What type of birth needs a doula?

I can’t tell you how many times I get asked this question, or I hear comments like “I don’t need a doula, I have a midwife.” The other comment that I hear all the time is that “my OB told me I don’t need a doula.” That right there should be a red flag. I think we should start talking about what a doula does and does not do, and how they differ from a midwife. Then we can uncover what types of births need a doula.

A doula provides physical, emotional and informational support to a birthing person before, during and after childbirth. We don ‘t catch babies. We don’t perform any medical procedures, or give medical advice. Here’s what would be important to me if I were looking for a doula. I would want someone that is familiar with positioning, comfort measures and has been present for a variety of birthing environments. What I mean by environments, home birth, hospital, birth center. I would also want someone who was connected in the birth community and had a strong list of referrals should I need something that would be out of scope for a doula. Most of all, I would look for connection. I would want someone with childbirth education, however, that being said, the certifications in the world are NOT a stand in for how this person make you feel, do you trust them? I would also want someone who provided more than one postpartum appointment. One in the first week after delivery and one around 6 weeks post partum. A lot can happen and change, and I would want the support.

Let’s take a look at what midwives do. A midwife is a health care professional. They may preform gynecological exams, write prescriptions, provide medical care during and after labor and delivery, preform fetal monitoring. A midwife is medically trained and qualified to deliver babies. The role of doula and midwife are different. A midwife does not usually stay with the birthing person for the entirety of their labor, a doula does.

So….let’s get to the question at hand! What type of birth needs a doula? ALL BIRTHS. Let’s list some scenarios. Waterbirth. Hospital birth. Birth Center. VBAC. Scheduled C-section. Epidural. All natural. ALL of these types of births would benefit from a doula. All of them. As we know, birth is unpredictable, and with that can bring anxiety, confusion, doubt. Here is where your doula can help. Your goals should be their goals. Period. Most people find themselves saying that all they want is a healthy baby, and while this is 100% true, there is more to than that. What if we could envision a birth that is not only safe, but also where you feel supported, heard, and empowered? Wouldn’t that be the most ideal situation? One of the biggest benefits of a doula is having someone who is your corner during one of the biggest and most important moments of your life. What’s more, evidence supports this. Birth outcomes are better. Doulas understand how health systems work, how OBS and midwifes work, and how to help you advocate for yourself. They shouldn’t speak for you, but help you understand and navigate the process.

So, in my opinion, all births need a doula. Remember, someone that you trust. Someone that you trust as the eyes and ears of your birthing space. That is what matters. All the certifications in the world will make no difference if you don’t trust this person. I am lucky, I have been invited into the moments that matter, and that is a true honor, and great responsibility. I am there to support, educate, and be a non judgmental support. Look for those things, and you won’t regret it. Again, there is no specific “kind” of birth that needs a doula, I really believe that ALL BIRTHS can benefit from a doula. I love this work, and just remember you can do hard things, and you are entitled to a safe birthing environment, where you feel heard, AND EMPOWERED. Birth is amazing, and you can do it!

What you need to know about your pelvic floor.......

Here is the most common thing that I hear pregnant people tell me about their pelvic floor. “ I have been doing my kegals so I’m fine there.” No. No you are not fine. The biggest thing that you can do for your body and your baby is understand the physiology of birth and their body. Kegals are not enough. We need to understand the impact of exercise on pregnancy, what works and what doesn’t. Here’s a little secret. Breathwork. Diet. Those things also impact our pelvic floor.

A lot of people talk about the fact that after they have a baby, they pee their pants a little when they sneeze or cough. I have had client’s that mention this to their provider, and they are met with comments like, “well you just had a baby. That’s common.” Here is what I want you to know, common does not mean normal. 25% of women have pelvic floor dysfunction, and many are just accepting that. You don’t have to. The very first thing that I recommend to my clients that they work with a pelvic floor physical therapist. There is so much that they can do to help this. Here’s a list of some tips and tricks for in the mean time.

• Avoid bladder irritants. Things like alcohol, chocolate, apple juice. The other thing that i suggest is that you keep a bladder journal for a few days. What we put in our body matters, and certain things irritate us, often times we just don’t pay attention.

• Don’t hover over the toilet seat. If you need to put some toilet paper down on the seat, but don’t hover.

• Don’t “just in case”. I think we are all taught to do this, and and it’s not great for your pelvic floor.

Simple breathwork can also help with your pelvic floor. Below are some of my favorites, but here is what I hear all the time. “This doesn’t feel like I am doing anything.” Trust me. You are. There are exercise’s that build strength, and remind our body to function properly, and that is exactly what breath work does. Here is one of my favorite’s.

• Find a comfortable seated position. Posture is important here as well. This means sitting upright on your sit bones, not back on your tailbone, and keep your back straight. You can sit on the edge of a solid chair, or kneel, or sit cross legged on the floor. You can use a bolster or a cushion under your bottom for support and to help you to sit up on your sit bones. Place your hands on your ribs, breathe in, fill your lungs, and let your rib cage expand. Then exhale, emptying your lungs, while drawing your belly button gently back towards your spine. Keep your shoulders down and your neck relaxed. Your tailbone should NOT tuck under, and try to keep your butt unclenched.

