Let's Talk Periods and Postpartum Bleeding

Let's talk about the period. I know everyone's favorite subject right?! ;) 

A lot of people think there is nothing really to talk about, you just buy your tampons or pads from Walmart go home take Tylenol for 5 days straight and then move on for the rest of the month right?

WRONG!

There is a better way!

Cloth Pads and Menstruation Cups! 

Until I got involved with cloth diapering I had never heard about eco-friendly menstruation items. So if you have been left out of the loop don't feel bad. 

If you use cloth diapers you will feel right at home because the concept is very similar. If you don't that's ok too because in many ways cloth pads are easier (you only need them once a month after all, not everyday!)

We will start first with a menstruation cup:

Picture from Domino Pad's website, link below

This is basically the eco and health friendly version of a tampon. The cup gently fits in the vagina and the blood from menstruation fills the cup up, once it is filled (usually takes the same amount of time as one tampon), you empty it in the sink (or toilet) then wash it in the sink. So let's talk about why it is health friendly first:

1. Many tampons come with applicators and you can't actually see what you are putting in your body. Read this story if you don't know why that can be a bad thing.
2. Tampons can cause cramping whereas many menstruation cup users say that the cup actually eliminates or at least helps ease cramping (I think we can all get behind that!)
3. Each time you insert a tampon you are inserting a non-sterile object into your body that was made by a person and could have God-know-what on it, but you only buy one (or maybe 2 or 3 if you are really passionate) cups so you always know where you have been keeping it, how clean it is and you can always sterilize it by boiling it (you can't do that with a tampon now can you?)
4. I have heard (no studies sorry, if you know of a study that proves this please link it below though) that it also is less likely to leak then traditional tampons (yay no leaks! Because that can be gross and embarrassing!) and I have heard that TSS can be avoided by using menstruation cups (correct me if that is just urban legend though).

Now lets talk about eco-friendly:

1. You only need to buy one menstruation cup compared to thousands upon thousands of tampons over your life. This means you are saving thousands of gallons of fossil fuels for transportation of the tampons, no more cardboard for the box they come in, no more tampons in our water ways (if they are flushable) or dumps (if they aren't), no more applicator and other individual packaging trash, no more gas to run to the store at 1 am to get more tampons, and no more resources going into actually making the tampon and all it's "accessories"!
2. I have never seen statistics on how much trash from menstruating women goes into land fills every year, but I would imagine it is quite a bit! Help break the cycle and make the world a cleaner planet for our kids! 

Now on to cloth pads:

These replace disposable pads. You simply store them in a "wet bag" once they are dirty, and then wash them in your washing machine much like you would a cloth diaper or clothes that had a blood stain on them. Here is a picture of them:

Cloth Pad's from Domino Pad's website, link below

These are eco-friendly too except you may need to buy more like 15-20 of them, and you will need to wash them once they get dirty.

They are eco and health friendly for pretty much the exact same reason!

But let's talk price! While I know pads and tampons don't seem that expensive I challenge you to really look at that! For example one menstruation cup would cost me $40 if we estimate that the average tampon sells for .20 each we can find out how many tampons it takes to "pay" for one menstruation cup. The answer is: 200. I know that seems like a lot, but lets break this down a little bit, if a woman has a normal cycle of 28 days that means she will menstruate 13 times a year, if her period is 5 days long (that's pretty average) and you absolutely cannot go longer than 8 hours before changing your pad then the average woman uses a little over 195 tampons a year! Guess what, one year financially pays for your menstruation cup and you have saved the planets exponentially on resources! Congratulations my friend you have done to world a service!

And just to be clear according to everyone I have talked to the average menstruation cup last years upon years so you will be saving yourself money for years to come and in this economy every cent matters! 

While cloth pads are not nearly as cheap (it takes more like 2.5 years to pay for themselves) they help decrease the use of fossil fuels (since many are made with plastic), and are still much healthier for you! And from my understanding will easily last several years, so you aren't out any extra money!

While there are thousands of great brands out there I have used all the pictures from Domino Pad's so I will recommend them! I am also recommending them because right now they have a give-away going on that you can enter on their facebook page! Check it out! That would be a great way to get started in the freedom of cloth pads even if you aren't quite ready to invest yet! :)

What are your tips for Cloth Pads and Menstruation Cups? 

Share with us in the Comments Below! 

Do You Doula?

I read an article yesterday talking about why some women don't hire a doula. I decided personally to address the concerns in the article from the point of view of my personal practice. Now being a doula I am obviously pro-doula but I do think finding the right doula for you is just as important as having one in general. I recognize that not all women are going to want me at their birth. So without further ado here is some insight into me as a person, my birth philosophies and what to expect when you hire me!

What does a doula do?
-Quite simply I support you and your choices! I answer questions, I provide resources such as my birth library for you to use if you want. I talk to you about your previous births and meet with you after your birth to let you process it. I help your partner support you and most importantly I stand up for you when you want me to and I make sure you have time to make decisions. I attend difficult appointments with you. I celebrate with you on the good days of pregnancy and labor and on the bad days I cry with you and hold your hand. I will help you achieve your breastfeeding goals and if you change your mind 3000 times about getting an epidural that's ok I will stay right in step with you the whole way!

Do you replace my husband? Can he even be in the room with me if you are there?
-No No No! I do NOT replace your husband or significant other! And most hospitals will allow both me and your significant other in the room with you. If you aren't sure you can ask me or your doctor about the protocols at your specific hospital or birth center. I cannot possibly replace the love and comfort your significant other brings to the table any more than a cheerleader can replace a loving parent at a basketball game. We do separate jobs but help facilitate one another. I know the lingo of birth. I know birth protocols. I know how to help you bring your baby into the world. Your loved ones know you. They love you. They care more about you than anyone in  the world. They will support you in ways I never could. But they don't usually know birth as well as I do just like I don't know you as well as they do. Between us being a team we will give you the best labor and birth possible!

