Milwaukee Doula Martha (262-902-8714) at Doula Woman post on labor induction

       This post is to clarify the general nature of labor induction and is not medical advise nor designed to persuade people to allow or not allow a labor induction on their body.

 Spontaneous labor almost always is the safest means to birth.  The likelihood that labor, birth, and  postpartum will be physically, emotionally, and spiritual healthy for the birthing person + baby  greatly increases with spontaneous labor.  Birth with both spontaneous labor and minimal or zero cervical exams very rarely causes fetal distress. Infection, c-sections, breastfeeding challenges, and postpartum depression happen more often with induction than with spontaneous labor.

Labor induction is common in southeast Wisconsin. It  happens about 50 to 70% of the time in first births.  Hospital and doctor protocol determine this percentage, so an individual’s likelihood of being induced is predominantly determined by which hospital they plan to birth in and their medical manager’s protocol.

You can say “no” to induction.

Under Wisconsin law, if you come to a hospital in active labor you must be “treated.” To my knowledge the legal and ethical rules about patient’s rights such as the right to informed consent and the right to be respected still apply when you come to a hospital in active labor.

Doula Woman has about a 32% induction rate. 90% of my clients are offered induction, or have an induction date set.  Of these over half have spontaneous labor prior to the induction date and some of my  clients say “no” to induction, often multiple times.

I wrote up the following summary of induction techniques.

  This is a summary of what I have learned and is  NOT a substitute for medical advise. 

1- AT HOME

NIPPLE STIMULATION:

This  releases hormones, so it somewhat resembles what happens naturally.  Suggest 10 or so minutes on each side for one hour at least.  You can use a pump. If contractions  start and then feel too strong or just wrong, you may want to contact your medical provider.

SEX:   Prostaglandin release can help. So intercourse here.  Also female orgasm.

Raspberry leaf tea:  Some swear by this.

Evening primrose oil:  Some providers will give you a script. I am pretty sure Outpost usually carries this.

Walk-rest combo. So you walk quite a bit and you also treat yourself to an extra good night’s sleep when possible.

Snuggle with your partner and create a spa atmosphere at home!

Acupressure:  Look up and you can do the “bring baby down” points too.  Pinky toe a good one and press hard!

Castor oil or black or blue cobash:  Obgyns say “no”to this.  These are commonly recommended by out-of –hospital or holistic providers and not  by in-hospital providers. FYI castor oil will cause you to poop up a storm.  Castor oil has been used in many cultures historically.

2-IN HOSPITAL

Hospital grade breast pump:  This can cause contractions and sometimes put you into labor.

Foley:  A catheter is inserted vaginally to open and soften your cervix. Usually done at night prior to a morning  Pitocin induction.  This is the most gentle way to soften the cervix.  Sometimes the Foley causes contractions for awhile, then these contractions stop. Rarely, the Foley alone can cause your active labor to begin.

AROM: One of your medical managers breaks your water by inserting a rod into your vagina.  This could kick you into labor, strengthen labor, or do nothing. Baby may have a harder time moving down in your body. You will probably feel contractions get suddenly very harsh.  You may be on shorter time clock than with other induction methods.  Suggest ask provider about potential negative side effects and how much time you have to give birth vaginally should you agree to AROM.   Generally best to do when baby already low in your pelvis.  Especially with a first baby this can lead to csection because baby cannot make the spontaneous moves needed to come down. 

CYTOTEC: 

Cytotec (Misoprostol) is commonly used to induce labor.  It is used to make the cervix “ripe.” It is a synthetic prostaglandin.  The med is off label and it’s intended use is to treat ulcers.  The Cytotec label states that it is NOT to be used by pregnant women.  Cytotec can cause severely abnormal strong-long contractions and hyperstimulate your uterus though  only rarely. Cytotec can cause fetal distress on moniter leading to csection.  Cytotec is strictly prohibited for vbac because it can cause uterine rupture.   It is used to cause planned abortions. Once in your system, cytotec  cannot be “turned off.” Time to work out of your system actually varies among women and the effects can last 6 +hours.  Sometimes cytotec can kick you into natural labor and you may be able to skip pitocin.  Most of the time cytotec  ripens your cervix but does not cause labor to start.  Usually given vaginally-can be given orally.  Cytotec is commonly used in most southeast Wi. hospitals. Suggest ask your medical manager  to go over potential side effects and alternatives.

CERVADIL: Mimics hormone dinoprostone in a hydrogel insert.  Used to ripen the cervix.   You may need to lie still for 12 hours.  May stimulate natural labor OR ripen you for Pit OR do nothing.

