childbirth

The very end of pregnancy

As I wait for this month-that-has-felt-unending to finally end, I have been thinking a lot about the last little while of pregnancy. It, too, can feel like it’s not going to end. But I promise you, it will!

First off, let’s talk about how to deal with those annoying people who keep asking you if you’ve had that baby YET!?!? I recommend when they ask, you just send them this link, without any commentary. Repeat as often as necessary.

Second, if you’re not at your due date yet, it might be helpful to be mindful of the things that are still happening and developing in your baby.

Baby shoes on a calendar with due date marked

If you are one of the many people to go past your due date, remember that “due date” is more accurately called the EDD, or Estimated Date of Delivery. It’s just a ball park guess, and you could deliver much earlier or much later. The variation can be as much as 5 weeks!

It may help to refresh your knowledge of what, exactly, it means to be “at term” as well.

It can be tempting to schedule an induction. Just to get it over with and end the suspense (and the backache, and insomnia, and heartburn…) already! Think carefully about that, and about the risks and benefits of letting labor start on it’s own.

So what can you so when you’re going crazy sitting around waiting for your baby to be ready to be born? Here are 101 ideas!

And finally, I really love the perspective on the last days of pregnancy in this article. I hope that your last days can be a time where you are able to find rest, patience and connection with your baby.

Cartoon woman holding sign that says No Thanks, with cartoon doctor in the background

If you don’t want it, just say no!

Vaginal exams in pregnancyWarning: Rant ahead! I wrote this years ago – the original version was a little more, um…passionate. I’ve just now toned it down to where I feel comfortable posting it. Still pretty opinionated. This rant doesn’t apply in the least to moms who want exams and get them. This rant is about moms who feel bullied into an exam they don’t want.

So three times in three places in the last 24 hours I have had people ask “Can I say no to a vaginal exam?” or “I really hate vaginal exams and wish I could say no.”

Can I just say that it really disturbs me that we live in a culture where women do not even KNOW that they can control what happens to their bodies? That they even think they do not have the power to prevent someone from sticking fingers into their vagina?

When will girls be taught that they are in charge of their own bodies? So that they grow up into women who know they are in charge of their bodies? My girls definitely know that, but so many others are being taught otherwise. It makes me sad.

NO ONE, not a doctor, not a midwife, not your partner, NO ONE BUT YOU gets any say about what does – or does not – happen to your body. Anyone who thinks they can override mom’s control over her body is crossing a scary line.


Why they suggest it:

To satisfy curiosity

What it tells you:
It tells you where things are right now.

What it can tell you about the future:
Absolutely NOTHING. I’ve worked with moms who walked around 5+ cm dilated for weeks. I’ve worked with moms who were emotionally devastated because the cervix was closed, firm and posterior at a prenatal, only to have a spontaneous labor and happy baby in their arms less than 24 hours later. There is absolutely no evidence that exams in late pregnancy have any benefit or predictive value.

What you can do if you don’t want one:

Take someone else with you to your appointment, and have them come in the exam room with you. It’s easier to say no when someone has your back.

Keep your pants on. It’s harder to say no when you’ve already disrobed from the exam.

If you’d like to learn more about creating positive and collaborative communication with your care provider, you can enroll in my complete online and personal childbirth classes where I teach some helpful communication skills!

New mom depressed

When birth does not go as you’d hoped…

Speech bubbles with insensitive Comments

Can you think of anything worse to say to a mom who is opening up about feelings of disappointment or pain after a difficult birth? I can’t. The unsaid subtext mom hears goes something like this:

“Just be glad you have a healthy baby. Any other emotions you have don’t count. There is only one acceptable emotion to experience after having a baby and that’s pure happiness and joy. Anything else means you are doing it wrong.”

“A healthy baby is the ONLY thing that matters. You, as a mother, don’t matter. Any fear, pain, or helplessness you felt during your birth does not matter. You are unimportant, your experience is irrelevant, and you should get used to it.”

“I don’t know why you are upset, from what I can see, your birth was perfect and you are being unreasonable if you are unhappy about that!”

If I could help new moms understand just ONE thing about processing their birth experiences, it would be this:
You can feel pain or disappointment from your birth and be happy about your baby at the same time!

It is possible to be happy and disappointed at the same time. It is OK to experience BOTH joy and pain at the same time. Negative emotions do not invalidate the happiness and positivity of birth. Having a mix of emotions about your birth is very common and normal.

Your feelings about your birth do not have to be ALL happiness. You can be happy that your birth was amazing AND disappointed a little as well. You can be sad that your planned natural birth turned into a cesarean AND happy to be snuggling your healthy newborn. You can be happy about how your birth went AND sad that breastfeeding is a struggle. You can be thrilled that you were able to birth unmedicated AND struggle with how intense your precipitous labor was and how overwhelmed you felt.