Diet. This is a big one. Everything that we put in our body matters. Insert eye roll here, but hear me out. I get it, life is busy and sometimes grabbing what is most convenient is processed food. Don ‘t do it. You will feel so much better if you eat the rainbow. Diets that are high in fruits and vegetables will serve your body best. It’s hard for me too. If you need a jump start, order a two or three day meal delivery service. Once your begin to feed your body in this way, it will crave it. My personal favorite jumpstart is SAKARA. It is perfect, comes right to your door, and is a plant based diet to jumpstart your healthy eating. The best thing about it is that they also have a digital magazine called S LIFE which will help you to eat healthy after the meals are gone. It’s the answer, I swear to you.

The biggest piece of advice that I can give here is SEE A PELVIC FLOOR PHYSICAL THERAPIST. Don’t wait. Don’t assume that you just have to live with and accept some of things that we are told are common. Just remember, just because something is common, does not mean that it is normal. Your bladder ad pelvic floor will thank you.

Food As Medicene..........

It is no secret that many cultures utilize food as medicine. In this country we are not as good at that principal. There is no other time like the present to be aware of what we are putting in our body. You are growing a human, so it is safe to say that it there are foods that are great for growing a baby, and some that are not. About 80% of your immune system resides in your gut, and what you eat directly impacts your gut. Digestive and immune health have never been more important.

My go to Food/health and wellness practitioners are Lily Nichols who is the author of Real Food for Pregnancy, Dr. Aviva Romm, and the wellness brand Sakara. People on this planet have relied on food for healing, nourishment and energy, but taking a look at how that is impacting the body is something that this culture has not valued until recently. We skip meals. We knowingly eat over processed food not thinking about how it impacts our microbiome. We skip meals. We don’t read labels, and if we do, we typically have not idea what they actually mean. Think about when we become pregnant our meals, and everything that we consume comes under instant fire. We are either told to go ahead and eat anything in sight because we are “eating for two” which by the way is the dumbest advice ever, or we are constantly watched and told that everything that we eat is bad for the baby. The problem? We don’t really understand how it all works. I have spent a lifetime fighting damaging food relationships, and I feel like I have finally found some resources that use science, and is not confusing and boring. Let me break down my favorites, what they are about, and why you need to visit these sites, buy the books, listen to the podcasts and understand how imperative this knowledge is and how making changes isn’t going to be as hard as you think.

• SAKARA: This is my favorite Lifestyle company around. Here’s why. It has changed how I eat, nourish my body, and take care of the single most important person in my house. Me. Now, I know that might sound a little egotistical, but stay with me. I have three children, a husband, and a gigantic Golden Retriever puppy (70 IBS at 7 months). If I have brain fog, exhaustion, energy issues, it really does come down to how I am taking care of myself. If I’m down…..I have a lot of people relying on me to take care of them, and I can’t do it if I’m not well. I used to grab what I could, eat whatever was lying around. I was exhausted, crabby and felt awful. I started listening to their podcast, and was hooked. There is no calorie counting, just real clean eating and they offer three or five day meal delivery. It is the best and easiest way to nourish your body. They focus on the their nine pillars of nutrition which are things like eat the rainbow, body intelligence, nutrient density, and it’s backed by science. I always tell my clients, even if you just do the three day meal plan for one week postpartum, you will be giving yourself the best food that you possibly can, and will not have any hassle in figuring out what to eat. The Prenatal Vitamin is curated to support all stages of pregnancy, is clean, plant-based, medical grade and doctor formulated. Use my code XOHOLLY for 20% off your first order. You’ll thank me later, I promise!

• Lily Nichols book Real Food For Pregnancy is an absolute godsend. There is no obsessive calorie counting or portion control on the menu. Just evidence based on science, and you all know that I am a big fan of that! This book is the missing peice. Lily breaks down the complicated science of food that we all roll our eyes at, and presents the information in a easy to apply change your life kind of way. It really is the most comprehensive nutrition book for pregnancy available. Giving you recipes and explaining what “Real Food” is and how use the information to nurture our body. “Real Food is as close to it’s source as possible and grown or raised in conditions that maximize nutrient density.” (Lily Nichols) Let me ask you this question. If you knew that what you ate during pregnancy could impact whether your baby suffers from skin issues, asthma or a laundry list of other issues, would you eat differently? What we eat impacts the long term health of ourselves AND our baby. Get the book! Just get it, you won’t regret it.

• Dr. Aviva Romm is frankly just no bullsh*t. Her new book is coming out on June 8th and is called Hormone Intelligence. Dr. Romm has spent over 35 years as a midwife, DR and herbalist. What we eat impacts our health ecosystem. Why do 80% of women suffer from gynecological issues? There is a wealth of FREE information on her website and podcast and it is well worth your time to get over there and give it a listen. The most important decision that we can make is to decide how we want to feel, and all of her research and education is a no BS way to help us do that. Little hint here….It all goes to back to what we consume, our microbiome, and our ecosystem. We can’t fix everything, but we owe it to ourselves to take the best care of ourselves that we can. If we aren’t well, we can’t be the best possible mom to our kids.

