Doulas

Five Things You Should Ask Before Hiring a Doula

By Rae Crawford, Certified Labor Doula

So you have decided you need a doula! What now? First things first, interviews! Each doula has different skills and services that they offer. One may offer a pre labor massage while the next may know how to use hypnobirthing. It is important that the doula you hire supports what you desire to have in your birth.

To read the rest of this article click here.

Down with the gown: Local doulas develop stylish skirts and tops for expectant mothers

By Pam Mellskog
© 2011 Longmont Times-Call

After delivering her first baby 10 years ago, a Berthoud mom boycotted the hospital gown that exposed her backside and bunched up as she moved in and out of different labor positions.

Carri Grimditch instead wore a homemade birthing skirt — an oversized miniskirt with a drawstring in a purple floral print — during the labor and delivery of her next three babies.

“You’re not getting your tonsils out at the hospital. You’re having a baby!” she said. “But some women don’t know that they don’t have to wear the gown.”

As a certified doula — a professional, nonmedical childbirth assistant — Grimditch, 34, designed her line of BINSI birthing skirts and tops to make the option available to other expectant moms.

“(The hospital gown) made me feel less like a soon-to-be mother and more like patient No. 2453-A,” Grimditch said. “Instead of walking in and putting on something drab and clinical, you can wear something that you’ve chosen.”

Research shows that personalizing the birth environment with keepsakes, music and scents decreases a woman’s stress, she said.

Longmont resident and fellow certified doula Kimberly Taylor joined the company in 2005 as a business partner.

To read the rest of the article click here

Doula Digest - Using Doulas for Birth Care

Midwifery Today July 20, 2009

Birth Essentials

Birth Story - Kellen and Aidan's birth

Written by Kellen, friend of BINSI

Hello all! I wanted to share my birth experience for those who are considering a natural (no medicine) birth. I must preface this by saying that when I initially heard about a drug-free birth, I thought the lady (who was doing it with twins) was absolutely crazy. Then, I started to think about it a little more and look into my options. That's when I discovered Hypnobirthing and my doula, Vivian.

I probably need to tell a little about Hypnobirthing... Hypnobirthing is a birthing method that uses breathing and relaxation techniques that allow you to eliminate/reduce the fear/tension/pain cycle that is the cause for most of the pain that a lot of women feel. The breathing and relaxation allows your muscles, hormones, and bodily chemicals to work in harmony and allow our incredible "baby machine" work easily!

Okay, with that said...here's my story! After I decided that HB was for me, I found a place that had the HB classes. My OBs had worked with many women who chose to use this method and they recommended my doula. We took the class (5 weeks - once a week) and I listened to my relaxation CD every night for a couple of months before my LOs birth.

Fast forward to delivery day (Friday, Nov 14th - due date was the 16th)... I woke up at 7:30 before my husband went to work to say goodbye and then laid on the couch for a little while. Around 8:30-8:45, I felt crampy, but wasn't sure if it was a "contraction" or if I just needed to poop...b/c I did the latter and felt better. Then a little while later I felt crampy again and pooped again - so, I figured the crampy was just b/c of the need to poop. I did this about 4 or 5 more times over the next 2 hrs until I just couldn't poop any more. Then, I figured I might be having "contractions."

I called my husband to ask him what he had planned for lunch and if he'd like to come home and have lunch with me...he was like "Well, I was going to have a short lunch so I could try to come home a little early today." So, I asked him again (hinting) are you SURE you don't want to come home to have lunch with me... I think I might be having contractions." I wasn't in any pain, I was only a little crampy about every 15-20 minutes, and not for long. My DH was home by 12:15 p.m. - we talked while he was coming home and I was fine. My DH had been timing my "contractions" from when we were talking on his drive home. I took a shower when he got home - still fine. We called our doula and told her what was going on. She said to just do as much at home as we could b/c we'd be more comfortable there than at the hospital.

We started getting the last minute things together b/c my DH told me that my contractions were now about 4 minutes apart...I hadn't been paying attention - I was just telling him when they started and ended...he was keeping track. :) So, my "contractions" had gone from every 15 minutes to every 4 in about 45 minutes. Needless to say, we left for the hospital. My doula was going to meet us there.

We got to the hospital by 1:15 and was admitted. They checked me and I was about 3.5 cm already! Yay! I had purchased a BINSI skirt for my labor, but I was so hot I only ended up wearing my socks. What I didn't consider was how handy it would be to have it after I had the baby. The skirt was totally cute and allowed me to walk around the hospital with him and look cute! I did my breathing techniques and moved to different positions until about 4:30. My dr stopped by, checked me and said I was about 7 cm. He had a c-section at 5 and would come back after that. The "contractions" got a little more intense, but not painful. My OB came back around 6:15 and said I was about 8 cm. I had had the urge to push every few "contractions" but he didn't want me to push yet as I wasn't completely effaced. I breathed through a couple of urges to push, but then told him I couldn't wait any longer. He did a little "stretching" down there and it was on from there!

He told me to give a push - I did - and we realized that the cord was around my LO's neck (his heart rate dropped). We waited a couple of "contractions" to let it stabilize, then pushed again. We got his head out (and cord from around his neck), pushed again and got his shoulders and most of his body out, and then pushed one more time. There was my beautiful little boy - born at 7 lbs 9 oz and 21.5 inches long at 7:10 p.m.! He was perfect in every way! Totally alert and ready to get going!

I even tore, and didn't know it! (I only knew after when my OB said he needed to stitch me up...)
I am going to do a natural/medicine free birth for all of our children, if medically possible! It was really worth it and was totally doable. It might not have been a leisurely stroll next to a babbling brooke, holding hands with your husband, but it was not a nightmare like so many people had told me. I wanted to let the people who are considering going drug-free know that it's a real option and a possibility. Don't rule it out!