Jen Shipston, from Queensland, Australia, wrote this about her most recent birth experience:

“When I was pregnant, I was informed, excited, confident and knew exactly what I wanted. I did everything I could to ensure a safe and happy birth. One of the things that was so very important to me was having the birth documented, something I’d also wanted with my second but that did not happen. I booked my photographer/videographer almost as quickly as I booked my midwife! The time came for my baby to arrive. I let my photographer know things had started, and kept her updated in the hours that followed. I called her when things were still quite slow and manageable, but not stopping, because she lived just over an hour away. 2 contractions later my waters broke, and my girl arrived beautifully, into my arms, in water – just as I’d wished for, 50 minutes later. 20 minutes before the photographer arrived. My birth was amazing but I was so disappointed to have missed having it documented. It seemed silly – I had an amazing birth, so something as insignificant as photos shouldn’t matter, right? But those photos/video were not insignificant to me, and I mourned…I can be disappointed about what didn’t go to plan while still being thrilled about my birth experience and completely besotted by my baby. Because that’s just how birth is.”

There’s no need to feel guilt over your feelings. Feelings are what they are.

Birth photographer and videographer Brooke Walsh, also a mom who experienced very mixed emotions about her birth that made it hard to talk about, shares what she’s learned:

“For most women, birth is a mix of glee and sorrow. It’s easy to feel that these divergent emotions don’t belong together, but they are perfectly valid. Somewhere in sifting through them we become better mothers, cognizant of the joy and hard work in our lives with our children as they grow, just as we found in birth. Being joyful about the beautiful moments in your birth does not tarnish the validity of the traumatic moments, nor does accepting and working through birth trauma remove the bliss from your baby’s birth. Sometimes birth is a mystery of divergent elements.”

You may find, though, that there are many in your life who are not willing to hear about how you feel. Hopefully you have someone in your life who will be willing to debrief and discuss with you. You can see if your midwife, doula, or childbirth educator can talk with you. Online, you may find the group Solace for Mothers to be helpful. This group was founded with the sole purpose of providing mothers with a place to work through emotions after a difficult birth.

Locally, I really like the women at The Healing Group for all kinds of support and help during the childbearing year.

I love this article, called “Making Peace With Your Birth Experience” by Kathleen Kendall-Tackett as a resource for helping moms process their birth experience.

If you are a friend, family member, doula, or lactation consultant wondering what you CAN do to help, here are some suggestions:

  1. Listen. JUST listen. Don’t tell mom what you think she could have done better, don’t try to find reasons for what happened, don’t try to make her feel better, don’t try to “focus on the positive” JUST LISTEN with full attention and some occasional reflective listening. Some moms might feel more comfortable talking if you work together on a talk like washing dishes or folding laundry rather than a face-to-face talk.
  2. If she needs to cry, let her cry. Don’t try to console her or make her stop, just hold her and comfort her while she cries.
  3. Don’t tell your birth stories. This is not about you. Your positive birth stories make it seem like you are trying to show you did it better, your difficult stories can turn into a “well I had it worse than you did!”
  4. Let her know you’re willing to listen again another time if she needs to talk. She may not be ready yet. She may need to talk more than once. Sometimes it takes moms a few times to process things. Sometimes they don’t get to the full depth of their experience the first time.
  5. Don’t tell her she can do better next time. While this is true, it does not help her process through THIS birth experience. A better birth next time will not erase this experience. When she’s ready to have another baby, then ask her if she’s open to suggestions.
  6. Don’t tell her to “focus on the positive” – instead allow her to process any negativity so she can move on. And SHE gets to decide when she’s processed enough, when she’s ready to move on.

Becoming a mom (or a mom again!) can be a difficult enough adjustment, let’s all gather around new moms and give them the freedom to feel and process their experiences without judgement, and with plenty of loving support.

Pregnant woman sitting in ocean waves

Surfing the Labor Waves

Surfing Lessons For Labor“You can’t stop the waves, but you can learn to surf”

This quote (attributed most commonly to Jon Kabat-Zinn but occasionally to others as well) has been commonly used to apply to labor. It is a good one, and one that definitely applies.

Last week my husband and I went to California to celebrate our anniversary. We spent a good hour watching the surfers in the wave.

The beach where we were sitting is in an area considered “advanced” and is dangerous for beginning surfers, so the surfers we watched were the more skilled and experienced surfers. As I watched, I noticed several things about their surfing, and this quote above came to mind. Here are seven of the things I observed (and yes, some of these metaphors are a bit mixed, but let’s just roll with it):

1. None of the surfers rode every wave. They didn’t even ride MOST of the waves. Often, they relaxed and let the waves roll on by without trying to take them on. In labor, particularly the first part of labor, much of labor is about letting the waves come and do their thing without inhibiting them or interrupting them. You don’t *have* to be active. You don’t have to get to standing and riding each and every time. You can relax and bob in the water and let the waves roll on by. Not all waves are alike. Some are small swells that crash too close to shore. Some are large, but collapse too early. Some have a perfect shape. The tides move in and out, but the waves are not always changing in a linear way. You can have 5 small ones in a row, followed by a large one, followed by 3 medium ones and then a much larger one. It’s all good, but you will deal with them differently.