PITOCIN:

Artificial oxytocin.   Pit  can be turned down and it can be turned off.  I suggest ask the nurses to tell when they are turning the Pit up or down.   Pit causes your uterus to contract but does not mimic your unique natural labor pattern.   You are on a time clock for cervical dilation.  Medical staff wants contractions every X number of minutes (usually 3 minutes from start to start).

If Pitocin causes your cervix to swell you can ask that it be turned/off down and that something be done to reduce swelling prior to going directly to a c-seciton. 

When you have an epidural and your medical manager gives you x amount of time to push your baby out and if you fail to do so next step is csection, you may ask that the epidural be turned off so you push your baby out in spontaneous positions, thus allowing  for vaginal birth.

Pit contractions are harsher  than spontaneous contractions and you and baby  give up the“love hormone” benefit from spontaneous labor as well as many other mechanisms that help you and baby physiologically.

The vast majority of hospital inductions involve Pitocin.

Hospital inductions include continuous fetal monitoring because these chemicals are dangerous.

 Suggest ask that if induction does start natural labor, could you switch to intermittent monitoring.

Also-if you agree to induction you can ask for your Bishop score….this gives an idea of both how to start the induction and the likelihood of a successful induction.

Oh, and if you agree to a night time arrival, you may look up benefits of a sleeping pill…Inductions can kick in AFTER you have already missed one to three  nights sleep.

Peace

Martha at Doula Woman

Milwaukee doula Martha at Doula Woman 262 902 8714 post on Hypno birthing

On a role with hypno clients, so sharing here.  I am a certified hypno-doula by Hypnobabies.

Hypno-birthing is a means to own your pregnancy and birth as you trust the physiologic process, stay healthy, release fear, and mold fear and demeaning stories of pregnancy and birth into positive strong and woman-capable stories.

As a hypno-doula I know the lingo and am fully trained in the concepts.

As a birthing person, Hypnobabies is your childbirth education.  You attend classes or purchase the at-home version.  This does involve at least a half hour per day of “homework” aka guided relaxation, putting yourself in hypnosis, many audio tracks, and more.

Hypnobabies is set up such that your “easy comfortable birth” flows well and you do not need an epidural and other interventions.  That said, there is a “change of plans” track.  Hypnobabies can be used for out of hospital OR in hospital births.

I did recently have an in-hospital client stay with her hypno the entire time.  She had a beautiful birth. The staff was supportive too.

Since I am a hypno-doula, we can discuss this option in greater detail if you like.

Sincerely, Martha at Doula Woman in Milwaukee, Wi. 262 902 8714.

Milwaukee doula Martha post on newborn breastfeeding to keep it natural.

Almost all women who birth can breastfeed.  About  95% of these women are capable of exclusively breastfeeding.

Still, due to hospital birth, medical management, and some cultural practices breastfeeding often is challenging. AND despite this women are strong and loving and babies are resilient.

When you veer from  physiologic breastfeeding and physiologic newborn-mom bonding it creates challenge.  Naturally mom and baby would be touching each other at or close to 24-7 even when mom sleeps.  Most of this time baby would be chest to chest with mom.  In this way, baby stays fed, warm, loved, healthy, and both mom and baby sleep.

Hospital protocol interrupts the natural course to varying amounts:  baby is in a container when mom sleeps, baby is bathed or toweled, baby must weight  X amount even though his/her birth weight is artificially high due to fluids that mom received during labor, baby is taken for tests, lights are bright, baby must cry right away or is removed from mom seconds after birth to be put on a warmer, baby is often swaddled.

When hospital protocol mandates supplemental bottle feeding in the first few hours or days, the likelihood of successful breastfeeding plummets.  Still, some babies seem to “forget” the one or two bottles they were given in-hospital and latch O.K. and go on to exclusively breastfeed.  Most of the time, when baby gets a bottle within the first few weeks, and especially within the first few days,  it is a long haul to keep up your milk supply and/or a long haul for baby to latch O.K.; both are needed for exclusive breastfeeding. You CAN regain supply and exclusively breastfeed though even when supply is interrupted, but you almost always need a lactation consultant or specialist to help you.

Once home you have control and can do the following:

