Archive for the ‘baby’ Category

Doulas and Home Birth

Monday, May 4th, 2015

Is there benefit to hiring a doula for a home birth? I say YES absolutely.

An oldie but a goodie, from Desirre, in honor of International Doula Month.

As a seasoned doula who has attended home births as labor support and now an  intern midwife who clinically supports the mother, I believe that many women can keenly benefit from a doula when having a home birth.

The most simple reasoning is that the doula is there physically, emotionally and educationally specifically for the mother and family just like at the hospital or a birth center. She (he) is an integral part of the birth team.

  • The doula will likely be laboring with the mother first, providing a continuous care support framework for when the midwifery team arrives.
  • As the midwifery team sets up and prepares the space clinically, the doula is right there maintaining the comfort, peace and encouragement of the mother. Often lessening any disruption that new people in the environment can cause.
  • The doula is there SOLELY for the mother and husband (partner), step by step, eye to eye while the midwifery team is there to first and primarily clinically assess, maintain safety and be unobtrusive as possible.
  • The doula offers guidance and suggestions for position changes, physical/emotional comforts and helping to ensure the mother eats, drinks, voids and rests.
  • The doula gives the husband (partner) the opportunity to rest, have less stress, do the very best he/she can do along with enjoying the process more.
  • A doula can be present specifically to help with the other children.
  • A doula’s presence offers reduction in any interventions and cesarean.
  • A doula’s presence offers increased satisfaction with birth, bonding and breastfeeding……….

Simply put. A doula being present at a home birth is effectively the same as at a hospital or birth center, with the general exceptions that she would have to help a mother and family self advocate or navigate  institutional policies,  protocols and staff.

I again say YES to doulas at home births.



Dad Matters – A doula’s perspective

Sunday, September 29th, 2013

Many men in our culture are fairly apprehensive about birth. Most have never seen a real birth, or talked about it outside of sex ed. They are often nervous about birth itself, seeing their partner in pain, the what-ifs, and all that may come after. They doubt their ability to support their partner in her journey, and wonder if they’ll be strong enough.

In fact, they often doubt and fear and wonder just as much as their partners do, but are often not allowed to express it, because they’re not the ones giving birth, so they feel that they don’t really matter. They may feel like they don’t have much voice in the process, and are just expected to go along for the ride, smiling and nodding whenever the experts speak.

Yet, at the same time, they are expected to know everything about birth, protect their partner, communicate her wishes, and support her physically and emotionally without pausing for breath.

Many worry that they just can’t live up to all of that. It really is an awful lot to ask of one human being, after all. Especially since history shows us that there have always been many support people surrounding a mother during birth.

Still, many men don’t realize just how much they are capable of. They don’t realize that they matter, too, and that they can enter their partner’s birthing space with confidence, ability, and strength to meet the challenges of supporting a labor and birth.


So, how do we help fathers to step into the birthing space with confidence?


We free them to be who they are, that’s how. We let go of our expectations, and help them to form their own expectations and desires for supporting the birth of their child. We help them to see that they alone can define their role in the drama and sacredness of birth.

I would suggest two important things that may help a father gain confidence and acquire tools to help him fulfill the role he wants to play during birth: 1) Independent childbirth education classes, and 2) Hiring a doula.

The more a man knows, the less he will fear birth, and taking Childbirth Classes is one of the best ways to lower anyone’s fear level in anticipation of birth. Many men appreciate information given in practical, interactive ways, and independent childbirth classes are often right up his alley. He can join with like-minded dads, ask questions, and have his concerns addressed more readily.

Information is a great, big factor in helping couples manage their stresses and fears regarding birth—as much for the father as it is for the mother. As an educator, at the beginning of a series, I usually see high levels of apprehension, which quickly fade from week to week, to be replaced by realistic expectations and informed confidence in both parents.

This is just as powerful for the father as it is for the mother. When Dad has confidence in Mom’s ability, she believes in herself all the more, and Dad begins to see that he has power to influence her for the better! Dad is able to acclimate himself more readily to the realities of birth, and begins to realize that he is an important part of her support team. Perhaps the most important part.