2. While they are waiting for the next wave, they don’t usually spend energy swimming. They rest. Those times between contractions when you can rest are invaluable! And when the surfers rest, they rely on their surfboard to carry them. Laboring takes good support, too. Your partner, your doula, your family, or your midwife can all be the support you need. Most surfers don’t ever want to be apart from their board. They tether it to an ankle to keep it close. Keep your labor support close and connected, too.

3. The waves closer to shore feel safer, but the waves out in the deeper water are often easier to ride and give a better, longer ride. Don’t be afraid to “go deep” in your labor. Deeper into relaxation, so deep you pull your focus inward. Deeper into your own power and strength. I’ve seen many women pull power and strength from deep within that they didn’t even know they had.

4. When they did try to catch a wave for a ride, they often didn’t ever get up. Sometimes they spectacularly wiped out, sometimes they just missed it. And they never let it get to them. They let it go, regrouped, and waited for another try. Sometimes in labor you’ll feel like you can’t manage well. Don’t let it get to you. Let it go, regroup, and try another technique.

5. When they did catch a wave and get a good ride, they rode it for as long as they could. When in labor, when you find a good rhythm and a technique that is working for you, ride it out as long as it is working. I sometimes hear women advised to change every 20-30 minutes. I don’t think an arbitrary time limit serves moms well. If you are riding a wave and surfing well, keep it up until you need to change.

6. The rides never last forever. And when it is over, they head back out to start finding a wave all over again. If you find when you’re laboring that the swaying and moaning you’ve been doing are not working as well as they used to, find another wave to ride. It probably won’t be the very next one, though, so keep trying until you catch a good one.

7. Learning to surf can be a long process. Or a short one. It’s OK if you don’t master it early in the process. As a teenager, I tried and tried and tried to learn to surf. I mastered many parts of it. I could swim out past the breakers with my board. I could identify good waves to ride. I could straddle my board and wait, or lay on my board to rest. I could bring my knees up under me and orient myself to the waves. What I never, ever managed to do was hop up and get my feet under me to stand. Oh, I could do it on the shore, I did it probably a million times. But in the water? Wipeout every single time. But I kept trying. I went out two or three dozen times a summer, for hours at a time. I worked with lots of different people trying to learn. (Every single one of my boyfriends thought HE could be the one to inspire me to make a breakthrough!) But I never did master it and surf the way surfers are “supposed to” do it.
Labor WavesInstead I learned to enjoy and appreciate the parts I could do. Some of my best memories from high school are from those days. I loved being able to push through the breakers and feel strong for moving forward despite their power. I loved lying on my board resting and feeling the warm sun on my back. I loved laughing with friends as we all sat straddling our boards resting out past the waves. I really loved it when a seal would come and play in the waves nearby and I could sit on my board and watch. If I’d given up on surfing after my first try, I would have missed out on many of those good times.
And my many wipeouts taught me how to roll in the surf and not get hurt.

I firmly believe that nearly all labors and births can have those moments of joy. Those happy memories. And there are things to be learned if things don’t go as planned, too. Don’t let complications or changes in the plan take those moments from you. Look for them. Do what you can to make them happen.

Pregnant person with suitcase

Packing for labor

I know there are LOTS of lists out there for what to pack for labor, but I wanted to post my own. If you’re planning a hospital birth or a birth center birth, this list is for you! (One nice thing about home birth is you don’t need to pack…) You won’t need EVERYTHING on this list, but this will give you some good ideas to get you started!

Header saying "Labor Items" with blurred background image of packing a suitcase.
iPhone showing music playing in a hospital bed next to a person having a baby.

Music This can be a whole post of its own – and someday I will write it. Basically, make two playlists or Spotify lists: one for relaxing music and one for energizing music. You don’t need special music, chances are you already have plenty of music you like.


Lip Balm Bring several of these, because those little suckers tend to get lost during labor. Moms in labor tend to get dry lips and hospitals either won’t have anything you can use, or they’ll give you a small tube of Vaseline and charge you $20 for it.


Tennis Balls Or, if you prefer, racquetballs. As a professional, I prefer racquetballs for their ability to be sterilized between clients, but tennis balls work just as well for personal use. These can be used for a rolling massage on the lower back or pressed firmly into mom’s lower back for counter pressure if she is experiencing back labor.


Unscented oil/lotion Laboring women are really extra sensitive to smell, so I recommend unscented. You can always bring a scented *and* an unscented if you want to give the scented a try. Just have mom take a sniff before you slather it everywhere in case it is too much.


Massage Tools I wouldn’t recommend you go out and buy any, but if you have massage tools around the house that you like, go ahead and throw them in your bag. If they are the vibrating kind, make sure you have batteries – and spares – for them.


