Midwifery Is Catching

Pregnancy and the Flu Shot

12/13/2011 07:53:00

I just finished reading a very informative and thought provoking article from the Mothering website. The article is well written and referrenced, if you are interested in learning more about whether or not the flu shot is right for you, and some of the contraversery surrounding this recommendation then I suggest you check it out at:

http://www.mothering.com/pregnancy-birth/what-doctor-isn%25E2%2580%2599t-telling-you-about-pregnancy-and-flu-vaccine

Midwives and Doula`s

12/09/2011 08:34:00

Research has shown numerous benefits of having a doula, and as a Registered Midwife I continually see the positive effects of Doula Care over and over. Because of this, as a midwife and mother who herself chose to have a Doula attend her births I am a strong advocate for doula care. however, it continues to surprise me how few women and their families understand the numerous benefits a doula can offer them.

Doulas (also called Childbirth Assistants, Labour Support Professionals,, or Birth Companions) provide emotional, physical and informational support during pregnancy, labour, birth and immediate postpartum for both the expectant Mother and her support team. this care is continuous and uninterrupted from whenever you feel the need for more support in early labour, throughout active labour and birth and in the first few hours after your baby is born. She offers you information, massage, suggestions for position changes, relaxation techniques, reminders to stay hydrated and keep your bladder empty, etc.

often I think women and their partners are concerned that if they have a Doula that the the Fathers will somehow be less. However a Doula does not replace a partner. Instead she also helps support the partner in ways that help enhance the bond between the couple. a couple may be in a very loving and supportive relationship, even if your partner is wonderful, caring is unlikely that he or she will be able to help you to have your best birth experience possible. Your partner whether that be your babys father,friend, or family member are not specialists in providing tools to make your labour easier, massage techniques appropriate to whatever stage of labour you are in, relaxation and focusing techniques,suggesting position changes to help your labour progress, know how to appropriately use the`take charge routine, know positions to ease back labour, aid relaxation and help pushing, etc.

Your Doula is there so that your partner can remain by your side, bringing you both drinks, snacks or ice chips. They will stay by your side so that your partner can take a break if and when needed. An experience Doula will instinctively know when you need someone to mop your brow with a cool cloth. They will know that your request for drugs is a way of asking for more physical and emotional support. If you would like them to they will take photographs of you, your partner, your baby, and other members of the birth team before, during and after birth. after your baby is born they will visit you at home a few times to help you review your birth and visit with your beautiful baby. Most of us are able to help you with breast-feeding as well.

In my experience I have observed that when clients are first introduced to the idea of having a doula, there are a number of comments that come up frequently.

These comments usually stem from coming from a place of not understanding birth and/or the doula’s role.

Common Myths I have heard about involving doula's in the birth team:

I’m very private … OR … I want as few people as possible … OR … There are already going to be a lot of people (friends, family or staff) … OR … A doula will decrease the intimacy between my partner and myself

A good doula will actually make it feel like FEWER people in the room, thus enhancing the intimacy of the experience. She can do this in various subtle ways:

Taking over the practical jobs that would otherwise take your partner away from you, fetching food, refilling your water, calling the midwife, heating hot packs, etc.

Giving pointers as to how best provide support: back massage, cold clothes, double hip squeeze.

Addressing the questions or fears of family/friends (whether present or on the phone) so that the labouring mom doesn’t have to.We frequently hear and see how having a doula takes the pressure off the partner to remember everything about every stage and variation of labour and birth, and then choose the appropriate types of physical, verbal and emotional support. This way your partner can relax and enjoy the beauty of the experience, as well as discover his/her own strengths. As a client once said, “It’s like having cheat notes!”

My friend who loved her birth experience didn’t have a doula … OR … I’ve already had a baby, I know what to expect

Yes, it is possible to have a birth without a doula, but even an “easy” birth can be enhanced by a doula. For this reason, even pregnant midwives and doulas hire doulas!