What if my doctor says they don't recommend doulas?
-Most doctors love doulas so you should ask them why they don't like them. They may not understand what a doula is or maybe they had a bad experience with one...but let me clear the air on something- it doesn't matter what they think for several reasons: 1) They most likely will not be at the delivery of your baby because the chance of them being on call when you go into labor is unlikely. 2) They deal with several births a day so you are literally one of thousands. However I only deal with one birth at a time (you will probably be my only birth that week) and each is as unique as the mothers involved. And most importantly you have to live with your labor- birth is transformative for better or worse. Do what is best for you, not your doctor. 3) They haven't met me yet. I will attend an appointment with you (if you want) so I can meet your care provider. And I am pretty good at winning people over to the idea of me being your doula. :)

What if I am using a midwife instead?
-Yay! I love working with midwives! I actually know several of them in the area (2 of them actually were at my baby's birth!) A midwife is great! But they are not doulas. They are there for your healthcare needs and your baby's needs. I am their for your emotional needs! If you need a back rub and for the baby's heart tones monitored you can bet the midwife will ditch your back rub to check on the baby (as they should!) but why have that when I can give you a back rub while they check fetal tones and your hubby tells you how amazing you are and rubs your feet?! :) See life is better with everyone working together!

What if I want to give birth in a hospital instead of at home?
-So far (besides my own labor) I have only been a doula for hospital births! I would love to attend a home birth but if you choose to give birth in a hospital I am just as much there for you as anyone! In fact in a lot of ways that is more the environment I have been trained to work in!

What if I already KNOW I am getting an epidural? This natural stuff isn't for me so why would I need you?
-Don't like pain? Me neither! Did you know that they did a study and having a doula present reduces labor time, reduces chance of an emergency c-section, reduces chance of needing instruments to deliver the baby (can you say ow!) and overall increase mother satisfaction of her birth. It also reduces the number of women who ask for an epidural- now that could be for several reasons but some (like me) think it is because we help to reduce the pain as well. Since it can take anesthesiologists a while to get there with the epidural that is probably a good thing!

What if I don't like hippies or granola ladies? Are you going to make me worship Buddha while I labor?
-Umm NO. I don't worship Buddha so I'm certainly not going to make you do it. I may be a little naturally minded -as in I think women are strong and can birth babies however they feel like- (natural, epidural, c-section, at home or in a hospital) but that means ALL women who take the path to motherhood are strong no matter how you get there! (can I get an amen?) I also wear cowboy boots and ride a horse and am a Texan through and through. I love hippies (my husband is one...gotta love Oregonians) but I am country. I support your right to birth the country way or the hippie way or anyway you feel is best for you. No braids or beads required. (But I will braid your hair if you ask me too)

What about the price?
Well as of right now my services are free but I do ask for a $25 traveling fee because gas has gotten SO expensive! However, I will waive that fee for lots of reasons some of the most popular reasons being:

• Women in a crisis pregnancy
• Women giving their baby up for adoption
• Women on Medicare/caid, SNAPs, TANF, or WIC
• School Teachers (my husband's one so I send a lot of love to you ladies)
• Peace Corp
• Women who's significant other is away for any reason- the most popular being because he is deployed
• If you are a foster parent

*if your specific situation is not listed above but you cannot afford the $25 please let me know and I am sure we can arrange something. :) Every woman should be able to have a doula! -I am also willing to barter if thats best for you and your family- seriously.

Now that you know a little about me, please let me know about you! What your goals are for your labor and delivery? How can I help you achieve them?

I work in the Lubbock, Midland, Odessa, and Amarillo area (basically any place within 2 hours of Lubbock). Feel free to call me at 432.638.6877 or email at sarahjohnsondoula@gmail.com
And please find me on facebook!

-Sarah Johnson
The Cowgirl Doula

The Nuchal Cord Scare

When you start talking about birth a lot of people bring up emergencies and fears. Some of these are legitimate concerns, others are perceived concerns (meaning they aren't actually an issue) and some are a mixture of both.

The issue I want to talk about today is a nuchal cord. Better known as the cord around the neck. This is one of those situation where sometimes it can be a problem but most of the time is just a perceived problem.

When it comes to a nuchal cord there are somethings we need to consider:
1) While the baby is in the uterus the only way it receives nutrition and oxygen (air) is through the umbilical cord. While for some of you this may seem like a given it is important to remember this when it comes to birth too.
2) As long as the umbilical cord has blood flow the baby is receiving all the oxygen they need for "breathing".
3) A cord can become compressed to the point that blood flow is restricted regardless of where the cord is or what is is wrapped around. When this happens the baby losses its continual oxygen flow and is in danger of suffocating.
4)Until the placenta has detached from the wall of the uterus there is blood flow to the baby. In normal births this doesn't happen until after the baby has been born.

Now keeping all this in mind when a baby is born and has a nuchal cord it is not immediately concerning because there is STILL blood flow to the baby- as long as there is blood flow there is limited risk of suffocation. This is an extremely important thing to remember because if your baby has a nuchal cord and they don't unwrap it before cutting the cord the baby may not be able to breathe because the cord then has no blood flow (ie no oxygen) and is wrapped around the neck.

While it may seem lifesaving to cut the cord and immediately unwrap it so "lifesaving procedures can begin" that is actually one of the most dangerous thing you can do. It is much better to unwrap the cord slowly and without pulling on it and then after it stops pulsing cut the cord as oppose to cutting it and then unwrapping it.

In most situations the cord around the neck is not dangerous and is actually safer because it is less likely to become compressed if it is around the neck.

While it is always good to ask your care provider if you have a question or concern also remember to do your own research and discover what are true risks and what are merely perceived risks. Also talk to your doctor/midwife about what they would do in a situation like this. If their answers do not match up with evidence based medicine never be afraid to transfer care or ask to have them do it the way you have researched.

This article has some cool pictures of nuchal cords.

GBS What is it? Why does it happen? Can it be prevented or cured? If you have it once will you have it again?

GBS stands for Group B Strep which is one of many types of bacteria that lives in the vaginal system of any healthy adult woman. In small amounts this bacteria is helpful, however if it starts to colonize in large numbers it can be dangerous if the baby passes through the birth canal at that point or if your water has been broken for quite a while.

Just like other infections, it can resolve itself on its own. However, if you test positive most doctors are going to want to give you antibiotics during your labor to "keep the baby from getting GBS". Antibiotics has been shown to reduce the risk of the baby contracting GBS from 1 in 200 (without antibiotics) to 1 in 4000 (with antibiotics). However, antibiotics have downsides as well. And there are more natural ways to deal with it. This website has lots of good information.

