A fellow doula, Tabaré Depaep, J.D., Esq., CLD (CAPPA), wrote up this response and said that I could share it with the world! 

As most of you already know, ACOG (American College of Obstetricians and
Gynecologists) is collecting data on elective home deliveries, even if there
were no adverse outcomes (see their data collection form at
http://www.acog.org/survey/hdComplications.cfm).  Here is my tongue-in-cheek
response (I am a lawyer and a doula):*

*Complications Related to Hospital Delivery*

We at Doulable Birth are concerned that high rates of elective hospital
delivery have resulted in an increased complication and morbidity rate.
Reports from clients indicate that doulas are being called in to try and
prevent these emergencies, and in some instances doulas and doula
organizations have even suggested legal proceedings against the hospitals
and doctors that seem unable or unwilling to learn from and address the
deficiencies of their practices. To attempt to determine the extent of the
problem, a registry of these cases will be maintained by Doulable Birth on a
year-by-year basis.

If you have attended a patient who came to you after an unsuccessful attempt
at elective hospital delivery, whether in the emergency room, operating room
or labor and delivery suite, please complete the following survey even if
there was no adverse outcome. Include only current events after June 15,
2009.

State:

 Hospital:

 Month/Year of Delivery:

 Gravida:

1   -  2   -  3   -  4   -  More

Para:

1   -  2   -  3   -  4   -  More

Maternal Age:

Less Than 20   -  20-25   -  25-30   -  30-40   -  Greater than 40

Gestational Age:

Less than 30 weeks   -  30-36   -  36-40   -  Greater than 40

Problem:

(check all that apply)

 Convenience Induction

 Artificial Rupture of Membranes

 Augmented Labor/Pitocin to Distress

 Defensive Medicine (e.g., procedures designed merely to prevent lawsuits)

 Epidural Induced Fever

 Episiotomy

 Formula Supplementation

Healthy Baby Removed From Mother Post-partum

 Healthy Baby Sent to Nursery

 Iatrogenic Infection

 Major Abdominal Surgery (“C-section”)

 No Continuity of Care

 Profit Driven Healthcare (e.g., unnecessary tests/procedures)

 Protocol Driven Healthcare (e.g., mandatory IV, monitoring, etc.)

 High-tech/low-touch care

Fetal Outcome:

(check all that apply)

 Fetal Intolerance to Labor

 Delayed/Unsuccessful Breastfeeding

 Delayed/Unsuccessful Bonding

 Routine Deep Suctioning

 Sepsis Workup

 Unnecessary Bath

Gestational Age at Induction:

2nd trimester   -  1 month before due date   -  2 weeks before due date   -
on due date   -  she’s late, she’s late for that very important date

Length of Labor Prior to C-Section:

Scheduled prior to labor   -  less than 30 minutes   -  less than an hour
-  Seriously they let it go that long?

Guesstimation of Fetal Weight Prior to Induction:

Off by: less than a pound   -  1-2 pounds   -  Greater than 2 pounds
-  “Ma’am based on the ultrasound we think you’re carrying twins.”

Dilation Prior to Epidural:

> 8 cm   -  6-8 cm   – 4-6 cm   -  2-4 cm  – 1-2 cm   -  why wait?

Number of Hospital Attendants:

A basketball team (5)   -  A baseball team (9)   – A soccer team (11)
 -  Bring on the marching band

This survey *IS NOT* collecting any identifying information from the
respondents. To help detect accidental duplicate submissions, please select
the numeric value of your birthday month + day, divide by the square root of
your home address, and subtract the absolute value of the ACOG minion that
came up with their survey in the first place.

For example: ((April (4) + 19) / Ö5922) – ½-25½= -24.07

 I hope you enjoyed my survey as much as I enjoyed writing it!
–
Tabaré Depaep, J.D., Esq., CLD (CAPPA)
Birth Doula, Breastfeeding Educator
Sleep Coach
cell 818.679-0947
pager 562.214.0346

Rebirth Blog is having a birth carnival and the next entry is First Births.  I realized I never posted my first birth as a doula.  So here it is! 

Callie took my first Hypnobabies class I taught and her birth was great.  Many of the births I attend as a Hypno-doula are this fast and easy.   Which is nice for mom and me!