As I move through this life and get older one thing that I have come to realize, is that all of it moves really fast. My oldest will be graduating in two weeks, and my youngest is five. There is a lot I still need to do to keep up with these kids and the best way to do that is through really taking a look at how I take care of my body. Once I started to pay attention, educate myself, I felt better. I mean a lot better. We hear it a lot. Stop eating all of the things, however sometimes we do what is easy and just say to ourselves that we’ll do it later. Do it today. Do it now. I promise you will be amazed at how you feel, how your body serves you. You honestly can’t afford not to make changes now. I know that I put it off for way to long, but now I don’t miss the “old” way of eating, I crave the rainbow, and you will too.

Let's Talk Birth FACTS........

First I want to say that this article contains statistics that could be upsetting to some birthing people. My intent with this information is to inform, not scare. We have to look at birth outcomes, and I believe that knowledge is power. Some people feel like birth is an everyday thing, and while that is true. It is also something to approach with a thoughtful and informed stance. We can do better when we are armed with information. These are things that people need to bear in mind, as it impacts every single birthing person in this country. When we know what the facts are, we are better equipped to make the best possible decisions for our family and situation.

According to the Centers for Disease Control and Prevention provisional data from 2019 (released May 20, 2020) 31.7% of all births in the country were by cesarean and 25.6% of the NTSV (low risk) population had cesarean births. The CDC also reports that babies being exclusively breastfed through 3 months of age sits at 46.9%. The American College of Nurse-Midwives reported that in 2017 CNM’s/CM’s attended 9.1% of total US births. Every Mother Counts reports that the US is the only industrialized nation with a consistently rising maternal mortality rate, despite spending more per capita on health care than any other country. READ THAT AGAIN. The Educated Birth reports that as of 2019, there are only 6% of the midwife population that is black. One thing is for sure, we NEED more black midwives. Among 11 developed countries, the United States has the highest maternal mortality rate, an undersupply of maternity care providers, and is the only country not to guarantee access to provider home visits or paid parental leave in the postpartum period. (Reporting from the The Commonwealth Fund.) More than 50% of pregnancy related deaths in the United States occur after the birth of the child, or post partum. In the United States, Black women are more than 4 times more likely to have a maternal death than White women. Black women are also more likely to have a severe maternal morbidity event at the time of delivery. The United States and Canada have the lowest overall supply of midwives and OB-GYNs. Why does this matter? Let’s talk about it.

How are midwives and OB’s different? Midwives manage a low risk pregnancy, assist with childbirth, and provide care in the postpartum time. OB’s are physicians trained to identify issues and intervene should abnormal conditions arise. OB’s typically provide care in hospital based settings. Midwife services are not uniformly covered by private insurance plans in the United States, in comparison to other countries where midwifery and OB care are covered by universal health insurance in some other countries.

Here are some things that I have seen since Covid. In the beginning, postpartum appointments were done virtually, most of my clients felt rushed, and some even reported that their appointment had been repeatedly canceled, but guess what. Guess whose appointments remained in place, ensuring post partum care and recovery….that’s right, midwives. Post partum care saves lives. It’s important. Post partum care, including home visits by midwives improves outcomes. It improves mental health, breastfeeding outcomes, and is associated with reduced health care costs. So why isn’t this being addressed?

We need change, and we need it now. What are solutions? We need strategic and strong post partum care, guaranteed maternity leave, and we need to work to close the racial disparity gap that exists. Addressing systemic racism so that Black and Indigenous people are not at risk when they are pregnant is critical to reducing mortality. Paid Maternity leave to all birthing people would contribute to their health of of their babies, while also strengthening the financial security of families. Families are making choices that they should not have to. The most concerning part to me is that the United States is willing to invest in health care, but does not invest enough into birthing people and birth outcomes. We need to invest in the outcomes of birth, to make sure that not one more mother dies a preventable death.

What can you do? Ask questions. Educate yourself on the process of birth. Decide what environment is right for your family. Hire a doula. Have difficult conversations with your provider. TAKE A CHILDBIRTH ED CLASS. Here are a few questions to ask:

1. What is your c-section rate? What circumstances would you do one? (hospital birth)

2. What if any appointments will be done via tele-health?

3. What is the likelihood that you, yourself will attend my birth?

4. Where are your hospital privileges?

5. Will you accommodate my birth preferences?

6. What are your transfer rates? (birth center)

7. What clinics provide services and backup for situations beyond your scope of practice? (birth center)

8. Is this center accredited by the Commission for the Accreditation of Birth Centers?

At the end of the day, your goals are my goals. If you want a VBAC, then I want you to have a VBAC. If your goal is to have a medicated birth, then that is my goal. I want you to be informed and feel like you have all the information that you need to have the birth that YOU want. The best way to do that is to know what you are up against, and to know that you have choices. When you understand the anatomy of your body, the physiology of birth, the statistics that surround birth and post partum, you are in a much better position. We spend so much time preparing for baby, I feel there is much work to be done surrounding post partum. Spend some planning and understanding what you and partner expect for the post partum time. Understand the healing process so you are better equipped to deal with what is to come. Birth is amazing, and even more amazing when we are able to impact our own outcomes. You can do this. We can do hard things! XOXO

You can find more birth statistics below.