Warm socks It’s normal for women to feel cold feet in labor. Sometimes it is the figurative kind (I’ve heard lots of moms say “I don’t think I’m ready to be a mom!” in labor.), but here I am talking about the literal cold feet. Warm socks – several pair – are good to have on hand. The kind that have tread on the bottom to make it less slippery are good if you have them. Or bring slippers.


Food Moms are burning LOTS of calories in labor, and if you’re hungry, EAT. Researchers are proving that food and drink in labor are just fine. Here’s a great article on what kinds of foods are good in labor.


Dim light Sometimes it is hard to get nice dim light in a hospital, especially in the bathrooms. If you’d like to labor in the tub and have dim light, bring some battery operated candles or a smallish flashlight.


Birth Ball Many hospitals have these, but it can be nice to have your own for use in early labor at home, or in case the hospital’s ball is not available. Get a standard exercise ball, sized right for you. I recommend it should be the burst resistant kind, and one that can hold 500 pounds of force at minimum. (I *know* you don’t weigh that much. We’re talking about FORCE, not weight!)

Couple carrying pillows into the hospital for their birth.


Pillow You may or may not want to bring your own. Most hospitals have plenty. But if you’re super attached to your pillow (like I am!) you will want it in labor. If you tend to bring it (or wish you could bring it) when you travel, you’ll want to pack yours. But DON’T have it in a white pillow case! It would really be sad to have it get lost in the hospital linens. Anything but white or close to white!


Fan Some moms really like a small battery operated fan.


Cheat Sheets I always tell my classes “Labor is an open book exam!” It’s OK – and GOOD – to look at your reference materials. Bring any books you read, any handouts from a childbirth class, and have mom make a list of things she wants to try. I also really like the iBirth App and the book “Deliver!” for this.


Birth Plan If you created a written document, print out several copies and bring them. Neon paper is good and helps keep it from getting lost in the shuffle. Give to your nurse, post one on the wall, etc.


Flavors for ice If you’re restricted to ice chips, having something to flavor the ice chips and add a little calories can help. This can be juices, electrolyte drinks, etc. Just no caffeine!


Ziplock Bags I use these mostly for creating ice packs (fill with ice, seal, wrap in a towel) or hot packs (Get a towel soaking wet with the hottest water from the tub or shower and seal it up so it doesn’t drip. Wrap in a towel or gown.) Occasionally I’ve used it to seal up something smelly (like a tuna sandwich with pickles one dad brought!) so mom can’t smell it any more. I bring sandwich size and gallon size and I prefer the freezer kind. They’re tougher.


Band for long hair If you have long hair, you may want to put it up to get in the shower, bath, or just because you’re hot and sweaty. Even if you never wear it up, pack something so you have the option. Most women just use a pony tail holder, but you could bring a clip or a shower cap, too.


Hand mirror I can’t emphasize enough that it needs to be an UNBREAKABLE hand mirror! Some women really benefit from seeing the results of their pushing. This is why many hospitals provide mirrors. Unfortunately, some hospitals mount the mirror to the ceiling (so it only helps if mom is on her back) or they have a small mirror on a big pole. An unbreakable hand mirror can be used in ANY position and has a lot more flexibility. They are particularly useful when mom is squatting, kneeling, or standing to push.

Header saying "Toiletries" with blurred background image of packing a suitcase.



Toothbrush/toothpaste
Because that hairy feeling in your mouth is no fun. And because moms want their partner to have fresh breath!

Assorted toiletries packed in a travel bag


Hairbrush Because it can feel nice to brush your hair out and feel good. Some moms use hair brushing as a labor comfort technique, too.


Contact lens supplies & spare glasses While most hospitals won’t make mom remove contacts for birth, even with a cesarean, if they’re bothering her she’ll want to take them out. And backup glasses so she can still see baby clearly at birth if she takes them out.


Deodorant Remember what I said above about moms being extra sensitive to smell in labor? ’nuff said.


Spare clothes for both partners Labor can go long, it’s nice to have something fresh to change into when it has been 24 hours. Plus I’ve seen moms pull their fully clothed partner right into the shower with them, and then you REALLY want something else to wear! Some partners will bring a swimsuit in case mom wants him in the tub or shower with her.

Basically pack everything you would pack for a weekend getaway, for BOTH parents!

Header saying "Don't Forget" with blurred background image of packing a suitcase.

Camera Since I am also a birth photographer, clearly birth photos are something I value and I would hope most parents do, too. Don’t trust them to just your cell phone camera. Have a better camera on hand, along with spare batteries, a spare memory card, and a charger if it uses a special camera battery. Or just hire a birth photographer and leave it in the hands of a pro. (BONUS! When you have a pro, both parents can be in the photos!)

Close up photo of phone charger


Phone charger Or iPad charger, Kindle charger, or charger for whatever electronics you might be bringing to the birth room. You don’t want your phone to die just before you send out the “BABY IS HERE!” text!


