at the time I felt I would have been fine staying pregnant forever.  At my 41 week appointment, my midwife informed me that she made an appointment for my induction for Monday at 8am, when I would be 41 weeks, 3 days.  At the 41 week appointment she tried to do a membrane sweep, but my cervix was only a fingertip dilated, so she couldn’t.  She did not tell me my Bishop score or discuss the risks of induction.  I didn’t know to ask at the time.  And she certainly didn’t make it seem like it was my choice to induce.  It was protocol.  I went home and read stories that induced labor was not any more painful than physiological labor.  I decided I would be fine, plus maybe I would go into labor on my own over the weekend, the odds of that were in my favor, after all.  My husband and I told our parents about our induction appointment.  My parents were in town.  My mother-in-law took off work for that day and the next, so she could be there to meet the baby.

On Monday morning, my husband and I drove to Presence Covenant Medical Center.  I called IKids and told them we were on our way to the hospital.  I expressed my disappointment that we were not in any rush to get to the hospital.  I had planned that I would labor at home until contractions were regular and no more than 4 or 5 minutes apart.  Then we would drive as quickly as possible to the hospital, like in the movies.  That didn’t happen.  Oh well, I was okay missing that step because I was going to meet my baby that day.  I was checked in and set up in a labor and delivery room.  I got medical bracelets and a heplock.  I had a vaginal exam and was 1½ cm and 50% effaced.  Hooray, progress!  At 9:30 am I was started on a 12 hour round of Cervidil.  The nurse seemed to have trouble placing it.  It felt like a tampon that wasn’t quite in all the way.  But I figured she knew what she was doing, so it was probably fine.

I was monitored intermittently until 9:30 pm, when the Cervidil was removed.  No change.  Still 1½ cm and 50% effaced.  After some brief research on my phone, I wasn’t surprised.  I read that Cervidil was prostaglandins, which are also in semen.  My husband and I had been having sex at least every day for the past month.  So, they put in another round at 11:30 pm.  I tried to sleep as best as I could on the hospital bed, but was not very successful.  I wanted the comfort of my own bed, where I could snuggle with my husband.  He slept even worse on the fold-out sofa in the labor and delivery room.  The next morning at 11:30 am the nurse took out the Cervidil and I was now at almost 2 cm and 50% effaced.  Ok, something happened!  Today is the day!

As soon as the second round of Cervidil was removed, a foley bulb was inserted into my cervix and I was started on Pitocin.  When the nurse started the IV in the heplock I had a shooting burning pain in my arm.  It didn’t feel right.  In hindsight, that was the greatest physical pain I experienced when I was at the hospital.  I told the nurse about the pain and she put a new IV in my right arm.  There was no pain that time.  As soon as the IV was in, I was told I was no longer allowed to use the shower or tub because I had to be continuously monitored, except for brief trips to the bathroom. I was also restricted to a clear liquid diet.  That was at 11:45 am on Tuesday.  Couldn’t they have waited until after I had a good lunch to tell me I wouldn’t be allowed to eat solids?  I had planned to eat throughout labor as I felt like it.  In the childbirth education class they said food was allowed during labor.  I was hungry at 11:45 am on Tuesday and I sulked as I sucked down my chicken broth while watching my husband eat a cheeseburger.

My parents and in-laws spent the day at the hospital, but left around 9 p.m.  My mother-in-law had to go back to work in Chicagoland.  I had planned to have her there for support, but she had to leave before I felt a single contraction.  Around 9:30 pm, the nurse checked the balloon and was able to pull it out. I was at a level 18 of Pitocin at that time and only barely feeling the contractions that were coming about 6 minutes apart, according to the monitor.  I was at 3cm and 50% effaced.  I heard screaming in another room.  The nurse said that there was a mom giving birth to a 10 lb. baby with no drugs.  She said, “She’s crazy.”  I thought, “That’s what I want.  When will I be screaming?”