CDC

World Health Organization

Every Mother Counts

Questions to Ask a Prospective Doula….

If you ask me, there are a lot of reasons to hire a doula. Birth statistics alone are enough of a reason. Let’s talk about some of the birth statistics. Evidence Based birth sites that people that have continuous support during their birth experience a 25% decrease in the risk of Cesarean; the largest effect was seen with a doula 39%. A 2017 Cochrane review site discusses improved outcomes for birthing people and children including “increased spontaneous vaginal birth, use of analgesia, use of regional analgesia, low five minute Apgar score and negative feelings about childbirth experience. We found no evidence of harm of continuous labor support.” The American College of Obstetrics and Gynecologists (ACOG) acknowledges the potential benefits of continuous labor support by doula in its Committee Opinion on Approaches to Limit Intervention. There are so many studies out there supporting doulas, but how do you know where to start? Let’s go over some questions to ask your perspective doula.

1. Do you work with a back up doula? This is one of the most important questions to ask. Life happens, emergencies happen and you want to make sure that your doula is covered in the case that they are unable to attend your birth. Most doulas work within the birth community with other like doulas. Their backup has a similar style, training and experience level. Upon hiring your doula, you may even want to request that you do a short meet and greet with their back-up. I can tell you this, I have had to use my back-up twice in the over 100 births that I attended. Once due to an ice storm and my truck went into the ditch and the other time I was at a birth where my client went into labor six weeks prematurely. Both my client and myself had no concerns and I knew that they would be taken care of the same way with my back-up as I would care for them myself. There were no surprises for my clients on their birthing day because they had met and spoken to my back-up. I’m a big fan of no surprises on your birthing day.

2. What does your package include? What other types of services do you offer? As with any other type of service, you always want to know what you are getting. Most doulas include prenatal visits, an on call period, and post partum visits. There is some degree of prep that you and your doula should do together. That way the lines of communication are open for your support during one of the biggest moments of your life. Some doulas do placenta encapsulation, birth photography, childbirth education. It’d good to know what services are included in your package and what services are available ala cart. I offer two prenatal visits, a one hour breath class, continuous support for the duration of your labor. Upon hire I am available for phone, text and email support as well. I offer a post partum in person visit or a weekly one hour call for the first four weeks you are home with your new baby.

3. How do you support my partner? A doula is not there to replace your partner. In fact a doula can provide support to your partner as well. Here is the thing that we need to remember. We think that we know what we want during our labor, however in the moment it may not be what you think you want when planning your birth. I think one really important thing to remember about partners is that this is a big moment for them as well. You are both experiencing one of the single most important moments in your life. They are also watching the person that they love most in the world experience discomfort and often don’t know what to do. A doula can make suggestions to them on how they can support you best in the moment. They remind your partner to eat, drink and go the bathroom. We need them in great shape as well, and we work with them to support you.

4. How many births do you attend per month? I’m not so stuck on the due date, but I can tell you that I only take a certain number of births per month. Most doulas know how many families they can support successfully in the course of a month. Let me tell you a little story. When I first began supporting families full time, I took nine clients one July. Yep. NINE. That is something that I will never do again. It was way to many for my comfort level. I did not miss one birth, however I missed a lot at home. I spent the entirety of that month not present for my family, and I learned that was way to many for what I was comfortable with. I want to be able to support your family and mine, and I limit my availability because of this.

5. Do you have experience with multiples? Advanced age? Blood Pressure issues? This last question is a insert your health issue or concern. Every pregnancy is different and everyone has something in their own personal health history that they may want to address. It’s important to ask those questions if you have a concern about a certain condition or diagnosis. WE ARE NOT DOCTORS. Read that again. I have experience in many types of conditions. This means that I have worked with them, this does NOT mean that I will diagnosis or prescribe anything. I will point you in the direction of a certain care provider should you need additional support with your condition. Preeclampsia, advanced maternal age, Crohn’s disease, muliples, Fifth’s disease, the list goes on and on, but if you have a specific concern regarding your health history, check in with your prospective doula and make sure that they are able to support your family in the way that you need.

You will know after spending some time with this person if they will be a good fit for your family. Trust your gut! It’s important to learn to trust your instincts especially in your pregnancy and birth journey. Ask yourself….Do I trust this person? Does she/he listen to me? Do we communicate well together? How does my partner feel about this person? You should trust them. Doulas have an immense amount of knowledge. We are not medical providers, but we can point you in the direction should you need help with any variety of things. Here’s a couple things that I feel are important things about me. I will not speak for you. EVER. I will ask you. I will empower you to speak up and for yourself. I want you to have the birth YOU want. Here’s the great thing about doulas. We are the calm in the room. We hear and see everything. We whisper. We support you. We will lift you up and stand with you as you move through one of the greatest moments of your life.