He feels a little more ready to step into his support role, and probably has clarified what he wants that role to look like. He will feel more confident about what he can do, and more realistic about what he might not be able to do.


In which case, he may begin to consider…


Hiring a Doula to help him fill in the gap in the support team he might not be able to fill himself. If he participates in choosing and hiring a doula, he is much more likely to have his own expectations met, as well as those of his partner. When Mom and Dad are both fully supported, Dad is far freer to just be and do what his partner needs him to be and do.

While he will likely remember a lot of what he has read and learned about, that information may become secondary to him during the birth, and take a backseat to more immediate concerns in his mind.

He may become simply focused on loving this woman who is birthing his child. And why shouldn’t he? Why should he have to remember every counter pressure technique? Every massage technique, position change, or even the water jug and bendy straw? Why shouldn’t he be the face close to hers, his eyes beaming his love, concern for, and confidence in her?

A doula allows Dad to be front and center in the support role he always wanted to fill for Mom, in whatever way makes the most sense for their individual relationship in this particular moment. If he wants to be the Expert – he ought to be equipped to do that. If he doesn’t, then he needs the space and freedom for that, too. Or anything in between.

When he is free, all his anxieties and apprehensions tend to fall away, and he finds that birth is a challenging, beautiful, amazing space to be in with his partner. He finds that he is strong to meet the challenge, just like she is. Together, they grow in strength and confidence, becoming truly ready to meet this tiny new person they have made.

Doulas help open wide the door, making the birthing space more navigable, understandable, and pleasant for fathers. This, in turn, can only benefit the mother as she is able to rest in the support of her birth team. She no longer feels concern for her partner, because he shows no reason for her to be concerned. She is able to just birth.

Then, we can just step back and watch, as he exceeds all the expectations we have laid on him, and as he steps into Fatherhood in the way that makes the most sense to him and his new family.

Tiffany Miller, CLD, CCCE

Scavenger Hunt Contest

Monday, December 3rd, 2012

Preparing for Birth is having an online scavenger hunt to ring in December.


You could win this cute pocket diaper.


Here is the scavenger hunt:


1)      How many births has Desirre Andrews attended?

2)      Name a doula that is working through Preparing For Birth?

3)      How many on average gel capped pills can be made from a placenta?

4)      What breast pump brand does Preparing for Birth have for sale?


Answer these and provide a link to the source:  

5)      What is the most common risk of induction?

6)      What is an evidence based reason for induction?

7)      What is the Bishop Score used for?

8)      What are Daniel Berwick’s three principals of patient centered care?



9)      A picture of a child nursing in a funny position.

10)   A picture of artwork that’s at least 100 years old depicting a woman in labor.


Bonus Questions:

1)      What is your favorite pregnancy or childbirth related blog?

2)      What is your favorite pregnancy or childbirth related book?

Send your entry to by 9pm Wednesday December 5th.

The winner will be announced Thursday, December 6, 2012, and must be able to pick up the prize in person. Everyone who enters will get a coupon for a free birth or postpartum plan session with one of the doulas from Preparing For Birth.

EMAB and Doulaparty Team Up

Friday, June 22nd, 2012



Join the #doulaparty on Twitter or follow along at, June 22nd 6pm PT/9pm ET to kick off summer birth work with something extra special!


I am very excited that Earth Mama Angel Baby is sponsoring this weeks live chat. EMAB has amazing products for all types of birth professionals and families.


A note from the EMAB Team:


Are you a midwife, doula, nurse or obstetrician looking for pure, safe products to comfort postpartum mamas and brand new babies? You’ve come to the right place! Earth Mama Angel Baby offers safe alternatives for your clients who are concerned with detergents, parabens, 1,4-Dioxane, artificial fragrance, dyes, preservatives, emulsifiers and other toxins. Earth Mama products are used in hospitals, even on the most fragile NICU babies, and they all rate a zero on the Skin Deep toxin database, the best rating a product can receive. Earth Mama only uses the highest-quality, certified-organic or organically grown herbs and oils for our teas, bath herbs, gentle handmade soaps, salves, lotions and massage oils.

