Can you REALLY birth without having a Vaginal Exam?

Ha! So true Forrest Gump…

So I’ve gotta say, vaginal exams SUCK. I’ve experienced them myself and I’ve watched the clients I support as an Edmonton doula struggle through them countless amounts of times. However, most of us Edmonton mama’s just accept the uncomfortable pain because they are very important. After all they tell you how far dilated you are! Because… dilation will tell you how much longer you’ll be in labour for right? Sorry friend, there’s no way of predicting how much longer you’ll be in labour for.

But what if I told you that you could actually have a baby without getting ANY vaginal exams? That before medical advances birthers had no vaginal exams and managed to get a baby out? That scientifically, there is ZERO evidence that shows better birth outcomes with more vaginal exams? Many people are never told this and many care providers spin this part of birth so that women think that this info (dilation, effecement) is useful and necessary. I’m here to tell you today that it’s not.

I recently took a Spinning Babies course and it was life-changing as a doula in Edmonton.  One of the issues with offering birth doula services is that I am not trained or able to do a vaginal exam. Before taking this course this used to frustrate me so much as I felt like I couldn’t truly help a woman without knowing exactly where she was in her labour. After the course, I learned many valuable lessons that I will take with me to every birth I support! Number 1 – If anything would matter about a vaginal exam, it would be if the care provider could tell the baby’s position and/or station. Dilation and effacement are not steady or predictable variables during labour… eeeeevery birth person opens and thins at her own rate. However, if you knew what position a baby was in you could help the birther to position her body better for her pelvis to open. You could also guess by how far up or down the baby’s presenting part is as to which part of her birth canal is preventing progress. Such an important thing!

So after learning how valuable knowing baby’s position and station came lesson Number 2 – you don’t need a VE to determine these two things! It was almost unfortunate for me to hear originally how important station and position were, so I asked the question “as an Edmonton doula on her own with a birthing couple, how do we know?”. The answer: look at what the birther’s body is telling you. Is the contraction pattern steady? Is it consistent? Is she having pain, and where? The reason that birth happened prior to our medical system is because as birth supporters we can intuitively tell what stage the birth person is at just by being with her (or in contact with her). At the very least, as a birth doula I can keep the mom at home (without the presence of warning signs of trouble) to cope and allow baby to come down naturally and easily. THIS was probably the greatest take-away from the Spinning Babies workshop I took.

The last valuable lesson came from a birth I was at with a midwife at home. This lesson, Number 3 – not all women will be fully dilated when their body begins fetal expulsion (pushing). Known as the early urge to push, many women feel “grunty” or “pushy” before their body is ready to push. So should they be? There’s hardly any evidence about adverse outcomes but the small research that has been done has linked no adverse outcomes to women who do push early (you’ll likely hear things like swollen cervix, damaged cervix, exhaustion, etc. as reasons why you should not push before you are dilated). So crazy enough, if we feel the urge to push early, we are usually told to wait until we achieve some random measurement of one of the organs at play instead of listening to what our body tells us!

Is your mind blasted?? So was mine when I began to learn all of these things! It’s pretty exciting to hear that enduring vaginal exams is not necessary. VE’s are yet another choice you have to make while you are in labour (notice how I say YOU, birthing person, and no one else). For some, the comfort of knowing how far along they have gotten provides a sense of relief. It can be very exciting to hear of progress, but it can also be disheartening if you haven’t gotten as far as you thought you have. It’s so important to know yourself, know how you’ll react to the information you hear, and also to know that those measurements are tricky little buggers! If you want to hear your dilation, effacement, station with an open mind, then a VE wouldn’t be a bad idea. It’s like with anything else in childbirth – educate, prepare for all scenarios, and let the process take over.

How many vaginal exams did you have in labour? Did you hate them, or not mind them too much?

My Journey to Becoming an Edmonton Doula

Dancing doula in Edmonton, AB

I recently got asked by one of my previous Edmonton prenatal class students (thanks for the inspo Alicia!) about how I came to be an Edmonton doula, and it hit me how much I love telling the story of my journey. So why not dedicate a whole blog post to it! The path that lead me here wasn’t a straight shot… sometimes I think that if you told me 5 years ago that I would be teaching childbirth classes in Edmonton and getting to watch babies be born on the regular I would have not believed you. Alas, this is where I am in life and I’m loving it – so here’s my story 😊

Though I had always wanted to have kids, the time that this whole journey began was not planned. In fact, my first pregnancy was a little bit scary for me considering I was just completing the very first year of my brand new business venture – a dance studio for adults. That pregnancy unfortunately didn’t take and I miscarried at 7 weeks, but it really revealed that my heart was ready to start a family. So after my husband and I tried for about 4 months, we got pregnant with sweet Callie.

