Why Would I Need a Doula if I plan to get an Epidural? Here's why.

As a doula, I see so many people say they don’t need or want birth support from a doula because they either have their partner or are planning on getting an epidural. Why would I need a doula when I’m planning on getting an epidural? Im here to tell you that a doula’s support with an epidural is also SO beneficial! Here’s why.

If you’re not familiar with the epidural and labor, here are some quick facts.

1.      An epidural provides pain relief by numbing from about the bellybutton down to your feet.

2.      An epidural can be a great choice for someone who has low pain tolerance.

3.      An epidural does not always work for everyone.

4.      Having an epidural does not mean you can’t labor in different positions

I love talking about epidurals and laboring because I feel like there is so much to learn. So many people think you just have to lay in bed. While that might be true, there are several positions that can be done to benefit the position of your baby, and benefit your labor! What I don’t hear often is how a doula can be of great support to you and your birth team.

Story time! Last week, I attended a birth with a mama who absolutely knew from the start that she wanted an epidural (you go girl, we love a strong confident girl). This was a very long and exhausting labor and she was very glad she opted for the epidural. Even though she had pain relief, I could tell it was taking a toll on her emotionally and mentally. This is totally depending on your situation because, keep in mind, everyone’s story is different.

My client was completely comfortable but I could tell she was struggling mentally. What she needed in that moment was emotional support and encouragement. My role in that time was to keep her grounded and remind her that everything she was experiencing was normal and her feelings were valid. I reminded her that this process is normal and her body is not failing her. Having that professional there to spit straight facts at the drop of a hat eased their worries.

Whether you are planning on an unmedicated labor, a scheduled cesarean, or an epidural, you can never go wrong with some professional birth support from a doula! 

What's Your Favorite Position?

When you think of having a baby, what comes to your mind? Where are you? What position are you in? Do you envision yourself in a hospital? Your home? What about the way you push your baby out? Are you in a bed? Are you laying flat on your back? If so, that is completely normal! Pushing on your back and in a bed has become the standard way of pushing your baby out. While some people may prefer to push and labor this way, there are some other great positions to labor and give birth in that actually work to our bodies advantage.

As a doula and student midwife, I am so passionate and CRAZY about UPRIGHT BIRTH! It just makes all the sense in the world. GRAVITY is your best friend when it comes to birthing. Would you poop laying down on your back? I mean if that’s what you’re into, then by all means, go for it.

Birthing and laboring upright has so many benefits and actually makes for a quicker birth in most cases. Moving around during labor also lets your pelvis move to work with the many changes and positioning of baby while theyre coming down to the birth canal. It is your right as a birthing person to have the freedom to move around and about in labor.

You do not HAVE to stay in the bed. Of course unless there is a medical reason, you or your baby have a life threatening situation that actually permits you to the bed. But we stan for informed consent over here and birthing patient RIGHTS! WOOOO. Anyways, Below are my favorite and BEST positions to labor in and WHY.

HANDS & KNEES: This position is one of my favorite positions to labor in, personally. Not only does this position take the pressure off your back, it allows you to rest in between contractions, and It also allows the pelvis to be opened. Hands & knees position can also increase your babys oxygen supply.

SQUATTING: Squatting is another gravity pulling position! I see lots of my clients use this position when theyre nearing transition. The squatting position gives your pelvis all room to open up, lets gravity do its job to bring baby down, and also makes it easier to bear down when its time to push. You can use a chair to hold yourself during a squat.

The Toilet: okay, I know what youre thinking, the freaking TOILET? Ew, why would I ever want to labor and birth sitting on the TOILET? Hear me out… we call this the dilation station for a reason okay. Sitting on the toilet lets your pelvic floor to RELAX, letting your cervix dilate. This sitting/squatting position also opens the pelvis. Combine the sitting position, the relaxation of your pelvic floor, the opening of the pelvis, gravity, and the intensity of contractions, you will get success! I have seen many of my clients go from 0-100 SO QUICK in this position!