Here are some thoughts though for deciding what to do if you have already been diagnosed with GBS:

• Most women are tested at between 35-37 weeks of pregnancy to determine if there is a risk of a baby becoming infected with GBS. Just like every test during pregnancy you can choose to not be tested for it. If you are not going to do antibiotics (regardless of the results of the test) then it would probably be best to just refuse the test altogether along with the antibiotics for your baby and yourself at the hospital. 
• If you have been tested and found to be GBS positive demand to be retested every week until you have your baby since many GBS infections resolve themselves and most doctors will NOT offer to retest you.
• Just because you had GBS before does NOT mean you will have it again and just because you were negative last time does NOT mean you will be negative this time.
• Just because you have a GBS infection does not mean your baby will contract the disease or have any problems. (The stats on that are listed above) However, for some that will be a risk they are willing to take and for others it will not, but either way know what you desire in the area and have it written in your birth plan and stick to your instincts!

Here is another blog about keeping yourself healthy, she gives some ideas that will also help with GBS. I don't necessarily agree with a couple of the things she recommends such as using silver to prevent disease. But if you are looking for some options for preventing and treating GBS naturally then that website will definitely be of help. 

Antibiotics aren't the end of the world, but they do cause some problems, such as thrush, antibiotic resistance in children, stays in the NICU and inability to "room in" in certain hospitals and all that can lead to issues breastfeeding. But your choices must be right for you and your family.

-Always consult a trusted medical professional about your medical decisions and do your own research!-

The Cowgirl Doula 

Services of a Doula

These services will not be the same for every doula, but these are the services I offer:

Prenatal:

• 3 visits over coffee or at your house to get to know one another, for me to learn about your previous birth experiences, what you desire from this birth, what support you would like from me, and medical updates (such as the baby is breech, scheduling a c-section or induction, or just changes to your birth plan in general)
• A prenatal library of books about birth, breastfeeding, labor, babies, nutrition, etc. These are free for any of my clients to use
• On call 24/7 for questions and advice as well as emergencies
• If you are worried about hearing bad news at an appointment and have no one else to go with you I will attend 2 appointments with you (possibly more depending on the situation)
• Help with writing a birth plan, information on parenting and childbirth, and addressing any labor questions you have.
• Information on evidence based medical practices when requested
• Information of risks and benefits of procedures during pregnancy and labor
• Unwavering support during pregnancy for decisions you and your family make

Labor:

• Providing certain labor aids (birth/yoga ball, music, candles, heat packs, oils and massage help, counter pressure items, a snack pack for other labor support person(s), toys/entertainment for other children, help cleaning or preparing for baby, etc. (many of these items will be discussed at the prenatal meetings)
• 24/7 on call 
• Will attend you while at home in active labor, at the hospital, or birth center
• Offer emotional, physical and continuous support throughout labor for both you, your labor support person(s) and your healthcare provider(s)

Postpartum

• 3 postpartum visits
• Breastfeeding support
• Postpartum library on parenting advice
• Help processing birth/birth story
• Check on bonding and answer any questions
• On call 24/7 for advice or questions for 2 weeks following birth (could be longer depending on certain situations)

Pregnancy Loss

• On call 24/7 for questions, emergencies and procedures
• Support during loss and time after loss (these will be case by case on duration and length of time meeting)
• Help in processing your loss
• Support for labor in loss situations 
• Library support books on recovering and mourning loss
• Support for choices during loss and after loss

If you have questions please feel free to call and ask (or email!) and I am willing under certain circumstances to provide other help on a case by case basis. I would like to remind everyone that these services are provided to anyone within 2 hours of Lubbock, TX and that all services are free for now because I am still in the training phase. I am also willing to work with other doulas, so if you wish to use a doula with the hospital of your choice as well as me that is wonderful! I am also willing to work with another doula that you hire (such as for homebirths or hospitals that don't have doulas included). I would love to serve you and your family during such an intimate time.

-Sarah
The Cowgirl Doula

Breastfeeding and Nursing in Public

These cards from Best for Babes are to give to encourage women who are breastfeeding and help them in case they have issues with harassment while nursing in public can be found here: 

The NIP (nursing in public) harassment line was created to learn about ways people harass nursing women, get accurate statistics, counsel women who are harassed and encourage them to seek the help of local legal personnel (such as police in states that protect breastfeeding women and their babies rights). Most people, regardless of whether they breastfed their babies or not recognize the effort that goes into breastfeeding a child and the accomplishment that it is to be able to breastfeed a child (especially in public). 

Support these women and the NIP harassment line by buying these card for $3 (you get 10) and free shipping. Please also call the NIP harassment line if you ever face problems while breastfeeding (especially in public). 

Praise For a Georgia Doctor and Breastfeeding Tips

At this page you will find the wonderful video I have included below:



This video shows a brilliant doctor in Georgia who is helping women breastfeed. Now it may come to a shock to you, but most doctors are not given much training or info. on breastfeeding and many have no experience with it (now of course this will vary by geographical location and the importance each individual puts on breastfeeding). And from breastfeeding my child, I understand that knowing textbook answers is not the same as practice. I knew all the "correct" ways to breastfeed but almost ended up with my daughter in the hospital because she was not actually getting much milk since her latch was wrong (we met with a great lactation consultant and my daughter is exclusively breastfed at 5 months old and are going strong with no intention to stop anytime soon and now I have a lot more of applicable knowledge not just "book knowledge").

I do like how in the news article that the doctor lists the 3 most common questions/concerns during breastfeeding. Hopefully that will help women who feel alone in their breastfeeding struggles know that many other women have gone through the same things! I also hope it encourages breastfeeding moms to seek out help when they are have trouble. I do wish though that they had also shared some common solutions to these 3 problems. But since they didn't I decided it would be a good idea to answer them.