Callie called around 10:45 and asked what I was doing this morning.  She is so cute.  I told her I would get childcare arranged and asked her to call me when she knew if she was staying or not.  I quick hopped in the shower… note to self, shower first thing every day when you have an expecting mom.  I got stuff arranged for the boys and nursed Bryson.  Frankly nursing Bryson has been my biggest concern regarding going to births… I think after Jenn’s birth I will not do another one until he is weaned…

Sam called around 11:30 and said it was a go, she was at 4 cm.  I got to the hospital around 11:50 (quick detour to McDonalds  because I didn’t know when I could eat next).  Callie was resting calmly on the bed, with her parents, Sam and their son Nick (2 ½) hanging out.  Whenever she had a pressure wave, everyone got quiet and let her relax through it.  The relaxation music was on in the background.  She was very chatty between pressure waves.  They seemed to be coming every 5 minutes or so.  She wanted to have the baby between 3-5 because that is when her Dr was available.   I wondered at first if she was being too optimistic with the times, but said nothing, just smiled and said, the baby will come when it is the right time. 

Around 12:45 Callie seemed to be a little more intense during her pressure waves, I was doing the relax cue, which helped.  We talked about going to the potty soon and the Grandparents were going to take Nick over to the mall to walk around.  Just then the other set of Grandparents arrived, at first it seemed like they wanted to stay, but I could tell Callie was ready to be alone, so we convinced them to go to the mall to. 

Finally at 1 the grandparents and Nick headed off and I got Callie on the potty.  She had a nice pressure wave there and said, “Wow, it really opens up on here.”  She then wanted to sit on the birth ball, so we got her situated and comfortable.  The nurse came into get the monitors on.  She was very sweet and got the telemetric unit so she could walk around, by then, I knew we were not going to be needing to walk around at all. 

10 minutes into the monitoring Callie started crying during a pressure wave, she didn’t even realize she was crying until after the wave.  She said she was crying because it was so beautiful and she had been so scared during Nick’s birth and was so calm and happy now.  I thought… AHH, transformation is starting. 

20 minutes of monitoring, with a lot the nurse holding the heart one on the right spot, VERY low on the tummy.  We had put the Easy First Stage Guide on for the room to hear and Callie was doing great, and was starting to AHHH during the pressure waves.  She was able to relax and was staying relaxed and focused between pressure waves.    She asked to get checked after the monitoring was done. 

1:20  She laid on the bed and had a BAD pressure wave, she couldn’t relax in that position (flat on her back), but was checked and was a stretchy 8, so we got her back on the ball and she was fine with the pressure waves there.

1:30, feeling pushy and making pushy sounds…. She gets back on the bed and gets checked, just a little lip left.  We say open, open, open through a pressure wave.  They get the bed set up.  Check again…. Ready to push.   I tell Sam to change the CD to pushing the baby out tract. 

She pushes her own way… no coaching and is doing great.   She gets a little scared and starts having discomfort.  She begs me, help me get back on top of it.  I try counting her down and talk about the anesthesia in front of the babies head.  Tell her to push how it feels right.  Then she screams and pushes, not comfortable for her any more… but is able to relax between pushes and the next push the baby crowns.

I told her the baby was almost out and she could do it.  Sam is at her head to, holding her hands as she screams and pushes.  She screams…”Come OUUUUUUUUT baby, come OUUUUUT”   It is awesome, the OB tells her how great she is doing, we are all quietly cheering her on.   

Then the baby comes out…. It is a girl (Callie knew what it was, but kept it a secret from everyone else)  It is 1:40.  7 pounds 1 oz.    Callie is thrilled and gets to hold her right away and baby is great.  Sam is crying a few tears of joy and I am in awe that I get to share this special moment with them.  How incredible for me. 

Then Sam, holding his baby girl called the grandparents, who had left 1 hour ago…. “You might want to come back over now…. and on cue the baby starts to cry….. and meet your new grandbaby.  They get back over after Callie is changed and nursing the baby.  Perfect timing and Nick is in awe of the baby.  It is SOOOOO sweet.  It makes me want another baby. 

I left around 2:15, because with 4 grandparents, Nick, Sam, Callie and the baby the room was a bit full.   

The baby was born about 2 hours after I get to the hospital.  This was the perfect first birth for me to attend, especially with a nursing baby of my own.