I slept for close to an hour until the Pitocin was brought up to 22, at which point I couldn’t sleep through the contractions anymore. It was around 11 p.m.  That is when I started vomiting.  I got up to use the toilet, then, I decided not only did I have to poop, but I had to puke too.  While I was vomiting the nurse came in because I was unplugged from the monitor.  She took me back to the bed and gave me a bowl.  There was no nausea leading up to the vomiting, just all of a sudden, I have to throw up and I have no control of my bladder.  I must have vomited half a dozen times, and urine and bits of mucous plug came out every time I threw up.  I thought the contractions were tolerable, and I was able to talk through them.  I wasn’t able to sleep through them and I was tired.  Sick and tired and shaking.  I woke up my husband to get him to figure out how to help me rest.  He said, “Rest between the contractions.”  I said, “What between?”  The contractions felt like waves rushing over me, but while I was already submerged up to my chin.  Not just up to my belly while I lay on the beach.  I wanted to get into the tub.  I had planned to labor in the tub.  I labored on my back in the bed, hooked to monitors on both sides, unable to get into any position where the contractions felt any different.  I was not allowed to move too far from the monitors.  That lasted until about 5 a.m. when I was checked and at 5 cm.  I had planned for a natural birth.  I looked longingly at the labor tub in the corner of the room and gave up on all my plans.

I requested an epidural.  Rather, I had my husband request an epidural for me, so I could rest.  I gave him our code word, banana.  That was way too easy.  He didn’t argue with me at all, and he loves to argue.  I argued with myself.  I resolved that I wasn’t moving from the bed anyway, I might as well rest up, especially if it might take another 6+ hours to get to transition.  The nurse said I could get an epidural in 30 minutes, after I went through the bolus.  42 minutes after she told me “30 minutes”, I reminded her that the time had passed.  I got the epidural less than 5 minutes after that.  The anesthesiologist seemed mad when he got there.  One nurse told me it would feel like a bee sting.  I remarked, “That does feel like a bee sting.”  The other nurse asked if she should turn down the Pitocin.  I think I said, “Sure.”  Almost immediately after the epidural shot, I fell asleep for almost 2 hours.  I think that was the longest single stretch of sleep I got in the hospital.

When I was awoken, the Pitocin was back down to single digit levels, and contractions were about 6 minutes apart again on the monitor.  I thought, “This is going to take forever!”  I was woken at a little before 8am for the midwife to break my waters.  There was meconium in the water and the baby was facing sideways.  For the next two hours I was rolled from side to side to try to turn the baby.  I couldn’t feel anything from my waist to my knees.  At that point, I didn’t care.  I just wanted to go back to sleep.

A couple hours passed, the nurse checked me, and told me I was at 5 cm.  She said, “That’s great!”  I said, “So no change?”  After my comment, she looked worried and left the room.  A few minutes later the doctor came in with C-section paperwork.  I would have signed anything to go back to sleep.  We thought we had some time, but as I finished signing the papers, baby’s heart rate dropped and I was whisked away to the operating room.  I’m still not sure that the monitor didn’t just slip briefly, but I was so out of it, I didn’t know what was going on.  Either way, my husband got really nervous.  With prompting from the nurses he was able to change into scrubs and come into the room with me.  I was conscious.  I was happy I got the epidural so my husband could be with me.  I was relieved I was finally going to meet my baby.

There were a lot of people in the operating room.  I just heard their voices.  There was a thin blue curtain that kept flapping onto my face.  I could only see my husband.  My midwife told me she was shaving me.  Ok, whatever, that’s the part you think I’m worried about?  I felt a very gentle tugging.  I was shaking, and some guy (maybe an anesthesiologist, maybe a troll that lives in the operating room, I couldn’t see him, it could have been either) kept putting hot towels on me.  I didn’t feel cold, I just couldn’t stop shaking.  Still, I was struggling to stay awake, to keep my eyes open, so my husband wouldn’t worry about me.  He was still worried.  But he was in the room with me and was able to take a photo right when they pulled my baby out of the gaping hole in my belly.  They asked if he wanted to cut the cord.  He said no, just like we planned.  They dumped the cord and placenta into a medical waste bucket.  I had planned to delay cord clamping and to have IKids collect the cord blood.  Someone showed her to us over the curtain and asked if she had a name.  I just looked at my husband.  He told them her name, Violet.  They took her away.  She had inhaled and swallowed meconium in the womb and had to be taken to the NICU.  I had planned to keep my baby with me and to nurse her as soon after birth as possible.

The midwife stitched me up.  I was struggling to stay awake to prove to everyone that my blood pressure wasn’t too low, that I was fine.  Everyone, except me, already knew I was fine.  My midwife told me that I would be an excellent candidate for a VBAC.  That might have made me feel better if I ever planned to have more than one baby.  I really don’t remember much of what happened between then and when I woke up in the postpartum room in the middle of the night without my baby.  My husband was sleeping on the couch.  I was cold.  I cried.  I sobbed quietly so as not to wake my husband.  The nurse came to check on me and asked if I was crying.  I said, “Maybe.”  In response to her inquiry of why, I told her that I missed my baby.  My husband woke up, oblivious.  The nurse took us to the NICU and we looked at her in the box with all the wires and tubes attached.  She had a pacifier and was wearing only a diaper.  She was 7lbs 15oz, but she looked big to me.