1) A jaundiced baby- This can come from several things. The first is that the yellow tint that indicates jaundice comes from bilirubin, which is basically broken down red blood cells (yes I know that is the super simplified version but really what causes biliruben in this case is not as important and being able to get rid of it). Bilirubin is iliminated through the poo and therefore it is very important for your baby to get breastmilk because it has a natural laxitive effect. If your breastfeeding is going well but your baby still is showing signs of jaundice consider allowing them to get a little more sunlight or use a light table that your doctor can get you (I prefer natural sunlight). If your baby is not seeming to get better, jaundice can be a serious condition so get them looked at sooner over later.

2) Sore Breasts- I did not deal with this even when I had troubles with the latch, so I do not have as much experience (and fixing a latch is better done in person) but I will tell you that there are a couple times your breasts may be sore and it will be normal and then signs that it is not "normal soreness". When you are engorged, you may feel that your breast are sore (or in my case feel like they are going to bust!) I never found a solution to this, but I promise it does go away. Try to breastfeed often and do not despair  Just take the Tylenol  I tried to be the martyr and not do it and it really just lead to more breastfeeding problems. Another time your breast may feel sore is if you have a blocked duct. These are painful in the breast (not the nipple usually) and the best thing to do is to massage the sore area (I know, not super comfortable) and let your baby nurse on that side a little bit extra. (You can also take vitamin C if you have a plugged duct. I actually take it rather regularly because I am very pron to plugged ducts so if I ever think I feel one coming on I take an little bit to help ward it off). If your nipples are sore you need to look into poor latch (call either your doula, lactation consultant or if you are in west Texas let me know and I will come over for free), yeast infection, etc. I found coconut oil cleared up my yeast infection in a matter of hours and P. never caught it in her mouth!

3) Poor Supply! The dreaded poor supply. First off I will tell you this is more of a myth then fact. Yes some women do deal with supply issues but usually that is from poor breastfeeding habits or lack of nutrient intake, not from actual supply issues. If you are having supply issues we need to look at the cause:

• Are you pumping?
•  If yes- are you pumping with a efficient pump that empties your breasts and are you pumping every 2-4 hours? If not then find a better pump and increase your amount of times pumping especially at night! If you are pumping every 2-4 hours with a quality pump and your supply is still diminishing then try pumping every 1-2 hours if possible. 
• If that does not work skip to supplements
• Are you breastfeeding exclusively? 
• If no: You really need to try to breastfeed exclusively...your supply will diminish if the demand is not high enough from your baby. You might skip down to supplements though if increasing breastfeeding is not an option.
• If yes: Try to spend as much time allowing your baby to breastfeed. One day my child was not feeling well (I only have her so I could do this without needing a babysitter, but it might be worth paying for a all day babysitter one day for the benefits I'm going to tell you about) so she wanted to nurse all day! Literally I think I got up from the couch where I nurse her 4 times all day. The rest of the time she nursed. For the next 2 weeks I have LOTS of extra supply! I was pumping all the time (because she doesn't normally nurse that much and I needed to get rid of some of it) but for someone dealing with supply issues this could really help (especially if you don't encourage it to go away like I did.
• Also try doing what my husband nicknamed "the dessert booby". Basically you feed the baby on side A until the baby stops nursing (like I mean falls off the nipple stops eating, don't remove the baby from you nipple though and don't take the baby away just because they unlatch only once they refuse to take it again should you switch sides) then switch baby to side B and offer that side to him/her. If she takes it allow her to keep nursing until also done on that side. Next time baby is ready to nurse allow her to take side B first and then offer "the dessert booby" which this time will be side A. And so on and so forth. If baby does not want side the "dessert booby" side that is ok too. Don't force it. If you baby is full they are not going to want to keep eating. If they are not full then they will take the other side.
• Are you taking supplements? 
• Prenatals or Breastfeeding vitamins? If no I recommend one. I take one that I get from Sprouts and it is amazing! Its called "Baby and Me" and I love them.
• Alfalfa? Let me tell you if I want my supply to increase I just have to take 3 of these little pills and I'm gushing! And the recommended dose is 9 a day! I can't imagine what would happen if I did that! (I take them for the vitamin K benefits- we chose not to do the shot) 
• Fenugreek? I have never tried it but I know a lot of women swear by it. So you might give it a try too.
• Are you eating enough?
• It takes a lot of calories to create breast milk. Once you get back to your ideal weight you should make sure you are consuming extra nutrients. If you do not you will begin to have supply issues (also try to stay away from junk food or so called "empty calories" healthy food (fresh fruits and vegetables, whole wheat, fiber, protein(!), and healthy fats). 
• Are you drinking enough? 
• Breast milk is a liquid and it takes lots of water to create it! Make sure you are drinking extra water so both you and your baby stay hydrated. 

I hope this helps you in your quest to meet your breastfeeding goals! If you have any questions or would like further help feel free to contact me (through comments or email or by phone)! I believe breastfeeding is the best start you can give your child and I would love to help you do that in any way I can!

-The Cowgirl Doual

What is a Doula

© Jakubjoachim|Stock Free Images

So it has occurred to me that some may not know what a doula is, or what they do. According to Websters Dictionary a doula is "a woman experienced in childbirth who provides advice, information, emotional support, and physical comfort to a mother before, during, and just after childbirth"

That is actually a very good definition. Doulas become experienced in childbirth in a number of different ways. In my case I have actually had a child so that helps. I also read birth stories as well as watch birth videos. That is not all though. I also read books and articles on childbirth, evidence based care and standard medical practices. I also of course attend births and act as a labor support person. 

Because of my knowledge I can also provide advice, information and suggestions (however, these are just that-suggestions. They are not medical advice nor should they take the place of medical advice or personal research). The emotional support is given regardless of choices a client makes. I am not the one that has to live with the births that I attend therefore I defer all decisions to the woman and her labor companion(s). Now, that does not mean I will sit idly by and allow birth trauma or abuse happen, it also does not mean that I will not fight for your choices. It simply means that even if you choose something I would not, I will support you no matter what. 

The physical comfort is something we discuss beforehand, at one of our prenatal meetings. If you have had a child before I will ask you what you liked during labor comfort wise and what you wish you had more of. If you have not had a child before then I will discuss what you like while you are sick, what you think you will like and ways I can help you discover things you will like during labor. There are several types of things I will bring with me to your labor (depending on what you request and where you are giving birth). For example candles (for non-hospital births), a birth/yoga ball, heat packs, washcloths, counter pressure balls and scarfs, pillows, aromatherapy oils and massaging oils, cd player, music, books, etc. 