It was such a dream being pregnant with her, easy and straight-forward. The real troubles in my heart came from thoughts of the actual birth… it scared the shit out of me! I was in the common, rookie mindset that the actual pushing was going to be the worst. I knew absolutely nothing about how to have a baby and so I started with a blank canvas and set out to paint the picture that I would most desire. I did my research, hired a private prenatal instructor, and read Ina May’s Guide to Childbirth (LIFE CHANGING book, it’s a must read). Before I knew it the day came for my daughter to arrive, and my birth, which ended up being 2 days of prodromal labour, an induction and ended up in cesarean due to fetal distress/failure to progress, ended up not being what I thought it would be at all… but that didn’t matter at that time because she was here! And she changed my whole world, in ways I never even imagined.

Months after my birth I started to feel this missing piece in my life. My business was struggling to grow, and I was slowly losing my motivation to keep growing it with all of my time and interests wrapped up in being a mom. January 2016 was the first time I had the thought about becoming a doula. I remembered someone telling me about it once in passing. I hardly even knew what the job entailed at that point but I thought “if this can be a little side job for me on top of my other business and I get to keep researching about birth, sounds good to me!”. After a google search I stumbled upon Sonya (my mentor and the head of the Collective I belong to, Full Circle) and called her up to see about registering for the April CAPPA doula training. Turns out she had an opening in the February training… one month to mentally prepare? Sure, afterall this wasn’t (at this time) the start of a career or anything, just a side gig.

Fate and my life’s calling all hit me like a ton of bricks when I took that training. I started the weekend thinking I was going to learn a cool new skill and I left thinking I neeeeeeed to do this work. I’ve never felt so compelled by the universe in my entire life. So yea, pretty major!

After this training my life got a little cray cray. I attempted to continue to run my business while also attending births and being a stay at home mom… it was chaos, and not the good kind. I was constantly in a battle between my head and my heart. My head was telling me to keep working on growing my studio, it needed me and my time. I invested too much time and money and sacrificed too much to throw it all away for some hippy dippy lifestyle. But in my heart… I wanted to be at a birth. I wanted to help women cross that threashhold of being a daughter to being a mother. I wanted to relive what had changed me for the better. And most of all, I wanted more time with my family. For those of you who have had babies and recall that beautiful shift from logical to primal that happens during labour… this is what I needed to do, just in the every day life sense. And after a lot of heartache, disappointment and major growing pains, an opportunity came for me to say good bye to my first born, aka my dance studio, and move on to what my real life’s work is.

This was by far the hardest thing I’ve ever had to do. Even harder than childbirth – I was grieving a loss of a huge part of myself while also discovering who I really was. And in the midst of all of this, I also suffered another pregnancy loss and months later, became pregnant with my second born. I don’t think I’ve ever felt a shift like this before… but the me standing here today and telling this story. This is exactly who I’m meant to be!

Since focusing my energy on becoming an Edmonton doula and instructor of prenatal classes in Edmonton, I’ve had the pleasure of meeting and helping nearly 50 families through the most transformative time of their lives. This career has brought me closer to human nature and what life is really all about. I’ve felt allllll of the feels. I’ve absorbed so much of my clients energy and I grow every single birth I attend and with every single parent I meet. My journey was rocky yet so worth it to be where I am now. I’m a doula and I’m proud!

Thanks for allowing me to share my crazy life with you, feel free to share your thoughts about my journey below!

Who’s delivering your baby? Why this really matters!

As a doula in Edmonton I witness the impacts that fear and insecurity have on someone’s birth process. It’s crazy because the smallest things you wouldn’t even think make a difference can literally wreak havoc on your plans for a peaceful and safe birth (I get more into this in my Fear-Tension-Pain post). Some of these things, like harsh lighting, bad smells or distracting or fearful sounds, are easily adjusted (us Edmonton doulas have a knack for making a room feel more ambient!), but there are others that are more difficult and tougher to navigate when things go wrong. One of these things is those who are providing care to you during your birth – midwives, doctors, nurses and other healthcare practitioners.

While it would be amazing if all of us were matched up with the care providers that best suited our personalities, beliefs and things we value, this is not always the case. In the most common negative circumstances, you’ve got a doctor or midwife that you just don’t vibe well with. Perhaps he/she isn’t supportive of how you want to birth, or they don’t go into enough detail during your appointments, or they just don’t share the same views on birth as you do. Whatever the case, as a doula in Edmonton I hear this the most when expecting parents express concerns about their care. Then EVEN if your care provider is an excellent match, if you’re with a doctor then there comes the nurses that will care for you for the majority of your time in the hospital. Some hospitals are good with matching nurses to your personality type – for example, here in Edmonton if a midwifery transfer is happening we often get assigned nurses who’s views align with the midwifery standard of care. However, usually you get whoever is on rotation. With midwifery care, perhaps you only like one of the two midwife partners, or the secondary midwife that comes for the delivery is not your cup of tea. Finally, I have had hospital clients who love their doctor, love the nurses they are assigned, but then when delivery time comes their doctor is not on call so they wind up with a new one that they don’t match well with. So as you can see, so many opportunities for a mismatch… at a time when dealing with conflict and confrontation is not really conducive to your progress!

