Ultrasound has become commonplace in our maternity care. For the majority of people, this is a procedure to look forward to. You get a sneak peak at your sweet baby, maybe learning the sex or confirming an estimated date of conception. To have an ultrasound or five (or even weekly) throughout pregnancy has become the norm.

Not to mention the popularity of “keepsake” photos and videos in 2D, 3D, or even 4D elective ultrasounds.

“Rite of Passage”

Elective ultrasounds for popularized keepsake photos and videos have become a rite of passage for expecting parents.

Like many people, I took this aspect of our maternity care for granted. I assumed its safety and usefulness. An automatic assumption that this was something that needed to be done, rather than being used sparingly.

While the research is often convoluted, poorly done, or absent when it comes to the safety, regulation, and effectiveness of ultrasound (sonogram) during pregnancy; I’m going to do my best to provide as balanced a perspective as possible.

By no means will this be a complete analysis, that would certainly take me more than a week of binge researching, but I hope this provides you some useful information for consideration.

As always, this is not intended to decide for you what you should do, but rather provide you a starting point for your own exploration and decision making. 

Let’s get into it!

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So, what is ultrasound?

Ultrasound, also known as sonography, uses high-frequency sound waves to create images of the inside of your body. Like a bat, “echo” waves bounce off of bone, tissue, and blood to create that image.

Ultrasound imaging uses pulsing waves to create these images whereas doppler ultrasound (the handheld device that allows you to hear your baby’s heartbeat) also uses sonography but with continuous waves. Both are forms of ultrasound with varying degrees of exposure, wave type, and usage.

The Electronic Fetal Monitoring (EFM) belts that can be worn during labor also use doppler ultrasound and tend to be used for longer durations and more frequently during high management births. 

Telemetric EFM

A wireless form of Electronic Fetal Monitoring. Still attached to your belly with belts; but without the tangle of wires plugged into a monitor. Uses doppler ultrasound; continuous waves.

It is not a form of ionizing radiation (X-rays), though an interesting parallel has been shown between the two. X-rays had previously been used during pregnancy for almost 50 years and presumed safe until much later research showed that unrestricted use of X-rays during pregnancy caused childhood cancer. The similarity between X-rays and Ultrasound use during pregnancy is the very quick adoption of both, assuming safety and usefulness without evidence to support the claim.

Routine Prenatal Ultrasound (RPU) is more controversial than the use of occasional ultrasound to investigate suspected problems. This we’ll get more into as we go. There are undeniably times where an ultrasound can bring clarity to a concern and be helpful. Whereas the push for routine prenatal ultrasound for every pregnant person regardless of potential risks or suspected complications, is what inspired me to dive deeper into this topic.

When is it used?

Typically used between 18 - 20 (or even 24) weeks to determine baby's estimated due date. Though research has shown this to only be fairly accurate when done close to 18 to 20 weeks, and even then the EDD (estimate due date) is only accurate a week to either side of that date. So it provides a 14 day guestimate of the possible due date for baby.

There is debate on whether a routine ultrasound at this time is necessary for all birthing parents as well as the routine use of ultrasound after this first initial screening. 

Ultrasound can be used for any of the following : 

• Confirming pregnancy

• Determining if you are having multiples

• Estimated Due Date & Gestational Age

• Monitoring for Intrauterine Growth Restriction

• Screening for abnormalities or concerns whether for Down Syndrome, Ectopic or Molar Pregnancy, confirming miscarriage and so on

• Gauging the position of the placenta or baby

• Used during other procedures such as amniocentesis or chorionic villus sampling (CVS).

Doppler Ultrasound is also used to gauge fetal heart tones. This can be at a prenatal appointment with a hand held doppler or during a NST (Non Stress Test) and labor with the Electronic Fetal Monitors (EFM) attached to your abdomen with belts. 

All of these use ultrasound.

Friendly Neighborhood Doula Note : As a heads up, there will be a topic that some may find triggering when I discuss the types of ultrasound. The topic will be marked with a TW and I will have it listed last so you can review the other types of ultrasound before skipping to the next section should you choose to do so.

What it looks like

Classic set up for receiving an ultrasound at your provider’s office. Elective options out of hospital & clinical settings are available as well.