The next morning I started pumping my breasts with the hospital pump.  I got what I thought was a lot at first.  More than fit in the syringe I was given.  I didn’t know what to do, so I poured what didn’t fit down the drain.  My husband took the syringe to the nurses in the NICU.  Every three hours, we got to hold her and feed her, with a bottle.  She got the colostrum first, then a lot more formula.  When she didn’t finish the 60mL she was supposed to eat, the rest was put through an NG tube.  I pumped for 30 minutes every three hours.  Each time I pumped I got less and less, until I was pumping for a half an hour and not getting anything.  My nipples were cracked and raw.  They didn’t hurt though.  Between all the painkillers and the belly band, I didn’t feel much of any pain.  Two days after the C-section, I met with the lactation consultant in the hospital and she showed me how to manually express.  I got a lot more by hand expressing and pretty much stopped pumping after that.  By then I was able to hobble, on my own, back and forth between my room and the NICU, with my little bottle of milk.  I would express for 45 minutes, go to the NICU for an hour to feed Violet a bottle, and then have an hour and 15 minutes every three hours to eat, shower, see visitors, or sleep.

Sleeping on the hospital couch and only being able to see Violet every 3 hours were torturous for my husband.  He was anxious and impatient all the time.  He was very concerned with Violet’s care, and frustrated that his questions weren’t clearly answered.  How does the doctor know she needs 2oz every 3 hours?  When can she get the tube out of her nose?  Is it really a good idea to keep waking her up?  Although we really liked the NICU doctor, we weren’t always convinced his decisions were in our family’s best interests.  We were quite thankful when one of the nurses convinced him to let me nurse her in the NICU.  The day after I first nursed her, which she took to much better than the bottles, and four excruciatingly long days after the C-section, Violet was allowed to be in the postpartum room with us.  The doctor finally acknowledged that she could eat on her own and was less concerned with measuring her intake.  By the time she was with us, I was technically discharged, but I was allowed to stay in the postpartum room as long as she needed to be in the hospital.  On Monday, June, 15, we got to take her home.  She was 8lbs 0oz when she was discharged.

We took her to the pediatrician the next day for her 1 week well visit and she had lost 5oz overnight.  We went back for a weight check a week later, and she weighed 7lbs 12oz.  We met with a lactation consultant at Carle twice in the next week, who told us that her latch looked good, my nipples looked bad (it now hurt to latch and unlatch and to pump), and she was taking too long to eat (45 minutes each side, every two to three hours).  Based on advice from the lactation consultant and the pediatrician, we started supplementing with formula.  She started gaining more weight.  At 1 month she was getting mostly formula, but it was a struggle to feed her from the bottle.  We got down to only 2oz of formula a day by 2 months.  When I went back to work 10 weeks after her birth, she was on all breastmilk.  She’s only had formula a few times since then.  I have had more success with my Spectra brand pump at work than the Medela, either at work, at home, or at the hospital.  Violet still isn’t a big fan of bottles, but she tolerates them at daycare.  Violet is now 10 months old, and doing great.  She just started walking and loves pointing things out to her father and me.

Looking back, I was disappointed with my birth experience.  It was not what I wanted or planned.  None of my care providers ever asked if I had a birth plan.  There was a lot of emphasis on pain, and no concern about stamina.  Each labor and delivery nurse had a different agenda, and it was never to make me, the patient, as informed as possible.  They didn’t seem all that informed anyway.  At the time you might have thought I was cool as a cucumber, but I was broken down inside, stripped of control, weak, and naked.  I’m just a stoic.  If I had known that with the induction I wouldn’t be allowed to use any of the pain management techniques I’d planned to, or that I wouldn’t be allowed to eat, or that my unfavorable cervix put my probability of a successful induction at about 50%, I probably wouldn’t have done it.  I would have waited, and probably given birth naturally between 42 and 43 weeks, like my mother, and her mother before her.  As it was, I really found the C-section to be a relief.  The surgery went well and I felt most supported while in the operating room.  I recovered pretty quickly.  It was only disappointing because it wasn’t what I had planned or expected.  And I will forever carry the reminder of my disappointment.