The relationship between a care provider and their patients is a sensitive one. Everyone has their own ideals of how a birth should go that stretch beyond the “healthy baby and mother” common goal. Some parents would rather be compliant and do what their care provider says throughout their birth, while others want as little guidance as possible. Some care providers view birth as a medical process that requires some level of intervention, while others view it as a completely natural process where it should never be touched. The problem when there is a mismatch is that level of trust and safety. If you don’t share the same ideals as your care provider and that starts to unfold during the birth, your natural response as a human is to enter fight or flight mode and stop the birth process until you feel safe again. I have seen this happen as an Edmonton doula with my very two eyes and it’s a fascinating, yet awful thing to witness. A parent should never feel disrespected or that they cannot trust everyone who’s in that room with them.

So what’s the solution? How do you navigate the system so that you are equipped with a birth team that works with you and not against you? One easy solution is to hire a doula! As a birth doula, we are your #1 supporter and our job is to advocate for what YOU want. We don’t work for hospitals or doctors or midwives, we work for you. In the event that you do not have a well-versed birth professional working for you, then the one piece of advice I can give is to stand up for what you want. And when I say you, I mean you the birth person AND you the partner! Both of you can make each and every last decision at your birth, and no one else can legally or ethically do the same. So if you’re in a situation where you feel unsafe with your care providers – speak up! Tell someone you’d like to be assigned different nurses or the other doctor on call at the hospital. You can even go to a different hospital to find someone else (though that’s probably the last thing you’d want to do while you are in labour). If you are with a midwife you’re butting heads with and at a hospital, ask for a transfer of care to a doctor. If you are at home, go into the hospital and transfer your care. These are all things that you have the right to do, and while they seem scary you have one clear advantage – you and your birth partner are a team. And no one is going to mess with your united front! Advocating for yourself or your partner and having a voice could be a little messy at first, but that feeling of empowerment and taking back your birth is an incredible feeling that you can look back on with pride.

Have you ever navigated yourself out of an unsafe situation while birthing? Share your stories in the comment field!

Running and Childbirth

So this post may come off as super random, but I had the coolest thoughts tonight that I just needed to get out there! (Afterall, that’s what blogging is for right?) So as an Edmonton Doula dedicated to being efficient at the physical aspects of my job, I partake in a number of activities to keep me in tip top shape for those long, sleepless nights. Running has been a part of my life for a long time, long before I became a doula in Edmonton and even before having children. It had been a while since I went running but tonight felt right, so off I went with my music blaring and my shoes hitting the pavement.

As I started to hit the difficult part in my jog I found myself falling into this habit of coaching myself through in almost the exact way that I would if I were with a client as their doula in Edmonton. Once I finished up and I thought more and more about this I realized something: running and childbirth are sisters! Ok so maybe running is like childbirth’s baby sister, but you get the point. Going for a run is like a mini version of childbirth – it takes far less time to complete and a fraction of the intensity, but the stages and layers are so there! Let me elaborate on this a bit more.

So you start your run, and at first you’re excited. You’re thinking “weee here we go! This is gonna be great! I’m going to feel so good afterwards and everything is going to be smooth sailing!”. You’ve got a real bounce in your step, you feel cool and fit and maybe even a bit like showing off by picking up the pace (k maybe that’s just me haha). Then you hit this point where things start to kinda hurt. Breathing is getting more difficult, maybe you’re getting a rib cramp or your legs are starting to ache… for whatever reason you’re thinking about stopping to walk for a bit. You’re hesitant because you know if you start to walk, it gets increasingly harder to start back up the jogging pace again. You don’t want to break your stride but on the other hand you look into the future and think “how the hell am I going to finish this whole route if I’m already needing to walk? I can’t do this!” So then this amazing thing happens. You say to yourself “well, I’ll just run up to this corner here and then I’ll take a walk break”, and as soon as you say that to yourself, all of the sudden you get what I like to call your “second wind”. All of these things that were scaring you completely disappeared and you started feeling great again. Amazing! THIS my friends, this is your beautiful endorphins doing their job. That moment when you see hope right in front of you, whether that be a break or the finish line or you get into your zone, you’re allowing your body to take over and fight that painful sensation for you. You’re letting go of whatever is causing you to believe that you are in danger, and by releasing this stress you are opening yourself up to the laws of Mother Nature. You’re putting full trust that you.will.be.ok.

This moment happens quite often in a jog. Well for me anyway. It’s really what carries me to the end of my route – in fact when I can visually see my house when I’m reaching the end, I get a blast of adrenaline and sometimes sprint! Much like the pushing phase of labour. I can’t believe I’ve never made this connection before but it’s so similar it’s feaky!