SIDE LYING WITH A PEANUT BALL: This one is a favorite of mine when the birthing person just needs to rest a little bit. Maybe labor is just beginning or it hasn’t gotten to the active stage yet. This lets you lay down and rest so that youre not too tired. Putting a pillow or a peanut ball between your legs will allow your pelvis to remain open as well.

The CUB : Also known as, Comfortable Upright Birth. The name of this inflatable device says it all and is fan favorite among us birth professionals. The CUB is ideal for women who have an epidural and are unable to freely move around the room.

These are just a few of my favorite upright birthing positions to labor and push in! All of these can be used while swaying during a contraction as well. Remember that if being on your back is comfortable for you, then you rock that shit! There is no right or wrong way to birth. Keep these positions in mind if something isn’t working for your during your big day. And remember, we love an INFORMED and CONSENTED, positive birth! YOU GOT THIS!

Written by: Natalie Story

Avoiding A C-Section. Is it Possible?

Pregnancy is such a magical thing. We go nine months dreaming and preparing for the perfect labor and delivery, analyzing every little moment. There are tons of fears and concerns for different people going into labor. Will it hurt? Will I tear? Will I poop? (that’s a whole other topic that we will discuss, but shit happens). One of the biggest concerns parents have going into their big day is, “What if I need a c-section?”. This concern is totally valid. A cesarean is major surgery and usually over with fairly fast. There are many medical reasons for needing a c-section, but the big question is, Can they be avoided? The answer is, YES! A c-section can be avoided, in most cases. However, in the event of a true emergency, sometimes its needed for the health and safety of the birthing person and baby. Please note that if you do end up needing a c-section… that is okay! You are still a bad ass and you are no less than anyone who has had a vaginal birth. We are all AMAZING. 

Anyways, Here are my top things you can do to avoid a c-section:

1.    STAY EDUCATED. Its so important to be educated on your rights during labor. Informed consent is real and you can say NO to anything you do not want. Staying educated will let you know what interventions are actually medically necessary for you or your baby.

2.    CHOOSE YOUR PROVIDER CAREFULLY. There are some providers/birthing places that are cut happy and love to revert to a c-section no matter what. If you are birthing in a hospital, check their c-section rates. 

3.    LABOR AT HOME AS LONG AS POSSIBLE. If the birthing person and baby are healthy and there are no further complications, laboring at home as long as possible can hinder any possible interventions that can lead to a c-section. Examples: Pitocin, AROM(breaking of waters).

4.    AVOID INDUCTION. Although there are multiple factors to this, avoiding an induction will minimize the number of interventions needed. 

5.    HIRE A DOULA. Hiring a professional to educate and help you advocate for yourself can give you some of the best outcomes for your birth. 

In hindsight, we can do everything under the sun to avoid a c-section, but sometimes baby has other plans. It’s important to remember that a healthy baby is really the goal and there is no shame in which way you birth!

Written by: Natalie Story

Guide to Nitrous Oxide in Labor

Almost three years ago, the Charlotte area was introduced to Nitrous Oxide for pain management for people in labor.

The change comes as a part of a broader movement across the country of patients asking for this effective and low-risk tool that is popular in the UK. 

Laboring people have been advocating for its use, and hospitals have started to add the pain management option with more frequency since 2014. 

Even though the pain management tool has been around for almost three years in Charlotte, there are still questions as those outside the birth community are introduced to it outside of a dentist's office. 

The Nitrous used in labor is a different mixture than what dentists use for dental work. When your dentist uses Nitrous Oxide, it is a 70/30 mix of Nitrous and Oxygen - and it is typically flowing and used continuously for the length of a procedure. 