During our prenatal appointments we will also get to know one another and discuss your birthing preferences and wishes (such as interventions desired or specifically wanting to avoid, breastfeeding goals, location of birth, information on your healthcare professionals, and labor companions, etc.). If you choose to hire me you will also gain access to my birthing library which contains books on childbirth, parenting, pain management strategies, leaflets on different evidence based procedure, videos, etc.  

A doula does not just support you though, they also help your significant other and other labor companions support you as well. They help to take some of the pressure off of your labor companions and help them out if they are feeling fatigued or are not sure what support to offer you. 

Some doulas offer postpartum care as well while others do not. I do offer it, I will check in with you several times after your birth to help you achieve your breastfeeding goals, make the transition to a new person in the family easier and help you process your labor and birth experience.

While where you birth does matter, WHO is at your birth is even more important. A doula is someone who will support you no matter what. Interviewing lots of doulas is always a good idea and then find the one that fits your price and philosophy/style the best. 

-The Cowgirl Doula

Questions to Ask a Midwife Before Hiring Her

© Netris|Stock Free Images

If you don't ask the right questions, you can't get the right answers. I say this because often we ask questions that will never give us the right answer.

Before you choose any healthcare provider there are certain questions you should ask. this blog (by Mama Birth-I'm a big fan) has some specific questions to ask a midwife before you hire her as well as some suggestions by Mama Birth. I think it is a good list and think you will enjoy it.

To be honest when we hired our midwives we did not ask most of those questions (and everything turned out just fine), but you always learn things the longer you are interested in a subject so I now have a list of questions I will ask and get more answers on next time.

There are  some questions I would add to the list too:
-Do you do the vitamin K shot? Do you "require" the vitamin K shot? What is your personal philosophy on it?
-Do you do the eye ointment at birth?
-What if I have breastfeeding questions after I give birth?
-Will you travel to meet me if breastfeeding just isn't working? (Should have asked about this one)
-What meds can you give me if I need them?
-Do you have a back up physician?
-Will you help me find a pediatrician? (should have found more out about that one too)
-Do you have a library of books I can borrow from? (This came in very helpful while I was pregnant)

Those are some questions that Mama Birth does not cover that I wish I had asked as well.

I would also like to address a question that came up during my birth and prenatal care. I was researching all through pregnancy and discovered a list of questions I should ask...but I had already hired my midwives so I was not sure what to do. If you find yourself in this situation I encourage you to follow your gut. If you think a question should be asked, no matter how "late in the game it is", then ask it. It is never to late to put your mind at ease. And if you get an answer that you don't like it's better to know sooner over later.

Learning From the Amish

© Kcphotos|Stock Free Images

Yesterday, my midwife posted a very fascinating article on birth stats and the Amish community that was published by no other than Fox news. It talks about several things that I will list in bullet form:

• "The study examined 418 Amish women who delivered 927 babies at a birthing center in Southern Wisconsin, a facility that lacked an operating room."
• Only 4% where born by c-section (they were transferred to a hospital if a problem was detected) whereas nearly a third (approx. 33%) of all babies are born via c-section across the US.
• Only 5.4 per 1000 infant deaths in the Amish community (mostly because of little to no prenatal care) compared to 4.5 per 1000 infant deaths across the US (which most usually get great prenatal care) 
• No mothers in the study died 
• In the Amish community 95% had VBACs (vaginal birth after cesarean) whereas only 8% of women have VBACs across the US
• "Historically, doctors have had concerns that a vaginal birth after a C-section, a so-called VBAC, would increase the risk of a rupture of the uterus. But in the study, no women experienced this complication." (emphasis mine)
• " In 2010, the National Institutes of Health recommended that women with previous C-sections attempt, in subsequent pregnancies, to delivery vaginally first, before resorting to a repeat C-section."
• They worked to turn breech babies before resorting to a c-section. This worked most of the time. Whereas in the US 92% of women whose babies are breech end up have a c-section. The article implies no one ever tries to turn the baby before resorting to c-section. I find that hard to believe but clearly they are either not trying or not using effective techniques. 
• " A national Institutes of Health analysis showed that 3.8 maternal deaths occurred for every 100,000 VBACs, whereas 13.4 deaths occurred for every 100,000 repeat C-sections." (emphasis mine)

*There are a couple things that the study notes that I think are important to add:
1) No high-risk pregnancies gave birth at the birth center therefore the statistic may have been higher if these women had been added to the study
2) Of the 19 babies that died only one of the babies died of a condition that could have possibly been prevented at a hospital.

I include both of those things not because I believe hospitals are safer (because I don't think that is always true. In fact I always wonder how many maternal and baby deaths could have been prevented if "interventions" had been minimized) but, rather, because I am not in the business of withholding facts that could influence a persons decision.  

I hope you will read the article yourself and tell me your thoughts. : )

The Family Centered C-Section

There are three different kinds of cesarean sections (c-section).

• The first would be the Emergency C-Section. This term is usually the one that is most misused. An emergency c-section will be done in the case of emergency (ie. within minutes of being diagnosed)  if there is time to sit around and discuss it then at that moment it is NOT an emergency c-section (we will get to what type that is momentarily). Those types of c-sections can turn into an emergency, but in the case of most emergency c-sections general anesthesia will be used and you will be being wheeled to the OR as they tell you what is happening because the situation is so serious.   
• The second would be a Medically Necessary C-Section. These are usually scheduled in advance or are done for things like "failure to progress" quickly enough to a doctors wishes. They are not elective (that is the third kind) but they are done because of a condition either the mother or baby suffer from. 
• The third is an Elective C-Section. This is one where it is not an emergency and there is no medical indication for it but for whatever reason a mother has chosen this as the manner in which she would like to birth her baby.

The most common forms of c-sections are elective and medically necessary (medically can often be misnamed emergency). Emergency c-sections are thankfully pretty rare. In the case of an emergency c-section a family centered style is usually not going to be an option because the mother is usually unconscious and the father is not permitted in the OR. For medically necessary and elective a family centered will often be available if requested. This video is of a "family centered c-section" I do not own this video, I found it on YouTube you may find the link here if you wish to look up more info.