Doula Digest - Writing a Birth Plan

Posted by Kim:

Birth Plans have become an important part of the birth experience. This is the time when you and your partner's most important wishes and concerns can be expressed to your doula, midwife, doctor, hospital staff and any family or friends who will be attending your birth. This document lets everyone know what you hope will or won't happen during your labor, birth and postpartum care. Be sure to give everyone a copy of your birth plan prior to your labor.

When writing your birth plan the two main points of advice that both Carri and I give our doula clients are

1) Write it in bullet point format
2) Try to make it no more than 5 main points.

I recommend that there can be 5 points in two different categories

1) Labor
2) Baby

Bullet points make it easier for everyone to read through your wishes quickly. If your birth plan is written in a long paragraph form it is difficult to get the gist of what your needs and wishes are and may not even be read, even if they have the best of intentions. Remember the staff and doctor may be caring for several laboring moms so you want to keep it easy and simple for the them. Plus this will also make it easier for your doula to quick reference your choices. The nurses really want to help you have the best birth experience as possible, but they are use to specific routines so they may do things out of this routine, not to go against your wishes. So having the easy bullet points helps to avoid confusion.

Items you may want to consider for your birth plan:

Labor

• Support People - Who will be with you in during your birth names of your birth partner, doula, allowed guests, whether or not you will be accepting guests
• What you would like to wear during your labor
  
• Vaginal Exams - preference to have exams only upon request
• IV - Preference to not have a continuous IV, but willingness to have a buff cap placed
• Urinary Catheter and Enema
  
• Induction - Use of pitocin during labor and delivery of the placenta
• Breaking the bag of water
  
• Pain medication - What methods of pain relief, if any would you consider? "Please do not recommend any method of pain relief unless I ask"
• Fetal monitoring - Prefer intermittent fetal monitoring vs continuous monitoring, would like to avoid internal monitoring
• Freedom to walk or eat and drink
  
• Labor Positions - Preferred positions, laboring in the water
  
• Labor Environment
• Preference to labor down before pushing
  
• Assisted Delivery - Preference to avoid the use of forceps or vacuum
• Preferred Pushing position - Squatting, in the tub/birth pool
• Partner to "catch" the baby
  
• Episiotomy
  
• Delay cord cutting until cord stops pulsating
• Partner to (or not to) cut the cord
  
• If stitching of perineum is required use of local anesthetic
• Placenta - would you like to keep it or have it disposed of in a particular way
  

If a cesarean section is required

• Partner present
• Epidural anesthesia if possible
• Breastfeeding in recovery room
• Partner to hold baby in delivery/operating room
  

Baby

• Baby to be placed on Mother's chest immediately after birth
• Perform all newborn physical exams and procedures while baby is with mother
  
• Baby to be rooming in with parents at all times
• Breastfeeding - use of supplemental formula feeding and/or water
  
• Preference regarding bottles, artificial nipples, pacifiers
  
• Eye ointment, Vitamin K shot
• Bath - do not remove vernix
• Clothing
  
• Vaccinations
• Circumcision
• Use of disposable vs cloth diapers
  

Ultimately your birth plan is your birth guide, a general outline of what your ideal birth scenario would be. But as we all know birth is a wonderful, beautiful, unpredictable experience and the need for everyone involved to be flexible is very important. However, in my opinion do not mistake flexibility with your ability to advocate for yourself and your baby. If at any time you feel pushed to make a decision before you feel comfortable with the results of that decision, don't be afraid to ask for time to consider your choices. It is your experience and ultimately your care and your baby's care should be a team approach between you and your care providers. That is why it is very important that you are well educated and you surround yourself with well educated birth partners so you can make informed decisions during your labor if questions arise.

Doula Digest - Bradley Class Reunion

In February the Bradley class I had taken with Michelle Mueller got together for a reunion. It was amazing to see all the new little babies. We had spent about 14 weeks together and really got to know each other well. Having thought of each couple as parents to be for the last three months of 2008 it was wonderful to see how they bloomed into parents in 2009! I of course had to hold every baby, especially my doula clients' little ones. Ohhh they were just too cute! Each couple went around and told their birth story. Each so unique and amazing experiences. One couple had a successful Natural VBAC, one a successful homebirth and of course you may have already read about Gina and Steve's and Elaine and Greg's births here on the blog. It was so fun to hear the story and learn about their experiences. Every story started the same, Mom would start telling the story in a general outline, but Dad would have to fill in the details because Mom couldn't remember exactly how it happened or was completely unaware of how time passed. This little reunion only fueled my fire to be a doula and I can't wait to be hired by more couples! What a phenomenal time to be with a new family!!

Partnerhships - Operation Special Delivery

Posted by Kim:






BINSI® Supports Operation Special Delivery

BOULDER, Colo. ---- BINSI®, the leading manufacturer of stylish and hospital-friendly labor and birth apparel, has partnered with the Childbirth and Postpartum Professional Association (CAPPA) to support Operation Special Delivery. Operation Special Delivery provides trained volunteer doulas to pregnant women whose husbands or partners are deployed, have been severely injured, or who have lost their lives due to the current war on terror. The CAPPA-certified doulas offer emotional, informational, and physical support to the women during childbirth in the absence of their husbands.

BINSI®, a female-owned company since its inception in 2005, is committed to supporting women through pregnancy, birth, and beyond. Through this partnership, BINSI® is donating 5 percent of their sales to CAPPA for Operation Special Delivery.

“No woman should ever have to give birth without someone there to lovingly support her,” says Carri Grimditch, founder and co-owner of BINSI®. “Operation Special Delivery offers that support by providing doulas to the women whose husbands or partners are away making an immense sacrifice for our country.”