Earth Mama now offers a Birth Pro Cart for wholesale pricing available for birth support professionals! Join Earth Mama Angel Baby on the #doulaparty chat Friday June 22 to talk about their new shopping cart plus answer any questions you may have. Earth Mama will be giving away Postpartum Bath Herbs and Monthly Comfort Tea, Mama Bottom Balm, Mama Bottom Spray, and a grand prize of their new Travel Birth & Baby Kit!

Low Intervention Birth Plan

Sunday, October 9th, 2011

A birth plan has a few real purposes. It can act as a values clarification exercise for you and your partner. Then it is a vehicle to open communication with your care provider about your needs, desires, wants for labor, birth and postpartum.  What you want and need matters.

 A brief one page plan with an opening paragraph with bullet point information specific to individualized care and desires not usually within your care provider’s standing orders or usual protocols of the birth location.

I advise you take the written birth plan to a prenatal visit at least a month prior to your given estimated due date. This gives time for conversation, to have a clear understanding of expectation and agreement.

If it becomes apparent that you and your provider are not on the same page, you then have time to seek out another provider that fits you and you fit with.

Remember it is not a legal document that your location of delivery or care provider must adhere to.


Birth Needs and Desires for: _______________________. 

Care Provider:_________________.

Estimated Due Date: _________________.

I am planning on a no to low-intervention labor and delivery.  I plan on being mobile, lightly snacking, drinking orally, and having ___________ present.   I understand that intermittent monitoring of me and my baby will be necessary.  I want to be fully consented for any procedure that may come up and fully participate in the medical care for myself and my baby.  I understand that there is pain management available to me, I will ask for it if I so desire.

  • I plan on wearing my own clothing. I will ask for a gown if I change my mind.
  • I would like a saline lock in lieu of a running IV.
  • Limited vaginal exams after initial assessment.
  • In the event an induction and/or augmentation is medically necessitated-
    • Ripening – Foley Catheter instead of Cytotec (misoprostol), Cervadil or Prepadil
    • Pitocin – A very gentle and slowly administered dosage increase.
    • AROM – will only consent to if an internal fetal monitor is a must.
  • Spontaneous pushing and delivery in any position I am most comfortable with.
  • External pressure and/or compresses instead of any perineal or vaginal stretching.
  • No cord traction or aggressive placental detachment, including deep uterine massage.
  • Delayed cord clamping for at least 10 minutes or until my placenta spontaneously detaches (baby can receive oxygen or other assistance while still attached to me).

Postpartum and Baby Care

  • Request that my baby is on my belly or chest for assessments and warmth (even oxygen can be given on me)
  • Delayed bathing
  • Delaying vaccinations including eye ointment and vitamin k.
  • Exclusive breastfeeding, no pacifiers, sugar water, or formula. I will hand express if necessary. I will hand express if needed to syringe feed my baby.
  • No separation from me unless absolutely medically necessary not just protocol.

Cesarean: In the event a cesarean becomes necessary and is not a true emergency requiring general anesthesia.  I would like to keep the spirit of my plan A to plan C so the delivery can be as family centered and intimate as possible.

  • Only essential conversation related to the surgery and delivery
  • Lower sterile drape or have a mirror present so I may see my baby emerge
  • Only one arm strapped down so I may touch my baby
  • Pictures
  • Aromatherapy as I desire for comfort, abate nausea and to mask surgical odors
  • Baby to stay with me continuously in OR and recovery
  • If baby must leave OR for treatment, my partner/spouse goes with baby and I would like my ____________ to stay with me so I am never alone.
  • Breastfeed in OR and/or recovery
  • Delayed immunizations
  • Delayed washing and dressing of baby
  • No separation from me except what is absolutely medically necessary
  • I am willing to hand express if baby cannot get to breast right away.