There are very rarely going to be any reasons why a hospital cannot offer a family centered c-section, but you still may find it difficult if you are the first person at your hospital to request one. However, these are clearly more beneficial for the mother, baby and father. If your hospital of choice or OB doesn't offer family centered births there are several options:
1) Find a new hospital
2) Ask your OB if they know what a family centered c-section is and if they have ever done one (write out specifically your wishes and show them this video). Depending on their answers you may need to find a new OB. However, if an OB is interested in doing one and you feel like they will really honor your wishes (and you have a doula present to help advocate for you) there is no reason not to let them (unless of course you just don't feel comfortable).
3) Talk to the administrators at your hospital of choice. Sometimes they simply have never thought of changing their systems because they don't know there is a better way. If you can get hospital policy changed that will benefit many women to come.

Sometimes a c-section is not only necessary but also beneficial to mother and baby. If more hospitals across America will begin implementing this system I believe we will see more women satisfied with their births, and more confident in breastfeeding as well as mothering in general.

Sorry...

I had been doing so good to publish an article everyday until last week. Our dog unfortunately passed away and I did not have the emotional energy to focus on this blog. However, I am feeling better and will get back to posting regularly. (I may even do some catch up posts!) If you notice I just posted a new blog below! I'm pretty excited about it! Check it out! : )

-The Cowgirl Doula

When Your Significant Other Isn't On Board...

When a couple finds out they are having a child several things happen. One is that for the woman she begins thinking about how to preserve the pregnancy and keep herself and the baby as healthy as possible. She will try to see how she can limit the chances of miscarriage, she will improve her diet, maybe change her music choices, or how she speaks about herself and to others. She will see radical changes in her body and get to know the baby inside of her. From the moment she knows she is pregnant she will begin preparing for birth. She will start deciding where she feels safe, who she feels safe with, and what she will need during labor.

This will not be the same for all women, but while I was pregnant I looked at spaces completely differently. I felt better in tight well lit places with only one entrance and an easy escape route. I know crazy, but I put it to the idea that at one time we didn't live in nice little houses and that as a pregnant woman I could not move as quickly or effectively as I once could, so I had to be more careful of my environment. 

In a similar way you significant other will begin also preparing for the birth. They may help you (or try to be helpful) by doing everything for you, fretting over every move you make, being more defensive about you/your honor/who you hang out with/where you go/etc. And in their own way they will begin to prepare for you to give birth.

Now some of you may be lucky enough to agree on where, with whom and how you would like to birth. That was the case between me and my husband, and if you are in that situation then congratulations! 

However, many will find that they and their significant other disagree on one or maybe all three points. If that is the case for you then I encourage you to read this blog post at BWF. While it is specifically aimed towards natural/midwife births it will still give good advice for speaking with your significant other even if you are not wanting that kind of birth.

I have several pieces of advice though too (coming from a lady who has given birth):

1) A woman NEEDS to feel safe during labor. I don't just mean would like to feel safe, I mean NEEDS to feel safe. And where you and her feels safe may be completely different, but its ok, because she needs to feel safe, not you. You can support her anywhere, she however, can only give birth effectively if she feels safe (notice I said feels-where she feels safe may not seem rational, but that doesn't matter. Labor is NOT rational. It is pins and needles, excitement  emotion all running through your body with rushes and contractions and love and fear and hope and joy and energy all wrapped up into one- remember women tend to be more emotional creatures and birth is very primal)

2) You may feel safer in "X" location because of their training, or their safety equipment, or their lack of interventions, or their lack of scary equipment or whatever (depending on whether you are afraid of hospital or out-of-hospital births) but it is her body (and trust me she doesn't want anything bad to happen to that baby any more than you do- she has 40+ weeks invested remember) and she is the one that is going to have to either push that baby out of have major abdominal surgery (a c-section) to get the baby out. So give her, her body and mind some credit in picking out where they would like to birth.

3) Your significant other loves you and that is why they are being difficult whether you believe it right now or not. Try to be sensitive to that.

4) Hear her out. You may think she is crazy. You may  think she is wrong. You may think its her hormones. But no matter what hear her out. Go talk with the healthcare professional she wants to go with. Ask questions. Be open minded. Find out why she would prefer them over options x, y, or z.

5) Rebuild bridges if you have burned them. If you have already had this talk but it went horribly wrong try to start over from a friendly place, a place of mutual love and respect and wanting whats best for you and your baby.

6) Find out why the other is afraid or adamantly refusing the options you are considering. Are they basing all their knowledge on an old TV show? Or did a friend lose a baby because of reason x? Did their Dad tell them something that has freaked them out about child birth? Did they have a bad experience with doctors or hospitals? etc. 

7) Base your decision on what is best for YOU not what is "normal" or what is "popular" or fear of "what ifs" or fear of the other options. Its not black or white, right or wrong. Birthing in a hospital with OBs has its place just as birthing with a midwife at home does and just as birthing unassisted does. But birthing one way over another because you are scared is not a good idea. And forcing someone else (even your darling wife) to birth somewhere just because you are scared of other options is NOT a good idea.

8) If you are worried about your wife's body not being capable then stop. Stop right there. She knows you are thinking it and you are wrong. (And if your not thinking it then tell her! Tell her everyday you know she is strong and capable and able to give birth the way she wants!) Her body was MADE to do it (even if she has had 100 c-sections). Believe in her. Give her a chance. Give her support. How would you like it if you thought your body was broken? Or if you thought your spouse thought your body was broken?

Supporting her in her decisions will show her that you will support her no matter what. However, not supporting her will confirm every fear she has ever had about leaving her and thinking she isn't good enough. With all the options out there find what works for you and your family! Don't be short changed by fear or a lack of options or what others may think. Find people that will support you in the decisions you make! 

The Toddler Cup and More: Helpful Tips for Comfort During Labor

http://www.meijer.com/s
/bornfree-set-of-2-straw-cups-pink-and-purple/_/R-213173

Well, I am finally beginning to feel like I am getting on top of this whole blogging thing.