So this Edmonton doula is a runner and will now be doing a lot more running to continue to put myself in the shoes of my clients coming forward. For in no other way can you fully understand the body’s processes unless you can relate something in your life to them on a regular basis. And I’m sure you can all agree that I’m not going to keep giving birth to try to relate!

Do you run? Do you do another form of activity that you can find similarities to childbirth in? Let’s hear your experiences in the comments below!

Trust your body: what does that really mean?

If there’s one thing that I’ve learned through attending births as a doula in Edmonton, it’s that our mindset going into labour is one of the most, if not the MOST important factor in both getting your labour to progress and having an overall satisfying birth experience. The state that your mind is in when you get pregnant, go into labour and become a new parent is influenced by the level of confidence and trust you have in your body. I’m sure you’ve all heard a doula, and specifically an Edmonton doula, say the words “trust your body” or “you body knows what to do”, etc. Let’s elaborate on this a little more though, as this may seem like a small statement but means more than you might think!

The language we use with pregnant and labouring people plays a role in how we perceive our bodies and bodily functions. Unfortunately, this language is commonly not so positive. I’m sure we can all name a tv show or movie that scared the crap out of you for when you were to give birth, and we’ve all had at least one friend or family member tell us a horror story from their birth. This is all so troublesome as both of these sources of information are notorious inaccurate. But believe it or not, even trained professionals – doctors, nurses, even (as much as I hate to admit this) some midwives and doulas – have been known to instil fear or discouragement into the minds of expectant parents. Sometimes prenatally, sometimes even during a birth! And, understandably, this is detrimental to birth culture for many reasons. One, there is a certain level of trust put in place for one’s birth team so saying incorrect things that could impact a birth person’s confidence goes quite a long way. Two, nothing spreads quicker then overly dramatic or negative information (whether it is true or not). You better believe that if someone hears that they will never be able to have a vaginal birth because their baby is too big, this is going to be told to friends and families who have babies in the future and taken seriously.

Our current birth culture has come a loooong way from what it used to be, but boy-oh-boy do we still have work to do. As Edmonton doulas, we need to be educating everyone about the importance of language used with birthing people – little things like “you’re only 5cm dilated” instead of “you’re 5cm dilated!” makes a humongous impact on someone’s trust during the process. This simple adjustment might just save the birth person from going into a state of worry, panic and overall disappointed state and in turn, “save” the birth (keep it more pleasent). For now, as us doulas in Edmonton continue to spread the “good word”, we can use our own clients as a starting point and really hone in on making sure you all trust your body.

So trust your body – what does this really mean? Well for starters, this trust stems from confidence, and for some of us confidence doesn’t come so easily. Confidence is more than skin-deep though, it’s truly trusting you body’s natural processes. So things like chronic illness and pain, pregnancy loss (hey ps, check out my post on miscarriage here) and body esteem issues will make it difficult to truly trust your body as it may have “failed” you before. Working through these past experiences with a counsellor or your Edmonton doula or midwife could help smooth the process of developing trust. Another thing I want you all to do is put on your rose-coloured glasses when watching any media-depicted birth scenes or listening to friends stories. Media is known to over-dramatize and straight up falsify what birth really looks like… your birth won’t be exactly or even remotely close to what you see on tv. Friends may have had an awful experience but look at the factors at play at their births – did they take a good Edmonton prenatal class (usually one that is out-of-hospital) and learn what informed choices and options they had? Did they have 24 hour birth support from a doula? Was their care provider’s goal in line with theirs for the birth? Most importantly, your body is not the same as theirs, therefore your experience won’t be either. So when you see birth on TV or hear about it from your friends, take that information purely from an amusement standpoint.

My final point is that I really want everyone to know that your body IS CAPABLE. No matter what anyone says, mother nature has hard-wired you to have babies, regardless of what that outcome might look like. No one knows your body better than you – not your doctor, not your nurses, not your midwife and not your doula. You need to get to a place where you are in-tune with what your body is telling you to do, and listen to it! If something doesn’t feel right, don’t consent to it and if you feel compelled to take a certain step in your birth, as long as you are comfortable with the risks associated, do it. Trust your body’s individual process to bring your baby to you and have faith in your capability of handling the most intense experience of your life with grace and dignity.

 

5 Tips for Surviving a Long Labour

If you’ve been following my blog for a while, I hope you’ll have realized by now just how unpredictable birth is. Regardless of how your pregnancy has been so far, or how your mom birthed, birth will take place whenever and however it must! I’ve covered the side about rapid birth in my Precipitous Birth post, so now I want to write about the opposite scenario: long labours. I find that long labours are more common among my clients than quick ones are, likely because they are usually first-time moms, and taking off my Edmonton doula hat and putting on my mom hat, I have personal experience with long labours as well.

