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What is missing from our care for women having babies?

Women today in this country are very lucky to have access to exceptional prenatal care from midwives, physicians, and obstetricians (and locally from Healing Hands Chiropractic!).  They have a variety of options available to them for labor and delivery as well:  hospitals, home births, free standing birth centers, etc.  Prenatal care and choices for birth have really come a long way over the last few decades in the United States.  However, I believe there has been a detrimental decline in one large area:  postpartum care.

Throughout pregnancy, women are consistently seen by their care providers.  However, after having the baby they are lucky to have a two-week follow up appointment with most only having a six-week follow up appointment.  An OB nurse practitioner who I spoke with recently said she feels badly for her patients that she sees at their six week check-ups.  “I’m supposed to be checking their physical recovery from birth,” she said, “but they all come in here crying and I just don’t have time to give them the support they need.”

Enter the postpartum doula!  Postpartum doulas are knowledgeable professionals who assist families during the critical period immediately after the birth of their baby.  They “mother the mother” and offer physical, emotional and informational support to the family, as well as practical help.  The doula’s expertise in mother and baby care enables her to assist with postpartum comfort measures, breastfeeding support, non-judgmental guidance in infant care techniques, information on normal postpartum restoration, and family emotional assistance through this major transition.

These doulas provide essential support during the modern postpartum experience, a time when many mothers today feel uninformed, isolated and anxious.  Traditionally, the postpartum period was a “nesting period,” when a new mother was attended to by other experienced mothers.  They helped take care of her and her family, so that the mother could focus on the vital tasks of postpartum recovery, emotional adaptation to great change and getting to know her precious little one.

Today few families have such support, and frequently become exhausted and overwhelmed by the immense work of becoming parents.  Postpartum doulas gently guide and support families through this transition so that they may get off to the best start with their new baby.

ACTION PLAN:

Instead of focusing on changes that need to be made with our healthcare system, I’d like to focus on societal changes that we can instantly start working on now -on an individual basis.

So, what can you do?

If you are pregnant:

  1. Complete a Postpartum Plan which can help you draft a list of postpartum resources that are available to you:   http://www.dona.org/resources/doula_practice_postpartum.php
  2. Hire a postpartum doula, to find one in your area, click here: www.dona.org
  3. Call your insurance company now to find out if they will cover postpartum care and if not, if your Flex Spending Account will.
  4. Line up friends and family to cook meals and deliver them to you.  If your friends are lousy cooks, hire a personal chef like The Dinner Goddess in Epping (http://www.thedinnergoddess.com/) or check out some meal registry sites like www.mealbaby.com
  5. Search out places to meet other new moms, like the La Leche League meetings at Healing Hands, Mom & Baby Yoga or Music classes and other Mommy & Me groups.   www.meetup.com is a great place to find people!   Include these ideas in your Postpartum Plan so you have them written down once the baby arrives.

If you have a new baby:

  1. Ask for help!  People always ask if there is anything they can do to help – take them up on it!  Say “Yes, please come hold the baby so I can shower.”  Or “Please cook me a pot of soup.”
  2. It’s not too late to hire a postpartum doula if you need to.  To find one in your area, click here:  www.dona.org
  3. Reach out to other new moms.  Get out of the house at least a few times a week.  See #5 above.
  4. Remember you are not alone.  Motherhood is hard and is better when you are getting the support you need.
  5. Push aside the thank you notes, step over the laundry basket and GO TAKE A NAP!

Darcy Sauers is a certified postpartum doula and the owner of Dover Doula (www.doverdoula.com) in the Seacoast area.  As a member of both the Seacoast Doula Group (www.seacoastdoula.com) and Great Bay Doulas (www.greatbaydoulas.com), she is passionately committed to helping new moms find the support, resources and information that they need. Darcy is very happy that moms in Southern NH are lucky to have such a wonderful prenatal and postpartum resource in Dr. Jess and Healing Hands Chiropractic.  Please do not hesitate to contact Darcy with any questions at darcy@doverdoula.com or 603-988-5945.  For more information on the postpartum period and local resources and events for new moms, follow her on Facebook (https://www.facebook.com/#!/profile.php?id=100000200069253)

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OB, Midwife, Doula – What Is the Difference?

Parents today have more options than ever before when deciding who will provide their prenatal care, who will attend their baby’s birth, and where the birth will take place. Many of these options indicate a positive shift in the way our culture views maternity care: Parents can (and should) be actively involved in selecting the type of birth they want for their family. Unfortunately, the overwhelming number of choices, combined with a lack of cultural familiarity with birth itself, sometimes leads parents to choose a “default” birth (read: OB-attended birth in a hospital with standard medical interventions) rather than thoroughly exploring their options.

The primary goal of Healing Hands Chiropractic’s pregnancy and childbirth workshops is to demystify the process of birth and the choices involved, allowing parents to choose the options that are best for them and for their baby. Understanding the difference between types of care providers is an essential part of planning the birth you want.

In the United States today, the vast majority of births are attended by an obstetrician (OB), a medical doctor who specializes in pregnancy and childbirth. Obstetricians are trained to manage low-risk pregnancies and deliveries, but are especially skilled at handling complications. They can attend vaginal births as well as perform cesareans. Among OBs, there may be a wide variety of attitudes toward pregnancy and birth. If you are considering care with an obstetrician, it is important to make sure that his or her philosophy on birth is similar to your own.

