Archive for the ‘childbirth education’ Category

Intangible Reasons

Tuesday, May 29th, 2012

Image from imdb.com

My husband and I watched “Away We Go” last night. It’s a movie about a pregnant couple’s quest to find the place where they want to give birth and raise their baby. Along the way, they meet up with a lot of old connections to try and get a feel for where they belong. During the obligatory “hippie-tandem-nursing-birkenstock-wearing-freaks” scene, one line really stood out to me, and bothered me.

As filled as the scene was with exaggerated stereotypes, it wasn’t those that bothered me, because all of the families in the movie were portrayed in a way that was a bit over the top. (Except the infertile couple – THAT was one of the best movie scenes I have ever witnessed. Ever.)

John Krasinki’s character explains why he and his girlfriend don’t need a doula. He says something along the lines of “Doulas are for women who are clueless, or have a partner who doesn’t want to be involved, and since I am involved and educated, we don’t need one.”

While he is right in the fact that a doula can be a great asset to a couple who are “clueless,” the quote illustrates the common misconception that doulas replace fathers in the birth room. That if the father is involved and supportive, a doula is just an extra. It’s simply not so.

For one thing, “clueless” clients have more potential to drive a doula crazy! We try to teach our clients to take responsibility for their own births, and encourage them to educate themselves as much as possible about everything relevant to their situation. Some do, and some don’t. The hardest births to be on as a doula are ones in which a mother has not educated herself much at all, and has unrealistic expectations of both birth and her doula. That is a problem that is usually easily remedied. However, not really the point of this post.

Moving on. Sorry to slow you down.

The truth is that men in the labor room is a recent phenomenon. For eons, it’s been women’s work. Birth is what women do. And we do it well. We did not “need” our men in the birthing room – we could handle it pretty well, thankyouverymuch.

However, we began to want our men in the birth room, and welcomed them. Super-cool! We felt it only made sense for the one who helped create this child, be there to help bring him into the world. And we were right. Men should have the chance to see the women in their lives be so strong.

We then threw the baby out with the bathwater, and banished everyone else in favor of the men in our lives.

No one – and I mean no one – can replace the father, husband, lover in the labor room. However, neither can the father bring the shared connection all women have. They can’t bring the “girl power” women thrive on when they are laboring.

Birthing women need both.

For example, I had both my husband and my mother at all of my births (this was before I’d ever heard the word “doula” – my mom essentially filled that role). I could not have done what I did with either of them missing. It is hard to explain tangibly the reasons that this is so.

When I tried to explain it to my husband, I told him that when Mom said I could do it, she was the one I believed.

It’s not that I didn’t believe anyone else, it’s just that it was her energy, faith, and connection to me that helped me put feet to my own belief in my ability to birth. I believed my husband when he said he believed in me, and I appreciated his confidence, but when my mom looked me in the eye and said “You can do this,” something inside me responded, and I could not doubt that she was right.

That is why even the most educated, proactive, emotionally-healthy, bonded couple can benefit from having a doula – and I would even venture to say, needs a doula.

I hear it all the time from my clients: that they just believe me when I tell them they can carry on. They tell me that they love and appreciate the safety and security of their partner’s presence; the love that radiates from his eyes when he holds her hand or brings her water gives her a comfort that cannot be matched. She blossoms under such romance (which is exactly what it is).

But when the doula speaks, moms listen, and their faith in their own ability to birth is given wings.

The truth is this: She cannot do as well as she wants to do without either.

Nearly every client tells me, “I couldn’t have done it without you!” then immediately turns to her partner, “But I couldn’t have done it without you either!” Both statements are as true as true can be. I feel the same way about my mom and my husband.

Of course, there will be exceptions to this, and only you can decide if you are one of them. There are also many situations in which a mother doesn’t have a partner at all, or her situation varies from the norm in some other way. Her need for a doula who will walk alongside her, hold her hand, and support her unconditionally is even greater! I have supported several such women, and stepping into what is essentially a dual role is tough. I could never do that for all births!

My point is that just because factors, A, B, and C all line up for you does not mean that you don’t “need” a doula. Sometimes, it’s the most educated clients that need me the most when push comes to shove. (No pun intended.)