Just as it’s important for women to feel comfortable and empowered by the clothing they wear during labor and birth, it’s also important for them to have people there to advocate for and encourage them. Research has shown that women who have a doula present during labor are less likely to require emergency C-sections and other invasive medical procedures. “Partnering with Operation Special Delivery seemed like a natural fit for BINSI®,” Grimditch says.

About BINSI®
BINSI®’s mission is to help women feel supported and empowered throughout their pregnancy, labor, and birth by offering products that make them feel beautiful, healthy, and in control of their motherhood journey. BINSI® labor and birth apparel is comfortable, modest, and stylish while still being fully compatible with any labor position and medical equipment—a great alternative to unflattering, immodest hospital gowns. All BINSI® products are tested and approved by mothers, doulas, midwives, obstetricians, and nurses. For more information about BINSI®, visit www.birthinbinsi.com

Pregnancy - Carri's Pregnant!!

As part of a series we are beginning in Carri's 2nd trimester, she will be giving us her input as a pregnant mommy with 3 boys already!

Posted by Carri:

I’m finally returning to the world after a very long and sick start to my fourth pregnancy. This pregnancy was a big surprise, but very welcome none the less. My husband and I went to Chicago to celebrate our 10th wedding anniversary and a friends’ wedding, only to bring home more than the guest chocolates. I had a lot of doula births lined up for the fall and before I had even missed my period I started showing signs of pregnancy. Fatigue and nausea – ugh. On our actual 10th wedding anniversary we took the test and found out that I was indeed pregnant! To make things even more wild, it turned out my due date was the exact date I miscarried last summer. This news was very exciting, overwhelming, daunting and humorous all at the same time. However, I proceeded to get more and more sick, which is bad enough on its own, but with three other children, a business, and many doula clients it was near impossible. Morning sickness is such a strange phenomena. Why some women get it and others don’t is unfair and mysterious. I did have it with the other three pregnancies as well, but this one out did them all. I ended up depending on Unisom – yes the sleeping pill. It was the ONLY thing that helped, and helped does not mean cured. I tried the prescription meds, even IV meds when I went to the ER for fluids. I do not recommend taking Unisom, because it is not recommended for pregnancy, but it was my saving grace. I do also have to give a shout out to my amazing husband during this time. Not only did he work a lot during this period, but he would come home, cook, clean, handle the children and get them to bed every night for many months. Without him it would have been disastrous! So now at 20 weeks, I’m back and will gladly share my weekly journey along the way!

Doula Digest - What to pack in your Birth Bag

Posted by Kim:

What should I pack in my Birth Bag?


Preparing for the birth of your child is one of the most exciting times for every mother, but what do you really need to bring with you? With my experience as a doula and mother of three, along with many experienced moms' opinions, we have the most comprehensive list along with many great tricks and inside tips. We hope this not only prepares you, but also educates and empowers you to create the best birth possible for you!

Labor Soothing Tools:
Massage Oil - not only does massage feel good, it also helps the body relax. If you like scents, massage oils are the best way to experience aromatherapy during your birth. But be aware, just because it smells good to you now, you may not enjoy the smell while you are actually in labor.

Massage Ball - using a massage ball creates pressure like a hand, but without the effort or stress on the massager. You will us it FOREVER!

Spikey Ball - rubbing a spiked ball between your hands (or on your feet) during contractions will relieve pain. The tactile stimulation focuses your pain receptors away from your contractions.

Barley Pack - wonderful to heat in the microwave or cool in the refrigerator to relieve sore spots (especially the neck and lower back).

Moist Heat Heating Pad - cordless microwaveable heating pad can soothe back aching. Be sure it is moist heat though!

Personal Items

Birth Outfit - don't be frustrated and intimidated by the hospital gown and environment. We at BINSI feel that you deserve the most practical and functional outfit possible on your big day. Check out our complete line of labor and birth apparel!

Robe - a soft, warm and comfortable robe will make a huge difference.

Slippers - slippers that slide on, are soft and cushioning and have a tread bottom are important. You want to be able to get in and out of them quickly and easily, all while feeling cozy and warm.

Personal Pillow - bringing your own pillow can be important, it is nice to have something soft and comfortable (not plastic) to rest your head on. Make sure you use a colorful cover, so it isn't mistaken for a hospital pillow. One mom even told us she brought a pillow with a red pillowcase to use as a backdrop for her pictures. Hey, its ok to want to look as good as you can!! You deserve it!

Music - bring all the genres of music you like. You may be surprised what you're in the mood for or need during your labor.

Flash Light or Night Light - turn off those horrible overhead lights (especially while you're in the bath) and relax with soft lighting instead of the harsh overhead lights.

Chap stick - the effort you exert, not to mention the breathing techniques you might use, will surely dry your lips.

Ponytail Holders - obviously very important during one of the most physically taxing events of your life. No one wants their hair in their face.

Sour Candy - labor can often create nausea. Having sour candy can help alleviate these symptoms.
Doula– be supported, encouraged and understood during your labor. A doula provides physical and emotional assistance for both you and your partner.

Baby Powder– labor can make you hot and sweaty. Baby powder can be an easy solution to helping you feel dry and fresh.

Bath Pillow – if you are able to labor in the tub, it is nice to have something soft to cradle your head as you relax.

Prenatal Vitamins – the amount of energy you exert during labor and birth is enormous. Remember to give yourself and your baby the best start by staying healthy and nourished.

Toiletries – all the basics (toothbrush, toothpaste, deodorant, shampoo and conditioner, hairdryer, makeup, etc.)

For Birth Partners:

Change of clothes –

Comfortable Shoes –

Toiletries –

Food – bring lots of non-fragrant snacks, granola bars and protein bars are great. Even though she won’t be able to eat, you need to stay nourished and in top shape to be there for her as best you can.

Video and/or Still Camera –

Phone List –

Cell Phone (and charger) – preload your friends’ and families’ email addresses into your phone so you can send pictures right from your phone.

