Welcome!

Welcome to my Doula Blog! I hope you find it interesting and informative.

My name is Natalie. I am a wife, a mother of almost five boys, a doula, and a Hypnobabies Instructor! I'm passionate about childbirth and hope to help women realize the power that is in them to birth more normally and naturally. It's my goal to help women feel confident and comfortable during pregnancy, labor, and delivery. Yes, it is possible! It's also amazing, incredible, wonderful, empowering, and life changing.

As a doula, I am a trained professional who understands and trusts the process of birth. I provide continuous care for the laboring mother and her partner. Studies have shown that when doulas attend births, labors are shorter with fewer complications. I attend to women in labor to help ensure a safe and satisfying birth experience in both home and hospital settings. I draw on my knowledge and experience to provide emotional support, physical comfort and, as needed, communication with the other members of your birth team to make sure that you have the information that you need to make informed decisions in labor. I can provide reassurance and perspective to the laboring mother and her partner, make suggestions for labor progress, and help with relaxation, massage, positioning and other techniques for comfort.

Feel free to contact me at doulanataliesue@gmail.com.
Thanks for stopping by!

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Saturday, October 2, 2010

What is a Doula? Is a Doula for me?





The word doula is a Greek word that meanswomen’s servant. Women have been serving other women in childbirth for centuries and have proven that this support from another woman has positive effects on the labor process.
My husband (partner) is my left hand and my doula is my right. - from Doulas Making a Difference

What is a doula?

A doula is a professional trained in childbirth who provides emotional, physical and informational support to the woman who is expecting, in labor or has recently given birth. The doula's role is to help women have a safe, memorable and empowering birthing experience.
Most often the word doula is referring to the birth doula, or labor support companion, but there is also the antepartum doula and the postpartum doula. In the following information, the word doula will be referring to the labor doula. Doulas can also be called labor companions, labor support specialist, labor support professional, birth assistants or labor assistants.

What does a doula do?

Most doula and client relationships begin a few months before the baby is due. During this time, they establish a relationship that gives the mother complete freedom to ask questions, express fears and concerns, and take an active role in creating a birth plan. Most doulas make themselves available to the mother by phone to answer questions or explain any developments that may arise in pregnancy. Doulas do not provide any type of medical care. However, they are knowledgeable in the medical aspect of labor and delivery so they can help their clients get a better understanding of procedures and complications that may arise in late pregnancy or during delivery.
During delivery, doulas are in constant, close proximity to the mother at all times. They can provide comfort with pain relief techniques, such as breathing, relaxing, massage and laboring positions. Doulas also encourage participation from the partner and offer reassurance. A doula acts as an advocate for the mother, encouraging her in her desires for her birth. The goal of a doula is to help the mother have a positive and safe birth experience, whether the mother wants an un-medicated birth or is having a planned cesarean birth.
After the birth, many labor doulas will spend a short time helping mothers begin the breastfeeding process and encouraging bonding between the new baby and family members.

What are the benefits of having a doula?

Numerous studies have revealed the benefits of having a doula present during labor. A recent Cochrane Review, Continuous Support for Women During Childbirth, revealed a very high number of positive birth outcomes when a doula was present. When a doula was present, women were less likely to have pain relief medications administered, less likely to have a cesarean birth, and reported having a more positive childbirth experience1. Find a Doula Now.
Other studies have shown that having a doula as part of the birth team decreases the overall cesarean rate by 50%, the length of labor by 25%, the use of oxytocin by 40% and the request for an epidural by 60%2.
Doulas often use the power of touch and massage to reduce stress and anxiety during labor. According to physicians Marshal Klaus and John Kennell, massage helps stimulate the production of natural oxytocin. The pituitary gland secretes natural oxytocin to the bloodstream which causes uterine contractions and also secretes it to the brain, which results in a feeling of well being, drowsiness and a raised pain threshold. Synthetic IV oxytocin cannot cross into the blood stream and brain, so it increases contractions without the positive psychological effects of natural oxytocin.

What about the father's role when using a doula?

The role of the doula is never to take the place of the husband or partner in labor, but to compliment and enhance their experience. Today, many husbands are taking a more active role in the birth process, but some partners feel that this is a huge expectation and would rather be able to enjoy the delivery without having to stand in as labor coach. With a doula as a part of the birth team, a father can do whatever he feels comfortable with at each moment. Doulas can encourage the father to use comfort measures and can step in when he needs a break. Having a doula allows the father to be able to support his partner emotionally during labor and birth and also enjoy it himself without the pressure to remember everything he learned in childbirth class!

Are doulas only useful if planning an un-medicated birth?