Never say never. Talk to doulas in your area, gauge your needs well, and make the right decision for you and your family. Don’t let anyone – especially a care provider or Hollywood – tell you that you don’t “need” anything when it comes to your birth. Only you can decide that. And take what the media says with an extra-large grain of salt.

Grace & Peace,
Tiffany

Do Moms Planning an Epidural Need a Doula?

Friday, May 25th, 2012

This question was posed on her facebook wall by my mentor, Desirre Andrews. I appreciate the thought that her questions provoke, and the way she challenges me to dig a little deeper and search out what my answer would be to this question.

I think, overall, there is an assumption in our country that an epidural is a panacea. The concept of labor with an epidural on board is one of passivity and a desire for separation from the experience because of fears about the process of labor. Whether those fears are well-founded or not really does depend on the individual, and is not the subject of this post. I would very much like to see a more realistic, knowledgeable view of epidurals begin to take prevalence in my community, and the world at large.

As a doula, I know that I can bring my community closer to that vision, one mother at a time. So, here is my answer to the question posed in the title of this post:

I usually tell someone that they don’t “need” a doula (if they want to get all technical), in that they can definitely have their baby without one. Yet, I would never say that a doula is a luxury, either. There is too much benefit to the presence of a doula, supported by scientific evidence, to label them luxuries. Not to mention the fact that women, for all of our world’s history, have always supported women during birth. Women need women who believe in them at their births. Period. Again – a subject for another lengthy post.

Moving on.

In the specific case of a mom planning an epidural, a doula can really help to optimize the use of this particular tool — maximizing its benefits, and minimizing the risks associated with it — if that’s what she wants.

A doula can help a mother stay calm through the procedure, and prepare her ahead of time to have realistic expectations of what epidurals do and do not do. Contrary to popular belief, epidurals are not a panacea. They vary in effectiveness for many women, and come with some side effects that are common enough that every woman who wants one should know about them.

A woman with a doula who has educated her ahead of time who experiences, for example, the drastic drop in blood pressure that can go along with an epidural, will know that the nurse will come in, place her on her side, put an oxygen mask on her face, and give her medication to raise her blood pressure immediately. The nurse will act, she will not ask. This prepared woman will be less susceptible to fear as the nurse takes quick action. The unprepared woman may end up scared out of her wits, and experience fear for her baby because of this process, if she did not know ahead of time that it could happen. A doula can prevent the latter circumstance. Doulas can help take fear out of the equation for women.

Along the same lines, a doula can assuage the fears of a woman’s partner, and reassure him/her that what’s going on is common, normal, and that mom and baby are likely to be okay. Partners who love these women so much often forget all they learned, as their gut takes over, and having a doula there for reassurance can really bring a sense of peace to the partners, freeing them to be fully present in their relationship to the laboring mother.

Doulas can also give women tools to cope with labor up until the time the epidural is placed. Mom is having a natural birth up to the point the epidural is in place, after all! A woman and partner equipped with basic labor coping skills and techniques will be able to handle whatever their labor throws at them up to the point the epidural can be placed.

Many moms, without the presence and preparation of a doula, may not know that the timing of an epidural is critical in avoiding some of the risks (both for herself and her baby), and maximizing its benefits. For one thing, an epidural placed too early can cause labor to slow down enough that Pitocin will be needed, beginning the lovely “Cascade of Interventions” all of us in the birth community are familiar with.

Without a doula, a mom may not have the confidence to believe she can handle labor beautifully until the time comes that an epidural would be more to her and her baby’s benefit than a risk. A doula can bring a strong sense of “I can do it” to the labor room, and help a mother to gauge when the time is right for her epidural.

Once the epidural is in, a doula will help a mother assume multiple positions that can keep it working well, keep her pelvis moving, and encourage progress. Progress in labor is directly linked to the amount of movement mom is able to do, and a doula knows this. She can help a mother and her partner work to keep an active role in her labor by maneuvering mom into alternating positions. Since epidurals are gravity-based, this also helps keep the pain relief on a more even keel, and minimizes uneven sensation.

A doula can also walk moms through what pushing with an epidural might be like, and teach them about different options for that stage. She is equipped to help them advocate for the option to “labor down” (a technique that can help preserve mom’s energy for more active pushing when baby is much further into the pelvis/birth canal), instead of beginning active, hard pushing as soon as she reaches full dilation. She can help mom assume different positions every few contractions, to maximize baby’s ability to descend and rotate well. This can also minimize the risk for forceps or vacuum extraction being needed.

