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Vaginal tearing is something that most expectant moms think about. I mean, how can we not?! The thought of an 8 pound human passing through something that was once the size of a lip-gloss tube... Kind of frightening.... Let's chat about how we can prevent that oh so thought about topic.

 

First, Lets talk about what tearing is and how It happens-  A vaginal tear is a lesion to the perineum when a baby is crowning or being pushed out of the canal. When the baby is coming out, your vagina has to stretch so that your babe can pass through. Sometimes the tissue stretches so much that a tear(s)can occur.  

Types of tears-  There are four degrees of tears, while 1-4 can be uncomfortable, some may require stitches or cause damage to the sphincter. Here are the types of tears with a brief description

First Degree- Typically affects the outside of the vagina and does not cause damage to the muscles

Second Degree- This is the most common of all of the tears. This affects both the skin as well as some deeper tissue and requires some stitches

Third Degree- Goes into the layers of the vagina and the sphincter. Each layer will need stitches

Fourth Degree- This one is all of the above and breaks through the anal lining. This typically occurs with forcep or vacuum births and is less common

Starting to get worried about tearing? Read on for ways to prevent it!

get in a bath- If you happen to be birthing where a tub is, get in that bad boy and relax for a bit. Sitting in the warm water will relax and help stretch those sensitive tissues. Make sure that it isn't too warm, though!

warm compress- Warm and clean wash cloths are an excellent way to help prevent tearing during childbirth. In the hospital? Ask a nurse to fill a basin of warm water and ask for 5-10 wash cloths. Homebirth? Fill a crock pot and keep them handy. Remember, make sure they are cooled enough before placing them onto your sensitive lady bits. 

position matters- Did you know that pushing in a squatting position greatly increases your risk of tearing, while side-lying and hands and knee positions decrease tearing? Position matters, folks! Get creative and try not to push while laying on your back.

breath- try your best to breath while pushing. pushing while holding your breath and bearing down can be one of the worst things you can do. Do not, I repeat, do not push with all of your might and energy. 

 

 

My Birth Tips

With just a few steps, you can take charge of your birthing journey and have an empowering and transforming birth. Here are a few of my very own tips on how to do just that!

 

Be Choosy- This is something that I see all too often, lovelies. Families settle with the first provider that they meet. My advice is to interview several before you commit. Ask what their cesarean rate is. Talk to them about you birth wishes. Do they seem receptive or dismissive? An involved and encouraging provider who believes in your ability to birth will greatly impact your journey. Don't settle, dear mama, you WILL find your perfect provider.

Take A Tour, Or 5- Go to more than one facility (if your provider has privileges there). Ask them to show you where you will labor, the recovery room, and their the nursery .Most importantly, ask about their policies and if it is accessible in writing. Do they have lactation consultants on hand? Most importantly, do they meet your needs?

Get Educated- Francis Bacon wasn't kidding when he said "knowledge is power". Take a prenatal class, hire a doula, read literature on all things birth. Whatever you do, be sure to research, research, research. You have a lot of decisions ahead of you. Look into everything from common interventions, to circumcision, to informed consent. I promise you, once you become educated, things get a lot easier.

Communication- Take this time to communicate with your birthing partner. Talk about your expectations, wishes, and fears. Let them be apart of this journey with you. Work on your birth plan, together. Afraid that you are going to hurt their feelings on the big day? Make a code word for when you are feeling overwhelmed or cranky. The last thing you want is to get into a tiff while in labor. Another thing is to make a game plan with them for unexpected visitors. Will they be the one to shew them away and do damage control?

Choose a Rhythm- It may sound silly but I highly recommend thinking of a birthing rhythm ahead of time. A rhythm is an action that you will do during your surges. For example, once that surge hits, you can hum a 30 second song, or rock back and forth with your partner. Choosing this early will help you get ahead of the game and know what to do once they happen.

Create a Sacred Space- Just because you are in a hospital, doesn't mean it has to feel like one. Create an ambiance and a serene and tranquil space. Bring flameless candles, birth affirmations, a comfy robe, and play some music. Dim those lights and place a sign on the door that reads "please enter quietly".  Make that room you safe space. 