So I am going to write one of my first posts from scratch (be impressed).

These are some ideas that I have come up with or have heard of that can help during labor:

First is the most brilliant one I just heard today: Use a Toddler cup for water (or other drink- such as coconut water or poweraid) one of those that has a bendy straw attached to the lid. It allows ease for           mother to drink while in interesting labor positions.

Rice Packs- this one comes from my midwife's facebook page. She took pieces of cotton cloth and put rice in them (and some lavender) and sewed the edges after using a "quick stitch" adhesive on the fabric. These can be put in the microwave to heat up and applied to whatever part of the body mother wants

Peppermint Oil- peppermint can help relieve pain, help the cervix dilate and calm the mind. Worked wonders in making me feel better during labor. Just use as directed on the bottle (I found using it on my forehead and neck helped the most) I wonder if having some soft peppermint to chew on would have been a good idea or not for early labor?? Any thoughts? I will have to look it up.

And then lastly music, some women enjoy a nice tribal rhythm while in labor. It helps them connect to their bodies and all the women that have gone before them in labor and birth. Some women will also go to a place of wildness, almost a primeval place to gain strength to push their baby out. Tribal music can often help them connect to that part of their brain.

Of course always listen to your body and what is says you need. And if you have an questions of concerns ask your healthcare professional and do research! : )

-The Cowgirl Doula

Switching Providers (Especially Late in Pregnancy)

Everyone has thoughts about their doctor/midwife and how happy they are with them.

And sometimes during a pregnancy you realize that you and your care provider do not agree. I'm not talking about on whether they think taking castor oil to induce labor is a good idea or not, I'm talking about big things like: whether they approve and support VBAC or not. Will they "let" you have your breech baby vaginally? What about pre-eclampsia, will they let you try to induce naturally or not? Or what about doctors that are TOO naturally minded for your taste. Won't do an extra ultrasound to calm your fears about the baby being breech. Won't take your blood pressure or listen to your complaints about headaches. Wants you to only induce naturally and will not give you the meds to induce. What do you do when these things come up?

Hopefully at your first consultation you got a lot of these things cleared up, but what happens when you are at 25 weeks? 30 weeks? or worse 36+ weeks? and something like this comes up?

Well, there really is only one thing to do: fire your care provider and go find someone else. If you are 36+ weeks this can be a scary proposition but it is the only thing to do. You DO NOT want to have to fight with your care provider during labor. It is better to just switch before it actually becomes a problem. As long as you have had prenatal care most doctors/midwives will take you, especially if they are pro what you are pro.

If you are needing to switch care providers ask like minded friends and organizations. Also ask your doula for their thoughts.

This blog post also gives some other thoughts and ideas and was my inspiration for this post.

-The Cowgirl Doula

Asking Questions and Using Your B.R.A.I.N

© Dgm007|Stock Free Images

This blog post talks about asking questions and getting answers while in labor and looking at using possible interventions. You are to use your "B.R.A.I.N" which is an acronym to remind you of the things to ask before consenting to a routine or emergency procedure (by the way I find this very helpful not only with labor/birth questions, but also with other medical procedures especially when talking about my daughters health with her pediatrician.)


I saw a blog post like the one above a while back but it had one of the letters a little different.

The link above does:

B- benefits

R- risks

A- alternatives

I- intuition

N- negotiate

but it misses a very important question I prefer the N to stand for nothing as in "what if we do nothing?" Of course it is important to know the risks and benefits of a procedure and knowing your alternatives is necessary for informed consent. And in general it is always good to go with your gut, but sometimes we get so caught up in wanting to DO SOMETHING that we forget in some cases doing nothing-even if its just for a certain amount of time- is the best option.

-For example at 40 weeks many doctors/midwives will begin wanting to schedule an induction (if you weren't already). If you think you might be interested in an induction at that time then you will want to discuss risks and benefits of inductions. Alternatives would be a good discussion since there are many natural ways to induce labor and many options of induction methods (remember you need to discuss the risk and benefits of each procedure. All natural induction methods and medical induction methods have different risks and benefits). Following your intuition if you think there is a problem or not would also be wise since you know your cycle, baby, body and situation the best. You will also want to ask what about doing nothing. According the the ACOG you are not "overdue" until at least 42 weeks. Therefore, inductions are not automatically necessary at 40 weeks (or even 41 weeks).

It would be better to ask if you can "do nothing" until 42 weeks. Then at your 42 week appointment you can reevaluate the issue (however I will tell you that there are many women that have gone to 43 weeks + and had perfectly healthy babies even though the doctors/midwives didn't think it was possible...but that was their situation and you will need to evaluate your own situation and comfort level).

The negotiating is a helpful tool but it sort of gives the impression that your doctors/midwives have some sort of say over you. You have the right to birth how you feel comfortable. As I heard one person say "This is America, they can't make you do anything you don't want to do. And if they ever do force you to do something you don't want to then you have the full backing of the law and usually the hospital to complain or sue and get justice." Negotiating can be helpful but only if they are willing to cooperate. Don't ever be afraid to put your foot down. They don't have to live with the consequences of your labor experience but you and your baby do.

-Also always remember to do your own research. The internet is a beautiful place. Be careful to only use reliable websites though. Also read the inserts given and websites made my pharmaceutical companies. They have a lot of information and can help you in asking questions to your doctor. But also look at independent websites. Read lots of books (if you are using me as your doula I have books you can "check out" and read) Take control of your birth by being as informed as possible. Sure it takes work, but its worth it.

-Some doulas can help you in this research. (they however CANNOT give medical advice, but they do know of websites to help you find information and get questions ready for your healthcare professional). I offer this help to my clients when they ask for it.

May you always feel free to ask questions and get the answers you need.
-The Cowgirl Doula

What I Hope to Offer

I hope that as I assisted women in labor and via my blog that I will be able to offer them support in birthing the way they want and that they will feel empowered after their birthing experience. One of my favorite blogs to read is Birth Without Fear. As a doula I hope to model the care I have seen on that blog. Whether you are birthing with a scheduled c-section or a home birth or anything in between I hope to support you and help you have the best birth possible.