Most OBs allow the fear of liability to motivate their decisions, often not providing true informed consent.

Think of a mom with a breech baby.  Is she even given vaginal birth as an option.  99% of the time NO.  Rather she is told a cesarean is her only choice.  This is because that is the “rule” from the hospital, insurance companies, etc.  Not because it is necessarily the best choice.  This is not informed consent.  Informed consent would be here are the risks of a vaginal breech birth, here are the risks of a cesarean birth.  Information presented objectively.  Then parents are asked, “Which one do YOU want?”

There are a rare few OBs who will really let moms make informed choices.  Dr. Fischbein is one of those care providers.  He fights for a woman’s right to choose her birth experience.  He is now being punished for this.  Here is a website with more information. 

I wonder how many other doulas think and do these things…

Preparedness or the lack thereof can prevent or cause births

If I am going somewhere I don’t want to have to leave for a birth, I make sure I have my doula bag, a change of clothes, an extra car.   Basically I am completely prepared to leave at a moments notice.  I somehow think that by being THIS prepared, then mom WON’T have her baby.

If I am going somewhere not as important, I leave my things at home, thinking it increases the chance of mom needing me.

Murphy’s Law?

It has proven true, in that one time my normal back up mom was busy the next day, in fact I was supposed to be watching HER son.  I didn’t find other back up and of course I got a call at 6 AM.  I said “Good luck honey!” to my DH and called my friend on the way out and said, “Sorry!”   It all worked out of course, but it was a little more stressful than normal. 

Ringing Phones

Almost every time the phone rings I wonder, “Is this a mom?”  I try not to think it, because then it will be a mom, whereas if I think it is a mom, then it isn’t. 

My cell phone has special rings for my doula clients, which helps.  But we don’t have caller id on my home phone, so it rings like normal.   So then I am guessing. 

Eating a LOT, just in case

I am a low blood sugar kind of gal.  So one of my biggest fears is a long birth with no food.  So far I have been able to eat during my long births and of course I have snacks in my bag.  But I seem to eat MORE when I am on call, JUST IN CASE.   I can see no benefit to this, because when I do get called, I seem to find more to eat and eat on my way to the birth. 

I am just so worried I will get hungry!

When will this baby come out? 

Sometimes I do think, this baby will never be born!  I tend to think this if my DH has a campout planned for a weekend and in my mind I want the baby born before the campout, so I don’t have to worry the whole time my DH is gone.  As the clock ticks closer and closer my mind gives up.  Baby staying inside forever. 

But we all know that baby’s are born when THEY want, not when we want!  I had 2 moms due a week apart and I would pray every night, let me make it to both births and I would like a good night sleep between the 2 births. 

Well, I did make it to both births, but no good nights sleep between them.  (This is the 3rd time it has happened to me) That was a really long couple of days.

I have 3 moms due now and I am praying for a week between them.  Maybe that will get me at least a nights sleep between them. 

Again a great reminder that we have no control over when a baby will be born! 

Seriously, being on call makes me a little crazy!

I just love it when it IS a mom calling and her birthing time has started and I get to go to a birth. 

That is what I LOVE best about being a doula and it makes it all worth while!  (Even when I don’t get a good nights sleep between births)

I know some of you have moved away and can’t come and some of you may be on fun trips!  But I wanted everyone to know you are invited to a fun park day reunion! 
 
There is actually a new OC Hypnobabies Yahoo Group for Hypnobabies Students/Graduates everywhere in OC.  If you want to join visit here.
 
So we have planned a morning at the park,
 
Please join us at the park on Wednesday, August 26th at 10am. I’dlove to see as many of you as possible.

Contact me for location!

I finished reading Your Best Birth: Know All Your Options by Ricki Lake and Abby Epstein.  I mostly really loved the book.  (I will put the only drawback I found at the end.)  Through most of the book I was thinking, this is exactly what I would say if I wrote a birth book!

I love that it is not a book about “natural childbirth” rather it is focusing on educating yourself on your options and choose what is best for YOU.  That is my own personal point of view as a childbirth educator and mom.  There are a lot of choices out there for birth.  This book gives a great overview of many choices and the pros and cons in a very easy to read format.