Laptop Computer -

Books and Movies – for big brother’s or big sister’s visit.

Medicine – even though you’re in a hospital, if you get sick they won’t give you anything. Make sure to pack a pain reliever and upset stomach medicine – just in case.

Swimsuit – you may want to join her in the tub – which we highly recommend.

Pillow – pillows can be scarce in a hospital, and you’re the last in the line. Make sure you’re comfortable and bring your own.

For after the birth and the trip home:

Maternity Clothes – even though you are no longer pregnant you will most likely not fit into your pre-pregnancy clothes.

Nursing Bra -

Book and/or magazines -

Baby outfits – your baby does not have to only wear a diaper or t-shirt while in the hospital. Bring some outfits for your little one for your stay in the hospital and for the ride home.

Baby Blanket – a soft, cozy blanket helps everyone to feel more relaxed and ready to brave the new world.

The Doula Book - Part II Reducing Discomfort, Pain & Anxiety

As a continuation of my coverage of the The Doula Book by Klaus, Kennell and Klaus here are the excerpts of the book that I highlighted in chapters 3 and 4.

Chapter 3 - Enhancing the Birth Experience

"Knowing the doula will be available anytime during labor lessens the parents' initial anxiety, and the couple can then remain at home longer with more productive labor and less pain." (page 35)

"The doula never interferes with the physician's advice, and the mother will need to follow that advice if there are other concerns." (page 36)

"Most mothers progress more rapidly in familiar surroundings" (page 37)

"During this period (the beginning of labor) mothers have found the following suggestions helpful:
1. Walk as much as possible
2. If the membranes are not ruptured, a warm bath can help you remain more relaxed. However in early labor a warm bath may slow labor; in late labor a bath may increase dilation. If the membranes are ruptured, a shower is preferablebecause of the risk of infection.
3. Change positions at least every half hour
4. Drink plenty of liquids... Urinate frequently" (page 37)

"The doula needs to notice the quality of the environment of the room and the woman's immediate needs or comfort level." (page 37)

"Asking the woman if a suggestion is or isn't working can validate her sense of control and choice as well as help her recognize her own needs and give her permission to voice what is important to her." (page 38)

"A doula will continually be
1. noticing
2. asking the woman
3. doing something to make an appropriate change
4. rechecking to see if the change is helping or not" (page 38)

"Being well hydrated has been shown to help labor." (page 39)

SIDE NOTE - One of my doula clients went to the hospital thinking she was in labor, but when we arrived her contractions completely stopped. After a thorough exam the doctor determined that she had an elevated temperature due to contractions. After receiving liquids via an IV her temperature went down and she was released. I have also read that dehydration can cause contractions and false labor which may have been what happened to my client.

"The doula can reassure the woman that the smells and fluids of birth, like blood, feces and amniotic fluid, are all normal parts of labor and are quickly taken care of by the staff" (page 39)

"The doula can be the one to have the somewhat difficult task to limit the number (of friends and family attending the birth) without offending anyone." (page 39-40)

"When mothers are in the hands-and-knees position infants often rotate in ten to fifteen minutes from a posterior position." (page 41)

"...Squatting during second-stage labor with each contraction. This position increased the area of the bony outlet of the pelvis by 28 percent." (page 41)

"The doula's ability to keep the mother informed is essential." (page 42)

"When a doula continually informs the mother, asks her gently what her thoughts, worries, or concerns are, talks to her confidently with real information, the doula can help the woman shift her fear to more inner security." (page 43)

"It is also important for the woman to feel that she has control not only over her labor but also has choices about what sort of interventions will be used." (page 43)

"...Although the PKU test is very important, it can wait a few days until the mother's milk comes in." (page 43)

"What is important to a laboring woman is sincere talk, not fake or glib reassurance." (page 45)

"The doula stays emotionally connected to the mother and by joining in her reality, may be able to move her to a more comfortable inner place." (page 45)

"Progressing toward full dilation of the cervix and delivery is near, the following signs may be noted:

1. Flushing of the face and body
2. An increase in bloody mucus
3. Longer and stronger contractions
4. Legs often becoming shaky
5. A feeling of nausea
6. feeling of an urge to push" (page 45-46)

"At this point (transition) the doula's support can give the mother the incentive to continue; the doula sometimes holds the woman, she reminds the mother (and the father) over and over again that she can continue and is doing great." (page 46)

"... Everyone attending a woman in labor 'has a responsibility to ensure that [she] genuinely understands the purpose of every medical procedureand the results of every examination' " (page 46)

"Often labor stops when too many people are present." (page 47)

"In reassuring the parents and enhancing their sense of accomplishment, the doula may be modeling the parental role for them - mothering the mother and parenting the parents." (page 49)

*** " The family is born in the delivery room." ***

Chapter 4 - Reducing Discomfort, Pain, and Anxiety in Childbirth

"When a woman comes into labor she brings her past with her." (page 53)

"Pregnant women have varied expectations of pain, based on what they have heard or experienced." (page 53)

"Though a doula cannot solve issues in the mother's past... she can begin her work being fully present with the woman to calm her fears, to validate her strength, to reassure her that she won't be alone, and to work with her on measures to alleviate pain." (page 54)

"Can you remember a time you met a challenge and conquered it?" (page 54)

"If labor is slowing down, a doula might ask 'How are you feeling righ now?' and then when the mother answers, the doula should restate her answer to be sure she understanda the mother's meaning." (page 55)

"By validating themother's fear, instead of dismissing it, the doula can offer new ways to think about the pushing stage." (page 55)

"Relaxin, which causes the tissure to be as stretchy, strong, and supple as soft elastic." (page 55)

"The mother's urge to push and ability to judge how to push in the second stage is reduced [with an epidural]." (page 58)