 

 

Amy’s Cesarean Birth Story

In honor of Cesarean Awareness Month, we are featuring some great birth experiences from moms who ended up having a cesarean for different reasons. Amy has had 4 very different births. Here she shares with us her last birth, a homebirth-turned-cesarean. Please welcome Amy!


I have had 4 very different birth experiences. My first was a vaginal birth in a hospital bed with an epidural. For my second I wanted a natural birth but it ended in a c-section. My third was a vbac in water without any medication. My forth was an attempted homebirth that ended in a hospital transfer and another c-section.

This is about my last birth. We chose to do a homebirth mostly because the idea of being in my own home and just climbing into bed with my precious newborn as soon as she came out was so incredibly appealing to me. I’d already had two vaginal births with no complications so we didn’t have too many concerns that it wouldn’t work out. Well, like any birth, you never know what’s going to happen.

Labor finally started at 42 weeks. I breathed through the contractions all night and early in the morning I called my doula. Shortly after she arrived I call the midwife. Labor progressed rather quickly after that. I was thinking “How awesome! This baby will be born by noon and it’ll be all over!” Noon came and went and still no baby. I pushed in every conceivable position for what seemed like forever but she just wasn’t coming. Something was keeping her from dropping down far enough for me to push her out. My cervix was swelling and my badder was starting to prolapse. My water broke and I lost control of the pain. I had nothing left. With every contraction my body was trying to push her out. It felt like a freight train ramming through my body.

We decided to transfer before things got really bad. When we got to the hospital I knew I needed a c-section and didn’t hesitate to ask for one. They checked me and the doctor agreed. I was brought right into surgery. I was never more grateful for that epidural! Before long the doctor announced I had a very beautiful and very large daughter (we didn’t know what we were having). I was stunned when they set a toddler size baby on my chest! She was eleven pounds one ounce and twenty two inches long! You could see some coning on the back of her head so besides being so big she was not quite in the right position.

I was very thankful that, in this instance, we chose a c-section. We have no regrets for trying a homebirth and for the choices we made. I was not disappointed or bitter that we did not get the birth experience we set out for. I was just very grateful that my baby girl was very healthy and that I was so wonderfully being taken care of.

What is a Postpartum Doula?

Postpartum care for a woman who has just given birth in the United States is, to put it gently, pretty abysmal. Bringing a new baby into your home, whether it’s your first or your 8th, brings with it changes in routine, sleep habits, eating habits, not to mention the social and emotional upheaval that comes with adding another person into your family unit. It’s not very often that a woman has a mother figure who can drop everything and come camp out with them for those first few weeks, or more ideally, months. More often than not, a woman brings her new baby into her home surrounded by friends and family—for about 2 days. If she’s part of a church or other close-knit community, she may also get a mealtrain for a couple of weeks so that she doesn’t have to cook dinner. Often though, beyond that, she’s on her own with her partner…until that partner has to return to work just days or at most a couple of weeks later. Sounds less than ideal, right?

…that’s because it is! All over the world, other countries and cultures are doing a better job of caring for the postpartum mother than we do. It’s culturally normal for grandmas and aunts to move in and help out for sometimes months on end, while mothers have a period of time called “lying in” with their newborn. In other countries, the government even subsidizes or pays for postpartum help for a new mother for up to a year!

So what are we to do?

Enter the postpartum doula.postpartum doula

A postpartum doula is someone who provides evidence-based information and training to new parents in areas of baby care, sleep, breastfeeding/bottle feeding, baby bonding, infant soothing, and more. Postpartum doulas come for blocks of time as often as the parents request their presence, and some postpartum doulas also provide overnight care. While in your home, postpartum doulas can do anything and everything to help care for both baby and mother. Sometimes this is holding and caring for baby while mom catches up on sleep. Sometimes it means preparing food and snacks for mom, cleaning, running errands, and helping siblings adjust to the new baby. Often it means helping the mother feel comfortable in her role…reassuring her in the areas that she feels doubt, and offering education in areas she feels she is lacking knowledge. Above all, postpartum doulas strive to “mother the mother,” and nurture the whole family as they adjust to their new family member. They provide a comforting presence, and a listening ear when new mothers need it most. Postpartum doulas serve families for a few days, to a few months–whatever the family’s specific needs are.