In labor, the Nitrous Oxide is diluted by half with Oxygen, as a 50/50 mix. Instead of a continuous stream, it is distributed by a hand-held cannula or mouth tube, the laboring person has to bring to the face and draw in a breath actively. Nitrous Oxide use in labor is used sporadically as a way for people to take an active role in administering pain relief in the way that feels best for each contraction and personal need. 

Typically, a laboring person will take a few breaths before a contraction starts, to have the relief on board at the height of the contraction. Then, with a few breaths away from the canula, the Nitrous Oxide is quickly removed from the bloodstream. This fast-acting, and fast short life of the gas is a huge benefit of its use. Nitrous Oxide does cross the placenta, but leaves quickly and does not interfere with the natural production of oxytocin, meaning a baby can be alert and bonding during the golden hour after birth.

Some Quick Facts About Nitrous Oxide: 

• No additional IV needed

• Nitrous oxide can be administered by the labor and delivery nurse, making it extremely easy and fast if a patient chooses to use this pain relief option. 

• The range of benefit for the person taking Nitrous is anywhere from feeling nothing to feeling everything - most identify still feeling contractions, but not caring they exist

• For many, they share feeling less anxious during or scared

• If you have a vitamin B12 deficiency or cannot hold the mask to your face, you are not a good candidate for Nitrous Oxide

How Do Doulas Help Parents Delivering By Cesarean?

Labor doulas are typically hired by people planning to have a vaginal birth. A doula's knowledge of normal physiological birth, the constant support through labor, and the skilled hands-on care are all reasons doulas are growing in popularity.

But what if you suddenly need a surgical birth or are planning a cesarean delivery from the onset? Are labor doulas helpful then?

Yes.

When it becomes necessary to decide to have a non-emergency cesarean, after long hours of hard labor, the flood of emotions is intense and overwhelming for many. The medical team will be focused on getting you prepared physically for unexpected surgery.

Your doula will be focused on your mental and emotional preparedness.

Having all your questions answered, understanding the risks, helping you wade through the options all happen before the choice is made. And once made, your doula can help you to prepare for what will happen next.

• Your doula will outline what you can expect to see, smell, and experience in the operating room.

• Your doula will outline what the next few hours will look like, and when you see her next (if doulas are not allowed in the operating room), and keeping you and your partner tuned into each other while getting ready to meet your baby.

• Your doula can help your partner know how they can support you through surgery if she is not able to attend.

Help During Recovery

After surgery, you are going to need immediate help from both the medical team and support team for the first hours after you deliver. Having a cesarean birth is major abdominal surgery, and nurses will monitor your vital signs and postpartum bleeding.

Usually, in those first hours, parents are eager to have skin-to-skin or start breastfeeding. Families now have time together that may have felt stolen because of the limitations a surgery places on movement and autonomy. All of these activities require more care and attention because of the strain they apply to the new surgical wound on the lower abdomen, and a doula is a skilled set of extra hands and knowledge to help families reconnect.

A doula can help with positioning, answer questions about breastfeeding, and be available to keep baby in a safe position. At the same time, the birthing parent continues to come fully aware after the anesthesia wears off.

Planned Cesarean Delivery

For those people who know they are going to deliver by cesarean, having doula support through pregnancy can offer some unique advantages. Having a doula can lead to better home planning for your post-operative abilities, combined with the needs of your new baby. A doula's experience can help you understand what will and won't be possible after surgery and help you identify any ways you may need to adapt.

It's a complicated world post-surgery of understanding your body's new abilities, caring for your baby, and the intense emotions that come with being a new parent. Having a doula helps make all of the big questions seem smaller, and the unknowns easier to adjust.

Doulas are not only for an unmedicated vaginal birth. Doulas are for any person who wants one-on-one personal support through an experience that can be intense and overwhelming.

What Should You Bring To Your Hospital Birth?

There are so many ways to pack for your hospital birth.

Do you like to have options?
Do you feel best being prepared for any possible need?
Do you need fewer options, so you feel less overwhelmed?

Only you know how you operate best in stressful situations. 