"If the epidural goes too high, some women feel as though they can't breathe." (page 58)

"Frequently, there is a rise in the woman's body temperature which reaches the level of a fever during an epidural." (page 58)

"During labor, some women copmlain of shivering and itching and experience urine retention requiring a bladder catheter." (page 58)

"The doula can remind the woman to stay relaxed, create positive images with her, help her with breathing and calming techniques, and validate how well she is doing." (page 59)

"The doula has to be sure there is no threat to her breathing." (page 58)

"With cool washcloths to the mother's face, neck, and chest, if all is well, the doula can cool the mother who is overheated or who develops a fever." (page 59)

"Helping women express feelings and utter sounds may relieve tension." (page 67)

"Make sounds along with the woman, encouraging the mother to let tension go with each sound." (page 67)

"Making low sounds or groans deep in the throat through a comtraction has an effect parallel to opening the birth canal." (page 67)

SIDE NOTE - To be honest making noise and validating the need to make noises was a concern of mine when I went to my first birth as a doula. Like a mother going into labor I was concerned that I would sound or feel silly doing this, but after reading this book I realized that no matter how I felt on the inside I had to always project complete confidence and not be concerned about what other people would think about what I was doing or how I was acting. My goal and my only focus was to make my mom focus on herself, relax, and let her let go of any inhabitions she was holding on to. It only took a little time for me to get over any insecurities and I just kept focusing on what my good friend Laurie told me, she said "Trust your instincts, mother your mother and everything else will follow." Now that was amazing advice from an experienced doula!

"When a doula remains accepting, nurturing, competent, and strong, the woman can internalize a model that might help her remain both nurturing and strong with her ownchild during tough moments." (page 68)

"The doula needs the confidence to help the mother express her needs to the caregiver especially before and during intervention." (page 70)

"The doula needs to know her limits, and occasionally when a fetal malposition does not change, ot a woman is not progressing as expected or feels great discomfort, medical help can give her relief. When this is necessary the doula must validate the woman's courage as well as her decision to have such help." (page 70)

Side Note - This is the exact situation I had with my first doula client (as you may have already read) she had been laboring for 5 days prior to the day we decided to go to the hospital. So she had not gotten more than 3 or 4 hours sleep each night for 5 days prior to going to the hospital and had labored at the hospital for 15 hours at the hospital only to discover that in that time she had only progressed 2 cm. Although epidural was not even a consideration for her and her hsuband before the birth, it became apparent that the epidural was something she needed. She was tormented by making the decision and we hugged, cried and proceesed what was going to happen, but I kept reassuring her that no one was judging her and that we would all honor her choices and that getting the epidural did not make her any less of a mom. After receiving the epidural, we hoped she would relax and progress, but it was still another 12 hours before the baby was born. Although she is still working on processing her choice to get the epidural I keep reminding her how hard she had worked and not only for that one day at the hospital, but for the 5 days before as well.

"Reducing th stress response enhances the body's own production of oxytocin, as well as natural opiates called endorphins." (page 70)

"When labor is not impeded by undue stress and fear, the woman's own natural oxytocin is secreted from the posterior pituitary gland intot he bloodstream. At the same time, her brain also secretes oxytocin to other areas within the brain itself. This has four effects:

1. First it markedly increases the pain threshold, so that the mother has reduced sensitivity to pain.
2. Second, it results in drowsiness
3. Third, it results in some relaxation or calming
4. Finally, after the birth it helps the woman feel closer to the baby" (page 71)

"Comfort measures cna be divided into five categories

1. actions and behaviors that give emotional and psychological support
2. mental activites that divert attention from pain or focus attention on thoughts or images that increase mental and physical relaxation
3. physical activities such as relaxed breathing, muscular relaxation exercises, movement, position changes, use of water, heat, cold
4. touch, including massage, acupressure, pressure, and counterpressure
5. rhythmic activities, music, chanting, singing etc." (page 72)

Side Note - Much to my client's pleasure and their ability to relax, there is about a 0% chance that I will ever sing to them to help them relax. However, I could consider my singing a diversion or a relocation of pain (from the abdomen to the ears).

To be continued.....

The Doula Book - Part I The Need for Support and the Role of the Doula

Posted by Kim:

The process of becoming a certified DONA Doula has several facets and one part of the certification process is to read 5 books from the required reading list and the DONA International Birth Doula Position Paper.

To see the entire required reading list click here.

One of the first books I decided to read is The Doula Book by Klaus, Kennell and Klaus. Because of the pending births of my doula clients I literally devoured this book and was very impressed by how informative it was and how easy it was to read. In my opinion the authors did a wonderful job intertwining the description of the role of the doula and connecting it with statistically significant studies.

In this blog series I thought I would share with you some of the points I highlighted while reading the book.



Chapter 1 The Need for Support in Labor

"Continuous support from a doula during labor provides physical and emotional benefits for mothers and health bonuses for their babies. With less medical interventions, fewer complications, and shorter hospital stays, there may be financial savings as well." (page 1)

"In studies of over 5000 women... we have seen a major reduction in the length of labor, a greater than 50 percent drop in cesarean sections, a remarkable drop in the mothers' need for pain medication, and several other important and measurable benefits." (page 3-4)

"I want the doula there to assure me that everything is fine and to comfort me. I want my husband there for emotional support." (page 9)

"A recent study found that women giving birth encountered an average of 6.4 unfamiliar professionals during labor." (page 11)

"When... the caregivers goal is to reassure, relax, comfort, and inform the mother rather than to tend only to the needed medical interventions, that person takes the same supportive role as a doula." (page 11)

"With such help, parents can capture the special moments and priceless experience of their own unique childbirth." (page 12)

Chapter 2 The Special Role of the Doula

"A doula learns that she has to be wiling to take anything for an answer... The experienced doula develops enough confidence and self-esteem that she is not offended by the woman's seeming rejection of that action." (page 16)

