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

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

Alternatives to Glucola for Diabetes Testing

Of all the tests pregnant women go through, the Glucose Challenge Test is arguably the one you hear about most often. Down an electric orange drink, wait, and have your blood drawn...sounds fun, right? Some people don’t mind the drink (called Glucola) while others search for alternatives. There are alternate options for both what you consume and how you test.

Guidelines currently call for a glucose challenge test around 24-28 weeks of pregnancy. The test is typically drinking a sweet drink and then having a blood test done an hour later to determine blood sugar levels. This test is used to help determine the occurrence of Gestational Diabetes which can pose a host of issues to both mom and baby during pregnancy.

If the pregnant person passes this test, they won’t be re-tested. Should they fail it, they’ll have to pass a longer test that involves a higher level of glucose.

Rates of GD have risen in recent decades so it is important to get tested. It’s estimated that anywhere from 5-10% of pregnant people have Gestational Diabetes and it’s important that those people be identified and treated to avoid complications.

Some people just hate the way Glucola tastes, some take issue with the ingredients...for whatever reason, there are definitely people searching for alternatives. The research put out found that the important part of the test was the 50g of sugar, not the source, and concluded that results were the same when a group of women given Glucola was compared to a group of women given Jelly Beans. The tests were the same.

It’s important to always refer back to your OB or Midwife when considering alternatives.

Common alternatives include:

6 oz Orange Juice and 1 Banana

28 Jelly Beans

A Soda with 50g Sugar

16 oz Orange Juice

These are options used by doctors and midwives around the country and definitely worth exploring.

Alternate ways of testing include Blood Sugar Monitoring as well as Hemoglobin A1C Testing. These both require much more testing, more time, and more involvement for you and your healthcare provider and it’s important to consult them on your options.

Blood Sugar Monitoring is exactly what it sounds like. You’ll monitor your own blood sugar levels by pricking your finger multiple times a day for a week and using a blood sugar testing unit.

Hemoglobin A1C Testing is a draw that monitors blood sugar levels over a three month period. It has been used as an alternative to the normal Glucose testing and is routinely used for those with Diabetes outside of pregnancy.

It’s also important to remember that the GD testing is a screening process and not an actual diagnostic. If you happen to fail the first screening, don’t panic immediately. It’s possible that you’ll be fine with the more extended testing!

Gestational Diabetes is something we should definitely monitor and treat but there are alternatives to the traditional screening. By working together with your provider to create a plan for you, you’ll find the perfect way to monitor and ensure your health is optimal and your baby is thriving through your whole pregnancy.

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.

It's Time: Foods that (Maybe) Induce Labor

You’ve reached it. 38 Weeks. Technically full-term.

And you’re mis-er-a-ble.

You’re also probably hungry.

(Same.)

What to do when you’re waiting for baby and hungry? Try some foods that allegedly induce induction, of course.

Let’s serve that baby an eviction notice with these 4 super delicious and possibly-labor-inducing foods!

1. Pineapple

Pineapple contains an enzyme called Bromelain which is supposedly responsible for sending people into labor. Ideally eat it fresh, but canned works too if it’s too cold for Pineapple season!

BONUS: you can make a tea out of the rind that extracts the Bromelain as well. (If you prefer organics, definitely do so here so your tea doesn’t end up with non-organic pesticides in it.)

2 Red Raspberry Leaf Tea

This tea is actually very helpful all through pregnancy for toning the Uterus. It can bring on contractions so make sure that’s okay with your provider (it usually is in low-risk pregnancies). Generally speaking, if you’re able to have sex, you’re able to have this tea.

Try brewing double strength (two tea bags or two tablespoons of loose tea per 8 oz of water), sweeten it with a bit of honey, and keep it in the fridge for a refreshing possible way to help bring labor on.

3 Basil & Oregano

It’s not known why but these herbs are supposed to be miracle workers when it comes to getting baby out the natural way. For this reason, many pregnant women have turned to Eggplant Parmesan to induce labor. Honestly, this one’s worth a shot because yum. (Here’s a simple baked version!)