The presence of a doula can be beneficial no matter what type of birth you are planning. Many women do report needing fewer interventions when they have a doula, but the role of the doula is to help you have a safe and pleasant birth, not to choose your type of birth. For women who know they want a medicated birth, the doula still provides emotional support, informational support and comfort measures to help the women through labor and the administration of medications. Doulas can work alongside medication by helping mom deal with possible side effects and filling in the gap that medication may not cover; rarely does medication take all discomfort away.
For a mother who faces a cesarean, a doula can be helpful by providing constant support and encouragement. Often a cesarean is an unexpected situation and moms are left feeling unprepared, disappointed and lonely. A doula can be with the mother at all times throughout a cesarean, explaining what is going on throughout the procedure while the partner is able to attend to the baby and accompany the newborn to the nursery if problems arise.
www.americanpregnancy.org

Tuesday, September 21, 2010

Doulas Make a Difference


"If a doula were a drug, it would be unethical not to use it." -- John H. Kennell, MD
If I could do my daughter's birth all over again - a birth that, because of a pregnancy complication I developed (HELLP syndrome), included numerous interventions - I would have hired a doula. I'd done my birth homework and for some reason I didn't think I needed one nor could afford one, but as I have since learned, having the right doula at your birth can be worth her weight in gold. I think if I had had a doula present at Ava's birth, I would have come away from the experience feeling like I had been better informed (we were left in the dark about so many things) and more of an active participant in my labor instead of a passive recipient. But as the saying goes, live and learn. I have learned and now I will share what I've learned with you.
‘Doula’ (pronounced doo-la) is a Greek word meaning "woman’s servant." Doulas are trained and experienced in childbirth, though they do not handle the medical aspects of it; those are reserved for a midwife or doctor. The role of a birth doula is to provide support for the woman and her partner during labor and birth. This support may include physical support such as suggesting different positions for laboring, giving massages or instructing the woman's partner how to massage her, breathing with her, getting food and drinks for the woman and her partner, etc.; emotional support in the form of reassurance and comfort; as well as informational support such as explaining different medical options, risks and benefits, and possibly suggesting natural techniques to achieve the same results. It is often said that a doula mothers the mother.
The 'Enjoy Birth' blog has a post called "Get a birth doula" that explains the type of support a doula can offer including:
Resource for Comfort Measures: Having a doula is like having your very own talking birthing guide. Doulas know what can help during birth and how to do it. Your doula can either perform these comfort measures herself, or help your family or friends to support you with comfort measures. Your birth partners will feel more confident knowing that they are doing the right thing.
Constant Encourager: A doula not only encourages the mother to keep going, but she encourages the labor support to keep going as well. The process of labor can sometimes be long. A doula can keep you and your partner focused during the most intense part of labor.
Helps Explain Options: A doula is also a source of information about ways to handle your birth. Medical attendants don’t always have time to get into all the options available, and rarely give all the risks and benefits for the options they do give. A doula can help you understand what options are available, and what the pros and cons are. This can help you make better informed decisions.
There are many benefits to having a doula attend your birth.
Proven Benefits of Doula Care
Decreased medical intervention in labor*:
  • Reduces need for cesarean by 50%
  • Reduces length of labor by 25%
  • Reduces use of artificial oxytocin (pitocin) by 40%
  • Reduces pain medication use by 30%
  • Reduces the need for forceps by 40%
  • Reduces epidural requests by 60%
Six weeks after birth, mothers who had doulas were**:
  • Less anxious and depressed
  • Had more confidence with baby
  • More satisfied w/ partner (71% vs 30%)
  • More likely to be breastfeeding (52% vs. 29%)
*These statistics appear in “A Doula Makes the Difference” by Nugent in Mothering Magazine, March-April 1998.
**Statistics from What is a Doula?
I've heard countless stories from women I know - both in person and on the Internet - singing the praises of their birth doulas. Every one of them feels their birth experience was more positive as a direct result of the support offered by their doula.
Alma from Chicago Moms Blog reflects on her birth and the help she received from her doula - "her hero" - in her post Not Without My Doula.
"It (labor) was really hard, and I couldn't have done it without the support of my doula, Tricia Fitzgerald. ... her dedication and support was worth far more [than] the typical going rate for a doula.
She also squelches the myth that a doula tries to take the place of a woman's husband or partner.
Doulas don't monitor or deliver babies; they're dedicated to mothering the mother, helping her achieve the birth experience she wants. And contrary to what some people think, your doula will not displace your husband. Rather, she just may keep you from cursing out your well-meaning partner who just can't seem say the right thing or rub you the right way."
I think it takes a very special kind of woman to be a doula and Leigh, a fairly new doula and mother of two young daughters, is definitely one of those special women. Leigh writes beautifully about each of the births she attends on her blog Mere Mortal Mama and I soak up every one of them. She seems to possess an ancient wisdom that allows her to be extremely in-tune with her clients. She is committed to helping them achieve the birth they desire. Here's an excerpt from her most recent birth, that of a teen mother:
And then that moment comes; the moment when you notice the slight shift in energy of the room and know it is time to be fully present for your client. I glue myself next to the bedrail and remain over her for the duration of labor. I breathe in deeply with her and exhale slowly, offering the most hushed of encouraging words. We establish a pattern together quickly: we breathe, she cringes and tightens her brow a bit, I press a firm thumb on her forehead and smooth her brows, she relaxes and breathes out. I stroke her hair as the surges release; she lets out a cleansing breath. Our fingers entangle as she rests between the surges.
I whisper breathy words and phrases into her ear and have no idea where they are coming from. Upon speaking some of them, her head nods in barely perceptible understanding – her eyelids fluttering closed - and so I stick with those.
And it is those moments where ego and heart humbly meet, swollen like a balloon about to burst. Two women, in rhythm to the song of labor, swaying into words and sinking into breath; connected through the pulse of birth.
I believe that - "two women ... connected through the pulse of labor" - sums up simply and perfectly what the experience of having a doula is meant to be. I think that all women and their partners should consider giving themselves the gift of a doula.
To learn more about doulas, including how to find one in your area and questions to ask when interviewing a doula, see the additional resources below.
Additional resources:
DONA (Doulas of North America) International - Learn more about doulas as well as find doulas in your area
CAPPA: Childbirth and Postpartum Professional Association
How to hire a doula - Questions to ask
How Dads/Partners and Doulas can work together to support the birthing mother
Information about Postpartum Doulas who's role is to help a woman through her postpartum period and to nurture the family
Contributing editor Amy Gates also blogs about attachment parenting, activism, green living and photography atCrunchy Domestic Goddess.