What a Postpartum Doula is NOT

A postpartum doula does NOT take the place of a health care provider, a licensed therapist, or a baby nurse. Postpartum doulas to not offer any medical advice, dispense medications, or offer therapy services (unless they are also licensed in that area of expertise).

Most postpartum doulas also have clear limitations on what they will do. A family seeking postpartum doula care should find out from their postpartum doula what her specific limitations are before hiring her.  (For example, some postpartum doulas do not provide overnight care, or work with animals, or sleep train babies younger than a certain age.) Everyone is different, so please make sure you are clear on your desires before hiring a postpartum doula.


 

If you know that you will not have the level of support you want/need after bringing a new baby into your home, consider how a postpartum doula could help you! Have you personally had experience with a postpartum doula? What was your care like? How did your family benefit from her care?

Why Hire a Doula?

When describing what a doula is, I frequently hear others say that doulas “mother the mother”. While I really like that description, it does not fully resonate with me. (Let’s just say my mother and I had a complicated relationship!) So, for those like me who are carrying mama-baggage (or if that relationship was absent), I’d like to offer slightly different vocabulary. Try thinking of a doula as one who gives thoughtful care and kind attention to the laboring woman…a doula is someone who “nurtures the mother”.

What benefits are there to being nurtured in labor? 

Rachael and Jill have provided some insight here and here as to what that might entail on a physical level. This can involve a wide range of duties from helping the smoothie-729922__180mother stay nourished via food and water to helping her to the bathroom to applying heat or counterpressure during contractions to fanning her while she pushes. We will do-ula just about whatever it takes to maximize the woman’s physical comfort levels in labor! (Little doula humor there!)

“The things that she did that stand out are give me a hair tie when mine broke, she brought me a nutritional shake, and she also made sure I got to eat right after he was born.”**

“She was there with a trash can when I lost my dinner and coolly told us it was normal and a good sign.”

“She applied counterpressure to my sacrum the ENTIRE time I pushed…it was a much-appreciated alleviation to all the pressure I was feeling!”

Women who hire doulas report increased levels of emotional satisfaction in their childbirth experience. Doulas do not come into births with their own agendas (or at least, they shouldn’t!). Our agenda is YOUR agenda. We are here to encourage YOU in making the choices that feel best for your unique family. We are here to build YOU up, so you feel strengthened in facing the important (and sometimes difficult) work ahead of you.  We are here to assist YOU in having a birth experience that you can reflect back on with peace. Isn’t it comforting to know there is someone whose sole concern is YOU?
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“She helped me emotionally unpack my first birth (when preparing for my second).”

“My first birth was an emergency section and I had no idea what was going on. It would have been less terrifying with someone there who knew what was going on and could focus on me.”

“She was beyond supportive and helped me feel like I had somebody on my side.”

The Biggest Benefit = Continuous Labor Support

Many women mistakenly believe their healthcare provider or nurse will be with them throughout most of their labor. While I have witnessed nurses on a slower night being able to stay with one laboring woman for a good chunk of her labor, unfortunately, it is just not realistic for a hospital setting. On most nights, the nurses have multiple patients to keep track of and attend to. Nurses are AMAZING and WONDERFUL and BRILLIANT people! But, they are just that…people with human limitations. We cannot ask impossible physical feats of them, like bilocation amongst patient rooms.

If you’d like to enjoy the perks of having someone with you every step of the way, a doula is your best bet! As a loyal companion, your doula is charged with the privilege of walking alongside you for the duration of your pregnancy and childbirth journey. For some of the trek, she might provide a listening ear or a hand to hold. At other points in the adventure, she might physically hold you up as you wonder whether you will crack under the strain this particular contraction. Still more, she may simply remind you of just how stunning you are as you ride out one more wave of labor contractions.

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As your doula, we will not shy away from the mountain peaks you might encounter in your birth. We cannot scale them for you, but we are here to cheer you on EVERY step of the way. A steady friend, a trustworthy confidante, a warm ally — we are here for you throughout the entire process.

“I thought it was great just to have someone I KNEW I could trust in that vulnerable space of birthing…having that consistent, trustworthy presence was probably the #1 for me.”

“I knew no one could do it for me….it was MY work to be done. But, it was like having a cheerleader meshed with a loving friend to keep me company along the way.”

Doulas as Part of a Birth Team

So, who WILL be with you then throughout your labor process? Perhaps a partner, or a family member, or even a close friend. It is good and beautiful and awesome to be surrounded by people who love you in the challenging moments of life! However, expecting loved ones to also wear a doula hat is not fair to them or you.