"The woman can be completely at ease with the doula and unconcerned about having to try to please her or put on a show for her." (page 17)

"The most important assurance that a doula can give in these initial (prenatal) visits is that she will remain with the mother throughout the entire labor and not leave her alone." (page 17)

"By her presence, manner, and comforting touch, the doula creates calmness and the essence of relaxation." (page 19)

"By her words and actions, the doula models behaviors and attitudes that are almost always copied and appreciated by the father. At times a doula needs to be resolutely strong and firm, and at other periods in the labor, tender, soft, and loving." (page 22)

"A woman in labor needs total support - in order to let go completely, to allow her own system to adapt and respond to the power of the birthing process." (page 23)

List of qualities for choosing a doula (page 27)

This book is definitely right on when it comes to the role and the need for a doula. Throughout the labor of my first doula client I kept thinking to myself, man I wish I had had a doula. Why didn't I know about this? I decided to become a doula because after learning more about the role of the doula, hearing stories about Carri's client's births, and attending many birth education conferences for BINSI I was invigorated by how a doula can enhance a woman's birth experience and how dramatically the presence of a doula can effect birth.

The more I learned the more I realized that the role of the doula is not to replace the partner, but rather to be there to support both the partner and the laboring mother so that they can stay emotionally connected. While it is special to me for my moms to tell me that they felt like I was truly there for them, there is a little special extra special when the dads say they couldn't have done it without me. I never want my clients to feel like I was trying to replace them, but rather I want them to feel like I helped them be the best support they could be.

I only wish I had listened to our friend Chuck when he said "Get a doula, it is the best money spent." WHY WHY WHY didn't we listen? Well as with everything in life hindsight is 20/20. So now I have made it my mission to at least educated as many women as I can about the role of the doula and how it can enhance their birth. I still struggle with the decisions I made during my births and will always wonder how different my births would have been if I had had a doula, but truthfully being a doula has helped me heal from some of my birth decisions and has also helped me to process my births. As with everything it is a process, but I hope to use my experiences as a mother and as a doula to help women have the best birth experience. It is my goal, and BINSI's, to Honor Moms!

Partnerships - Operation Special Delivery - CAPPA

Posted by Kim:







Our mission as a company and as mothers is to not only enhance a woman's birth experience by changing what she wears, but also to forge partnerships with other organizations in the birth world so that we can use our business to help benefit women around the world. The first organization we joined forces with was Operation Special Delivery.

Press Release April 15, 2008

Boulder, CO - BINSI, the leading manufacturer of stylish and hospital-friendly labor and birth apparel, has partnered with the Childbirth and Postpartum Professional Association (CAPPA) to support Operation Special Delivery. Operation Special Delivery provides trained volunteer doulas to pregnant women whose husbands or partners are deployed, have been severely injured, or who have lost their lives due to the current war on terror. The CAPPA-certified doulas offer emotional, informational, and physical support to women during childbirth in the absence of their husbands.

BINSI, a female-owned company since its inception in 2005, is committed to supporting women through pregnancy, birth, and beyond. Through this partnership, BINSI is donating 5 percent of their sales to CAPPA for Operation Special Delivery.

"No woman should ever have to give birth without someone there to lovingly support her," says Carri Grimditch, founder and co-owner of BINSI. "Operation Special Delivery offers that support by providing doulas to the women whose husbands or partners are away making an immense sacrifice for our country."

Just as it's important for women to feel comfortable and empowered by the clothing they wear during labor and birth, it's also important for them to have people there to advocate for and encourage them. Research has shown that women who have a doula present during labor are less likely to require emergency C-sections and other invasive medical procedures. "Partnering with Operation Special Delivery seemed like a natural fit for BINSI" Grimditch says.

About BINSI
BINSI's mission is to help women feel supported and empowered throughout their pregnancy, labor, and birth by offering products that make them feel healthy, beautiful and in control of their motherhood journey. BINSI Labor and Birth Apparel is comfortable, modest, and stylish while still being fully compatible with any labor position and medical equipment - a great alternative to unflattering, immodest hospital gowns. All BINSI products are tested and approved by mothers, doulas, midwives, obstetricians, and nurses. For more information about BINSI, visit www.BirthInBinsi.com

Product Review - Labor Lab

Posted by Kim:

As a new doula I have probably been going overboard trying to devour everything I can find about being a doula, doula techniques, the outcomes of births with vs. without doulas, networking with new doulas, interviewing and seeking out the advice of seasoned doulas (you get the picture here right?). I may be going a little overboard and my new doula bag may be packed (shall we say stuffed) with many I may never use, I have found one amazing item that truly gives me confidence knowing that it is in my bag as a resource: Labor Lab. Because one of my major goals throughout labor is to keep mom active and to help her manage her surges and find positions that help lessen the intensity of each surge, Labor Lab is the perfect resource giving me position suggestions, accupressure points, massage techniques and so many ideas on helping mom manage her labor.

Labor Lab is an easy, hands-on way to teach pregnant women and their support team, skills to enhance the experience of labor. The lab itself consists of 12, two-sided laminated cards packed with information as well as facilitator's guide with suggestions for use. Each card contains a labor situation practice, a question to discuss and various coping techniques. It is a wealth of information, but the thing I love about it the most is that along with the descriptions there are practical real life pictures so you can actually see the position and why it is used. I often find in a long labor my mind is so driven by adrenaline and I get so pumped up that I can barely think and keeping these cards out as reminders not only gives me position suggestions, but it is helps to me remember to keep mom moving and change positions every 45 minutes or so. If you have the chance check out Laurie's website and I highly recommend purchasing the set.