After the birth, during the postpartum visits, a doula can help walk moms through any after effects she may be experiencing. She will have prepared the mother to recognize signs of a spinal headache (one possible side effect that is fairly common, but not overly so), and to get help quickly for it. She can help moms understand the back pain that may come along with it; the longer recovery time often associated with it; and – if it was on board for more than four hours – the side effects that her baby may experience. Usually, a baby might be sleepy, and have trouble latching on for the first time.

Once a mom is fully equipped with all the information about an epidural, she is equipped to take any side effects in stride, without fear. She knows that they may happen, and she accepts and owns her decision. She can come out on the other end still satisfied with her experience, even if she has experienced some negative side effects, when she is fully informed and fully supported in the way that only a doula can really do.

So, do moms planning an epidural need a doula?

You tell me.

This is just the tip of the iceberg regarding the knowledge a doula can bring to an epidural birth. If you are a birth professional, what would you add to this? If you are a mother who chose an epidural: Did you have a doula? If so, how did she help you? If not, would you want a doula the next time? What was your experience – doula or no doula?

This is a safe place for you to share – so, please do!

Grace & Peace,
Tiffany

Top 10 Things I’d Do If I Were Pregnant Again

Tuesday, April 10th, 2012

Image from decalsground.com

We all have things we’d like to hit the rewind button for. Today, I thought I’d share the top ten things I’d do differently if I were to miraculously find myself pregnant again. Why not? It’s not something I’ve shared before on this blog. I don’t often get very personal, but I’d like my readers to see me as a real person, who has made real decisions about birth.

So, without further ado, and in no particular order:

The Top 10 Things I’d Do If I Were Pregnant Again:

Image from richmondmidwife.com

1) Have a water birth.

The first time I’d heard of water birth was at our group tour of the birth center where DS #1 was born. In answer to another mom’s question, the midwife leading the tour said something like “No, we don’t do water births here, because we don’t think babies were meant to be born that way.” They did allow moms to labor in tubs, and I tried it. My labor practically stopped. I didn’t know then that if you get in the tub too early, the water can slow/stop your labor. I never thought twice about it all the time I was birthing my four children. Now that I have seen several water births, I would definitely choose to have a pool set up in my house for that purpose.

2) Have my placenta encapsulated.
This is an option I had no earthly idea about when I was having children. I think it could really have helped me with a whole slew of issues. I never struggled with baby blues or a PPMD, but I did have pretty roller-coaster-y emotions in the immediate postpartum days. Also, I have never been able to say that my milk supply was abundant, and I think the reassurance of the placenta pills’ ability to boost supply would have been a welcome comfort to me.

3) I would take a comprehensive, independent childbirth class.
Since I am a certified childbirth educator, I don’t think I’d actually take a full course, but I would probably take a refresher workshop of some kind, just to see if there is any new information out that would be important for me to know, and to give my husband a chance to internalize information he has heard at random since I became a doula. There is always room to grow, and I think we would both benefit from additional education.

One more thing. If I found out that I had to birth at the hospital, for some medical reason, I would definitely take a full, comprehensive course. Since I have never birthed at a hospital, I would really need to fully equip myself for the big differences I would face.

4) I would take a breastfeeding class.
Breastfeeding, for me, though a beautiful experience, was a struggle. I never had cracked, bleeding nipples. I never had to overcome hospital “booby traps,” because I never birthed in a hospital. I had the full support of my husband, my friends, and my mother.

Still, I was never able to meet my breastfeeding goals. When I look back, I know it was simply a lack of basic knowledge of how breastfeeding works. I hadn’t even read a book about it. I think that, if I were pregnant now, that is the first class I would sign up for, and would make sure I had the phone number to some good lactation support.

Image from portlandplacentaservices.com

5) I would make placenta prints.
Before I had it encapsulated, of course. I would frame them and hang them in my living room. They’re gorgeous when done correctly.

6) I would exercise.
Now that I have started trying to take care of my body, and can see the immediate benefits to my emotions, my confidence, and my overall well-being, this is something I would do during pregnancy. Though I did eat well, I never officially exercised with any of my kids, except for the occasional walk with a friend. I know that if I kept up a good exercise routine, I would probably enjoy my pregnancy more.