If I have a midwife, I won’t need a doula … OR … My midwife will bring her student

Midwives and doulas do have much overlap in styles and skills. There are also a number of key differences:

Increased labour support: Because a midwife’s primary responsibilities are clinical – to make sure that you and baby are safe – certain situations will take her away from focusing on just labour support.Early labour: Midwives do not attend you until you are in active labour - 4 cms dilated and having regular contractions. If you are like many other women, chances are you will have hours of early labour – ranging from 2-24 – when having a doula to reassure and support you could be very helpful for you and your partner. Rather than navigating this time alone, you and your partner could have the additional support offered by your doula. A doula will be there when your partner needs to eat or sleep, if you run out of coping strategies, or even just need a reminder this is still normal.

Precipitous labour: If you have a very fast labour, your midwife will be occupied with getting ready for the birth. When things need to be done quickly, a doula can be an extra set of hands that frees your partner to stay with you during this intense experience. A doula can also be the person whose voice is constantly in both your ears reminding you this is normal, just fast, and will be over soon.

Moment of birth: As mentioned, at the moment of birth the midwife is focusing on her many clinical duties, most which are below your belly button (including reducing your chance of tearing). A doula will still be available to do all other forms of physical and/or emotional support that you and your partner may need.

Scary outcomes: When things are not going ideally, there may be a flurry of clinical activity. A doula can stay with you and your partner/family to “translate” what is happening and help facilitate information flow. Your doula will be a grounding presence for you and your partner while your health care providers work to ensure that you and your baby are safe.

My partner will be my doula … OR … My mother/sister/best friend will be my doula

Each labour is unique in its own way. Unless your partner/mother/sister/best friend has extensive birth experience, they may not have the creative resources necessary for the twists and turns of your labour. In addition, the added element of being emotionally involved can have moments of such depth that they need to step out of the doula role. This is especially true for grandmothers (your mother)! Doulas have much more of an ability to maintain neutrality when confronted with the intensity of a laboring woman; for example, if your birth plan is to avoid drugs but your sister had three epidurals, she may not know how to support you if you have moments of doubt about your ability to continue without drugs.

"My friend who had a doula still had a long, difficult labour"

Having a doula does not guarantee a fast, easy labour or a vaginal delivery. It can, however, enhance your experience no matter what that is.

I can’t afford a doula

Some doulas work for low or no cost in order to get more experience. Many of these women have a natural instinct or other skills that make them excellent despite their minimal experience. The only time a newer doula would not be recommended would be if you have special or complicated birth needs, such as planning a VBAC, breech, etc.

Midwives and doulas have been working together for centuries. Historically, doulas were women from the neighbourhood who attended births and helped out a friend in need. In the last century when birth became more medicalized, the labouring woman was expected to be alone. Partners have been invited into the labouring rooms only for the past several decades. For centuries, birth was an event where families, and experienced women, supported the natural birthing process. I hope you have found this post helpful, it is my attention to to offer you resources so that you can make decisions that suit you and your family best.

Bleeding in Pregnancy

11/21/2011 20:38:00

As a Midwife the number one reason I hear from my pregnant clients in between their regular check-ups is because they are experiencing bleeding or spotting. As a Mother and a Midwife I am aware of what they are thinking, am I having a miscarriage?

Of interest bleeding in pregnancy is much more common then you may think studies suggest that one in three women experience spotting or bleeding in pregnancy. Only 50% of these go

on to have miscarriages, the majority in the first trimester. Often this is reassuring when one realizes that anyone who is pregnancy has a 33% chance of seeing bleeding at some point in their pregnancy.

While pregnancy can end in miscarriage, approximately 40% of pregnancies end up in miscarriage, and most of these are before 4 weeks of pregnancy (i.e. 2 weeks post conception, when you would miss your period). In these cases the woman may not even realize she was pregnant, she may think her period is "late" . After a positive pregnancy test, 4

weeks from your LMP, the miscarriage rate goes down to 15%. In addition, once your baby’s heartbeat has been heard(10-14 weeks) or seen on ultrasound (as early as 6-7 weeks), the chance of miscarriage goes down to 5%.