1. Feed your baby as much as you and baby are able. Aim for averaging 2 hours from start to start of feedings with no time limit on duration of feedings in the first few days to weeks.  Keep baby on your chest as much as possible. Notice the difference between actual feeding and comfort suckling.
2. If baby sleeps more than 3.5 hours at a stretch consider waking him/her to feed. This is the current advise from most specialists.  That said, it is your baby, and every person needs sleep.  If you find yourself circling here, you may choose to take a break from waking up your baby.
3. Hold off on bottles for 6 weeks if feeding is going well, and longer if you have challenges.
4. Contact a specialist if baby does not reach the “medical bar” on wet and poopy diapers, does not seem satisfied from feeding, YOU have sore nipples or engorgement, or either of you have a fever.
5. If you agree to supplement use a supplemental nursing system, and if it takes you awhile to obtain one of these use a dropper or spoon until you obtain one.
6. Baby stays with mom almost all the time. The co-sleeping cycle advise has recently moved on the pendulum and now some experts advise TO co-sleep when mom is O.k. with that.
7. Ideally, mom does nothing but care for herself and baby and eat and rest.
8. If you have challenges:   change nursing positions, head-off engorgement, address latch for as long it takes, and contact a lactation specialist immediately rather than later.
9. And no 1 REALLY-PUT YOURSELF FIRST, BABY SECOND, and postpone activities and decisions meant to please other people until you are settled with your newborn.
10.  And Sincerely, Milwaukee doula Martha at Doula Woman.

Unassisted home birth v. midwife home birth

Home birth currently is divided into three general categories.  This post outlines the three categories from my perspective as a birth and postpartum doula working in Southeast Wisconsin.  The purpose here is explain the similarities and differences among these birth options in a general sense.  YOU are always the decision maker and final authority on yourself and your pregnancy.

1. PLANNED UNASSISTED AKA FREE BIRTH.  In this model, you are the sole power and authority for your birth.  You are the only person managing your birth and you have consciously decided to do this.  So during the birth process you and your baby remain as a single unit.  You birth in your home, the home of someone else, outdoors or “other” such as a motel.  Your labor and birth are physiologic and undisturbed.  You may choose to do this alone,  you + your partner,  or with the support team of your choice.  When a doula attends free birth, the scope is the same as managed births in that the doula is not medically managing you such as:  not assessing baby’s or your health, not performing cervical exams, blood pressure checks, blood loss estimates, etc.  Some people receive medical management during their pregnancy  and then free birth, while others skip medical treatments entirely.  Some people research and make personal choices such as what to eat, water-birth etc. based on this research.  Some people birth this way because they have full faith and trust in the birth process and value the sacred nature of pregnancy and birth.  Some people birth unassisted due to fear and/or have been brutalized or traumatized by  people in the medical establishment. Some people birth unassisted when they have hidden their pregnancy. And, of course, this is a continuum with people birthing alone for a combination of reasons.
2. PLANNED HOME BIRTH (OR BIRTH CENTER BIRTH) WITH A MIDWIFE. In this model, you and your midwife together manage your pregnancy and birth.  Attention is on your over-all health and you and baby are viewed as a single unit.  In contrast to most doctor-hospital based  models, you are cared for with attention, respect, and holistically.  Midwives will spend plenty of time with you at prenatals, work with you to reduce stress, and suggest you maintain your health and create a healthy body and mind for birthing through self-trust, creating a balanced life, trust in the birth process,  nutrition, etc.  You birth physiologically and often primarily undisturbed. Your midwife comes to you during labor, catches your baby, and medically assesses you and your baby during labor, birth, and post-birth. A second midwife joins the primary midwife prior to birth so that when baby is born there is a midwife for you and one for baby.  Midwives carry emergency equipment such as oxygen, newborn CPR equipment, and medicine to stop hemorrhage.  You may have a nurse-midwife or a certified professional midwife and both are highly trained.  These midwives operate within the scope of Wisconsin law and so are somewhat accountable to the medical model; for example, you are sent for medical tests sometimes,  you must be in progressing labor at least 24 hours from membrane release, you must maintain a certain blood pressure, etc. If the midwife, at any point during your pregnancy or labor, feels you are not low-risk enough, you get “risked out” and sent to birth in-hospital. When a doula attends a midwife birth, as with unassisted birth, the role is 100% non-medical.  Midwives can and do help with labor support, but their basic role is “instead of a doctor” as opposed to “doula work.”  Most people choosing midwife attended birth do so because they trust the birth process, value the sacred nature of pregnancy and birth, and feel comfortable with a “just in case” medical management team present.  Some choose this to keep their power and voice  because this is impossible in-hospital.
3. UNPLANNED HOME  or OTHER OUT OF HOSPITAL BIRTH. This happens when you planned to allow managed birth by a doctor or midwife either at home, hospital, or birth center, and your baby is born prior to the arrival of the medical provider and/or prior to your arrival at the hospital.  Most of the time this happens when you have a fast labor or fetal-ejection-reflex meaning your body goes totally primal and your baby suddenly appears earthside.  This could happen due to logistics, such as extreme weather, traffic jams, being tied to duties such as providing childcare, elder-care, or paid employment.

 

Sincerely, Martha at Doula Woman in Milwaukee, Wi. 262-902-8714. And feel free to ask me how to obtain more information on any of these birth options.

Southeast Wisconsin doula Martha at Doula Woman post on labor positions.