Tips for Morning Sickness......

First of all, it’s not just the morning. It may be better to refer to it as any time of the day sickness. It really can pop up at any moment. It usually will resolve by the second trimester, however, I’m sorry to say, for some it can last for the entirety of your pregnancy. I know that it can be frustrating when all you can think about it is how sick you fell, and then the worry sets in about how to make sure that you are getting everything you need for your baby. In order to figure out what to do about it, it can be helpful to figure out what triggers it, Is it smells? Does it happen at a particular time of day? Did you allow yourself to get to hungry? Did you overeat? Under eat? Below are a few tips that may help.

1. Some people find it helpful to eat smaller meals more often. This helps you from getting to hungry and having your blood sugar drop.

2. Carbs. I know that this may be contrary to what some people think, however according to Lily Nichols, who wrote Real Food for Pregnancy, carbohydrates tend to be easy to digest, which means that you probably will digest some of it before you have to throw up. This means that you get a little something.

3. If you are having a hard time stomaching ANY food, opt for things like fruit, smoothies, sweet potatoes or rice, just be aware that big fluctuations in blood sugar can also bring on nausea, so if possible, follow it up with a protein. This will stabilize your blood sugar. Greek yogurt, beef jerky are also good options for protein.

4. Some people experience it the worst in the morning. If that is the case, keep something right next to the bed. Crackers can spike you blood sugar, so honestly nuts can be a great item to grab even before your feet hit the floor.

5. Protein shakes are also a great option, just make sure to read the ingredients. There can be a lot of added sugars in them. That again, would spike your blood sugar.

6. Cold foods can be a alternative is smells bother you. Tangy popsicles, avocado with salt and lemon juice, frozen berries are also great.

7. There are some supplements that help as well. Vitamin B-6 usually given 10-25 mg every 8 hours. (Real Food For Pregnancy) You could also try snacking on vitamin b-6 rich foods such as avocados, bananas, pistachios, and sunflower seeds. Ginger has also been used for hundreds of years, and comes in many different forms. Some people also use magnesium supplement as well.

8. Acupressure or acupuncture are also options. The pressure point is located on the wrist, called the P6. I had the best luck with this option myself, there is a company who makes wristbands that put pressure on this part of the wrist. They worked like a charm. They are Sea Bands and you can find them here.

9. If you do find yourself throwing up a lot, make sure to replenish your fluids. Homemade bone broth, diluted juice, coconut water can help. I also had luck with taking a few sips of coke, the sugar in the syrup settled my stomach enough to get additional fluids in avoiding dehydration.

10. Eat what sounds good. Remember, this will pass, although I get it, at the time it is tough.

There is a condition known as Hyperemesis Gravidarum, which is extreme nausea and vomiting during pregnancy. This occurs in about 3% of pregnancies. Birthing people that experience this need treatment. It is not something to be ignored. They experience serious dehydration and at times are not able to stop throwing up and need to be seen by their provider. For most it occurs during the first trimester and can return during the last few weeks of pregnancy. Just try to eat what you can, and stay hydrated. Hang in there, we can do hard things. XOXO

Things to do when in early labor.......

I get a lot of questions about what to do once someone realizes that they are in early labor? Maybe we should start with some of the signs of early labor. Your baby begins to “drop”. This is also referred as “lightening.” This is when your baby starts to make their way into the pelvis. Your cervix starting to dilate and efface in the days or weeks before you deliver. Don’t pay to much attention to this, as everyone is different. Those numbers can move quick, or take their time, but any bit of change is progress. Remember that. Some people experience diarrhea, or are nauseous, there could be back pain, water breaks, and contractions begin. Here’s the thing, more and more people are wanting to spend early labor and what leads up to active labor at home. Studies show that people are more comfortable in their own surroundings. I usually suggest that people touch base with their provider as well, but normally in an uncomplicated pregnancy, they will tell you to look for contractions that are building in strength, and are about one minute apart. Every provider and midwife is different, so make sure that you check with your individual provider. Below is a list of things that tend to help in early labor.

1. Eat and stay hydrated. You are going to need energy. Eat what sounds good. You don’t need to sit down and have a burger, fries and a shake, but if that is what sounds good, do it. Most people eat small snacks like nuts, peanut butter toast, smoothies, and drink water. I always recommend that people have honey on hand, it turns to energy quick. The more you empty your bladder, the more room baby has to move down. Spend a little extra time sitting on the toilet as well. I love the toilet for early labor. It’s really helpful in getting baby to move down. Just remember, not having energy and being dehydrated is not a great way to go into labor. You need strength.