Your hospital bag can serve so many other functions, too, besides holding all your stuff!
Is planning your bag something that helps you relax in the days leading up to labor? Does it make you happy to put it together? Do you like a challenge to start with ALL the things and then whittle it down to what will fit in your ideal case?

OR

Do you see birth as a short overnight trip away from home and pack economically?

Packing your hospital bag can be a “labor project” or something that helps you take your mind off some of the stress the end of pregnancy can place on you.

Here is the part where we reassure you and offer the reminder that people often have babies at inopportune times. And the hospital has things to help everyone - not just people with their overnight bag. Things like toothpaste and toothbrushes, towels and wash rags, and those lovely hospital gowns to keep your clothes as fresh as possible. 

But let's hope you won't need to walk into a hospital off the street, and you'll have time to go to the hospital in the way and manner of your dreams. With that as the plan, what would you bring? 

The items below are listed as a building set. Based on our experiences, we have seen families use the following items and appreciate their being with them from "Essential" to "All The Things." Have fun reading through, and if you think of something that would be perfect for you and it isn't here - pack that too!

What To Pack For Your Hospital Birth

Essential:

• Wallet: medical card, ID, Debit or Credit card

• Cell phone & charger

• 2 Shirts

• 2 Pants with elastic waist

• Slip-on shoes

• Dop Kit: toothbrush & toothpaste, chapstick, any medication & glasses

• Carseat

Added comfort: 

• Robe

• Slippers

• Book/magazine

• 2 Nursing bras

• Dop Kit: lotion, facial cleansing cloths, brush, hairbands, shampoo & conditioner

• Hand fan

• Water bottle

• Snacks

• Headphones

• Baby: going home outfit, muslin blanket

• Underwear for going home

A bit more for the unknown:

• A printed copy of your birth plan

• Pillow

• Preferred nipple cream

• Breast pads

• Tissues

• Extra outfit for baby

• Essential oils

• Belly Band

• Hand cream

• Battery-powered fan

• Towel

• Bluetooth speaker

• Flipflops

Details for all the things you want: 

• Any tools you imagine for pain management: birth ball & pump, tennis balls and/or massage tools

• TENS Unit

• Rebozo or woven scarf

• Heating pad

• Meditations and/or affirmations

• Eye mask & earplugs

• Props/outfit for newborn photos

Birth Options: Use Your BRAIN!

Pregnancy and birth can be an experience full of tons of different emotions. One we see frequently is worry! What procedures are “okay”? Which options do you have? With everything you need to decide, it seems impossible to know the “right” answers to each and every question. In most cases, though, there isn’t a “right” answer, just an answer that is right for you!

As doulas, we have a brilliant method of helping you explore your options. Simply use your BRAIN!

No, really. B.R.A.I.N.

This is a really quick and easy way to explore what your options are and make a choice that works for your family.

Let’s use an Epidural as an example and walk through what it might look like to use your BRAIN to make a quick decision.

Benefits

Ask “what are the benefits of this procedure/decision?” Answers are often health of baby, comfort of mom, or improved outcome overall. The

In our scenario, the benefits of an epidural might be increased comfort of birthing person which could result in sleep, allowing them to recover the strength they need for pushing in the event of a long labor.

Risks

What are the risks of the decision? The risk of an epidural might be decreased feeling which leads to less control during pushing, loss of mobility (meaning the rest of the labor will continue in bed), and inability to use a shower/bath as a means of comfort.

Alternatives

What are the alternatives? In the example of an epidural, alternatives may be any other physical comfort measure that provides relief. A warm bath or shower, counterpressure, massage, distraction, Rebozo, or position change could all be considered alternatives.

Intuition

What does your intuition say? We are often more in tune with our bodies than we give ourselves credit for and taking a moment to pause and reflect may give you a great idea of what the right decision is for you.