I previously recommend The Thinking Woman’s Guide to a Better Birth and probably still will.  But it is definitely geared towards natural childbirth and more technical, so I think most mainstream moms wouldn’t read it.  I think most moms would enjoy reading Your Best Birth: Know All Your Options.  I want to buy a copy and give to every pregnant woman I know early in their pregnancy!  The sooner you figure out what you want for your birth, the sooner you can see if your care provider is a good match for you.

Here are some of my favorite quotes and my thoughts about them.

Why bother learning about birth?  You can’t predict what will happen!

“Even though you can’t predict, you can prepare.  You can get to know your body, understand your fears, strengths and values and get familiar with how the medical world might react to all of that and all of you.  This book is an attempt to put in your hands all of what we didn’t know when we started to consider the births of our children so that you can give your life with your baby a good start by arranging the best birth possible.”

YES!  So true, you can’t predict what your birth is going to be like, but you can prepare to have the best birth possible.  I think this book does that.

What is a Best Birth?

“…we feel that the true mark of a “best birth” is when the mother is respected, informed, and treated as a participant in every decision about her pregnancy, labor, and delivery.  We have observed that when doctors and midwives treat mothers as active participants in their own childbirths, the mothers always feel empowered, no matter whether their births are natural or surgical.”

YES!  Again a mom may have an elective cesarean be her best birth, after researching her options and making a choice to do so.  If she chooses to have an elective cesarean because her OB scared her into it, it will not be empowering.  It is the same type of birth, but very different experience for the mom.

Choosing Care Providers

“If your prospective caregiver makes you feel uncomfortable, difficult, or stupid sitting in the office, just project forward to how those same feelings will affect you on the day your child is born.”

YES!  Choose your Care Provider wisely!  This can not be overstated.  Also, even if they make you feel comfortable, you still need to know where they stand on certain issues.  If they induce most of their patients at 38 weeks, that will be setting yourself up for an induction.  ASK questions and listen to the answers and notice how you feel when they are answering them.

Childbirth Classes

“…there is no other area in our lives where we would so easily give over the decision making.  “Many peoples spend more time researching the stroller than they do trying to understand the physicality and the emotional-loadedness of getting a baby out of their bodies,” she said.  And a good birth class might actually change your mind about some of the things you didn’t consider.”

YES!  This is so true and so sad.  So many moms don’t take the time to learn about birth.  They say, “I will go to the hospital and they will know what to do.”   This is crazy to me, the hospital knows how to give institutionalize, one size fits all care.  So yes, they will know what to do, but it may not be what is best for you or your baby.  Also dealing with your emotions and fears before your birth will help so much during your birth!

“Look for classes that limit enrollment to no more than ten couples and take up fifteen total hours of class time.  Erica believes that’s the minimum time necessary to educate couples in all their choices as well as coach them in some effective coping techniques.  “Massage is a tool; privacy is a tool; vocalizing, breath work is a tool; visualization is a tool.  This is why I don’t believe there is a method.  It’s like telling people there is a method for sex.”

YES!  I like that they earlier said, “don’t take hospital based classes.”  An independent childbirth class is the best place to learn about all your options.  Smaller class sizes are better for more individualized instruction.  Also I agree there is no “method” to give birth.  I teach Hypnobabies, but in the class I am teaching many tools and with their practice at home they are reinforcing those tools.  Then during their birth they have a huge bag of tools to pick and choose from!

What I didn’t like.

As a Hypnobabies instructor I was happy to see hypnosis for childbirth mentioned.  Moms have different choices when choosing which method to use.  Each program offers different tools and information.

From the book, “Some midwives and doulas feel that moms who study HypnoBirthing may derive benefits from taking the course but are often disappointed when they start to experience pain during their labors.  These midwives and doulas warn clients not to harbor a false expectation that their births will be painless and then feel discouraged when they are not.”

This is a concern for many midwives and doulas that have only seen HypnoBirthing births.

I wish that they had shared information about Hypnobabies, which is a very different program. Hypnobabies has medical grade hypnosis (same depth used in dental surgery), 6 post hypnotic cues, and 10 hypnosis scripts on CD to listen to with 3 just for your birthing day.  The tools with Hypnobabies are so powerful along with complete childbirth information. I hate to see moms and care providers lump all hypnosis for childbirth methods together.