Most importantly, trust in yourself and the process. You are an extraordinary being and you will rock this birth, just like you do everything else in life.

Have some questions? Contact me today! 

Informed Consent

Your water breaks and you can no longer talk through your surges. Your husband grabs your hospital bag and you head out the door to the hospital. You spend 12 hours in labor and your OB wants to discuss a cesarean since you aren't "progressing" as he thinks you should. Are you given informed consent?

What exactly is informed consent? Informed consent is a doctors obligation when recommending an intervention or procedure. So when your doctor recommends a cesarean in this situation, he needs to thoroughly discuss the procedure, risks, benefits, and alternatives. This is an opportunity to get your questions answered and know exactly how they will do the procedure..

Easy peasy, right? Wrong. Think of a time where you needed a procedure. Were all of the above thoroughly explained to you? Probably not. 

It is not true consent when you are frightened into saying yes without knowing the benefits, risks, and alternatives. Each one of these must be addressed.

Need help remembering what needs to be explained? Remember B.R.A.I.N.!

 

 

 

 

Pregnancy and Infant Loss Resources

 

 The month of October is pregnancy and infant loss awareness month. I've decided to dedicate a blog to those who have suffered or are suffering a loss. Below are some amazing resources available to those who need it. One million pregnancies will end in a loss this year. You are not alone.

Organizations

Still Standing Magazineis a magazine dedicated to giving a voice to grief. It also is an amazing resource for both grieving parents and those close to them so that they can learn to support.

Share Pregnancy and Infant Loss Support    This website has many resources available to those who has suffered a pregnancy or infant loss. It has online support for both parents and those who would like to show their support.

M.E.N.D  Mommies Enduring Neonatal Death is a christian based non profit dedicated to bringing parents that have suffered neonatal deaths together.

 

Books

Facets of Grief is a beautiful creative workbook for grieving mothers

Tear Soup: a Recipe for Healing After a Loss " Affirms the bereaved. Educates the un-bereaved. A building-block for children"

Grieving the Child I Never Knew : A devotional companion for comfort in the loss of you unborn or newly born child

 

Keepsakes

Project Bear- Project Bear donates keepsake teddy bears to pregnancy and infant loss families. They run strictly on donations

 

 

VBAC Chat

     When a birthing client has a cesarean section and falls pregnant again, they have two choices. Another elective cesarean, or a VBAC (vaginal birth after cesarean). Both carry their own risks and benefits, but one is played up to be this huge and risky ordeal. It's no surprise that vaginal birth after cesarean (VBAC) is met with profound opposition and is often even shunned by OB's and Hospitals. If you ask your OB why this is, typically, they will say the risks of uterine rupture, placenta accreta, maternal morbidity, and infant death outweigh the benefits. Well, my lovely readers, I want to help settle some of those fears. Let's begin, shall we?!

You are probably a candidate- That's right my friend, you are probably a candidate for VBAC! Roughly, 90% of those who have had cesarean sections are a good candidate for a VBAC. Of course, there are some instances where It wouldn't be a good decision. You should have a low transverse uterine incision and not have had any prior uterine surgeries that have caused scarring. Bottom line, even ACOG says that VBAC is "safe and appropriate for most woman".

Cesarean sections are just as risky- Obviously, we all know that there are risks with cesareans. But did you know that your chances of maternal morbidity more than triples when you go into that OR (operating room). Other risksare placenta accreta, hysterectomy and blood loss - the same as VBAC. I bet your provider and hospital didn't tell you that when you were talking about your options! Still, cesarean rates are a whopping 32.8% That doesn't make much sense, does it?

Uterine Rupture- Ahhh, the go to scare tactic when discussing VBACS. Now, don't get me wrong, UR (uterine rupture) is a real worry, But it's less of a worry than you'd think. UR results in. 2% of laboring mothers with no augmentation (intervention) and 6% of that .2% end up in infant death or brain damage. That's 1 in every 26,000! Even then, lets say UR occurs, the OB and hospital staff have 15 minutes to prep you and take you in for an emergency cesarean. Despite what you may think, 15 minutes is a lot of time in the hospital world.