This “plan” may be copied, pasted and edited  for use by others.

Could this be labor?

Wednesday, September 21st, 2011

For first time mamas, previously induced mamas or those who have loads of prodromal labor, getting a handle on the nuances of when labor is going to start or if it is lasting labor can be really confusing. There is no way to know exactly when labor is going to start, but there are many things to look out for that can give clues and signs that onset of  labor is sooner rather than later.

Here are my favorite categories to look at and simple ways to decipher what is going on with your body at the end of pregnancy.

Remember to take a look at the whole puzzle picture not just one piece.

  • Vaginal Discharge:
    • Loss of mucous plug (after 38 weeks);
    • Steady mucousy output;
    • Thin and watery mucous;
    • Blood tinged – similar to the beginning or very end of a menstrual period. This means there is effacement and ripening of the cervix going on and even a bit of dilation happening.
  • Contraction Characteristics:
    • Longer and more intense contractions that most often find a pattern;
    • They do not stop or even increase with activity change;
    • Sudden increase or onset of regular Braxton-Hicks;
    • Low period crampiness, pelvic heaviness, off and on backache, thigh achiness.
  • Other symptoms
    • Increased nesting;
    • Insomnia or excessive tiredness;
    •  Flu-like symptoms;
    • Intuition/Instinct;
    • Loose bowels;
    • Weight Loss in the last week.
  • Testing out contractions for possible labor:
    • Change activity level – if resting get up and move, if moving sit down and rest;
    • Drink a large glass of water;
    •  Eat a snack, preferably higher protein;
    • Take a bath or shower.

After doing these things if contractions continue and increase in intensity over another hour or so likely labor is becoming established. Congratulation! As always, contact your care provider at the agreed upon time.

A Guide to Finding Your Doula

Tuesday, August 2nd, 2011

Building a labor support team is part of conscious preparation during pregnancy for your labor,  birth and life with the very newborn. Hiring a labor doula continues to gain in popularity for the expecting family. Your doula comes alongside you in pregnancy through labor and delivery with some additional early postpartum follow-up.  For additional after birth support, a postpartum doula is a great addition.

Step 1: Finding a Doula

  • Inquire with friends, family, local support/informational groups (for example – ICAN, LLLI, Birth Network, Birth Circle, Cloth Diaper store), childbirth educators, care providers, prenatal massage therapists, prenatal exercise instructors, lactation experts and chiropractors for referrals.
  • Use your favorite search engine and type in your city or area name with the keyword doula
  • Search training and certifying organizations such as CAPPA, DONA, ICEA ToLabor , Birth Works and Birth Arts International
  • Search general doula sites such as All Doulas,,, Doula Match or

Step 2: First Contact

Once you have located local area doulas, the next step is  to make contact. You will likely find that most doulas are women though occasionally you will find a male doula in your area.  After visiting any websites; phone or email only the doulas that most interest you and fit your particular needs.  Generally there is not much need to contact more than three perspective doulas.

During your initial phone conversation or in your email be sure to include:

  • Full name
  • Contact information
  • Estimated Due Date
  • General location where you live
  • Care Provider
  • Birth Location
  • Top needs and desires for birth
  • If referred, by whom
  • Any financial considerations

Step 3:  Setting up the Interview

I encourage after the phone or email contact and response, set-up in-person interviews with the doulas you found most compatible with you.

  • Unless the doula you are meeting has her own office, interviews are usually held in a public place such as a coffee house, restaurant, library, park, or shopping center. If you meet at a place where beverages or food will be ordered you can offer to pick up the tab for everyone if you desire, but it is never expected.
  • Your partner, husband or other support who will be attending the birth needs to be at in-person interview if at all possible.
  • Expect the interview to be approximately an hour and to be free of charge.

Step 4: The Interview

The interview is to gain more detailed information from the doula, as well as, share more  about yourself and what you want.  It is customary for the doula to either email ahead of time her client packet or bring it with her to the interview. It may include her professional profile, client agreement, services, and support details, as well as, additional offerings.