So what do you do to prevent having a long labour? Well, other than a few things that could possibly help, theres just too many factors at play to completely avoid having a long labour. However, many women have had vaginal, intervention-free and positive births after labouring for what feels like forever. Here are some tips if you find yourself (especially without a doula in Edmonton) in a long labour:

1. Ask yourself, where is baby?

Optimal Fetal Position is becoming more and more prevalent in the birth world as experiences and evidence moves forward. In layman’s terms, how your baby is positioned in your womb matters. That being said, us Edmonton doulas want you to know that it doesn’t mean the birth will all go to hell in a hand basket if baby is not optimally positioned! The most important thing is knowing how baby is positioned and taking steps to enhance that. The most ideal position for your baby is with them engaged in your pelvis and facing towards your spine (anterior or OA). In this position, contractions will likely (but not always) progress smoothly, you’ll feel a lot of pressure down low that will build and build, and you won’t feel a lot of kicks in the very front of your tummy. If you notice these signs, then follow your body and do what feels right. There are tons of other positions baby could be in, but a less ideal one that can be in is posterior or OP. In this position you may have a labour that stops and starts often, you may feel instant back pressure that can be quite painful, you may feel tons of kicks right in the front of your tummy and you may feel that baby is still quite high up. If you find yourself in a situation with any of these symptoms, head on over to www.spinningbabies.com and troubleshoot with some of their awesome positions to help you feel more comfortable.

2. SLEEEEEEEEP

If you’ve ever had a baby and hired a doula in Edmonton, you were probably told when you first stared labour to get to bed and sleep. Easier said than done, right? While I know first hand how impossible it may seem to sleep at an exciting time like this, it is simply a must! First of all, you’ll need lots of energy for the parts of labour where sleep is actually impossible… and especially if you’re labour ends up being quite long. Second, sleep can really help you forget that you’re in labour which is actually what you’re going for at this point. Might sound silly, but the saying is true – a watched pot never boils! You’ll end up driving yourself crazy if you watch your early part of labour like a hawk, so get. to. bed.

3. Clear the air with your thoughts

Prodomal labour is a term that refers to labour that starts slow but drags on for days and sometimes weeks without any progress. I don’t know about you, but that sounds to me like my own personal form of hell… I’m way too impatient to want to deal with that long of a wait! While no one has really found a specific reason as so why prodomal labour happens, many Edmonton doulas (myself included) have a hunch that maybe it is a mental blockage thats preventing things from getting any further. Our bodies have a unique way of blocking oxytocin from being released from the brain at certain times (I dive into this more in my Stages of Labour post) and this is because of our fear or stress-induced fight or flight response. So if you are freaked out by the thought of pushing a baby out, or you’re nervous about the contractions getting stronger, or even if baby coming right at this moment is bad timing with other life events or children that need attending to, this can ALL slow down our labour, stop it completely or prevent it from progressing any further. My best advice for this? Tap into your psyche. Try journaling or scheduling a meeting with your doula to get these feelings out through conversation. Take some time for yourself at a float or a walk or a bath while listening to music. Anything to keep those hormonal responses to fear or stress at bay is crucial to see some progress begin.

4. The Gate Control Theory is your best friend

Never heard of the Gate Control Theory? Let me give you a quick explaination: this theory says that there is a gate located in your brain that lets in a limited amount of nerve signals to your senses at a time. Therefore, if we flood this gate with pleasurable signals, we’ll prevent from having too many painful signals getting through and therefore perceive pain with less intensity. There are tons of ways to stimulate with pleasure signals and you can really get creative with this one! I’ve seen simple things like hair combing, eating something sweet (Tim Hortons chocolate chip muffin, oh yea) and taking a bath work, and there are higher levels like sterile water injections and using a TENS machine that work well too. Think pleasure sensations and the possibilities are endless!

5. If you’re birthing in the hospital, know when to go

For some of us, going to the hospital too early will literally ruin your labour. Crazy, I know! Reason being: if you feel uncomfortable, stressed or unsafe in your environment, the oxytocin can’t flow optimally. Some are quite comfortable and maybe even prefer being in the hospital but I know for many of my clients as an Edmonton doula, and even for myself, things like the smells, the beeping, the harsh lighting, etc. really hinder my ability to keep calm. The great news is if you are hiring a doula in Edmonton they will know when a good time would be to head in. In my opinion, the best case scenario is you are only in the hospital for a few hours before pushing, and your spending the rest of your time at home before you head in relaxing, being intimate with your partner and getting ready for your little one’s arrival home.

How long was your labour? I’d love to hear your stories about getting through the long journey of birth, use the comments section below!

A Day in the Life of an Edmonton Doula

I’ve gotta say, life as a doula in Edmonton is quite odd. I mean I love it, but when I talk to friends or family (or anyone not in the birth industry, really) or meet new people, and the topic of what I do for work comes up, the conversation usually ends in a blatantly obvious change in subject to something a lot more generic (cue the ‘how about the weather?’). The Edmonton doula industry has its quirks and definitely isn’t made for your average-joe… but really, who will get as turbo-pumped to talk about perineal tears or pooping yourself as we do? We’re cut from a different fabric is all.