Tuesday, September 14, 2010

Why your due date isn't what you think it is...

by: Misha Sanfranski
associatedcontent.com


We have it ingrained in our heads throughout our entire adult lives-pregnancy is 40 weeks. The "due date" we are given at that first prenatal visit is based upon that 40 weeks, and we look forward to it with great anticipation.


 When we are still pregnant after that magical date, we call ourselves "overdue" and the days seem to drag on like years. The problem with this belief about the 40 week EDD is that it is not based in fact. It is one of many pregnancy and childbirth myths which has wormed its way into the standard of practice over the years-something that is still believed because "that's the way it's always been done". 

The folly of Naegele's Rule

The 40 week due date is based upon Naegele's Rule. This theory was originated by Harmanni Boerhaave, a botanist who in 1744 came up with a method of calculating the EDD based upon evidence in the Bible that human gestation lasts approximately 10 lunar months. The formula was publicized around 1812 by German obstetrician Franz Naegele and since has become the accepted norm for calculating the due date. There is one glaring flaw in Naegele's rule. Strictly speaking, a lunar (or synodic - from new moon to new moon) month is actually 29.53 days, which makes 10 lunar months roughly 295 days, a full 15 days longer than the 280 days gestation we've been lead to believe is average. In fact, if left alone, 50-80% of mothers will gestate beyond 40 weeks. 

Variants in cycle length

Aside from the gross miscalculation of the lunar due date, there is another common problem associated with formulating a woman's EDD: most methods of calculating gestational length are based upon a 28 day cycle. Not all women have a 28 day cycle; some are longer, some are shorter, and even those with a 28 day cycle do not always ovulate right on day 14. If a woman has a cycle which is significantly longer than 28 days and the baby is forced out too soon because her due date is calculated according to her LMP (last menstrual period), this can result in a premature baby with potential health problems at birth. 

The inaccuracy of ultrasound
First trimester: 7 days

14 - 20 weeks: 10 days 

21 - 30 weeks: 14 days 

31 - 42 weeks: 21 days 
Calculating an accurate EDD

Recent research offers a more accurate method of approximating gestational length. In 1990 Mittendorf et Al. undertook a study to calculate the average length of uncomplicated human pregnancy. They found that for first

time mothers (nulliparas) pregnancy lasted an average of 288 days (41 weeks 1 day). For multiparas, mothers who had previously given birth, the average gestational length was 283 days or 40 weeks 3 days. To easily calculate this EDD formula, a nullipara would take the LMP, subtract 3 months, then add 15 days. Multiparas start with LMP, subtract 3 months and add 10 days. The best way to determine an accurate due date, no matter which method you use, is to chart your cycles so that you know what day you ovulate. There are online programs available for this purpose (refer to links in resources section). Complete classes on tracking your cycle are also available through the Couple to Couple League


ACOG and postdates

One of the most vital pieces of information to know when you are expecting is that ACOG itself (American College of Obstetricians and Gynecologists) does not recommend interfering with a normal pregnancy before 42 completed weeks. This is why knowing your true conception date and EDD is very important; if you come under pressure from a care provider to deliver at a certain point, you can be armed with ACOG's official recommendations as well as your own exact due date. This can help you and your baby avoid much unnecessary trauma throughout the labor and delivery. Remember, babies can't read calendars; they come on their own time and almost always without complication when left alone to be born when they are truly ready. 

Sources: 

Mittendorf, R. et al., "The length of uncomplicated human gestation," OB/GYN, Vol. 75, No., 6 June, 1990, pp. 907-932. 
ACOG Practice Bulletin #55: Clinical Management of Post-term Pregnancy