Nothing

What happens if we do nothing? In the case of an epidural, doing nothing does...well, nothing. If we do nothing we could wait an hour and come back to the option again. It doesn’t take it off the table, just changes the timeline.

This super simple system (try saying that five times fast!) is an easy way to explore your options quickly and help you make a decision. Sometimes we have more time to research and don’t need a snap decision. In these instances, using BRAIN will still help walk you through exactly what you need to research.

Making the right decision for your family is important! Exploring your options for laboring, birthing, pushing, feeding, and even birthplace often leads to feeling more empowered, more secure, and having a better birth experience. Whatever you decide, we’re here!

Supporting C-Sections: Doulas for Cesarean Birth

Cesarean Birth is something that every pregnant person must evaluate. While it’s not ideal for most birth plans, there is a myth that doulas can’t support a C-Section. False! Doulas can be an incredible source of help for any birth outcome, including a C-Section. Combining a wealth of knowledge and experience, doulas bring emotional, physical, and educational support to each and every client.

1 Emotional Support

Any surgery can be fraught with worry, stress, and a general sense of uncertainty. This is super normal but especially when faced with a surgery to bring your baby into the world. Not only does this affect your life, it affects the life of your unborn baby! It’s no wonder there’s a huge need for emotional support when your birth plan includes a Cesarean. Often fear comes from the unknown. Your doula knows all about common procedures, options, and exactly what will happen once you embark upon your birth. They’ll walk you and your partner through each and every step beforehand and be there to affirm and support during and after as well.

2 Physical Support

Some hospitals allow doulas into the Operating Room. While in the OR, often your doula will stay with you if your partner needs to leave to go to the NICU with baby. Should you feel cold or unstable, your doula can be there to help keep you warm or even just place a hand on your shoulder. Once your procedure is complete and you’re in recovery, often women find themselves shivering and unable to control it or even nauseated. Your doula is skilled and experienced in helping you through these physical symptoms as well as helping you to nurse your baby as soon as possible if you decide to breastfeed. The stress can also get to your partner, your doula can be there and allow your partner to sit and take a breath after the birth of your new little one!

3 Choices in Childbirth

You may not have seen your birth going this way but that doesn’t mean that through the twists and turns you don’t have options. A doula can help walk you through what choices you can make as well as you journey through. From how and when baby is fed to what music is played during your cesarean, you do have choices! There are things that may be available to you that enhance your birthing experience such as clear drapes, skin-to-skin just after birth, and attempting to breastfeed in the OR.  Your doula will be familiar with your birthplace’s options and can help you pick the best things for you and your family.

Maybe you knew you’d need a C-Section when you got pregnant. Maybe it’s a surprise change you weren’t expecting. Planned or unplanned, your Cesarean birth can be a beautifully supported experience with the skills your doula brings. In addition, they can help you know exactly where in Charlotte is ideal for what you’re hoping to experience during the birth of your baby. Your doula will navigate seamlessly, helping to make for a more smooth and comfortable experience for your family.

Coping with Prodromal Labor

Early labor, Active Labor and Transition make up the three stages of labor.

While most mothers go through all three phases of labor, there is a possible fourth phase known as prodromal labor. This phase is one that is rarely spoken about, but commonly experienced by first time mothers.

Prodromal labor certainly deserves attention.

Although prodromal labor is totally normal, pregnant mothers who experience this do not always think so. Prodromal labor (AKA False Labor) is an elongated period of time that can last days of hard labor type contractions and discomfort but doesn't progress into a "normal labor pattern". Prodromal labor can be very intense, however, your uterus is NOT broken and medical intervention is NOT the only way out.

Actually, what prodromal labor absolutely means is that you’re nearing the end of pregnancy you’re your baby will soon be in your arms.

While you may not find many articles on this topic, the new mom blogs, the community boards are flooded with experiences. All of them say the same thing. Make rest, hydration, and nourishment your number one priority; add a little patience and you will get through this.  I Promise!