7) I would try a few different baby-wearing carriers.
For all four of my babies, I had a trusty ring-sling. One was a hand-me-down, and one was custom-made for me by a dear friend. I loved my ring sling, but there were some definite downsides to it. I had no idea there were any other carriers out there that would be properly supportive of my babies (Snugli’s and others like them are not ergonomically correct for a developing baby). So, if I were pregnant again, I’d hook up with the local “baby-wearing lady” in town, and try something new.

Image from hottopic.com

8) I would YouTube/Facebook/Tweet my birth.
I wasn’t on any kind of social media during my other pregnancies, but this time, all my friends would be hearing from me regularly! I’d probably try to facebook/tweet pictures and thoughts as I labor, and be able to announce my little one’s arrival as soon as he got here!

9) I would have professional prenatal photos taken.
This is something I really wish I had done before. I look at all the adorable baby bump photos around me, and sigh a little, wishing I had done the same.

10) I would have a professional photographer at my birth.
There is nothing as powerful as positive birth images. Images that reflect the intimacy, the intensity, the power, the strength, and the sacredness of birth.

There, that about covers it. I can come up with a few more, but I’ll leave that up to you! What would you do if you were pregnant again? If you’re already pregnant, what kinds of things are important to you? What are you doing to enjoy your pregnancy this time around?

Grace & Peace,
Tiffany

One Small Goal

Tuesday, January 17th, 2012

Today marks Week 3 of teaching yet another childbirth education series as a volunteer at our local crisis pregnancy center. I can’t even begin to describe the blessing that this ministry is! To be a part of what they do is such a joy to me.

Serving women who are often abused in the system is a privilege and an honor. My goal for each woman who leaves my class – no matter how young she may be – is that they would feel confident, equipped, and ready to make adult decisions reflecting the adult nature of their responsibilities as mothers.

One of my goals for the year 2012 is to take the Teen Educator training through CAPPA, in order to be even better equipped myself to minister to this under-served population of young women.

I can’t wait to have enough saved up to get started!

I’m hoping to share more of my 2012 goals by the end of this month, but I’m taking my time to sort them out and pray over them carefully before I do. What are some of your goals for 2012?

Grace & Peace,
Tiffany

Homebirth Preparation Classes are Open for Enrollment in 2012!

Saturday, January 14th, 2012

I have been blessed to join the team of educators at Preparing for Birth, in order to take advantage of a wonderful opportunity to be mentored by Desirre Andrews.

Under the Preparing for Birth name, I am offering classes in my personal specialty: homebirth. As a mother who has only birthed out of hospital, I feel a strong pull to equip and prepare women to birth in this non-traditional setting. Many women aren’t quite sure just what typical homebirth looks like, or how to prepare well for it. I aim to fill in that gap, and supplement the education your midwife is probably already doing with you.

The home birth preparation class is based in the evidence of healthy birth practices using a variety of techniques and tools for successful real life application by class participants.

  • Connect more deeply with your labor partner(s) and baby.
  • Learn how your body works and why during pregnancy through postpartum.
  • Understand how you and baby labor, birth and bond together.
  • Utilize tried and true techniques.
  • Be encouraged and grow in confidence for the entire process.
  • Practice role-playing of common scenarios.
  • Solidify your birth and parenting philosophies.
  • Sharpen communication and consumer skills for real life application.
  • Gain strategies and techniques for the postpartum period.
  • Apply knowledge and information into life skills.

View the complete class outline HERE.

Tuesday Evening Homebirth Prep 4-week Series

  • February 7th-28th
  • April 3rd-24th
  • June 5th-26th

What does it cost?

  • Homebirth Prep Class: $100
  • Homebirth Prep Class (military): $85
  • Homebirth Prep Class (community discount): $60
  • Ask about other options when you call.

Call or email me now to reserve your spot:
tiffany@prepforbirth.com
791-432-9712

Or register and pay online HERE.

I am also volunteering my childbirth education services at the Colorado Springs Pregnancy Center.

Grace & Peace,
Tiffany Miller CLD, CCCE

Something is Better Than Nothing.