Suggested Interview Questions:

  • Why are you a doula?
  • What is your philosophy of childbirth?
  • Where did you get your training?
  • Are you certified? Why or why not?
  • How long have you been a doula?
  • What is your scope of practice?
  • What types of births have you participated in?
  • What types of birth locations have you been to?
  • How many births per month on average do you attend?
  • How many clients would max you out in a month?
  • Have you ever missed a birth? Please explain why.
  • Do you specialize in working with a specific type of clientele or birth plan?
  • What has been the most challenging birth you have attended? Why?
  • How do you work with my husband/partner/other support?
  • Have you worked with my provider before? If yes, please describe the experience.
  • How many prenatal visits would there be?
  • In general, what is covered in the prenatal visits?
  • Will you help me make a birth plan?
  • Please explain how your fee is structured.
  • Do you accept barter?
  • Do you have a back-up and do I meet her ahead of time?
  • When do you go on-call?
  • Do you labor at home with me?
  • What do you do if I am induced or need to schedule a cesarean?
  • When will you see me postpartum and what does it include?
  • What are your expectations of me as a client?
  • How long do I have to decide before you would contract with someone else around my EDD?

Of course that is a fairly long list of overview questions. Brainstorm some of your own. The interview is not meant to be a free prenatal visit, it is simply to find out if you and the doula are a fit personality wise and in how she practices.  Most doulas do not expect to be hired on the spot. You  need time to think and process after each interview. If a doula is pressuring you to hire on the spot because she fills so quickly, that could be a red flag and cause for you to take a pause.

Step 5: Hiring the Doula

Within 1-2 weeks,  contact the doula you would like to hire and proceed and those you did not choose to let them know you have hired someone else so they will not be holding your EDD space open any longer.

Details to be clear about when initially hiring your doula:

  • Sign and return the agreement/contract she gave you at the interview (if applicable).
  • Return any intake paperwork by mail or email.
  • Payment  – First portion of fee is usually paid upon hiring a doula.
  • Ask her usual business hours and contact preference for non-emergencies or labor related needs.
  • Let her know your contact preferences and all phone numbers to reach you and your spouse/partner or other support.
  • Set the date and time for the first prenatal appointment. Give her directions if your home is not easy to find.
  • Get clarity on what routine contact she would like from you (updates after care provider appointments, etc.)

Happy doula-ing!

Blessing the Mother…..

Thursday, July 14th, 2011

Blessing the mother ease the period at the end of pregnancy and ease the transition into postpartum.

Ideas that bless before and after birth:

  • Freezer Meals
  • Organizing Fresh Meals for end of pregnancy through first month post birth.
  • Buy baby wearing gear for her.
  • Organize a Blessingway
  • Write down encouraging and affirming words in a beautiful card.
  • Listen to her.
  • Buy her a baby wearing, cloth diapering, breastfeeding class, etc. to her desires as a surprise.
  • Organize housecleaning party for end of pregnancy and once or twice postpartum.
  • If she has other children, have them over to give her a rest.
  • Donate toward her doula, midwife or doctor.
  • When she is postpartum, visit her and prepare a variety of snacks so she is never without food.
  • Offer to run errands after the baby is born.
  • Offer to give her time to shower.
  • Buy her a reusable water bottle so she drinks enough fluids.
  • Give her permission to phone you during odd hours after the birth if she needs support, advice.
  • Offer to dog sit or take care of any pets as needed after the birth.
  • Check in on her about 3 weeks after birth to see how she is doing emotionally and physically.

What other ideas do you have to add? Please leave me a comment.

Postpartum Preparation

Tuesday, April 19th, 2011

Planning and preparation toward the postpartum period is very important.  Sometimes it is even more important than pregnancy and birth preparation due to circumstance or birth outcome.  Too often labor, delivery and perhaps the “stuff” that goes with having a baby take priority, while the incredible change that occurs with having a new baby is seemingly ignored.