They are great for childbirth educators too because they can easy be used to assist in creating labor stations when you are having a labor rehearsal and you can even purchase the Parent Booklets as a small, easy item to carry or as reference material in your student folders. The Lab costs only $45 and includes the 12 cards two-sided full color cards, instructor's guide and 1 copy of the Parent Handbook. The handbooks are a screaming deal at only $2.50 and both are available in English and Spanish as well as the fact that they feature moms of different ethnic backgrounds. In my opinion, it is a must have!

The Twelve Labor Lab Cards include:

• Advantages and disadvantages of
  • Standing
  • Leaning forward
  • Side-lying
  • Squatting
  • Walking
  • Semi-sitting
  • Back-to-back
  • Kneeling/Hands & Knees
• Coping with Back Pain
• Rotating a posterior baby
• Breathing Techniques
• Tips for riding in the car
• When to call your doctor
• What to look for when the water breaks
• Difference between 'True' and 'Practice' labor
• When to go to the hospital
• Using a 'Birth Ball' - positions and safety tips
• Aromatherapy
• Massage
  • Hands
  • Feet
  • Jaw
  • Hips
  • Shoulders
• Ways to progress labor
• Acupressure points to
  • help nausea,
  • decrease pain, and
  • increase contraction strength
• Dealing with panic
• Creating an ideal labor environment
• Suggestions for encouragement and coaching phrases
• Ideas for cooling off or warming up during labor
• Signs and how to help with hyperventilation
• Ways to help with nausea or vomitting
• Pictures of
  • single women
  • married couples
  • women with labor companions
  • hospital settings
  • home environments
  • people of different ethnicities

About the Creator

Laurie Boyer is a certified childbirth educator, massage therapist, and labor doula. She has been active in the childbirth field for over 20 years. In an effort to keep her childbirth classes a "hands-on" and exciting learning experience for her students, she incorporated interactive learning stations to her teaching style. With the suggestions and ideas of many educators as well as feedback from class participants, Labor Lab evolved into the product available today. Her hope is to make a distinct and substantial impact on the overall experience of birth by providing Labor Lab to parents, childbirth educators, doulas, doula trainers and hospitals.

Doula Wisdom Circle - January 13th

I have recently become obsessed with Twitter (my name is birthinbinsi if you would like to follow me) and have met several great new people with interesting ideas, quotes, support, and mini business consulting tips. You should check it out, it is pretty cool. Anyway, one of the Twitter gurus I have been following (and vice versa) is savvydoula. She has offered support as I was going through the births of my last two clients as well as advice on stalled labor and other questions I have had. It is amazing because my new Twitter friends seem to be immediately and almost constantly accessible, it is rather revolutionary I think. Well anyway, savvydoula is hosting a Wisdom Circle tomorrow and I just wanted to tell you about it just in case you would like to join in on the call.

"The Savvy Doula Community Wisdom Circle was created to bring together our community to connect and learn from one another. Held monthly over the phone, doulas are able to seek support, validation and gain new perspectives from the breadth of knowledge and experiences each brings to the call.

Facilitated by Darlene MacAuley, participants will have a safe space in which to share her story and offer and receive feedback from other doulas.

Each month, all participants need to bring to the call is a compassionate heart and an open mind. Participants will have the opportunity to share something that’s been going on with them. In response, those who share will receive acknowledgment and validation from others on the call. Those who share may also be offered new perspectives to the situation or may be asked to come up with their own new perspectives. There is no set agenda, but each participant will leave the call having received support, validation, new knowledge and inspiration."

The Savvy Doula Community Wisdom Circle will be held monthly on the second Tuesday of each month, from noon-1:15 pm Central Standard Time. For more information please check out her website http://www.savvydoula.com/savvy-support/savvy-doula-community-wisdom-circle/ or simply www.savvydoula.com

I am going to check it out and see how it goes. I am definitely in the doula information seeking stage. As my passion for being a doula becomes more and more important in my life, the more knowledge I am trying to absorb. However I am so lucky to have so many wonderful friends you have been doulas for many years and have taken their time to answer my questions and help suport me throughout my client's birth process. Does life get any better than having a beautiful circle of friends?

Birth Story - Elaine & Greg's Birth

Posted by Kim:

I was lucky enough to be hired as the doula for another wonderful couple and I was honored to be present at the birth of little baby boy Nikolai! It was an amazing experience and has made me even more passionate about being a doula! To be honest it was only the second completely natural birth I have ever seen, the birth of Carri's third son being the first.

It was interesting because Elaine had a few instances of stalled labor as my previous client did. On Monday evening Greg called me to let me know that Elaine had stopped in to see her doctor that afternoon and she was dilated to almost 4 cm and 100% effaced. The doctor said she could check into the hospital then if she wanted to, but they chose to head home and relax to prepare there instead. This was great news seeing as though Elaine mentioned that she had not really had any major contractions, just what felt like some annoying menstrual cramps. Remembering what a marathon Gina's birth was I began to mentally prepare myself for labor and went to bed early anticipating a call from them that night (again, silly new doula). No calls. I ask them to stay in close touch just so I would know how they were feeling. So we talked Tuesday morning and everything was back to normal.

On Tuesday they ended up coming into the hospital again because they were concerned that they really hadn't felt the baby move at all that day. Luckily the nurses monitored the baby and everything was fine. So they went home and Elaine rested, ate and prepared for pending labor.

Around 12:15am on Thursday morning Greg called me again and said that Elaine's contractions were coming on very regular and they were going to head into the hospital and wanted me to meet them there around 1am. So I jumped out of bed, hit the shower (I had some hot water this time) and was in Boulder by 1am. It was a very interesting drive however because the Old Stage fire was raging and literaly lit up the entire sky. I had never been so close to a brush fire like that and actually felt a little guilty that we have had such a dry winter, I guess I better hope for some snow (hard for me to do). In addition to the fire there was also a major accident on the Diagonal Hwy and as I approached I just kept praying that it was not Greg and Elaine, luckily they took 287.