While I do give tips they are not going to be for everyone and that's ok. My tips are only a way to help you decide what you want at your birth and how you want your labor to go. The same with the information that I post. It is only to help you know what options are available and the associated risks and benefits. If you do not feel that the benefits out weight the risks in your specific situation that is ok. There is no "right way" to birth. As long as you are informed and choose the path that is right for you, you will have an empowering birth.

This blog post explains what "Birth Without Fear" is all about (P.S. I love her site please check out the stories and information there too).

What does an empowering birth mean to you?
In your opinion how can a doula best help you?
What are you looking for in a doula?

-The Cowgirl Doula

Leaning on God During Labor

I read LOTS of birth stories. Its part of my training...plus I just love birth stories. There is truly few things in the world as amazing as the raw power in birth.

Birth stories that are positive and empowering help me to be a better person and a better doula.

I don't often repost birth stories because like I said I read so many of them and I have yet to find a positive birth story I didn't like. But this birth story had a piece of advice that really rang true to me and I feel like women tend to forget in labor: lean on God. Through each contraction worship God, because each contraction is bringing your baby closer to you and God will sustain you through each contraction.

I also liked the idea of anointing a woman's head with oil and praying for her during the early stages of her labor.

Obviously this will not be what every woman wants or needs, but for a religious woman I can see this having some real benefits.

Meditation can also really help while in the early stages of labor as well as when you need the baby to change positions, or help lower blood pressure and other physical needs during pregnancy. Never underestimate the power of asking and believing.

She says at the end that God redeemed her previous birth experience and gave her the desires of her heart and everything she asked for. Sometimes all it takes is the courage to ask for what we need.

Tips for Labor: Olive Oil and Counter Pressure

© Contentfactory|Stock Free Images 

This is the last post in my 5 day series of Tips for Labor. I hope you enjoy. And feel free to list in the comments any tips you would add the my series!

If you read my birth story you will see that I had an amazing midwife that really helped me during the crowning stage. In fact she helped me so much that I did not tear nor did I need any stitches. Her work inspired me so much that I wanted to pass on some advice that she gave.

1. Do not push the baby out quickly (once they have begun to crown). Instead push them out millimeter by millimeter and make sure your doctor/midwife knows that you do not want to be cut or have an episiotomy.

2. Feeling the "ring of fire" is actually a sign you are NOT tearing and is a good thing. Push slowly and gently during that time and allow your skin to stretch. Remember it was designed to do this.

3. Counter pressure! Having someone (ideally someone that has done it before) provide counter pressure on your perineum is very helpful and reduces tearing significantly.

4. Rubbing olive oil over the skin while crowning helps the skin to stretch, and lubricates the area more. (You can also use vitamin E oil if you prefer.

5. Do not push on your back while crowning! That will lead to a tear for sure. Instead push on your hands and knees, standing up, or while squatting instead.

6. Hopefully, if you have received any sort of pain meds they will have worn off by this stage, because being able to feel where to push and how is also very important toward not tearing or only tearing minimally.

Crowning is one of the most intense moments of birth. While it only lasted a matter of minutes, to me, it is what seems like took the longest in hindsight. : ) So be prepared and make sure you, your healthcare provider, your doula, and your labor support person (ie. spouse, mother, etc.) are all on the same page about what your wishes are.

-The Cowgirl Doula

Tips for Labor: Food=Energy

© Zlideshowpix|Stock Free Images

Labor is hard work and hard work takes energy and your body needs food to create energy. This is why you should eat before, during and after labor.

Ask your health care provider about options for eating during labor. From my understanding the only reason not to eat during labor is in case of an emergency c-section. However, if you are not at a high risk of having a c-section then not eating will put you at greater risk of having an "unnecessary" c-section ("unnecessary" because if you had been eating it probably wouldn't have happened.)

This is one of those "weight the risk" type deals.

However, not eating is in a way setting yourself up for failure. The example one of my birthing friends loves to use is: You can die from going to the restroom. It is possible to injure yourself due to having impacted poo or falling or all kinds of other things-but we will keep this G rated so that's all I'll list for now- but you don't plan on having those problems in the restroom because in general pooing is safe. But what if you went to the restroom and took every precaution: had a nurse/doctor present watching you, kept the door open, didn't eat before going to the restroom-in case of emergency surgery, was hooked up to a monitor, had an IV, etc. It would be silly! And you would probably get "stage fright" and then really have problems because you might be labeled "failure to progress". You get my drift. Its a silly example but it shows that with all other natural things we work to not set ourselves up for failure. But often with birth we take SO many precautions that we end up in a bad situation that was preventable.

So (this is just my opinion) I think unless you already know there is a decent chance of c-section you should eat. But if you feel the risks out weight the benefit then don't eat. You know your body and you know what you need. Listen to those instincts above all else! Our bodies are the ones birthing our babies and humans wouldn't have survived so long if our bodies were not designed well. : ) And make sure you have support for the decision you choose to make in that regard.

If you do decide to eat during labor (yay!) then here are some good things to eat:
-honey sticks: lots of energy, easily digestible and pretty healthy
-chicken: its soft on the stomach and has good protein
-pasta: good to eat early on in labor because they are complex carbs and will give you energy if your labor lasts a while
-fish: lots of good oils and proteins
-soups: preferably homemade
-sports drinks: coconut water is suppose to be the best but if your like me and hate it a simple powerade will suffice (however, do recognize coconut water is better for you...but I just can't stomach it...)

Things that aren't as great to eat (unless you are having contractions on top of each other with little to no break or prodromal labor):
-baked potatoes: they have magnesium which relaxes muscle contractions
-red wine: slows contractions too (alcohol is NOT recommended at anytime during pregnancy in the USA- do your own research and let your conscience be your guide...)
-cinnamon: slows contractions
-anything with high levels of magnesium (see baked potato)

But remember it doesn't matter what I think, it matters what you believe your body is telling you. Always listen to your body. I can give you advice from things I have seen and read and I can let you know that you DO have an option to eat, but it is your birth so you need to do what you feel is best for you! That is the doula code so to speak, helping women listen to their bodies and helping you stand up for the birth you want! That's true empowerment: knowing your options and choosing what's right for you regardless of what anyone else would do!

-The Cowgirl Doula