Below is a listing of important information to think about, investigate, understand and/or plan for.  Make a note of people in your immediate life that can be a resource as you go through the list.

Look carefully at class descriptions you may take in your local area, some are very thorough and others may only be introductory or without valuable content.

Here’s to postpartum preparedness!

Common Physical Changes and Needs for the Mother (first days or weeks)

  • Uterine involution, after pains and bleeding
  • Breast expectations and breastfeeding norms
  • Hormones and symptoms
  • Healing – Vaginal tears, episiotomy, cesarean, perineal soreness or swelling, hemorrhoids
  • Nutrition
  • Night sweats or urination
  • Fatigue

Common Psychological Changes

  • Mother and Father/Partner Changes
  • Processing the birth experience
  • Processing becoming a family
  • Postpartum mood disorders
  • Peer and professional support resources

Understanding Your New Baby

  • Babymoon
  • How baby’s feed
  • Attachment
  • Infant development
  • Normal sleep patterns
  • High, average or low need baby’s

New Family Dynamic

  • Coping with sleep deprivation and exhaustion
  • Managing stress
  • Grieving the changes
  • Siblings and pets
  • Knowing how to get the right support
  • Postpartum doulas and practical support

Making Your Best Decisions

  • Defining Parental Roles – Financial, Baby Care, Changing the Status Quo
  • Choosing a health care provider for your baby
  • Early Infant Health Care Decisions – Vaccinations, Circumcision, etc.
  • Parenting philosophies
  • Developing your parenting style
  • Where baby will sleep
  • Boundaries with family and friends
  • When to seek professional help

Relationship Care

  • Realistic expectations
  • Sexual intimacy
  • Practicalities of life
  • “Dating”
  • Priorities

Single Parenting

  • Arranging practical support
  • Making a community
  • Parenting needs

Unexpected Outcomes

  • Processing a difficult birth
  • Babies with medical needs, coping and advocating
  • Dealing with loss, grief, and trauma

We also offer a postpartum strategies class that goes into more detail on many of these topics.

Creating a relationship 10 minutes at a time

Sunday, February 27th, 2011

It has occurred to me through my time with doula clients and students,  that many care providers serving hospital birthing mothers do not ask any questions of their pregnant patients during the 7-10 minute prenatal visits that lead to a substantive working relationship.

I have also learned that too often the pregnant “patient” does not know to tell her provider anything about what is going on in her life or pregnancy since she is not queried first.

Thinking there must be a way to better bridge this very real separation to solid patient-provider relationship building, I am drawing from my work as a midwife assistant in the making of this tip list.

Pregnant mothers your provider needs to know so much more about you and your pregnancy than blood pressure, weight, fundal height and fetal heart tones. I encourage you to freely offer the below information at every appointment to grow personalized care, advisement and support.

1) Appetite/Diet/Supplements – tell your provider if your appetite has increased or decreased between visits. Do you have food aversions? Are you taking any supplements or want to take supplements?

2) Sleep habits – tell your provider how you are or are not sleeping.  For example, are you having trouble falling asleep, falling back to sleep or staying asleep.

3) Nausea – Do you continue to have nausea? When? How often? Does it correlate with anything in particular?

4) Hemorrhoids – if you have them or not. What you are doing for them.

5) Varicose veins –  Are there veins sticking out or causing issue anywhere in your body?

6) Bowel habits – Are you experiencing normal or abnormal bowel habits?

7) Exercise – What have you been doing? Do changes need to be made?

8) Stress – Is there anything in your life that is really stressing you? Stress can impact pregnancy health. Important to discuss.

9) Related Providers – Are you going to any pregnancy related providers (such as chiropractor, acupuncturist, yoga, etc.)?

10) General  – Are you feeling well or not. Do you need more information or referrals?

There is so much more to you than a pregnant uterus. You are a holistic person who needs to be treated as such. I would venture that something much more individualized can come out of your care with simple sharing!

Here’s to whole care!