When I reached Elaine's room Greg told me that their contractions were very intense at home, in the car, up the elevator, but as soon as she got into the hospital room they literally ended. Elaine placed the intensity of the contractions at only a 2 on a scale of 10. In addition to the lack kof contractions she also had an elevated temperature so the doctor wanted to monitor Elaine closely and she received an IV of fluids as they were thinking the elevated temperature was possibly due to dehydration. This was hard for Elaine to accept because she felt like she had been drinking tons of water, but as she received the fluid her temperature did go down. Just prior to going into the hospital Elaine had been taking a hot bath so I asked the nurse if that could have effected her body temperature and she said it wouldn't really have effected her overall body temperature, and especially for this length of time. Good to know. So I headed home around 4am and Greg and Elaine were released shortly after. I called Carri later that morning to talk with her about what was going on and her thoughts about the stalled labor again and she said that the contractions Elaine was experiencing could actually have been caused by the dehydration. Again, good to know I will keep that in my knowledge bank.

But the real fun was just about to start because Friday morning around 4:30am Greg called and said that they had been laboring since about 9:00pm Thursday night and they were ready to have me come over. Remembering Gina's labor I didn't freak out, I took a quick shower, gathered my doula bag and personal items and headed out ready for a long day (again, silly new doula). When I arrived at the house Elaine's car was running in the driveway so I figured we would soon be heading to the hospital. Elaine was in her bed and Greg was being an amazing coach. While I could tell the contractions were intense for Elaine she seemed to be handling then amazing. SHe breathed through them as Greg was reminding her to take deep belly breaths and I tried to help her relaxed her hands and face. It was interesting because Greg told me that she was also experiencing significant discomfort in her back but when I tried to apply the same massage and pain relief that I used on Gina this was of no comfort to Elaine. Again, I had to remind myself that this was a completely different person so what works on one may not work on the other. Greg and I began talking about when to go to the hospital and seeing as though she had been laboring for quite a while and the intensity of the contractions were so strong we decided that it was time to go. However, getting Elaine to the car was my biggest fear because she was obviously feeling so much intensity and handling them seemingly so well in the bed that I hated to move her, get her to the hospital and have the contractions slow, but I knew we had to go. So step by step and in between each contraction we headed to the car we eventually reached the Boulder Foothills Hospital around 6:15am.

Greg said that one of his funniest memories of this experience was our trip from the car into the hospital. He had gotten a wheelchair for Elaine and I had made myself in charge of carrying all of our gear. So he said as we were walking down the hall he looked over at me and couldn't help but laugh because all he saw was me carrying 18 bags and a pillow. I told him not to worry that it was my job to take care of the things that he should not occupy his mind with. He should be worrying only about Elaine. So we then named me the Doula Sherpa! : D

When we got to our room Elaine settled in bed and the intensity remained and I think we were all thankful for that. The nurse was wonderful and asked Elaine if she would like to get up and walk, take a bath or try some different positions. She said as soon as she checks her she could do whatever she wanted. Much to all of our surprise, when the nurse checked Elaine she was 10cm dilated and the nurse said she would be able to push whenever soon. The only thing standing in the way of her and the baby was the bulging bag of water. Because Elaine had been experiencing a lot of discomfort in her back I suggested she get on her knees and lean on the birth ball. I told her that this would relieve some of the discomfort and would also be a great position to start pushing once her water broke. It seemed to help for while, but the doctor came in and we all discussed if she should break the bag of water for Elaine or if she should wait for it to happen naturally. It was decided that the doctor would break the water so Elaine could start the pushing phase of labor. By 7:00am her bag of water was broken and the urge to push was rushing over her and by 8:05am little baby Nikolai was born. Elaine was a wonderful pusher and having the nurse use her fingers to help Elaine feel where to push really seemed to help! It was beautiful and amazing, again I felt blessed to be there.

After Nikolai was born the placenta would not expel itself naturally, even after several minutes of nursing (Nikolai was a natural). So they finally decided Elaine needed to receive some pitocin to encourage the placenta to come out. Unfortunately when it did there were pieces of the placenta left behind and the doctor tried a manual extraction to remove the remaining pieces before Elaine bled too much. This however was ineffective and Elaine eventually had to have a spinal epidural and a D & C. Not the ending we anticipated after a healthy pregnancy and beautiful natural childbirth, but medically necessary.

This was another learning experience for me (although I can't think of a birth that won't be a learning experience). I was impressed with the nurses and doctor at Boulder Community Hospital and I was thankful we were there, but I was most impressed and awed by how Elaine breathed through her contractions and how great a coach Greg was. This may sound a little corny, but I could truly see how deep their love is for one another and what an amazing family Nikolai was being born into. It was truly a blessings. Elaine's recover has been more difficult than we would have hoped, but ultimately the most important thing is that there is a very healthy baby and a healthy recovering Mom and ecstatic Dad!

Welcome to our blog!

Welcome to the BINSI blog. We are starting our blog as a way to introduce you to new BINSI products, other great birth products, and most importantly birth stories (ours and yours)! In addition, I will also share information and stories from my newest venture, Doula Certification! I am so excited about this opportunity and I can't wait to share with you what I am learning and about the births I am attending. Childbirth is an amazing and exciting process and I feel so honored that two couples have already asked me to be their doula! Everyday I discover more about birth (wish this was happening before I gave birth) and I am excited to share what I am learning with you. Carri will also be sharing information and stories from the births she attends as a doula and a mom.

We look forward to hearing your birth stories, comments and suggestions as well. If you have a birth story, a specific product or a suggestion that really helped you through your birth we would be happy to post it to our blog. Please send comments and suggestions to me at kim@birthinbinsi.com. Many Blessings...... Kim