Midwives are extensively trained in providing care for low-risk pregnancies and deliveries. A midwife practicing in a hospital is usually a certified nurse-midwife, or CNM. CNMs are registered nurses who have additional training and experience with maternity care. CNMs in hospitals generally work in conjunction with one or more obstetricians, and can consult with them or even transfer patients to their care should complications arise. Many CNMs tend to have a more hands-off, holistic attitude toward pregnancy and birth, though this is not always the case. A CNM practicing in a hospital is often subject to institution policies, including standard procedures for length of labor after admission to the hospital, eating and drinking in labor, and management of complications.

Midwives who practice outside of the hospital have different credentials depending on licensing regulations in each state. (In New Hampshire, the designation is CPM, or Certified Professional Midwife.) Unlike hospital-based professionals, Direct Entry Midwives are trained in birth first, medicine second. Even more than a CNM, a CPM tends to regard pregnancy and birth as a natural, healthy process that requires little to no intervention. (Midwives have been known to say that they do not “deliver” babies, they just “catch” them.) Direct Entry Midwives attend births in free-standing birth centers and at home. They are trained to watch for and manage complications, and to transport clients to the hospital when necessary. Their labor bags include medical equipment to prevent or manage maternal hemorrhage, to provide sutures in the event of a perineal tear, and to resuscitate a newborn. An out-of-hospital birth for a healthy, low-risk mother is neither dangerous nor irresponsible. In several studies, home birth has actually been shown to be safer than hospital birth, because the mother is not subject to standard procedures that may lead to complications.1

Doulas are labor support professionals. They are not responsible for the medical aspects of birth, but provide emotional and psychological support for the mother and her birth partner. A doula is also trained to interact professionally with hospital staff, and can act as an advocate for the mother should the need arise. A doula generally arrives earlier in labor than other birth attendants, often supporting the mother while she labors at home and then traveling to the hospital with the parents. She can help with the initiation of breastfeeding and may also offer additional postpartum support. (For more information, including the distinction between labor doulas and postpartum doulas, please check out Doulas of North America: http://www.dona.org/mothers/index.php)

Practitioners at Healing Hands Chiropractic regard pregnancy and childbirth as natural processes in which both parents should be involved and educated. For more on birth choices, consider an upcoming childbirth series or early pregnancy workshop. Email jenny@healinghandsnh.com for schedule, rates, and registration information.

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The Ecstasy of Birth

Quote: “There’s just no reason to do it any other way.” Said by many a new mother sitting in a hospital bed, following the virtually pain-free birth of her baby, thanks to the wonders of modern medicine. Years ago, when my sister-in-law and I had this conversation, I found myself at a loss. Having just delivered my own daughter without medication or other intervention, I felt conflicted. I disagreed with her logic, but could not seem to come up with an articulable counter argument, and that frustrated me.

Before we go any further, let me be clear: I count women who have chosen  medical birth among my dearest family and friends. I have no wish to offend them or anyone else. And for a minority of mothers, medically-oriented labor and delivery is the best option. But natural-birthing mothers have been silent too long, and it’s time we respond, “Yes, there absolutely is a reason to do it another way.” To more accurate, there are several reasons, and the evidence on the sheer physical benefit of physiologically normal birth is compelling. But let’s forget about the science for a moment and talk about one specific, albeit abstract, reason: Elective childbirth without medication just may be – no, will probably be – one of the greatest sensations of your life.

Is childbirth painful? You bet. It’s probably some of the most extreme discomfort many women will experience in their lives. Childbirth educators like myself often shy away from the word “pain,” because we don’t want to scare anyone. But let’s face it: “Discomfort” does not begin to describe the sensation of transition contractions. Birth hurts.

But that’s only half the story, and if that’s all you’ve heard, you’ve missed the best part. Yes, birth hurts. But birth also heals. Childbirth is not only one of the most physically painful things many women will experience; it is also one of the most physically and emotionally ecstatic.

I’m convinced that many mothers shy away from discussing this aspect of birth for two reasons: 1) It is highly personal, and 2) It is extremely difficult to articulate.

Describing to anyone your feelings at the birth of your child is to let them in on one of the most intimate experiences of your life. It requires a level of intimacy that most of us share with very few people. Even more challenging, the ecstasy of childbirth is nearly impossible to put into words. But its inarticulable nature does not mean it doesn’t exist. By way of contrast, consider some of the more intense experiences of your own life – moments that enveloped you physically, emotionally, and spiritually. And then ask yourself: Could anyone possibly put that experience into words? Poetry might be able to come close, but prose? Could a random, double-blind, controlled scientific study even begin to touch it?

For most people, the answer is no. There are experiences that cannot be put into words. Science may reflect the hormonal surges that lead to the feelings we experience, but science cannot describe the feeling itself. Now ask yourself: How do you normally respond to an experience that is “too good for words”? Doesn’t its inarticulable nature only make you want to try it more?

So here’s my suggestion: If you are expecting a baby and find yourself on the fence about natural childbirth, put down the research books. Instead, talk to a mother who chose to deliver her child without medical intervention.  Ask her about her experience. (Don’t be shy – most mothers love to tell their birth stories!) Notice her enthusiasm, her attitude towards labor pain, her level of confidence. Ask her if she would have chosen a different approach to her baby’s birth. I’ll wager that she’ll tell you: “There’s just no reason to do it any other way.”

 

Considering a natural birth? Want to learn more about your options? www.HealingHandsNH.com/childbirth.html