So I thought to lighten up the mood, I’d talk about a few interesting aspects of life as an Edmonton doula. Just so that all of you out there get a little taste of what makes us so… unique 😉

We operate on completely whack-o schedules

Ok so you know the usual work week – 9-5pm Monday to Friday, weekends off, simple schedule that is very predictable. Then we’ve got oil field workers who work out-of-town for days or weeks at a time until their job is complete and they get a series of days off (or sometimes they get the advantage of consistent days out and in). Then we’ve got the shift-workers like nurses and doctors, who work 12 hours straight and sometimes though the night. Thats all interesting, but an Edmonton doula? It is completely normal, in fact common, for us to work 24 hours straight, get called to work in the middle of the night and go without working for weeks to then all of the sudden be working 3 or more complete days out of our week. We literally have NO idea what day or time we need to work. With us frequently being awake at strange hours of the night, it’s very normal to get a text from us at 3 or 4am and to not hear from us when calling during normal human hours. I heard a hilarious phrase recently that said “waiting for a baby is like picking someone up from the airport… but you don’t know who they are or when their flight gets in”. I’ll be over here, living at the “airport” for the next two weeks for a complete stranger, haha!

Nearly nothing body-related makes us uncomfortable

There was a time in my life that I remember getting weirded out when my mom talked about periods in front of my dad. Or going red when someone asked if I had regular bowel movements. However now that I’ve entered this realm of working as a doula in Edmonton… I can’t wait to chat about ovaries! And placentas! And HORMONES! Wooo! I’ve had a client complain about talking about mucous plugs while we were sitting in Starbucks for our prenatal meet-up, and I felt bad afterwards but honestly it’s just so normal to me. Us Edmonton doulas see various bodily functions happen before our very eyes on a regular basis. We know what lots of different bodily fluids look like, and we are (well I am anyway) totally comfortable talking about sexuality openly because that is how we get our work in essence (also, just saying, it’s true – what gets a baby in, gets a baby out). I feel like becoming a doula in Edmonton has really opened my eyes to these systems that I only read about in textbooks before, and I so passionately am fascinated by them no matter how many times I watch them unfold.

We become close friends with complete strangers in a fraction of the normal time

I’ve never been a stranger to connecting with random people very easily, being the extrovert that I am, but as an Edmonton doula I am constantly meeting new people and getting to know them very quickly during such an intimate time in their life. I feel such a connection to every client I support, sometimes to the point where I find myself thinking about them months and even years after their birth. To me, being a doula in Edmonton has really made me feel closer to humanity. I see couples through one of the most, if not the most intense part of their lives and in order to allow me into this incredibly intimate space, they need to learn to trust me completely. The fact that so many people can do this really demonstrates how much humans as a species are so connected through our similarities and primal instincts. One added bonus is my friends know that they can take me pretty much anywhere and I’ll leave with a new friend, because thats how I do what I do!

Our bodies LITERALLY function differently

So this is a bizarre one, but many other Edmonton doulas can attest to this – regularly attending births, especially home births, messes with OUR regular hormonal ebbs and flows. I’m sure I’m not the only doula in Edmonton thats come home from a birth and felt incredibly emotional, crampy in my uterus, maternal, primitive, etc. We literally are subjected to come-downs from oxytocin from how receptive we become for our clients. We soak in all of the emotions, and hormonal climaxes that are around us, and physical touch with our clients who need it add to this (some may not believe it but I truly think that you can get a high from being in physical contact with someone who is experiencing a hormonal high). I have heard of many who’s moon cycles (periods) get disrupted due to attending births, and I’m sure my day will come for this. Overall I just feel like this work has made me more empathetic and more receptive to the energy of others, even though I felt sensitive in this way before.

We eat, sleep and breathe our jobs

One thing is straight across the board with all of us doulas in Edmonton (and I’m sure in other geographic locations too), we freaking love our job. Sometimes I think about how I get to help babies be born for a living and think, is this ACTUALLY what I do for a living?! Don’t get me wrong, I work dang hard for the money I make. And balance is a constant struggle and effort. But I just couldn’t imagine doing anything else ❤

Let’s hear your doula experiences in the comments below!

Precipitous Labour & Birth- When Babies Can’t Wait to Join the World!

I was recently at a birth where a first-time-mom had her baby incredibly fast. In this particular case, stage 2 was the speedy part, but I know that there are many parents out there that have speedy first-stages as well (have we all seen those photos of the woman in Kansas who gave birth to her baby in the hospital hallway? If not click here to see the Facebook post… truly amazing!). As a doula in Edmonton I can’t say that I was completely ready for just how quickly things went during this experience, since most birthers experience longer labours and births, especially with their first babies, but now that this experience is under my belt I want to chat a bit more about the good, the bad and the interesting when it comes to precipitous labour and birth.