Labor positions are often taught in childbirth education classes.  Examples “when baby is posterior go to hands-knees” or to “speed up labor do the miles circuit” or to “decrease back pain lean forward in the shower.”  All of these and many more can be helpful when you are on a timeclock for labor to “progress.”  Especially when you are in hospital and then especially when you have been induced and/or allow cervical exams.  When you labor and birth physiologically there is no need to “learn” these positions as you and your baby and your hormones will dance into just the right positions for your mom-baby unit.

Labor at home in Milwaukee

Milwaukee doula Martha at doulawoman.com post on Skip vaginal exams and birth!

Yes, you can give birth without any vaginal exams.  Your baby will come out of you, and into your arms, and you become a mom of a newborn.

Your body can do this.  This is why there are so many people around today.

The idea of knowing cervical dilation as necessary to healthy birth is very new.  Some male doctors put out a curve about normal dilation.  Then, from that birthing women went to accepting a passive role as needing to be cared for and told what to do.

In my doula experience not one clients who agreed to routine vaginal exams  has actually come close the “normal” curve of dilation when birthing.  The exams do sometimes create a mental block and labor slows down.  And, there is a risk of infection which could lead to fetal distress and csection.

Of my clients who birthed free from vaginal exams, they ALL rocked it and birthed a healthy baby who went straight to their mom’s chest.

Sincerely, Martha at Doula Woman in Mke., Wi. 262-902-8714.

Milwaukee Doula Martha at doulawoman.com post on free birth.

I  started my on-line course with the Free Birth Society.  At completing   4% of  the course  I already love this!   I found people who see pregnant and birthing people and parents as living breathing animals-not victims of their own bodies and in need of rescuing.

If you consider physiologic pregnancy and birth as options for you, I suggest check this out.

Sincerely, Martha at Doula Woman in Mke, 262-902-8714

 

Southeast Wisconsin doula Martha at Doula Woman post on csections and doulas.

Yes, doula support is for planned csection births.  Now sometimes called belly birth, this is you giving birth and you can have doula support.

You get physical, emotional and spiritual support as you would with a vaginal birth.  You get guidance to research your options should you like.  For example, a birth plan stating your wishes about delayed cord clamping, skin-to-skin, bottle substitutes if hospital protocol demands a supplement, vaccines, etc. is an option.

Most of the time I end up in the O.R. with the birthing person and the partner.  When you are single, your doula can almost allows be allowed in the O.R.

Translation of medical talk is always a big part of my doula support for planned csection clients.

I stay with you in recovery and as long as needed after birth and can help with breastfeeding, keeping your wishes known to staff, and partner support.

Many people only want a csection as a last resort.   Hiring a doula and choosing a “trust women” provider can maximize your chance of a vaginal birth.

Almost all of my clients who had csections had them due to breech presentation following numerous attempts to turn baby.

Breech babies can be birthed vaginally.  The reason for csection breech births is geographic.  In southeast Wi a handful of providers will attend a breech birth if you have birthed vaginally prior to a full-term baby and meet other criteria.  You CAN birth without an attendant or you can travel to a place where there are providers willing to attend most vaginal breech births.

Your options.

Sincerely, Martha at Doula Woman in Milwaukee WI.  262-902-8714.

Doula Milwaukee Martha at Doula Woman post on freebirth.

Free birth means you give birth physiologically.  Your baby is born from your body naturally as with other animals. Your birth is not managed by anyone or anything externally.  You may choose to have a support team or birth alone but you are free from a provider.

As a doula I can attend free births as a support person.  There are  free birth classes available on line for you to prepare, you can look things up on your own, or just go with it at the moment.  Some women choose to have prenatal care for part of their pregnancy and then free birth.  Sincerely, Martha at Doula Woman in Milwaukee Wisc. 262-902-8714.

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Doula southeast Wisconsin: Martha at Doula Woman post on What is the best way to_____? Schedule a free consult: 262-902-8714.

As posted prior, I am deep in doula land and my doula work and life in general are interwoven now.  So, with moving toward more “oneness” time comes more reflection time. And this is today’s reflection.

Often clients consider:

• what is the best way to breast feed?
• better to feel it all or have an epidural?
• agree to care provider on everything or say no to some things?
• free birth or managed birth?
• (if managed) birth in or out of hospital?
• lots of family around after birth, or keep it just mom-baby (or mom-baby-partner)?
• no to immunizations, yes to all, yes to some?

Currently there is so much advise, studies, “best” ways to do things, etc… This can be challenging for many people, especially when pregnancy and parenting are new and when looking within for answers is often discouraged or something not practiced.

So,yes another to consider FROM WHERE IN ME is the answer to “what is the best way to do_____________?”  There are as many best ways as there people.

Sincerely,

Martha at doulawoman.com 262-902-8714.