Over the last 4 years I have gathered quite a bag of tricks that I bring along to births that I attend as a labor support doula. Some of what is inside my bags was passed on to me from other doulas, some of the things I picked up at my recent Midwifery Assistant class at The Farm and some I figured out on my own.
I dont always use everything that I bring along, but it is nice to always have the option should I need something that could provide comfort to the mother in labor.
I personally only bring one bag along, a back pack, since I want to have my hands free to help the mother and carry anything that she needs. My back pack has three compartments. So lets start with the front and work our way back.
Small front pocket
My watch. I dont always time the contractions, but I like to get an idea of how long the contractions are lasting and how far apart they are. Plus, I keep detailed notes of all internal checks and other relevant information, for example, when we go to the birthing center or hospital or when the water breaks.
Pens and Notes books. This is for my note taking.
Toothpicks- I often bring cut fruit for everyone that will be involved at the birth. This is a good way to create diplomatic relationships with the hospital staff. Plus, I am a strong believer that laboring women should not be starving themselves. So if mom wants a piece of easily digestible fruit, it is right there waiting for her. (I also bring frozen grapes since they also have natural sugar and are refreshingly cold)
Those that have given birth might be confused to why I bring food since many hospitals state they only want the patient to have only clear fluids or ice chips. Here is my reason: Lamaze International states: A recent review of the research on this topic found that there is no evidence that restricting food and fluids in normal labor is beneficial.15 Recent research shows that eating and drinking are safe in normal labor.15,20,26,29 Based on the best evidence available, food and fluid should not be routinely restricted in labor.
The American Society of Anesthesiologists and the American College of Obstetricians and Gynecologists (ACOG) recommend that clear fluids be given to low-risk woman during labor.3 The American College of Nurse-Midwives recommends that healthy women experiencing normal labors determine for themselves what, if anything, they wish to eat or drink.1 The Cochrane Pregnancy and Childbirth Group recommends a diet of easy-to-digest foods and fluids during labor.13
Washcloth even though the hospital has paper towels, I find a soft terry cloth washcloth is much more comfortable on moms neck and face.
Plastic Ziplock bags- I have been quite fortunate that I have never needed to use the bags for this purpose, but the cab ride to the hospital can be bumpy and uncomfortable and mom may vomit. Often times we go to the hospital rather late in the labor process and vomiting is a sign of transition!
Corn Starch- It is not good to use baby powder during labor since inhaling talcum powder is not good for you or baby. So instead I bring corn starch. More often I use massage oil, but if the mother doesnt like the feeling of oil, I have the corn starch available.
Several packs of high quality hard candy or honey sticks- if the mother does not want to eat or drink anything and she is not receiving intravenous fluids, it is likely that her blood sugar will drop. In that case, sucking or chomping on a hard candy can perk her back up.
Middle Pocket on the Bag.
Bendy Straws- When mom is in hard labor or pushing, it is much easier just to place the bendy straw at her lips then to try to have her sip from a cup.
Big plastic bag- After I leave the birth and before I step foot back in my apartment, I take off my shoes and place them in the plastic bag and then wash my shoes before wearing them again. Birth can be a rather messy experience. I could have possibly stepped on vomit, urine, amniotic fluid, or blood. I certainly dont want to track that back into my house.
Hydrogen Peroxide- I typically wash off the sink, counter, toilet and bath tub. I know that the rooms should be cleaned, but I would rather do a quick cleansing of the space before hand.
Band aids and Neosporin should I or anyone else at the birth get a cut, a hospital is no place for an open wound.
Soft gardeners pad- the mother may want to be on her hands and knees, so a little padding could go a long way.
Inside the small toiletry bag-
*toothbrush and tooth paste. I am often very close to moms face, she doesnt need to smell my coffee breath!
* massage and aromatherapy oils- I bring several different options, lavender, Bindi herbal massage oil, lemon, peppermint and non-fragrant.
* hair bands for both mom and me
* lip balm- women in labor often breath heavily and their lips get dry. A little lip balm can be very comforting.
* deodorant- always want to smell fresh!
*nail file, advil, cough drops, tea (caffeinated, for me!), wet naps, emergen-C or airborne (hospitals are full of germs), energy bars, cough drops
Yoga Strap- should mom want to do a supported squat and my arms and hands are tired.
Big Pocket of the Bag
Birth Ball and pump- I take a 65 cm ball and a VERY good, quick pump with me. I recommend to all my clients that they have one to use at home before the birth, but in case it gets left behind, I have one on hand. The ball is EXTREMELY useful. Most laboring women use it to sit on, lean against, hang onthe possibilities are endless! Even if mom doesnt end up using it that much, it provides another seat for the people in the room, since generally there is only one chair available.
Hand held fan- labor is tough work and mom will build up a sweat. So a little cool breeze could feel real nice.
Squirt bottle- this has two purposes. 1. I add a little bit of essential oil (what ever smell mom likes) and spritz it around the room. Labor doesnt always smell so good! 2. it could feel really good for the hot laboring mom to get a refreshing mist of cooling, yummy smelling water on her face, neck, chest or back.
Eye pillow- this could feel really good on the laboring moms eyes if she is resting. It could be heated or chilled.