 

 Before we move on to the next part of my blog, lets compare. .2% of VBAC moms end up with a uterine rupture and repeat cesareans more than triple the risk of maternal death. Which would you be more frightened of?

 

I also wanted to dedicate a section of this particular blog post to providers.. Why, you may ask? Because they can either make or break this decision. It is I-M-P-E-R-A-T-I-V-E to find a provider who is VBAC friendly, not just VBAC tolerant. If your provider says "Okay, we can try", "Okay, But we are going to opt for a c-section if", then they are not VBAC friendly. Find a provider who won't wheel you into the OR if you are 40+ weeks with no "progress" (what does that mean, anyway!?) Find one who isn't going to put a time limit on your birth.

You deserve to have this, if you want it (within reason, of course). I'm not saying that if there is a medical emergency to not let them do what they need to. I'm saying that you need to be supported and to be able to relax and not feel rushed. Cuz' guess what happens when you are stressed and feel rushed? You stall, clinch, and make your birth that much harder.

Another fib birthing family hears when attempting a VBAC is "we aren't equipped to handle an emergency during a VBAC." Newsflash, if a hospital has the means to handle an emergency cesarean, they have the means to handle a VBAC. It's just as simple as that.

 

I am not here to push you into a VBAC or cesarean. Ultimately, this is your birth and you are going to make the best decision for you and your family. There is no right or wrong way, only YOUR way. As a doula, it's my job to give you the cold, hard truth and to help educate you during this amazing time. I hope that you see VBACs in a new light and perhaps don't find them as frightening.

 

Looking for a doula for your VBAC or Cesarean? Contact me so that we can chat about your birth goals.

 

 

 

 

 

 

 

 

 

 

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Here Is Why You Shouldnt Discredit That New Doula.

      Recently, I met with a wonderful family that was eager to meet their new baby. They were in the market for a Doula, so we met to see if we were the right fit for each other. Whether you are using my placenta encapsulation services or birth Doula services, I always have the same question. "What qualities are you looking for in your Doula/PE Specialist". This allows me to really see if we are a good fit for each other. Will we mesh well or would a family benefit from another reputable Doula in the area? I had asked this question to the partner, first. His response was"I want a Doula who has been to a ton of births and has seen everything!" I sat back and listened to what he had to say and we ventured off onto other topics. After arriving back home, what he said really resonated with me. I have decided to tell you all of the reasons that you SHOULD hire a newer Doula, instead of immediately overlooking them.

NEWER DOULAS ARE TRAINED: Every trained Doula puts their heart and soul into their training. They all go through hours of work shops, write essays, learn the language and attend certifying births. We all learn the same techniques and coping mechanisms as Susan from so and so. Trust that newer Doula because she knows her stuff, because she spent hours researching it and learning about it.

THEY ARE HUNGRY AND EAGER: After all of that training they are so eager to get started that they are going to be so gun-ho about your birth wishes. That new Doula is going to be just as excited about this birth as you are...How special is that?! This is not to say that a more seasoned Doula wouldn't be, but I'm sure all Doulas can attest to those first few amazing births.

FLEXIBLE SCHEDULES: Since newly trained Doulas are building their baby business, they may have more time to dedicate to those first few families. How does this benefit you? They are more likely to be there a bit faster and have less time constraints. Need a bit more birth education? She's got you covered!

 NO ONE HAS SEEN EVERYTHING: I could scream this from the rooftops if I could, guys... There is not one Doula on the face of this earth that has seen everything. A Doula that has attended 200+ Births may not have seen something that a Doula of 2 births has. No woman, vagina,uterus,cervix, and baby is the same. Just because someone has been in the baby game for 10 years, doesn't mean they are "better", they have just had a bit more experience.

   Listen, Guys... I am not trying to deter you from a seasoned Doula. What I am trying to do is open your eyes so that you can see the positives in a newly trained birth worker. Every family has their own preferences, and that's fine. All I ask is that you meet with that newer Doula to see if you mesh well. Ask them why they got into this field and really give them a shot, because all she wants to do is empower you on this beautiful birthing journey.