Tuesday, December 6th, 2011

As a birth professional, a big part of my job is walking alongside women and their partners during the childbearing year by educating them about almost every aspect of their pregnancy, labor, birth, and postpartum period.

I meet women where they are, not where I think they should be. Often, not even where she thinks she should be. Ask any mother, and she can give you a whole laundry list of things she thinks she can do better. Her mind is filled with “if only’s.” Part of my job is to encourage her to grow and change in ways that will benefit both her and her baby.

However, I’m not the one walking her journey. I’m just with her for a relatively short period of that journey. I get glimpses and snapshots of her and her life, not the big picture. I do not have the power to make decisions for her, and even if I did, how can I really know, at the deepest levels, what is truly right for her and her family?

In pregnancy, labor, and birth, there is not a definitive “right” and “wrong” for many decisions that come up. There are things that are good, things that are better, and there are things that are usually best, but even those can be subjective. There are no guarantees.

So, as an example, take a smoking mother.

We all know that smoking is harmful to anyone, and there is no known “safe” level for nicotine in an unborn baby. We all know that it’s wise to quit when we are carrying a child. Of course, we would love nothing more than to see her totally quit the habit, for her health and for her baby’s. However, we also know how horribly difficult it can be to cut off a nicotine addiction.

How horrified are we when we see an obviously pregnant woman smoking? How much do we look down on her poor choices, and feel a righteous indignation that “we would never do something so terrible!

What we are missing is the other side of that coin.

How do we know, on the surface, that this isn’t the first cigarette she’s had in weeks? How do we know she’s not working her butt off to quit, but is struggling just like anyone else? How do we know she’s not eating really healthy foods, staying hydrated, and doing mild workouts to stay as healthy as she can?

When will we get to the point when we realize that something is better than nothing.

If that woman were my client, I would assume she knows the dangers of cigarettes to her unborn child. I would assume she feels badly enough about smoking as it is, and that what she needs from me is encouragement to do what she can with what she has at that moment, just like the rest of humanity.

I would remind her that everything she is able to do well, is enough. That something is always better than nothing. That smoking one less cigarette everyday does make a difference, and shows that she is trying.

Even if I did know exactly what would be right for this mother, should that change the way I see her as a human being? May it never be!

As a doula and childbirth educator, I have come to realize that I might be the only person this woman ever meets who does not look down on her. Who treats her with respect and dignity. Who believes in her ability to make good choices for herself and her baby. Who will cheer her on and encourage her in every effort she is able to make, and will ultimately help her to empower herself to continue in her personal growth beyond the ending of our professional relationship.

It’s a valuable lesson I think all individuals would do well to learn. To look beyond what is seen, to the heart, whenever we can. And, when we can’t, to leave well enough alone and refrain from judgment. It’s one I am grateful to have learned early on in this birth career of mine.

This posts is an offshoot from a seed planted by my mentor and friend, Desirre Andrews, who has taught me to think outside the box more than anyone else I know.

Grace & Peace,
Tiffany

Social Media and You

Sunday, October 16th, 2011

Get your pregnancy, birth or postpartum story heard!

I am looking to interview several mothers/families who have been positively changed, supported or impacted emotionally, physically, socially, educationally and/or spiritually during the perinatal (pregnancy, labor, childbirth, postpartum) and/or into the first year of mothering/processing birth outcomes through the use of/participation in social media outlets (Twitter, Facebook, Google+, Forums, Message Boards, etc.).

Purpose: Information will be used to complete a speaking session about birth and social media, as well as, material for additional writing, educational sharing opportunities.

If you are interested, please email me by October 31, 2011 with your contact information, when due if pregnant, how old your baby is if in the postpartum period and how you were affected by social media.

Contact: Desirre Andrews – Owner of Preparing For Birth LLC, birth professional, blogger, mentor, healthy birth advocate and social media enthusiast. Site: www.prepforbirth.com

Email: desirre@prepforbirth.com

Tips to finding the right “childbirth” class

Friday, October 14th, 2011

If you were my best friend, I would tell you there is not any one-size-fits-all “childbirth” class.  Education can be foundational to informed decision making and better outcomes for both mother and baby.

I encourage you to go about choosing a class series in the same way you would choose a provider or birth location. Do some investigating and even interview the educator.

