Your Partner's Role During Your Birth

My role (your doula) is NOT to replace your partner. Their role is critical in pregnancy, birth, and post-partum time. Birth can be confusing to partners. First, they are watching the person they love most in this world go through something that they can't "fix," and that alone can be a challenging place for them to be. They want to fix it, and they don't know how. More importantly, this is not something they can improve or need fixing. This is something that you both go through together. A doula can help you both.

Taking a childbirth education class should be on the list. The more you understand physiological birth, the better you will be. We fear what we don't understand, which helps us prepare and navigate the journey a little easier. Let's talk energy. The energy of the room is something that you have control over. One of the most important things that we can remember is that there are many things about birth that we can't control, but let's wrap our arms around the things that we can control and that birth space is something that you can protect. If your partner understands birth, it will be easier for them to support you. Birthing people tend to like a more tranquil environment. For example, if you are in the middle of a contraction occurring during active labor, that is the time for everyone in the room to honor what you are working through. Keeping people from asking questions etc., during this time is helpful. Allowing space for quiet when you need it is critical.

Breath. I can't tell you how important this is. Your breath pattern has the power to regulate the nervous system. Breathing techniques are one of the many things I have taught my kids as soon as I knew they could use them. Labor can be a time of excitement and anxiety, so knowing how to support you with breathing is very helpful. Here is another thing that may help you. Reminding you how to breathe and the pattern that will best serve you is valuable. If we bring the focus back to the breath, we aren't as focused on fear or pain. Your partner can breathe with you, count for you, and remind you to return to the essential breath. Using the breath in the birth space creates space in your core canister, precisely what your baby needs to move down. I'll let you in on a little secret, the unsung hero of breathwork is in the exhale. You can learn more about breathing from one of my breath classes here.

Hydration. This is a tool that can be used in many ways. Hydrotherapy can be great for active labor. I will say this if you want a waterbirth, even better. This is only for some, but it is a great option. The tub promotes relaxation, and labor tends to be a little easier when the body is relaxed. The other critical element is that we NEED you to drink water throughout your labor. I like people to pee at least every hour, and people often forget when they are in labor. One of your partner's primary goals should be to ensure that you are drinking enough water and that they remind you to go to the restroom. If your bladder is full, your baby can't move down, so it's essential to empty the bladder throughout.

Encouragement. This is important. Never underestimate the ability to be encouraged. We need to hear this during this process. We need to hear at that moment when we sometimes doubt ourselves that you are there telling us that we are doing a fantastic job. That we CAN (because you absolutely can) continue. Never underestimate the power of vocal support from your partner. Here's the thing, you know them best, what motivates them, and what doesn't, so hearing your voice is very helpful. Reminding the birthing person that they are strong and amazing is beneficial.

Advocacy. Your partner knows your birth goals; if they don't, make sure they do. They can also act as a filter, meaning only some can access you. They have the power to help control the room to ensure that you only need to focus on birthing your baby. They know you best, and helping you communicate what is important to you is a critical piece of support. You both should have conversations about your wishes so that they are comfortable saying what your desires are and making sure that you feel heard and supported by everyone in that room.

A doula can help with all of this. I have seen all situations. I have seen the partner who is super excited to be fully involved with the birth, and then they get into the room and freeze. They also need support. I have seen a partner saying, I'm so glad we have a doula because I want to be in the room, but I am nervous, and then they are all hands on deck. As your doula, I support both of you. We are a team and work together to support you in whatever YOU need. You can do this! I would be honored to walk with you through this journey and support your family in the ways you wish and deserve.

XOXO-Holly

Induction

I’ve heard all the reasons why providers want to do an induction. Some are necessary and some are just for convenience, Let’s go through a couple of them. I have heard providers tell people that their baby is going to be big, that their provider is going to be on vacation, and in some cases, people elect for induction because they are tired of being pregnant. That being said, there are some very real reasons for induction. A few of those are preeclampsia, fetal growth restriction, RH incompatibility, 42 weeks past guess date, Oligohydramnios (not enough amniotic fluid). There are many reasons why an induction could be necessary, but what I want you to understand more than that is the process, and that it can take days. Yes, days. I have actually heard providers tell their patients that they will meet their baby much sooner with an induction, and I am here to tell you that in most cases, that is not true. It’s a process.

Let’s talk more about the process, and what to expect. First, you need to understand that induction and actual labor are two separate events. They are not one and the same. The first step is to ripen (soften) the cervix. This is done by using Cervidil or Cytotec. This process can be taken orally or vaginally. The usual dose is 50mcg orally or 25mcg vaginally, and can be repeated every 4 hours if contractions are absent or not painful. In other instances, a small tube (catheter) with an inflatable balloon on the end is inserted into the cervix. Filling the balloon with saline and resting it against the inside of the cervix helps ripen the cervix. Once your cervix is sufficiently relaxed or dilated, your provider will begin the second step. This usually involves stimulating the body to produce contractions if they have not started on their own. A medication called Pitocin is used to stimulate contractions. This is usually administered through an IV drip, and they begin with a small dose, and this can be gradually increased until contractions are strong and frequent. Unless your pregnancy has been diagnosed as high risk, you will be able to eat and move throughout this process, however, monitoring is consistent throughout this process. Once the Pitocin has begun to contract the uterus, sometimes your body will take over and they are able to shut the Pitocin off, and other times it increased at steady intervals usually every 30-60 min. This is when we are dilating the cervix.