A list of the people you want to remember to contact, so that no one gets forgotten. I would hope that families would cut new parents some slack, but I’ve seen a lot of pettiness over who gets called first, who gets a text and not a call, etc. etc.

Partner taking picture of mom and new baby

To tweet, or not to tweet? Social media during labor

Social Media Graphic

Most people would not dream of streaming their birth live on the internet or inviting strangers to be there as a piece of performance art. But just how public and immediate should your birth story be? With social media, it’s easy to have an audience of friends and family waiting for the minute by minute details. If you are thinking about posting your birth on Twitter or Facebook, here are some things to consider:


Who will see it? These days, not everyone you are “friends” with on Facebook is really someone you know. You have even less control over Twitter followers. Do you really want relative strangers knowing that you are away from your home and will be for quite some time? Do you want them knowing the current status of your cervix?


What will others do with the information? You can control what information you put out there. You cannot control what they do with it. I have seen family members show up to the birth – uninvited – after seeing on Facebook that mom was in labor. It got awkward since the parents did not want them there. While you might want to have people thinking of you and sharing your joy in real time, it also means they are waiting for a follow up. Once you put it “out there” that you are in labor, expect a large response of people calling/texting/posting wanting updates. It might make it difficult to focus on your labor.


What will you do with the responses you get back? Similarly, the responses you get may not always be supportive and positive. Some people have nothing better to do than to criticize the choices of those around them. I had one instance where mom was planning a home birth but when complications arose transferred to the hospital. Her husband had posted on Facebook hoping for support from friends and family but instead got responses like “Good! Home delivery is for pizza, not babies.” and “I told you that you’d never be able to do it naturally.” Both comments hurt the parents feeling deeply at a time when they were feeling scared and vulnerable about the change in plans. Might be a good idea to have someone else filter out the unhelpful comments you may receive back and only pass on the helpful stuff.


I urge you to think carefully about what you put out there on the internet. Sometimes staying off the radar until the big “It’s a GIRL!” or “He’s HERE!” announcement might be the wisest thing to do.

The Birth Plan of ACTION!!

You can find boatloads of information out there on birth plans. But most of them miss what I consider to be the most important part: Putting The Plan Into ACTION!

I consider there to be 4 steps in writing a birth plan:

  1. Researching your options
  2. Deciding what is important to you and what you want
  3. Writing the document
  4. Carrying out the plan

We will briefly go over the first three before discussing that fourth, often forgotten step.

STEP 1: Researching your options

There are the major choices like

  • Where to birth (home, birth center, hospital, WHICH birth center or hospital)
  • Who to hire as your care provider (Midwife, Family Physician, Obstetrician)
  • Hiring a doula
  • Whether to use pain medications or not

and more minor decisions like

  • Which music to listen to during labor
  • What to wear in labor
  • To tweet or not to tweet

Consider all your options and figure out the pros and cons of each.

STEP 2: Deciding what is important to you and what you want

Once all the facts are in, spend some time deciding what is most important to you and what you want. For some, birthing with a midwife might be more important than whether or not they hire a doula. For someone else, the doula might be more important than the place of birth. There is no one RIGHT answer to all of these options, only the right answer for YOU.

If there is something you do not have a strong opinion about, it does not need to be in your birth plan. Save the most important topics for your plan.

STEP 3: Writing the document

Does the thought of doing this make you cringe? That’s OK! You can totally skip this step if you want to! While having a written birth plan can be an excellent communication tool for the nursing staff, the document is not what birth planning is all about. Everyone has different planning styles. Some people like to just think about what they need to do that day when they shower in the morning. Some like to make a list on the back of an envelope (that’s me!) and some like to have color coded calendars. All are perfectly valid ways of planning.

If you want to just think about and discuss what you want, that’s plenty. And you can skip to step 4!

If you’re interested in a formal written birth plan, keep reading!

Some tips for a written birth plan:

  • Make it yours! Don’t do a checkoff plan from the internet. You are not ordering off a menu, and you want the written plan to accurately represent the time and consideration you’ve put into it.
  • Keep it to one page maximum! Bullet points are nice. This is where prioritizing is very important!
  • Keep it positive in your wording. Your aim is to enlist the staff’s help in achieving your goal, not to put off the staff with “NO this, NO that!” I like to suggest wording like “I plan to birth unmedicated and you can help me by encouraging me to stay active and suggesting techniques you think may help.” or “Since I am planning a HypnoBirth, I would appreciate it if you would chart “Patient declined” instead of asking me about my pain levels during labor.”
  • Address any non-birth related issues that you think might be helpful. I have had clients use the written birth plan to remind the nursing staff about Latex or iodine allergies, request a special diet, and inform the nurse how to best communicate with a client who was deaf and needed to lip read in order to understand the nurse.

Step 4: Carrying out the plan

THIS is where most birth plans fall apart, in my experience. Just like browsing Pinterest for 600 hours won’t get you the wedding of your dreams, writing the document without doing anything to make it happen won’t increase your chance of getting the birth that you want.