“Can’t my partner be my doula?”

In American birthing history, you can see how the pendulum has swung from one extreme to another. A few generations ago, fathers were expected to stay out of the “women’s work” and wait until he was informed that his son or daughter had arrived. Picture the black and white videos of a well-dressed man in a suit, pacing the lobby floor while smoking a cigarette. Nowadays? Well folks, we have swung clear the other direction. Too often, partners are expected to DO ALL THE THINGS for the laboring woman, simultaneously anticipating her every need and being armed with an array of knowledge of how to help her in every moment. What a heavy burden and unfair expectation!

Can your partner support you? Absolutely! Can your partner be your doula? That is a lot to ask of someone who is also getting ready to welcome a new life into the world and transition into parenthood. One big benefit of a doula is having a trained, compassionate professional working in tandem with your partner (who knows you intimately) to best meet your birthing needs. Linked by the common purpose of nurturing YOU, doulas and partners compliment one another beautifully in the process.

“…everything she said to me was gold. It was empowering and allowed my husband the luxury of being a part of the birth of his son! There is also something encouraging about having a woman there that understands the work you’re doing.”

“Can’t my mother/sister/best friend be my doula?”

The answer to this question is similar to the previous one. Can a family member or loved one support you? Without a doubt! Can that same person act as your doula? Again, that is a tall order to give someone who is emotionally invested in YOU, your health and your team-472488__180happiness to an incomparable degree. If a tense situation arises in labor, a doula does not have the same attachment to you that your family and loved ones do. Thus, we are less likely to feel rattled, defensive, threatened or scared; we are more likely to assist in constructive ways with a clear head. We are there to help your entire birth team navigate circumstances as they arise and support you without our own emotions getting in the way.

Lastly, if you are seeking any further motivation to add a doula to your birth team, be sure to read this and this and this.

So, it seems the real question now is…why NOT hire a doula?

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**All quotes in this post were taken from local Chambana moms when asked about their birthing experiences with a doula.

 

by Shannon Morber

What is a doula?

Have you been tossing around the idea of hiring a doula for your upcoming birth but have a few questions about what they do and how they can help you? You have found the right blog… read on to learn more!

A doula is someone who has been trained to offer continuous support during the labor process. A doula also provides support during the pregnancy and helps to prepare the couple for childbirth by meeting with them before the birth process starts. Doula comes from a Greek word that means “a woman who serves.”

The doula meets with the couple after they have hired her to get to know each other, practicing comfort measures and reviewing options and resources as needed. This also helps create a relationship so the laboring mother doesn’t see her doula as a stranger but someone she is comfortable with and feels supported by completely.

Once labor begins your doula is available by phone during early labor to provide support until active labor starts, this is when she usually joins the couple to provide in person support. Once your doula is there, she will not leave until you are ready. A doula doesn’t have an agenda for your birth—your doula is there to support your wishes and preferences. At Gentle Transitions we are here to provide nonjudgmental support!

A lot of times the partner is concerned that with a doula their role becomes obsolete. And that isn’t the case at all. A doula’s role doesn’t take over your partner’s role; the 2 roles are very different. I have been to births where the partner knows he wants to play a huge role as main supporter but I have been to births where the partner isn’t sure which role to play or how comfortable they are with the whole process. We work together to find how we all can support the laboring women best. After all, no one knows the laboring mother better than her partner, there are a number of times I look to the partner to know how to support her the best. This is another reason why getting together before the birth and talking over roles and expectations is very helpful.

Although a doula doesn’t prevent interventions from happening at births, research shows having a doula present decreases the need for common interventions. Evidence Based Birth pulled together research on doulas and they found that women with continuous labor support have an overall increase in satisfaction of their birth experiences. The research also found there was a 31% decrease in the use of Pitocin and a 28% decrease in the risk of a cesarean.*

It is also important to remember that while a doula is certainly a part of your birth team; a doula doesn’t provide medical support or advice. We won’t suggest going against your care provider’s recommendations. Our role in labor is to help with comfort measures like breathing, movement and positioning. We work on relaxation physically, mentally and emotionally. We can remind you of your birth preferences and help ask questions that help you make a choice that is best for you.

It is important to find someone you feel comfortable with and who you want to have with you on this wonderful day. The doulas at Gentle Transitions would love to meet with you and talk about how we can work together to support you and your partner during this time in life.

 

* http://evidencebasedbirth.com/the-evidence-for-doulas/