4 Spicy Foods

Spicy foods have long been a standby for moms who have HAD IT with being pregnant and want to get the show on the road. While there isn’t a lot of science behind it, it’s thought to induce a laxative effect that stimulates the uterus to contract.

Lucky for us here in Charlotte, we can pop over to Hawthorne Pizza and try the nationally-known spicy pizza dubbed “The Inducer”. A buffalo chicken pizza featured on Food & Wine, Fox News, and even Live! With Kelly Ripa, this pizza has reported magic in it that helps mothers who eat it go into labor.

No matter what you’re craving you can likely find something delicious that may, in fact, get that baby to make their appearance. Regardless, you may as well have some fun trying, right?

How to Induce Labor Naturally: A Doula's Guide to Natural Induction

37...38...39...weeks keep passing and your baby is still hanging out? We’ve heard it said before that the first part of pregnancy goes so quickly and the last month lasts a year. It totally feels that way. Between a baby that has grown to nearing the size of a watermelon to your shifting center of gravity and ligaments stretching and loosening, there is often a lot of anticipation and discomfort that comes with the final days of pregnancy.

As doulas, we’re often asked about natural induction techniques.

Now, while anything involving induction is clearly some sort of augmentation of normal labor, there are some home remedies that have been suggested to begin or help labor progress. Bear in mind, each person is different and not every technique will work for every person. Some of them are kind of funny and some of them have an origin of scientific evidence. No matter which you choose, always be sure to check in with your doctor and pay close attention to how you’re feeling.

1. Pineapple Juice/Spicy Foods

One of the widest known (and easiest techniques is eating or drinking something to help bring on labor. Pineapple juice is a very common suggestion (and a pretty delicious one). It’s said that the enzymes it contains can help jump-start labor. Honestly, this one is probably worth a shot. If nothing else, it’s a nice, fruity pick-me-up.

Another edible option is spicy food. Wives tales tell us spicy food can help naturally induce labor. The two main theories why this may work are that the spicy foods may stimulate the digestive tract, bringing on contractions. Another is it may stimulate Prostaglandin, one of the things known to help soften the cervix. Regardless, this is a great excuse to grab yourself some Indian food or chips and salsa.

2. Chiro Care

This is a big one! While Chiropractors don’t claim to be able to start labor, Chiropractic care has been known to help get baby into a good position in the pelvis. In order for your cervix to dilate, thin, and efface, baby’s head must be against it. It’s not too far-fetched to think that getting baby positioned properly may help bring on labor. The other main benefit of Chiropractic care is increased comfort throughout pregnancy. Make sure you seek out a Webster Certified Chiropractor, which is one that works specifically with expectant parents.

3. Massage

There is both scientific and anecdotal evidence to back this one up. Anecdotally, there are some pressure points that may help bring on contractions. This is why people often have to be careful when getting pedicures and often seek out acupuncture or acupressure to bring baby out. Scientifically, touch stimulates the production of Oxytocin in our brains. This hormone (also called the “love hormone”) is responsible for the progression of labor. When you get a massage, you’re spending an hour or so stimulating Oxytocin in your brain.

This is also a great opportunity to help your partner connect with you through the process (and spoil you a little bit).

4. Sex

Ah, yes. Sex. We’ve often heard it said that you get baby out the same way you got baby in. Frankly, there’s some truth to that. Semen contains Prostaglandin, the same hormone found in Cervidil which is often used to help induce labor in the hospital. The gel is placed against the cervix in hopes of helping it soften. The DIY version of this is to...well...get it on. In addition, sex and, more specifically, orgasms produce a lot of Oxytocin in our brains. The combo of Prostaglandin and Oxytocin may just be exactly what you need to send you into labor. And, honestly, it’s a fun way to pass the time even if it doesn’t.

Natural Induction of Labor is a highly searched term on Google and a frequently asked question from our clients. We’re often walking people through exactly how they can serve their baby an eviction notice. The last month or so of pregnancy can often drag on so sometimes even just giving these methods a try can help you get through.

Have you tried a Natural Induction? What methods have you heard of? Let us know in the comments!