Some important things you can do to carry out your plan:

Laboring mom’s best friend providing great active support.
  • Choose a birth place that does births similar to what you want on a regular basis. I have had many friends and neighbors choose to go to the hospital close by, just because it is close. They plan for and want a natural birth, but they have chosen to birth in a place with very high induction, epidural and cesarean rates. And (not surprisingly) they have a very high chance of being induced, getting an epidural, or having a cesarean.
  • Choose a care provider who practices in the way that you hope to birth. A perfect example of this is episiotomy rates. I have yet to meet a pregnant woman who wants an episiotomy, so they often discuss it with their doctor or midwife. Invariably, they get the response “I only do them when necessary” so they feel good about that – but they don’t realize that everyone’s idea of “necessary” is very, very different. I’ve known providers who do 1-2 a year, and I once heard a doctor say that his idea of necessary was “every first time mom needs one, and every mom who had one before needs another one.” Dig deeper. Ask how often they do one, ask if they think you will need one, ask how they can help you not need one. But look closely at the care providers you are considering, and don’t be afraid to change in order to get care that is compatible with your values!
  • Take a GOOD childbirth class, actually go, and PRACTICE what you learn! I’ve had moms tell me they only went to 2 of the 5 classes, never practiced a thing, and then be disappointed that hypnosis “didn’t work” at all. Practice will help you to master the techniques before you need them.
  • Build a birth support team that will build you up and help you reach your goal. Choose carefully who will attend your birth. I hope you’ll choose to hire a professional doula (maybe even me? :)) and bring others who are supportive of your goal. If your mother thinks the natural birth you’ve planned is a stupid idea, you probably don’t want her fretting in the corner about how hard it is to watch you in pain (been there, seen that!). If your sister thinks epidurals are an anti-woman plot by the paternalistic misogynistic health care system, and you plan to use an epidural, maybe she should wait out in the waiting room. (Also been there, seen that!) You deserve to be surrounded by supportive, helpful people, not Debbie Downers!

So you’ve gone through all four steps, and your Birth Day is finally here! Will it all go exactly as planned? Not too likely. Keep in mind that life rarely goes exactly as planned, and birth is no different. If things do happen and you have to adapt your plan, that’s OK. It does not mean you need to give up EVERY aspect of your plan, it just means you have to improvise a little. Writing a birth plan is not writing a script, but rather a process to help you get the birth you wanted. Staying in the game as an active decision maker is an important part of having a birth experience you can remember as a good experience, and that is possible in just about any type of birth experience.

If you want to learn more about birth planning, and get my downloadable birth planning templates, you can sign up for my Birth Connected Childbirth classes, with online learning and personal support, or just sign up for the Birth Planning module.

Letter for labor partners, with partner providing hip pressure in background

Open letter to family supporting laboring moms

This letter was one I wrote to my brother-in-law when my sister was expecting her first baby over a decade ago. I recently found it saved on my computer and thought it would make an excellent blog post. It has tips that would help just about any friend or family member supporting a laboring mom as well. I’m posting it below without any editing.

Dear Jared-

I know you’re not the one birthing, but I feel pretty strongly that childbirth classes are for the dads as much as – if not more than – for the mom. After all, when she goes into labor, who is she going to turn to first? YOU. And so it is important for YOU to learn how to cope with labor as well. She will not likely be thinking rationally and logically in labor, so you will be the one to think of what to try next and how to help.

So I thought I’d write up my very own “Top Ten Ways to help a Laboring Woman” just for you.

Dad smiling while supporting mom
Not my brother in law, but this dad was an amazing birth partner!

10. Bring with you everything you’d pack for a quick overnight stay – toothbrush & paste, deodorant, change of clothes. Labor can be long, and laboring women are highly sensitive to smell. Plus, sometimes moms will pull a dad into the shower with them, or the mom’s water will break and they’ll be in the way, or something like that. It’s nice to have a change of clothes.

9. Keep an eye out to help her stay modest. Sometimes the nurses & doctors are not the greatest at making sure moms are covered up again after exams, etc. Or they leave the door open and the curtain pushed aside. Knowing her, she’ll appreciate it if you help with those things.

8. Try to stay calm. She’ll pick up on your tone, and she doesn’t need added stress from you. If you’re feeling anxious, talk to a nurse, the doctor, or even call me, anytime.

7. She’s queen of the room. If she wants the lights off – they are off. If she wants the TV off, it’s off. If she wants it on, SHE picks the channel. Even if it is Super Bowl Sunday, and she wants to watch Trading Spaces or something else.

6. Don’t rush her. Ignore the clock. Don’t complain about how long it is taking, how tired you are, or make predictions about when baby will come. Don’t go to the hospital too soon – it won’t make baby come faster. The time to go to the hospital is when she feels there isn’t time for a shower on the way.