2. Hydrotherapy. In other words, take a bath. This will help your body relax. When contractions hit our body, we tend to tense up. When our body is tense, our cervix is tense. We want to help relax your body. When I have watched women labor in the tub, sometimes it is a night and day difference. In a position statement on hydrotherapy during labor and birth, the American College of Nurse-Midwives concludes that ,”Warm water immersion hydrotherapy during labor provides comfort, supports relaxation, and is a safe and effective non-pharmacologic pain relief strategy that promotes physiologic childbirth.” It’ll help I promise.

3. Rest/sleep. Now this is one is easier said than done. The excitement alone of knowing that you will meet your baby is enough to prevent anyone from resting, however it will arm you with power. Labor is a lot of work. There is no denying that. You wouldn’t run a marathon after having not slept, and this is no different. I have seen what happens when someone enters their labor on fumes of sleep, and you don’t want that to be you. It makes everything harder. My mom always says, “Everything is always harder when your tired.” She’s right.

4. Birth ball/toilet. I’m going to let you in on one of my favorite places to have people spend time. The toilet. It is an amazing place to labor, and to sit when in early and active labor. If you face backwards on the toilet, bring a pillow and lay or lean on the back of the tank. There is no counter pressure below you, and your hips are spaced. It gives the baby on opportunity to continue to try to move down. Remember, it is important to create space. This is how babe moves down.

5. Breath. Doing some stretches and using your breath is a really effective way to create some space. Take a big breath in, and as you are doing so raise both of your arms above your head and fill your lungs. As you exhale, lower your arms, and make sure that you are exhaling slowly. Do this at least three times. Learning to breathe during labor will serve you well. This will really help to elongate the body and help baby to move down. I will keep bringing up things to help baby move down, because it is that important.

6. Heating Pad. If you don’t have one, get one. If you should experience back pain, this is a life saver. Sometimes in early labor, we can experience low back pain or hip pain. Having a heating pad can sometimes mean the difference of being able to doze in between contractions and getting some sleep and not being able to find a comfortable position to try to rest.

7. Get one all fours and do some cat-cows. This will feel amazing as well as you guessed it, encourage baby to move down, and head over to a optimal fetal position. I also feels pretty great. Movement is great in labor, and I encourage it. The cat-cow accompanied with some breathwork helps the nervous system and allows you to focus on breathing and provides your back with the ability to stretch. All great things for early labor.

8. Hip circles. You can do this on your birth ball, or standing. Move your hips in a circular motion one direction, and then the other. I usually suggest doing these in sets of five, one direction, and follow with the other direction.

When people realize that they are in early labor it tends to be an exciting time. We can’t wait to meet our baby, however just remember, there is work to be done. Preparing your body and your mind to work together is a critical step in the process. Don’t lose site of how to make sure that you are still doing some of the most important things which is eat, sleep, and move. Some people like to go for walks, others make a last run to Target, and some even run out for dinner (or takeout because…. Covid). I recommend that people check in with their provider, and then depending on how quickly you progress, the above steps can provide some relief as well as allow us to stay home a little longer. You have a lot of choices, but one thing is certain, it is only a matter of time until you meet that sweet baby of yours. You can do this. We can do hard things! XOXO

My Go To Breakfast's for Pregnancy.......

I realize that a lot of people are told that they should eat what sounds good, and while I am not in 100% disagreement, we all know that not all foods are created equal. I’m also a huge fan of quick and easy. I know that when whatever we think of makes us nauseous, it’s hard to really eat anything. Here’s the deal on morning sickness. There is not just one thing that causes it, and the severity that it shows up varies. There is some evidence that it is the increased hormone levels, and another thought is decreased blood sugar. One thing that can help is to keep small amounts of food in your belly throughout the day. We can’t just not eat. I have always found that starting the day with a good healthy breakfast can help. Below are some of my favorite healthy and easy breakfast options.

1. Healthy Breakfast Oats: There is a lot to discuss in regards to carbohydrates and pregnancy. Carbohydrates are like long lines of chains of sugar all linked together, and are the only macronutrient that significantly raises your blood sugar. ( Real Food For Pregnancy) That being said, it is perfectly normal and ok to consume more carbs during your first trimester. There is some evidence that it can help with morning sickness.

2. Avocado Smoothie: Here is another one that sometimes helps. At times it feels a little easier to drink a smoothie rather than have a heavy breakfast. Avocados are a great source of vitamins C. E. K and B-6. They are fiber rich and contain more potassium than banana’s. Smoothies are quick and easy and can be brought with you in a hurry. This recipe is one of my favorites.

3. Breakfast Bowls: The thing I love best about these is that you don’t have to have “breakfast” items in your bowl. Truth be told. I am not a huge fan of breakfast food, I would much rather have a burger so sometimes these appeal should you want a little heartier choice. And the options on this are endless. Love and Lemons always has so many great recipes!

4. Breakfast Tacos: This is super simple, scramble up some eggs and throw in whatever veggies you have in the fridge, or simply add sausage and egg. These are also great to make ahead of time. I would take the small tortillas, eggs, and sausage and wrap that in parchment paper, and then wrap in foil. and put in the freezer. Then go ahead and throw them individually in the microwave, minus the foil of course. That way they are ready to go. No fuss in the morning.