Part of the reason that so many pregnant women experience spotting is that there is a

tremendous increase in blood volume, which means that capillaries in the cervix are

easily disturbed causing bleeding. This is the equivalent of having your gums bleed after

brushing or starting a nosebleed by blowing your nose – both things that many pregnant

women also experience for the same reason. An average non-pregnant woman has

about 4 litres of blood.

COMMON CAUSES OF BLEEDING AND/OR SPOTING IN PREGNANCY

FIRST TRIMESTER

• Implantation spotting (i.e. as the fertilized egg attaches itself to the uterus it may

cause some irritation and bleeding)

• Ectopic pregnancy (i.e. the embryo is growing outside the uterus)

• Miscarriage

SECOND & THIRD TRIMESTERS

• Abruption (the placenta is lifting away from the uterine wall)

• Cervical dilation

• Early labor “show” (a sign of cervical dilation starting to happen)

WHAT SHOULD I DO IF I AM BLEEDING OR SPOTTING?

Miscarriage cannot be predicted, only diagnosed. If you are having signs of a threatened miscarriage, your midwife or doctor may be able to send you for some testing:

• Ultrasound will be able to determine if the embryo is implanted inside the uterus, and once you are past 6-7 weeks, if there is a heartbeat.

• Early in the first trimester, bloodwork that is repeated every 48 hours will be able to demonstrate whether your pregnancy hormones are increasing at an expected rate.

• If you are beyond 10-14 weeks gestation, your midwife or doctor may be able to find your baby’s heartbeat in the clinic with a Doppler.

WHEN SHOULD I CONTACT MY MIDWIFE OR DOCTOR?

You should let your careprovider know whenever you experience bleeding or spotting in pregnancy. Depending on the severity or your symptoms a decision can be made on the best way to assess the situation.

Nausea in Pregnancy

11/12/2011 23:49:00

Often when I meet women at their first prenatal visit one of their main questions and concerns is how to deal with feeling constant nausea. Nausea in pregnancy is common, in fact 85% of women experience nausea at some time during their pregnancy. More than half of these women will also have vomiting. Since each woman is different and each pregnancy is different, the severity will vary.

Women ask what causes nausea? To date nobody has determined the exact cause of nausea in pregnancy, it is believed that it’s a combination of the many physical changes taking place in the body, especially the higher levels of hormones during early pregnancy.

Nausea usually starts between 5 and 6 weeks of pregnancy. Although common in the morning, “morning sickness” can actually last all day, or even be worse in the evening. For 80% of sufferers, nausea gradually lessens, with more and more nausea-free days, until it ceases completely around the 12th week – although physical or emotional stresses can causes temporary relapses. The other 20% of sufferers will have nausea for a longer period of time, some even until the end of pregnancy.

Nausea, especially if severe, can be emotionally draining. Many women find that it interferes with usual daily activities, making it necessary to find ways to cope. But the large majority of the time nausea isn’t physically harmful to mom or baby. If you were healthy before you started pregnancy, your body and your baby will draw on your nutritional reserves.

Here are some suggestions that many women have found helpful to help cope with nausea in pregnancy.

When you first wake up, eat a snack, and then rest for 15 minutes before getting out of bed.

Smelling citrus fruit – oranges and lemons – can help. Eating citrus also helps your body to efficiently absorb iron.

Avoid spicy, fatty and fried foods

The smells of coffee and red meat are often triggers.

Don’t let dehydration make your nausea worse: drink at least 2 litres a day.

Don’t take supplements on an empty stomach.

Being tired makes nausea worse. In the first trimester it’s normal to need more sleep, so go to bed early.

Try 25mg of Vitamin B6, up to 6 per day.