5. Pay attention to the MOM, not the monitor! Too many dads make the bonehead mistake of saying “Honey, you’re having a contraction now!” when mom is struggling to cope. Or “This one doesn’t look like much on the monitor, why are you moaning for such a little one?” Or my favorite – one I’ve heard several dads say “Wow! This one’s off the charts! Does it hurt really bad?”

4. Take care of yourself – bring foods you can eat quickly and that won’t leave much smell behind. Scarf a granola bar while she’s in the bathroom, etc. Time bathroom trips so she’s not alone during a contraction.

Dad holding mom in a dangling squat during labor3. Follow her lead. If she’s laughing and cracking jokes herself – it is OK for you to do it, too. If she’s quiet and serious, you should be too.

2. Stay positive. Tell her she is doing well, even if you’re not so sure. Help her stay focused on the fact there is a baby coming. As unbelievable as it sounds, many women forget the whole point. Reminding her that soon she’ll be holding Vale, soon she can count fingers & toes, etc. can be very helpful.

1. Stay close to her. Be within arms reach as much as possible. This is especially important if she chooses to have an epidural. Many women feel abandoned after the epidural, as everyone tends to back off once she isn’t as needy. Affection & love go a long way to making a woman feel supported in labor, and that’s something only YOU can provide. The nurses, doctor, even a doula cannot do that for a laboring mom.

I hope this is helpful. I mean it when I say you can call me any time. I’ve included in this package a book that I think you should read. It is one specifically meant for birth partners. If you don’t crack any of the other books, read that one!

Call or e-mail me with any questions.

Andrea

Pregnant person talking with doctor

The Culture of Risk

“It’s just not worth the risk”
“I don’t want to expose my baby to ANY risk!”
“I’m not comfortable with any risks”

I hear these comments, and others like it, all the time. Unfortunately, they’re just not realistic. Risk is all around us, and it’s an unavoidable part of life. But in this culture of fear mongering and attention grabbing headlines, it can be hard to thin calmlu and realistically about risk.

Here are some ideas for ways you can check the anxiety about risk and think clearly:

Give up on the idea of avoiding risk and shift to thinking about minimizing risk. This can be much harder said than done, but shifting away from a knee-jerk running away from something someone says is risky can be very freeing. Otherwise you’re living in fear and ping-ponging your way around life at the mercy of headline writers. Sometimes you need to decide what level and type of risk you are okay with.

In addition to the risk of doing a thing, consider the risks of NOT doing the thing. I’ll use induction as an example. While I absolutely believe that in most cases waiting for labor to begin on its own is best, there are definitely times when choosing induction is the safe route. I have seen families so afraid of the risks of induction they let complications get quite scary before they were willing to choose induction. The end result was that the baby was exposed to much more risk.

Make sure you’re looking at absolute risk, not relative risk. In an effort to draw attention to their work, study authors and people writing articles about studies have a tendency to report the results in the most dramatic way possible. Headlines that scream things like “DOUBLES THE RISK!” etc can be very misleading. For example, people commonly hear that waiting for labor to begin past 41 weeks has (cue scary music) double the risk of stillbirth than when babies are born earlier in pregnancy. The rate of stillbirth is very low in either case, going from .004% to .006%. So *technically* it does go up, but the absolute risk isn’t changed much.

Make sure that you’re not comparing apples and oranges. Let’s take another look at the example above. If you are 41 weeks and trying to decide about induction, the risk of stillbirth at 40 weeks is totally irrelevant. Delivering at 40 weeks is no longer an option. When you’re evaluating the risks to make a decision, what you need to consider is not the risk of delivering at 40 weeks vs 41 weeks. What’s relevant is the risk of induction now compared to the risk of waiting for spontaneous labor. The only risks that matter are the comparative risks of the options available to you.

It can feel very overwhelming trying to figure out what’s safest for you and your baby. I hope these tips are helpful as you try to navigate the information out there. A trusted care provider who has a practice style similar to your birth plan can also help you navigate it.

Wednesday Wrap Up January 20

WednesdayWrapUpAThis is so true, and something I have tried to convey to the women I work with. If you don’t like the care, and it’s not a good fit for what you want, move on. Take your health care dollars elsewhere!

Maybe I loved this so much because I can relate, but I really appreciated how this letter to the bloggers and writers who want to feature birth photography addressed the issues we face as birth photographers. I’ve been there, and it’s not fun.

There is some irony in the fact that this article is published….on the internet. But it’s a good one anyway: 4 Things You Can’t Learn About Birth On The Internet

I have explained this to so many parents, it’s a ridiculous conundrum. Why Most Private Practice IBCLCs Don’t Take Insurance (Hint: Probably better phrased as “How Most Insurance Companies Get Out of Paying for Mandated Breastfeeding Services”)

Great overview of why cesarean rates are high, and how they can be lowered. I found it really interesting to see what step had the biggest impact in this pilot program in Southern California.