The prodromal phase can typically last anywhere from 24-72 hours.

Yes, this early phase of labor is considered to be extremely uncomfortable, and may even become painful but the intensity usually wavers throughout the day. This phase of labor starts with regular elongated contractions. These contractions usually do not progress, become stronger, or closer together for some time.

Mothers who have previously had a baby may only experience prodromal labor during the night.

Rest is your key to getting through this. Endurance may seem impossible because these contractions are STRONG and consistent, which is quite disruptive to rest. Your doula will have some incredible comfort measures and supportive suggestions for you to get power through.

Truth is, the only way to end prodromal labor is to move on to the next phase… delivering your baby.

Partner Anxiety. How A Doula Can Help

Through sickness and health…

This statement doesn’t always include the delivery room. Labor can bring about major feels for your partner.  While they are not the one birthing, we cannot discount that this experience is complex and emotionally driven. The atmosphere may be extremely difficult to navigate and may cause your partner anxiety.

While we have chosen our partner to support us throughout our life, they may not be well equipped to be our “rock” during labor.

Our expectations of them alone, may be enough to send them into a tail spin.

Remaining objective and focused may become impossible for your partner being that they are so emotionally involved. Anxiety can show itself in many ways with the partner. Some partners mentally check out, some faint at the first sight of “fluid”, while others go into control mode making it near impossible for the clinical staff to do their job.

So, if the possibility of panic is more of a probability, add a Labor Doula to your birth team. Anxiety is a major enemy of labor and can be highly contagious. The presence of an anxious partner may spike the creation of adrenaline in the birthing partner, shutting down the labor process or elongating it. A calm and nurturing environment is the ultimate goal for the delivery room.

A doula will never replace the loving attention of your soulmate, they can actually guarantee it, increasing the flow of oxytocin and reducing unwanted partner anxiety.

Labor doulas provide support to both partners, not just mothers. The doula tends to everyone's needs of rest, hydration and education. That way the couple can maintain focus on each other, assuring that they stay attuned to one another.

Just knowing that the birthing partner is being emotionally, and physically supported will lessen stress and absolve partner anxiety.

Thinking of adding a doula to your support team? We find having a doula can help reduce partner anxiety and promote a more calm and nurturing birthing environment. Contact Uptown Doula for your free consultation.

Your Birth Playlist! Music is a Labor Of Love!

It’s you third trimester and the countdown to the big day is… well… getting close. All of the boxes are steadily getting checked off on your Before Baby Comes Must Do List. You have even packed your hospital bag.  But you are forgetting something. You forgot to make your Birth Playlist. Think about it, how many times have you needed to get rid of all the feels …. so, you blasted “that song” in your car. Or, “that song” that you hear and no matter what you catch yourself dancing.  And we won’t even talk about “that song”, you know your guilty pleasure song, the one that puts a smile on your face on even the grayest day.

A Labor Playlist may even ease your delivery.

NO! We are not kidding. Music makes everything better! Your Birth Playlist is a real thing, Even Spotify has created one.  Singing requires breathing, a key component to laboring. So what better way to bare down then during one of your favorite choruses. There is actually a rhythm to labor some artists have even created music specifically for it like The Rhythm Within. It is proven.

So why not prep a playlist for one of the most incredible experiences of your life, it might even help?

Here are our Top 10 to get you started… then the rest is up to you…

1. Capri – Colbie Caillet
2. Better Together – Jack Johnson
3. Warmth - Incubus
4. Dog Days Are Over – Florence & The Machine
5. To Make You Feel My Love – Adele
6. Colorblind – Counting Crows
7. Oceans (here Feet May Fail) - Hillsong United
8. I Will Wait - Mumford & Sons
9. Home – Phillip Phillips
10. Brave – Sara Bareilles

We have so many more incredible song suggestions that are sure to have you laboring and listening to music you love.

Visit us at Uptown Doula. We would love to connect with you!