It’s not really that predictable

According to a study done by National Center for Biotechnology Information, U.S. National Library of Medicine to analyze the clinical significance of precipitous labour, fast deliveries are much more common in second-or-more-time parents than first-time parents (21.5% compared to 6.9%). Risk factors that are more common are physical – things like having an incredibly efficient uterus, a perfectly positioned baby and really great pelvic structure and soft tissues. These are all things that a first-time mom won’t be able to tell are even characteristics for her. While there are many women who have precipitous labours who have relatives that have experienced the same, this is less prevalent then you would think… many of us experience completely different births than our relatives.

Higher risks of pelvic floor/perineal damage and haemorrhage 

I’m all about delivering the bad news first and ending with the good (this Edmonton doula likes to share positivity and empowerment!), so with that I will say that the worst part about having a fast birth is the higher chance of tearing and haemorrhaging. Both of these things can be quite scary. A 4th degree tear is no joke and requires extensive repair, and from what I’ve heard it sometimes feels worse than the actual birth (not to mention the healing process is quite long). A PPH is more likely simply because the uterus expelled everything so fast that it hasn’t had time to catch up and contract back to a smaller size as quickly, which can sometimes cause more blood and tissue loss than normal. With both of these situations there isn’t anything you can do to prevent them from happening. Some evidence does suggest that giving birth on your back can slow down fast labours (where normally us doulas in Edmonton urge women to get off their back to push), but this is definitely not the case for everyone. One thing to remember is that while both of these situations aren’t great, recovery will happen as long as you are in the hands of a good care provider and follow their instructions for a safe recovery.

Higher chance of a vaginal and/or unmedicated birth

Is having a vaginal birth important to you? Or having an unmedicated birth? Well the good news is that many women with fast births don’t need a cesarean or any pain medications (or in many cases, can’t have pain meds due to the fact that they are already too far along in the process). Due to the fact that many women who do have fast births have extremely efficient reproductive systems, the chances of these births needed any help from medical interventions are slim. Whether it be excellent contraction strength, ideal pelvic openings (“birthing hips” as we’ve probably all heard before) or tissues that are responsive and just know exactly what to do, women with fast labours have got some really great stuff going on in their baby-makers! And sure, having the luxury of pain medication taken off the table would suck if that was a part of your original plans, but with things happening so fast that intensity happens fast too.

I’m glad that I was able to experience being a doula at a birth like this, as it really opened up my eyes and yet AGAIN proved to me just how unpredictable birth can be. Did you have a very fast birth? I’d love to hear you story, feel free to leave it in the comments section!

 

Had a Cesarean? What you need to know about your scar tissue

Since having my second unplanned cesarean, I’ve been dedicated to both my personal recovery process and “preaching the good word” to potential clients of mine as an Edmonton doula. As someone who has had cesareans, supported women in the OR while having cesareans and supported women through VBAC’s (Vaginal Birth After Cesarean), I’d like to think that I am quite knowledgeable of the difference you can expect in recovery as opposed to vaginal births. However, one thing that was never taught or talked to me about until my second child was scar tissue and the importance of work being done on your healed incision. Something so simple, yet oh so important and a powerful tool in healing your body post-op! Let’s dive into this whole realm, shall we?

So let’s start with a crash course on scar tissue – what it is, what it can cause and how to treat it. All of our body’s connective tissue is made up of a certain fiber called collagen. When any injury or incision is made into our skin, muscles, ligaments, etc, new collagen fibres replace the tissue that has been damaged to create scar tissue. The problem with these fibres is that they are not as smart and organized as our original tissue and often form in a very mismatched way, which can hinder the function of the structure where the scar has formed. There are many problems that can arise from this – movement in the area where the scar is can be stiff, nerves and sensory feedback to the area where the scar exists can be damaged, and it causes a disruption in well-functioning fascia. Ok now before I lose you (because this was all a lot of info for my average, Edmonton doula brain when I first heard it too!), basically this all means that a scar, especially one located viscerally (deep, abdominal cavity) can literally effect ALL areas of our bodily function. This is because fascia is like a giant spider web that moves smoothly with our muscles, so when part of this web is cut and grows back incorrectly, the whole web moves different. Fascinating, I know!

So how can we get back to a place where our body is functioning again as it should? This is where scar tissue massage comes in. This unique type of massage can be done on any healed scar, but cesarean scars are extremely important as they are located in a particular part of our body where function is extremely important and because a cesarean incision goes deep into our visceral layers. When a scar forms adhesions (these wacky new collagen fibres I was talking about earlier), the adhesions tend to pull on different organs and sometimes cause them to move out of their designated position. Scar tissue massage works to “break up” these adhesions to help our organs to move back into place and function as they should. This massage also allows the skin, fascial and even muscular layers of the scar to move with more flexibility, therefore allowing our whole body to function optimally.