As the Hypnobabies Yahoo Group Moderator I read many birth stories where mom is completely comfortable for her birth!  I have gathered over 200 here and continue to put new ones on the Hypnobabies Blog.

Overall Great Book!

So overall, I think this is a great book for expecting moms to read.  Just remember if you are interested in hypnosis for childbirth, look at all your options!

This is the most challenging part of being a doula for me.  I can’t commit to anything except my expecting moms.

A friend calls and asks, “I have a dentist appointment on Wednesday.  Can you watch Logan?”

I respond, “Sure.  Unless I am at a birth.”

This leaves my friend in a quandry.  Does she hope I am not at a birth and risk being stuck with her son at the dentist, or does she find someone else?

Then there is the craziness of the fact my husband has a job of his own, which occasionally requires him to go out of town.  He will now suddenly be gone Sunday night through Monday night.   Apparantly my job doesn’t trump his and I am on my own to figure out what to do.

So I call my friend, “Are you willing to be on call to watch my kids on Sunday and Monday, just in case I am at a birth?”  She is kind enough to say yes, but I imagine she is praying that none of my moms birth Sunday-Monday.  She would double the size of her family,  potentially for 2 days.

“Just in case I am at a birth. ” I say that SO much,  I should really make an acronym for that phrase.

JICIAAAB

Pronounced, JickieAhb

Sounds like Hickie Saab, With a J and Without the S.  Getting a hickie in a Sabb could lead to a birth.

Though I think I more frequently say, “Unless I am at a birth.”

UIAAAB   Oooo EEE ahhh B

This really doesn’t sound normal at all.

I really like JickieAhb though.

Maybe this post should really be titled, Weird Acronyms and the Potential Problems Associated with Being Friends with a Doula.

Tomorrow I am heading to the Aquarium with above mentioned friend.  She says, she is happy to be my friend, but might be angry tomorrow if after paying $25 to get into the aquarium, we have to leave and drive home because someone is having a baby.

Hmm, maybe we will take 2 cars.

I love this part of the quote from my Restaurant Wars and Birth Wars post.

At home, you or the person doing the cooking is most likely preparing only one meal at a time.

That is the huge difference between hospital and home birth.

At home, you are the only one birthing.  You are getting individualized care.

At the hospital, there are many women birthing and you are getting institutionalized care.

I think moms should birth where THEY want to.  But they do need to be aware, if they choose to birth in the hospital, no matter how they prepare and what birth plan they write up, it is an institution and they are limited to that type of care.

Then why would you give birth without drugs?

This is a common question asked to moms preparing for Natural Childbirth.

Here is a great explination on you tube!  A shift in perspective. 

(If you prefer to read, rather than watch go here.)

[youtube=http://www.youtube.com/watch?v=I0xyB-Ujy8s]

Here are the videos referenced in the above video.

Video 1 – Man gets root canal using only hypnosis.

[youtube=http://www.youtube.com/watch?v=it_UfJ2by4k]

Video 2 – Woman gets teeth pulled and inplant put in, using only hypnosis.

[youtube=http://www.youtube.com/watch?v=Xgu6vk3_ByE]

Video 3 – Childbirth using Hypnosis

[youtube=http://www.youtube.com/watch?v=OA7Y_DnC_kA]

I really have enjoyed Elizabeth Pantley’s book the No Cry Sleep Solution.

I hated hearing my boys cry and while I did the Cry It Out with my older 2 boys once they were 1 year old, with Bryson I wanted to do things differently.  I found her book very helpful.

Here is an excerpt that we all can learn from!

Early Bedtime Mean Better Sleep

In their efforts to encourage their baby to sleep better, one approach that many parents use is to put their baby to bed later in the evening. They think, “If he’s ‘really tired,’ he’ll sleep better, right?” Wrong! This often backfires because Baby becomes overtired and chronically sleep-deprived.

In the majority of cases, a baby’s biological clock is preset for an early bedtime. When parents work with that time, a baby falls asleep more easily and stays asleep more peacefully. Most babies are primed to go to sleep for the night as early as 6:30 or 7:00 p.m. I often hear about how babies and toddlers have a “meltdown” period at the end of the day, when they get fussy, whiny and out of sorts. I suspect that it’s simply a sign of overtired children longing for sleep.