There are risks associated with induction, however, as in most hospital interventions, the benefit can outweigh the risk depending on your individual situation. Some of the risks can be a failed induction. According to Mayo Clinic, about 75% of inductions are successful vaginal births, and the remaining 25% result in a c-section. We could see a low fetal heart rate from the medications used during the induction. There is a rare but serious complication of uterine rupture, and lastly the risk of more serious bleeding which usually occurs due to the medications.

I have been seeing inductions suggested much more than I have seen in the past, and I think people need to be aware of how it is done, and some of the risks that could be involved. More often than not I am seeing inductions suggested with not enough clarity and understanding. It is a process, and a process that can sometimes be beneficial to both the birthing person and the baby, just make sure to ask all of the questions and understand that induction is not easier or shorter. It is sometimes being sold as a quick fix, and honestly, there is nothing quick about it.

Here are a few questions to ask if your provider suggests an induction.

1. Why do I need an induction of labor?

2. When is my due date?

3. Do we have other alternatives, including waiting?

4. What percentage of patients in your practice are induced?

5. How will an induction change my birth plan?

6. When are you wanting to induce?

7. What will you be using to induce?

8. What is my Bishop Score?

9. What are my options if it isn’t working or progressing?

10. What are the risks?

I think that if an individual goes into any medical procedure with our questions answered, and being heard, we will feel a lot more confident and trusting. Remember an induction is not a guarantee to C-section. I have been at many inductions that ended in a vaginal delivery. I just want to make sure that you understand the process and know how to get answers.

XoXO-HOlly

Use Your Voice.......

I want to let you know how important your voice is during your pregnancy and postpartum time. I feel like this is a little known tool that holds immense power. I can’t tell you the number of times that I will be talking with a client, and I will hear, “I didn’t know that I could say that.” Here’s the thing. YOU ARE IN CHARGE. That’s right, let me say that again. You are in charge of your body, your birth, and your care. I think that in this culture we are taught from a very young age to not question any type of authority, especially as women. Here is thing, if you don’t advocate for yourself, no one else will.

Picture this. You have been very clear with your provider, your partner, and your birth team that you are requesting an unmedicated birth. You are not high risk. You have taken your childbirth education. You have created your birth plan. It has all been made very clear. Imagine you now arrive at your birthing place. You have again stated your wishes, yet you are being constantly asked about an epidural, or other medications that can be used for pain during birth. You are in labor, you are uncomfortable, and you are using all of things that you have learned to cope. That one question about pain medication will continue to throw you out of your rhythm. It is ok to say no. It is ok to ask them to not ask you about pain medication again. It is even ok to request that you get a new nurse. Yep, all of that is ok. Now, I’m not suggesting that this be done in a disrespectful way, however, asking that you receive a new nurse is perfectly acceptable. It is ok to ask for a new provider all together DURING your birth. This is your right. You do not need permission to feel safe, heard and respected during your birth. And yes, I have seen this done before.

Now picture this. You are 38 weeks, and headed in to one of your last pre natal appointments with your provider. They would like to do a cervical check “to see where you are in relation to dilation. You have an otherwise healthy pregnancy marked with nothing out of the ordinary. Baby sounds good, birthing person’s vitals look good. Do you need to have a cervical check? Well, that depends. Do YOU want one? Again, perfectly ok to say no thank you. Same for a membrane sweep. During Covid, I will say that I am seeing more and more providers suggest a membrane sweep if for no other reason than “to get things going.” In my experience, I have seen this work about 50% of the time, but make no mistake…it is a way to induce labor. Again, you may decline. If something is explained to you that you do not understand, you should and can question it. Ask for clarity and understanding. Don’t feel bad. Think about it this way, if you are at work and someone asks you a question in regards to something they don’t understand. You answer them, and try to have a conversation about it. This should happen with your care team as well.

This also goes for things in regards to your baby after birth. If all is well with baby, testing can wait. You can enjoy and get to know your baby, begin to breast feed if that is your choice, decline eye ointment. All of these things are within your control. You just need to know that it IS in your power to use your voice to let your care team know what your preferences are. You are not at their mercy. Do not be afraid. ASK!

I say all of this not so that you enter your birth in a combative environment, but so that you feel empowered to get answers that you need in order to make the best choices for you and your family. I often hear my clients say that they don’t want to bother their provider with what they are afraid is a silly question. Let me say this loud and clear. THERE ARE NO SILLY QUESTIONS WHEN IT COMES TO YOUR BIRTH AND YOUR BABY. Read that again. It is their job to answer your questions, and to make sure that you feel heard. That is their job. This is what they signed up for. This is their job description. To take the call in the middle of the night. To answer your questions when they are asked. To make sure that you feel heard. If for one second that is not happening, it may be time to switch providers. This can be done up until the very end of your journey. Don’t feel trapped. You have choices.

At the end of the day, we all want a healthy birthing person and baby. Plain and simple. You owe it to yourself, and to your baby. Don’t allow fear, and misinformation be your guiding principles. Listen to your gut. I have learned that 99.9% of the time it is right. YOU know your body and your baby. That is powerful. That makes you the perfect advocate. May you have a healthy and safe pregnancy, which is guided with what you need to make the best choices for your family. You’ve got this. I believe in you!