5. Chia Seed Pudding: This is honestly one of the easiest things to throw together. Chia Seeds are high in Omega 3 Fatty Acids, anti-oxidants, fiber and protein. They really pack a nutritional punch.

6. Sakara: This is an excellent option for meal delivery, and their breakfast meals are my absolute favorite! Use Code XOHOLLY for 20% off of your first order! You won’t regret it.

Pregnancy nutrition is a really interesting topic, and deserves it’s own blog post. Look for that in the near future. As I’ve been researching more about it, one thing that I found shocking was that only 25% of accredited medical schools in the US require a dedicated nutritional course. (Real Food for Pregnancy). If you don’t have this book, Real Food for Pregnancy, GET it here! You will love it. This is not a book full of recipes, although there are some, but if you are concerned about nutrition this is THE ONLY book that you need. Some find it helpful to eat small throughout the day, and others have a difficult finding any relief for their morning sickness. It usually levels out after the first trimester, however if you are concerned or are finding no relief from vomiting, make sure to partner with your provider. One thing that most can count on is having very strong love/hate feelings about certain things. Listen to your body, eat as healthy as you can, and as my mom always says, “You can’t start your day without breakfast.” XOXO

Questions to Ask a Prospective Doula….

If you ask me, there are a lot of reasons to hire a doula. Birth statistics alone are enough of a reason. Let’s talk about some of the birth statistics. Evidence Based birth sites that people that have continuous support during their birth experience a 25% decrease in the risk of Cesarean; the largest effect was seen with a doula 39%. A 2017 Cochrane review site discusses improved outcomes for birthing people and children including “increased spontaneous vaginal birth, use of analgesia, use of regional analgesia, low five minute Apgar score and negative feelings about childbirth experience. We found no evidence of harm of continuous labor support.” The American College of Obstetrics and Gynecologists (ACOG) acknowledges the potential benefits of continuous labor support by doula in its Committee Opinion on Approaches to Limit Intervention. There are so many studies out there supporting doulas, but how do you know where to start? Let’s go over some questions to ask your perspective doula.

1. Do you work with a back up doula? This is one of the most important questions to ask. Life happens, emergencies happen and you want to make sure that your doula is covered in the case that they are unable to attend your birth. Most doulas work within the birth community with other like doulas. Their backup has a similar style, training and experience level. Upon hiring your doula, you may even want to request that you do a short meet and greet with their back-up. I can tell you this, I have had to use my back-up twice in the over 100 births that I attended. Once due to an ice storm and my truck went into the ditch and the other time I was at a birth where my client went into labor six weeks prematurely. Both my client and myself had no concerns and I knew that they would be taken care of the same way with my back-up as I would care for them myself. There were no surprises for my clients on their birthing day because they had met and spoken to my back-up. I’m a big fan of no surprises on your birthing day.

2. What does your package include? What other types of services do you offer? As with any other type of service, you always want to know what you are getting. Most doulas include prenatal visits, an on call period, and post partum visits. There is some degree of prep that you and your doula should do together. That way the lines of communication are open for your support during one of the biggest moments of your life. Some doulas do placenta encapsulation, birth photography, childbirth education. It’d good to know what services are included in your package and what services are available ala cart. I offer two prenatal visits, a one hour breath class, continuous support for the duration of your labor. Upon hire I am available for phone, text and email support as well. I offer a post partum in person visit or a weekly one hour call for the first four weeks you are home with your new baby.

3. How do you support my partner? A doula is not there to replace your partner. In fact a doula can provide support to your partner as well. Here is the thing that we need to remember. We think that we know what we want during our labor, however in the moment it may not be what you think you want when planning your birth. I think one really important thing to remember about partners is that this is a big moment for them as well. You are both experiencing one of the single most important moments in your life. They are also watching the person that they love most in the world experience discomfort and often don’t know what to do. A doula can make suggestions to them on how they can support you best in the moment. They remind your partner to eat, drink and go the bathroom. We need them in great shape as well, and we work with them to support you.

4. How many births do you attend per month? I’m not so stuck on the due date, but I can tell you that I only take a certain number of births per month. Most doulas know how many families they can support successfully in the course of a month. Let me tell you a little story. When I first began supporting families full time, I took nine clients one July. Yep. NINE. That is something that I will never do again. It was way to many for my comfort level. I did not miss one birth, however I missed a lot at home. I spent the entirety of that month not present for my family, and I learned that was way to many for what I was comfortable with. I want to be able to support your family and mine, and I limit my availability because of this.

5. Do you have experience with multiples? Advanced age? Blood Pressure issues? This last question is a insert your health issue or concern. Every pregnancy is different and everyone has something in their own personal health history that they may want to address. It’s important to ask those questions if you have a concern about a certain condition or diagnosis. WE ARE NOT DOCTORS. Read that again. I have experience in many types of conditions. This means that I have worked with them, this does NOT mean that I will diagnosis or prescribe anything. I will point you in the direction of a certain care provider should you need additional support with your condition. Preeclampsia, advanced maternal age, Crohn’s disease, muliples, Fifth’s disease, the list goes on and on, but if you have a specific concern regarding your health history, check in with your prospective doula and make sure that they are able to support your family in the way that you need.