I hope that some of these tips and suggestions can help make mom and her labor partners more comfortable.
October 30th, 2007
Recently I have been feeling uninspired and tired. As much as I love what I do (and I consider myself fortunate that I really do love my career!) I feel like I have not been putting my full passion into it the way I usually do.
I come home complaining that I want to get a way. I am not really sure where I want to go to since John and I are not shy about taking a vacation. But this time it feels different. I dont think this uneasy feeling is going to be solved by a weekend at a spa (although that does sound really pleasant!) because upon returning I am still stepping back into the role of a small business owner and need to find a way to be present and grounded amongst the chaos of daily life. Plus - how realistic is it to run off every time I feel overwhelmed! I was talking to my friend and fellow yoga teacher, Karen, about this discontent I have been feeling. Since she is the mother of two teenagers, I figured she has experienced this same thing on at one time or another. She responded, Absolutely there are times when I just want to check out. But you need to find a way to reground yourself without actually leaving.
So since booking a last minute vacation to the spa is out of the question, I have been exploring other ways to clear my mind and get grounded. And then it hit my like a load of bricks, meditation. I have been practicing Hatha yoga for 10 years but never really committed to a sitting mediation. The study and practice of Hatha yoga is to prepare the body to sit for mediation. For me the natural progression into mediation feels very comfortable and welcoming.
I have started to explore a sitting mediation practice. I know I should probably go study with a mediation teacher, just as I do with hatha yoga, but for now, I am just trying to find stillness within my mind and learn to just sit without feeling the need to be entertained and distracted. My practice right now is pretty basic. I have a few Sanskrit mantras that I like and repeat those or just focus on the word OM. I find that this quite time allows me to refocus and clarify my intentions for my life, my job and my relationships. It has been like taking a little vacation right in my own skin.
I am slightly embarrassed that it took my 10 years to get here, but I also believe that everything has its own schedule. Our eyes are opened to reveal what we need, when we need it (even when what we may need might have been right in front of us the whole time.)
October 14th, 2007
Three weeks ago I received a phone call from Pamela Hunt at the Farm Midwifery Center informing me that a space became available in the Midwifery Assistant Workshop. At first I hesitated. The class was to start in less then 2 weeks and if I went, I had a lot of preparations to take care of. But after talking it over with my husband, I decided to just go for it! After all, as I have learned from many of my students, “If you always wait for the perfect time, you will always be waiting.” Besides, I was dying for the chance to go see and learn from The Farm midwives.
After a slight delay at the airport gathering some of the other members of our group we soon passed through the gates of The Farm. (Let me pause here for a moment to give you some of the background of The Farm.)
Back in 1970 a group of well intentioned hippies took to the road on a caravan of more than 300 people and more then 50 white topped and pastel bottomed buses to start an experimental community. Along their travels, as nature would have it, a baby was ready to be born. None of the attendants on the caravan had any experience with helping to birth a baby, but Ina May and several other women went to assist with the birth. After finally “landing” (as the locals like to say) in Tennessee, it became apparent that the babies were still coming and they did not have the means in which to pay a doctor so they were going to have to learn how to deliver babies themselves. With the help of a generous and kind local doctor, Dr. William, the women taught themselves how to birth babies. This was the starting seed to what has now developed into a notable, very skilled and highly respected group of women called “The Farm Midwives.”
Fast forward a bit and the “crew” refined their skills and became certified midwives. One study compared The Farms statistics with US National Natality/National Fetal Mortality Survey and revealed The Farm to have a 1.5% cesarean rate, a lower perinatal mortality rate, labor related complications and assisted delivery (the use of cesarean birth, foreceps or vacuum extracator) In the past 30-something years thousands of babies have been born in the cabins and homes of the expectant moms. Women from all over the country come to The Farm to have their babies. One reason could be because of the excellent care (many of the original crew members are still catching babies.) and the fact that these midwives still deliver vaginal breech babies and twins. Sadly, these are skills that are not often taught to many current OB/GYNs.
The week I spent at The Farm revealed the most meticulous, instinctual and caring work I have ever seen in childbirth. These women palpated bellies and felt for fetal suture line to determine baby position instead of solely relying on ultra sound machines. They check for the baby’s heart rate without being confined by an external fetal heart rate monitor by using a fetal scope. I wish more doctors would roll up their sleeves and dive into the trenches and not be afraid to touch a woman. I have attended about 50 births to dates and very rarely see a doctor touch the mom’s belly.
The first hint to this amazing history was revealed not long after arrival. After a short orientation, I walked over to the cabin I was staying at. While waiting for my roommate, Pamela (our primary teacher) and I were chatting. I expressed how excited I was to observe and learn their birthing rituals. I asked her when we will get to see the midwives “in action” at a birth. She promptly replied “Oh no. You have to have met the mom at least 4 or 5 times before being invited into the birth. This way the mom can feel comfortable, unselfconscious and relaxed.”….”Interesting” I thought…But of course! How many of us can poop or make love with strangers walking in and out of the room. Yet we are expected to open up and experience the intimacy of birth with a myriad of people parading in and out of the labor and delivery rooms!
So I had been at the Farm barely an hour and I was was already seeing the error of our ways….
….More about The Farm to come!
October 3rd, 2007