Newborn looking at mom after birth

My favorite moment at births

There are many things I love about births. I love seeing women be strong and powerful. I love seeing the relationships between partners and the way partners step up and provide just what is needed, or say just the right thing at just the right moment. I love the humorous moments – and a time or two the parents and I have had an inside joke by the end of the birth.

But there’s one thing that I see almost every time, and it gets to me every single time. Not unusual for me to have the tears start welling up at that moment. It’s that moment when a parent makes eye contact with their baby for the very first time.

Newborn looking at mom after birth

Often that sweet moment comes soon after birth, when mom is snuggling that baby skin to skin and baby lifts their head up to look at mom eye-to-eye. Often there will be sweet words for the baby “Oh how I love you already!” or “Hi, I’m your mommy and I love you fiercely!” are two from recent memory.

Generally a little while later comes the moment when the other parent gets a chance to hold baby close and stare into their eyes. This sweet little girl even reached up to touch her mama’s cheek!

Newborn touching mama's cheek

I’ve loved and appreciated these moments throughout my entire doula career, but it’s only in the last few years when I’ve been doing birth photography that I’ve been able to capture them and share them with the families I serve. I hope you enjoy this collection.

Venn diagram of the three kinds of birth doulas

There’s more than 1 kind of birth doula?

Venn diagram of the three kinds of birth doulasIt’s been at least a decade since I first heard of the concept of birth doulas with different ways of looking at the job, and it has been an interesting concept to consider as I’ve come to know other doulas and mentor new doulas just starting it. I feel it can be a useful concept for parents considering which doula can best help them meet their goals as well.

At some point in the first 2-3 years of being a birth doula, I took a little quiz that categorized doulas into three types:

Birth focused – These doulas were focused on helping moms have the kind of birth that they felt was the best. They are the ones who are advocating for all low risk women to birth at home, for midwifery to be the standard of care unless higher level care is needed, and who have in mind an ideal birth they’d like to help their clients achieve. They tend to be huge fans of birth plans and often align themselves with specific methods of childbirth. Some doulas who have this philosophy will work only with out of hospital birth, and many go on to become home birth midwives.

Baby focused – These are the doulas who view everything about birth through the lens of the impact on the baby. They tend to be attracted to the work of APPPAH, to encourage mothers to talk to their babies and to be huge proponents of skin to skin bonding and breastfeeding. Many doulas who philosophically fall in this area tend to be very much against circumcision, routine newborn procedures, and formula. They can be passionate and valuable advocates and supporters of moms who have similar philosophies.

Woman focused – These are doulas who are most concerned with mothers feeling supported in their decisions and having the power and right to make decisions for themselves. They have an easier time supporting moms who make decisions that they may not have made for themselves. They tend to work in homes, hospitals and birth centers somewhat equally, and can support women planning everything from a planned cesarean birth to an induction with epidural to a home waterbirth or lotus birth.

Now these three types of philosophies are not at all mutually exclusive, nor are they unchanging and constant. As doulas learn, grow, and see more births, their thinking often changes. I would say that when I started out, I was definitely more birth focused, but over time I have become more woman focused, though I still do have quite a bit of overlap between the two with some baby focus thrown in there for balance. I feel pretty passionately that there is not any ONE way of giving birth that is “correct” for everyone, and I firmly believe parents have the right – and should be trusted – to choose what is best for their family.

Want to take the quiz for yourself? You can find it here: What Kind of Advocate Are You?

I don’t think that any one focus of a doula is necessarily any better than any other, but I do think it is important for parents to consider if the doula they are interviewing has a focus that is a good match for them. Most doulas will (like me) have quite a bit of overlap, but often there is one area that is more passionate for them, and it sure comes out when doulas talk about what drives their work and motivates them to do this job. You’ll hear it in their tone of voice, in the fire in their eyes, and in the power of their words.

One thing to watch out for is the doula that ProDoula founder Randy Patterson calls the “Birth Avenger” style of doula work. I’ve seen many times that new doulas come to this job because they had a horrible birth experience and they want to “save others from what happened to them” – this can create a really difficult situation when the doula has not processed and resolved her difficult birth experience. I’ve heard from a doula that she had to leave in the middle of a client’s birth because “she was going down the same road I did and I could not stick around for the train wreck” that she believed was coming. It was her last birth as a doula, she dropped all her remaining clients and left the field. I’m sure the client felt abandoned at a vulnerable time as well.

I’ve counseled doulas who were retraumatized by attending births at the hospital where they delivered – even if all went well.

Let me be clear here: Having experienced birth trauma does not mean a woman can never be a doula. It does mean she should do whatever it takes to process and heal from her birth trauma before attending other women’s birth. It may mean she sets boundaries such as not working with a specific place of birth or provider, too.

Being aware of what drives a doula philosophically is an important thing when practicing as a doula or when choosing which doula to hire. Not all doulas are alike, and find a good match in style, philosophy and personality is crucial for a good working relationship with your doula.