The iron in daily vitamins can make nausea worse. Take vitamins with food or just before bed. If this doesn’t help, then decrease or stop taking daily vitamins until your nausea is gone. Vitamins are supposed to fill the nutrient gaps in your diet – if you eat worse because of increased nausea, then they are not helping. Continue to take folic acid alone on a daily basis.

Take 250 mg capsules up to four times a day, or 5-6 cups of fluid per day. Try ginger ale, ginger beer, ginger tea, candied ginger or ginger-lemonade.

Try SeaBands, available at drugstores, designed to offset motion sickness by stimulating acupressure points in the wrist.

Diclectin is a medication considered safe for treating nausea in pregnancy. It is a combination of Vitamin B6 and an antihistamine. It can have uncomfortable side effects such as dry mouth or sleepiness, so it’s usually only for serious nausea. Ask your midwife for more info and/or a prescription.

Hope some of these ideas will help you!

How Midwifery found me

11/02/2011 20:29:00

If you had of asked me12 years ago if I would have would become a Midwife, I would have confidently replied no! I had no plans to become a Midwife and frankly I couldn't imagine why someone would want a career with such responsibility and personal demands. But here I am in 2011, an experienced Registered Midwife of nine years and I couldn't imagine not being a Midwife.

My journey to Midwifery was completely unplanned and unexpected as some of the best things in life are. Prior to becoming a Midwife I was a stay at home Mom to my two oldest children and loving it. I was involved in La Leche League as a Leader and enjoyed working with breastfeeding women and their families on a volunteer basis. The turning point for me came after the birth of my second child Alannah. My first child had been born by C-Section, and when I became pregnant for the second time I wanted to plan a VBAC. During my pregnancy I was so blessed to have a doula, my dear friend Jocelyn to support and care for me. She met with me countless times throughout my pregnancy and we discussed everything we could in anticipation of my VBAC. Through our priceless , enriching, and to be honest "life transforming" time spent with one another, I was given the wisdom and peace to trust that my body knew how to give birth and that I could do it! I immersed myself in labor support and natural childbirth books and started to find myself fascinated by everything to do with childbirth. When the day of our daughter's birth finally arrived, Jocelyn came as soon as we needed her. Having her AND my husband there supporting me was wonderful. In the midst of intensity, prayer, harmony, rhthym, relaxation, music, massage, and laughter; I was beyond grateful for the loving support that amplified this beautiful experience! From the beginning of the labor to the end our doula never left our side. After that experienced I truly discovered that having support and encouragement during a woman's labor is key to a healthy and happy birth!

After our daughter's birth, I felt a fire had been lit inside of me. I had experienced labor and birth delivery and wanted to learn more! The idea of becoming a , doula, was born I wanted to actually I needed to help women the way I had been helped during my labour and birth.

As I have searched my heart for what has inspired me to be here today, I have found that my personal birth experiences have impacted my life in a tremendous way (as I'm sure it would for most women).

Almost immediately I began to research and plan on becoming a Doula. When my daughter was nine months old I travelled with my family to take the Douglas College Doula course, it was amazing and completely reaffirmed my desire to become a Doula. Shortly after I began attending births, those first births were challenging, beautiful, and inspiring. However they also brought about feelings on my part of confusion, anger and a conviction that women deserved unbiased information from their caregivers. In these early births it struck me how little input the women had into their care, even if they entered their births well educated, with birth "wishes" etc. these ideals often went by the wayside as their caregivers were unsupported. How could I help women achieve the kind of births they wanted if their care providers (who had the power) were not supportive? Then it hit me, I could become a MIDWIFE! Once the idea was born I absolutely knew it was what I was meant to do. I had no idea what being a Midwife entailed but it didn't matter I just knew I had to do it. Within a few short months I had applied and been accepted to Midwifery school in New Zealand, my family and I were off on one of the biggest adventures of our lives! We left Prince George in the Winter of 1999 and returned in 2004, I had completed Midwifery school and was ready to serve the women in my community to the best of my ability.