Now who does work on scar tissue massage? Well first of all, YOU! You can start the scar mobilization process on your own – this video is a good place to start. In regards to hiring a pro, looking  for an RMT (Registered Massage Therapist) who is experienced in scar tissue work. Personally, I’ve had my scar worked on by my physiotherapist (read here about why I think you need postpartum physio) and my chiropractor as well, and both did incredible work for me. You’ll likely have to get multiple treatments done before you notice a positive change, but stick with it! Whoever you decide on, allow them to help you navigate your number and frequency of appointments. Do know that some mild pain and discomfort are normal in this process as your systems get back into place… it will be worth it in the long run.

If you’ve had a cesarean I encourage you to read my story – especially if you are going to be attempting a VBAC or you are disappointed with the outcome of your birth. As a birth doula in Edmonton I understand the complexity of healing from a cesarean, and have both had my own emotional healing to do as well as aided in the emotional healing of others. Cesarean scar massage is a very important factor in your physical healing postpartum and the better you can heal physically, the stronger of a mom you can be to your little one(s) and the more smoothly you can move on and learn from the experience of a caesarean birth.

The Lost Art of Uninterrupted Pushing

I’ve officially entered back into the adventures of being an on-call Edmonton doula, after taking a hiatus from attending births following my own pregnancy… and boy did I miss this! In the coming months I’ll be pushed out of my comfort zone and attending primarily home births (most of my previous clients have delivered in hospitals). While there are some things I quite like about attending hospital births (yes, a doula in Edmonton who likes hospital births… who would have thought!), one thing I definitely will not miss is the coached pushing phase. Many of you will be familiar with this method of stage 2 management, and this is one I’ve seen many-a-time. This type of management is characterized by health care providers essentially telling you what to do and when to do it when it comes time to push your baby out. And while this can sometimes be necessary and actually crucial to birth a baby, like in the case of an epidural on board for example, women who are unmedicated should never be told when they can or can not push (in my opinion).

Let me start off by giving those of you who have never experienced unmedicated birth a bit of back story. When a woman labours with natural surges of oxytocin and endorphins, a certain rhythm just sort of happens to the labour. There are times when contraction strengths and lengths shift to the next phase and then the next, until finally the birth person is ready and starting to push. Us Edmonton doulas can often visibly see when these shifts happens due to the birth person’s body language. Some classic signs of shifts into a further labour stage are low moans, inability to communicate and towards the very end, uncontrollable grunts and bearing down. These sensations are our body’s way of communicating that our baby has made it’s way through most of the pelvis and is ready to come earth-side, and these little pushes that we begin to involuntarily make actually help the tissues to stretch at a good pace to avoid tearing. Watching a birth person experience stage 2 of labour this way is incredible to see – it often doesn’t even look like they are pushing at all, and I guess technically they aren’t (it’s their body doing the work for them).

Now if a women is heavily medicated often this urge is blocked or less noticeable, in which case it may be best for nurses to monitor the tocodynamometer to see when your contractions are coming and when (and for how long) you should be pushing. Coached pushing is meant for these cases and important, so I definitely don’t want or mean to de-value the place that medical advances hold in certain circumstance. However, how can anyone tell you how big your baby is going to be, exactly what position their head is in during all stages of labour, therefore determining how long or strong a birth person can push, other than that particular person? The answer is, no one can. The female body is absolutely incredible and is expertly designed so that when it comes time to labour and birth a baby, an intricate concoction of hormones give us the signals to know what position we need to be in and what we need to do to get baby from in to out. Another fascinating component of labour are the cardinal movements (I really think this needs to be my next blog topic, kind of obsessed with these). Baby instinctively will move down and through the pelvis in just the way that they will fit through these crevices and passageways, and causing no or minimal damage along the way. Allowing baby the freedom to do this without exerting voluntary force is important and necessary for a safe birth.

So the problem begins when medications and instruments are used to block and interfere with these natural systems. In some cases these medications and instruments are life-saving or very important to the health of mom and baby. But many more times than us doulas in Edmonton would like, these resources are used at a time when they are not truly needed, thus removing the natural sensation labour gives the birth person to know how to bring baby out. Even more problematic is when a women has not had any of these medications or instruments used on her and is still being coached or told to push/not push. In our most natural state, our body knows when pushing is needed, and this is not the same for every women and can not be predicted. One woman might be fully dilated and feel that she needs to wait for an hour before that urge has kicked in, and another might just barely reach full dilation and be ready to get that baby through the finish line. Birth is unpredictable, and this is one of the things that makes it such an impactful and meaningful experience – we can truly see the variety of human form from childbirth. So let’s embrace these differences and leave a woman who’s experiencing a natural labour to push on her own terms!

What was your pushing stage like? Did it go smoothly or would you have wanted something different? Share your “pushing” stories below, I love to hear them all!