In the search:

  • Get referrals from:
    •  Women who have had or wanted the type of birth you are desiring
    • From local birth groups or doulas
    • Your provider
  • Do a web search for classes in your area. There may be many offerings of differing methods and philosophies outside and within the hospital setting.
  • If  you are thinking about a hospital sponsored course, find out if it is a comprehensive series or a what happens to women once they get to our hospital class? This is otherwise known as a good patient class.
  • Check out the course website, then call or email the instructor to get a feel for her style and philosophy. Even a hospital based educator should be able to call you back or email you.

Before paying and registering:

  • How long is the series?
    • A comprehensive series is between 12 and 24 hours of instruction and a minimum of  4 class sessions up to 12 class sessions. The condensed express classes of one or two partial days are not designed for good retention or appropriate processing. It IS worth the investment of time.
  • When is the class? Day of week and time of day needs to fit into your lifestyle. Again, I encourage your investment over a period of time versus a one-day class. If you cannot find a fit, consider a private class. It is important to have classes finished by 35 or 36 weeks pregnant.
  • Where is the class held? Classes may be held in like-minded businesses (chiro office, yoga studio, doula office), in home, care provider office, birth center or hospital.
  • What organization is the instructor trained and certified with? Though certification is not required, it can be very important what training and background an educator has. If instructor is certified, check out the organization’s philosophy and beliefs.
  • What does the instructor’s experience involve?
  • What is the instructor’s philosophy and style?
  • What is the cost of the course? Classes can cost anywhere from free through a hospital to a few hundred dollars. It really can be a wide range. Find your comfort level. Though expect to invest in a good class. Free or low cost classes are often not comprehensive in nature.
  • What is the course content? A comprehensive class should include a variety of topics, such as, pregnancy basics,  common terminology, normal physiologic changes, emotional health and connection, exercise, nutrition, prenatal testing, birth plans, informed consent, communication skill building, overview of spontaneous labor and birth, labor milestones with comfort and position strategies, overview of all options in labor and birth, labor partner role,  immediate postpartum, navigating first weeks postpartum, overview of infant feeding, infant norms, medications and interventions, cesarean, unexpected events, role-playing scenarios, relaxation practice and local/online resources. It is usual to expect homework on top of class time as well.
  • What are the birth outcome statistics for class participants? It may be difficult though to get true data whether a philosophy-based or method-based class.
  • What is expected of me as a class participant?
  • What do I need to bring?
  • Who may come with me?
  • Is there a lending library?

Now Taking July Registration!

Thursday, June 2nd, 2011

Registration is open for July childbirth education courses at Preparing for Birth.

6-Week Comprehensive Courses are available on Monday and Thursday nights, for $125.

A 4-Week Comprehensive Homebirth Preparation course is available on Saturday afternoons, for $100. This is the course I will be teaching! (Can you tell I’m excited?)

To see class outlines/topics, available dates, or to register for either, follow this link: Preparing for Birth Group Classes.

I hope to see you there!

Grace & Peace,
Tiffany Miller, CLD

Announcement!

Friday, May 27th, 2011

As of the beginning of May, 2011, I have become an official part of Preparing For Birth here in Colorado Springs. Desirre Andrews, the founder and owner, has a passion for mentoring other birth professionals, which I am now taking advantage of.

I am not really very fond of diving into something head first, and hoping I make it. I am much more the “read-every-instruction-then-proceed-with-caution” kind of person, so having a mentor is actually quite important to me. I have so many gaps in my birth work that I desire to fill, and I know I cannot do it alone. I am still finding my voice in the birth community, and I only have glimpses of what that will be in the future, but I don’t yet have the whole picture.

So, in an attempt to go about this career choice in some semblance of order, I have chosen to learn from those who are farther along in their journey than I. I fully intend to blunder about for awhile as I find my feet, but with such women to learn from, I’m confident it won’t take as long as I feel like it will!

To start, I will be teaching a specialized Homebirth Preparation class! This coming week, I will be calling and speaking to several of our local homebirth midwives in order to garner support and gain a better understanding of what the homebirth community needs. Much of the curriculum is the same as traditional classes, but there are definitely some things specific to homebirth that many birthing families would benefit from.

I cannot tell you how excited I am to become part of a team like this!

Grace & Peace,
Tiffany