You will know after spending some time with this person if they will be a good fit for your family. Trust your gut! It’s important to learn to trust your instincts especially in your pregnancy and birth journey. Ask yourself….Do I trust this person? Does she/he listen to me? Do we communicate well together? How does my partner feel about this person? You should trust them. Doulas have an immense amount of knowledge. We are not medical providers, but we can point you in the direction should you need help with any variety of things. Here’s a couple things that I feel are important things about me. I will not speak for you. EVER. I will ask you. I will empower you to speak up and for yourself. I want you to have the birth YOU want. Here’s the great thing about doulas. We are the calm in the room. We hear and see everything. We whisper. We support you. We will lift you up and stand with you as you move through one of the greatest moments of your life.

10 Must Have Postpartum Products.......

There is so much out there, it’s often hard to even know where to start. There are some products that really will make your postpartum much easier, and comfortable. I think it is really easy to get sucked into having things that sound beneficial, but truth be told…won’t get used. I’m a huge fan of comfort. You’ll hear me say this a thousand times, but when you first get home, guard your time with your baby. Ten days in the bed, ten days on the bed, and ten days near the bed. You are just getting to know your baby, and you are also getting to know yourself on this new journey of parenthood. Not a single person has had any regrets about taking this time. Not a single one. Below are some of my favorite must have postpartum items.

• Peri Bottle: These will feel like life savers. You can’t have enough of them. Keep one in your diaper bag, each bathroom in your home. With my last baby, I only had the one from the hospital, and I lost it. Let’s just say it was a very uncomfortable 24 hours. These are amazing. You’ll want more than one.

• Postpartum Underwear. This company is my favorite. Nyssa. They are woman owned, and take the postpartum time seriously. Their underwear securely holds an ice or heat pack anywhere in the garment. You can not beat this. You will be everyone’s favorite person if you give these as a shower gift. Your other option is to go with an organic maxi pad, and yes organic is important. Most of the pads on the market contain bleach and other chemicals, and you really don’t want that close to such a sensitive healing area. Manufacturers aren’t legally obligated to disclose what are in period products. That’s ridiculous! My favorite organic pad is Rael.

• Perineal Cold Packs. These speak for themselves, and are great to have on hand. You will be a little sore, and these work wonderfully.

• Nursing Bras and Tank Tops: Kindred Bravely has many different styles to choose from, and their comfort is top notch. I personally loved the tank tops, but their bras are really comfortable. I choose the tank tops as the compression felt super supportive after my third baby. They have several colors, and the fabric is really comfortable. After having three children, I have tried tons on the market, and these are by far my favorite!

• Thena Sitz Bath: I have four words for you. DO THE SITZ BATH. You will not regret it. It promotes healing and frankly feels amazing. This brand developed these with stiches in mind. There is a ton of healing that takes place, and these really are soothing. Again, be careful with ingredients. I am a big fan of any that are not full of chemicals and non natural fragrance.

• Meal Service. These are a life savor. It’s hard enough to figure out your new normal once you get home, and it is amazing to have food delivered that is healthy and has healing the body top of mind. I love SAKARA and you can use my Code XOHOLLY TO SAVE 20%. They are organic plant rich meals, and taste fantastic. Ready to eat and delivered to your door. If you are local to the Minneapolis area, Hola Postpartum is fantastic. Alexia is a trained chef AND a doula, she will custom curate meals for you.

• Barefoot Dreams Cardigans: Everyone needs a cozy sweater, and you will love these. They are like wearing a blanket, and perfect for skin to skin time, and great to throw on over your nursing tank. Little story about these. When my third child was born, these were all I wore, and he became very attached to them. Instead of a blanket, my son drags around one of these sweaters everywhere we go to this day. They do have baby blankets as well, however a sweater in my house ended up doing double duty. I will wear these for the rest of my life. That is how much I love them!

• Button Down Pajamas: J crew Pajamas are my go to, pregnant or not. The tops are button down, they have short or long sleeve. Pants or shorts depending on the season, and you can usually find a set on sale. The cotton stretch of these really are dreamy, and I’m a big fan of an elastic/draw string bottom. They are all round comfort, and are cute too.

• Nursing Pads: These are organic, and again due to all the chemicals that can be found in them, it’s important to look. You can also purchase re-usable/washable ones as well. Either will work well, you just need to get some. Little story, when my first was born and came home from the NICU, I had to run to the grocery store, and believe it or not, no one suggested these little gems. I was wearing my nursing bra and a t shirt. And guess what, when I reached for something, my arm felt wet. You guessed it, the entire front of my shirt was soaked with breastmilk. Trust me when I say, you’re gonna want some of these.

Most of the things on this list are for you. This time is precious, and hard. You deserve things that will be comfortable, and make things easier. You really do, and as I tell my clients…. I give you permission to take care of yourself. Do things for you. It will make you feel good both on the inside and outside. You deserve it!