Three Rivers Birth Services

I just love a good birth story, and it is hard to top this one…

When the cook on his shrimp boat went into labor 30 miles offshore, captain Ed Keisel grabbed a roll of paper towels and a first aid manual and did the best he could.

He successfully delivered Cindy Preisel’s baby boy, even though the baby’s feet emerged first.

“I’m no doctor, but even I knew that’s not supposed to happen,” Kiesel said.

Check out the rest of the breech birth story here.

In CNN’s recent article entitled “Five Ways to Avoid a C-Section“, the number 5 point is to hire a doula.  I’d like to add that there are several things we doulas do to help moms avoid cesarean birth.  I’d like to point out, though, that a doula’s role is less of a patient advocate and more of a resource.  We can remind and suggest to do points one through four in the article, as well as helping a mom cope with pain that can avoid or postpone epidural anesthesia which will limit her ability to push.  Additionally we can help mom stay upright and move during labor which can help a baby get into the right position for birth.

I have my first three clients!  I’m one birth down and two to go towards my path as a DONA-certified doula.  I do think I’ll be offering a discount on my usual fees until I have my certification papers in hand, but unfortunately I can’t go on taking free clients forever.  As much as I love this work and would do it for free every time if I could, there are costs associated with running a doula business including business licensure, birth bag supplies, advertising, and child care to name a few.  Instead of my usual fee of $500, I’ll be asking for $300 until I’m officially certified.

In addition to my personal business news, I’m thinking that I’ll use the main page of my website here to post the latest obstetrics/midwifery research.  I try to stay abreast of the latest thinking, and I’m hoping this will help pregnant moms stay up-to-date too.  Of course, in any given week there are thousands of studies taking place and this is not intended to be a complete catalog.  I’ll just note a handful of stories that made me think, and possibly add my own thoughts.

First up, we have a study that shows diet in pregnancy might be more important than previously thought.  An epigenetics study determined that what a mother eats during her pregnancy can actually prevent or lessen disease in her children later in life.  Pretty cool, huh?  Epigenetics is the study of how a gene (for instance, for a specific disease) is not removed but can be altered to change how the gene is expressed.  So, for instance, what you eat during your pregnancy might actually suppress a gene for, say, breast cancer in your child later in her life.  Amazing.  Now – my guess is that all sorts of dieticians are going to start “mandating” that a pregnant woman eat a certain number of tomatoes each day or what have you, micromanaging her diet down to the impractical.  I prefer a much simpler solution:  Eat food. Not too much.  Mostly plants.  (I also can talk to you about eating in awareness…but we’ll save that for a different day, shall we?)

In other pregnancy diet news, the Institute of Medicine (IOM) is considering changing its weight gain guidelines for gestating women.  We’ve heard this before, haven’t we?  Back in my mother’s day, she was told to aim for a total weight gain of 15-18 lbs., which proved to be dangerous for the unborn child.  Today, women are told to shoot for gaining about 25 to 35 lbs. if they were of average weight before their pregnancy.  Of course, how practical is it to tell a woman how much weight to gain?  My dietary suggestions are to eat healthy foods in reasonable portions until you are full, eat in awareness, and exercise a bit if you can.  It still can be important to weigh pregnant women regularly, as a very high or a very low weight gain could be a symptom of another condition (such as gestational diabetes, a twin pregnancy, or other issues), but weight gain it in itself is not a condition of concern.  I’m interested in seeing what the IOC’s new guidelines will be, and more importantly, why.  If it’s fueled by the obesity epidemic, I think much more success would be achieved if mothers were given nutritional information on how to eat, and not how much weight to gain.

Finally, there was a fun article about belly dancing being used during labor.  It may seem odd, but if I look at the concept through my lens — that of a doula’s — it makes a lot of sense.  Body positions can make a big difference in the success of a baby aligning properly in the birth canal, which can reduce the use of vacuum, forceps or cesarean birth.  I know many positions and movements that can flip a breech,  turn a posterior presentation or get a slow-to-start labor going (or at least won’t do any harm trying).  So why not belly dancing?  I doubt I make it part of my standard practice, but for a woman who belly dances regularly it would be fun to try.  I enjoy looking for ways to include a woman’s normal relaxation routines into her labor – the familiarity can breed comfort and relaxation, lowering pain.

I’ve been turning over how best to write the story of my first client’s birth.  Long story short: induction at 39 weeks, Cytotec for 5 hours that did not do much in way of getting labor started, membranes ruptured and immediate active labor melting into transition, epidural cart came (and left) while mom started to push.  All in all, she felt everything a normal laboring mom might feel compressed into only 96 minutes.  A beautiful, empowering birth.  I gave her the birth story yesterday at our last prenatal appointment and I do have her permission to talk freely about her experience, but I don’t think anyone wants to read the five page single-spaced story here.  Instead, I think I’ll do things a bit differently:

What I learned from my first doula client:

- I really enjoy the prenatal period just as much as the birth itself.  It is an opportunity to get to know someone you might not normally get to know and to really dig deep into fears and thoughts about birth that really can make a huge difference.

- Some of my deeply held philosophies of doing doula work are much easier to write about than to practice.   But that does not change the fact that I feel they are more important than ever.

- I care more about my clients than I ever expected to.  That is a good thing, I hope. 

- Although at the peak of birth it can be scary and it might seem like we don’t know what to do next (for mom and for the doula!), it turns out that what we were doing naturally in the moment was the best thing after all.

- Mom can yell and curse in the middle of labor and be in a lot of pain, but still be very powerful and strong – and embrace fully how her birth story unfolded after the fact.

- I have the opportunity to make a huge difference in the lives that I touch.

- God, how I love this job.