What are the 7 types?

Transabdominal ultrasound - The main method of ultrasound for pregnancy. Moving the transducer (the hand held wand that typically gets a gel applied to the end) across the abdomen. This is that classic image of a prenatal ultrasound typically done in 2D images. The following ultrasound types (excluding the last one) are all variations of the transabdominal ultrasound.

Specialized sonographic evaluation - The advanced version of transabdominal ultrasound. Your provider may suggest this when they have specific concerns or suspect there is an abnormality present. A more in-depth evaluation looking for confirmation of a specific problem or question.

3D ultrasound - Using a combination of 2D images from multiple angles to create a 3D view of baby in utero. Providers may use this to detect facial abnormalities or neural tube defects.

4D ultrasound - Same as 3D but baby is viewed moving in real-time. Common with “keepsake” elective ultrasound.

Doppler ultrasound - Rather than detecting structures such as bones and features; the doppler measures moving objects within the womb such as blood flow. Often used as a hand held fetoscope to listen to baby’s heart rate and tone. Also present in the Electronic Fetal Monitors (EFM) that are attached to the abdomen via belts during Non Stress Tests and managed labors.

Fetal echocardiography - Used to get a detailed picture of a baby's heart and to screen for or confirm congenital heart defects.

TW

The last being Transvaginal ultrasound. Rather than the transducer moving across the surface of the abdomen, the transvaginal transducer is inserted into the vagina. Often used in early pregnancy or if clarity is difficult to achieve with a transabdominal scan. I want to make a special note of this, because I certainly did not know this was a method of ultrasound when I started researching this topic.

While marketed as “non-invasive” I know there are plenty of expectant birthing people who would disagree. Whether due to past trauma or a general reserve toward who, what, or when your vagina is involved: you would probably appreciate the heads up that this is a possibility. 

Especially since this is common for the FIRST visit in early pregnancy.

I’m linking an episode by The Midwives’ Cauldron Podcast HERE that touches on the topic of trauma-informed care and a pervasive culture of conditioning birthing persons to be submissive throughout the birthing process.

In the future I will explore this topic more (probably after another deep dive of research and hopefully a guest to interview who specializes in trauma-informed care).

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Is it safe?

Honestly, I’m not sure.

Ultrasound is generally viewed as being safe, primarily due to the lack of conclusive evidence (and lack of well developed research studies to say one way or the other).

“Currently, there is no reliable evidence that ultrasound is harmful to a developing fetus. No links have been found between ultrasound and birth defects, childhood cancer, or developmental problems later in life. However, it is possible that effects could be identified in the future. For this reason, it is recommended that ultrasound exams be performed only for medical reasons by qualified health care providers.”

— American College of Obstetricians and Gynecologists 2013

The concern being a noticeable lack of recent research with current models, settings, frequency, dosage, exposure and so on when it comes to determining safety. There are a lot of variables that aren’t being accounted for to give us a clearer picture (puns low-key intended...) of the safety and usefulness of ultrasound.

The machines used (whether for imaging or for listening to fetal heart tones) are unregulated. The dosages of frequency are substantially higher than the original studies between the 70s and 80s.

All of this makes it really difficult to know if something is actually safe or not.

What are the potential risks?

There are two types of risks I will address here. The ones that are potentially directly related to the physical aspect of ultrasound, and the indirect risks that can come from searching for problems that might not be there.

Potential Direct Risks are drawn from concerns related to how ultrasound affects the body and baby. Such as Cavitation and increased heating in utero. There are concerns about increasing the risk of preterm labor, miscarriage, growth restrictions, hearing & visual damage, speech delays, left-handedness (sometimes a marker that neurological damage occurred in the womb), and perinatal death.

As I stated earlier, there is a significant lack of research studies being done that include the wide array of variables from the machine’s settings/dosage, duration, frequency, and comparing ultrasound imaging with doppler ultrasound. These are the risks that others have noticed and are concerned about that would greatly benefit from randomized controlled trials with a large enough sample size to get a clearer picture of safety and associated risks. 

Indirect Risks are also worth noting. When we search for problems, our medical system will usually “find” them. I touched on this in my review of Henci Goer’s “The Thinking Woman’s Guide to a Better Birth.” She looked at studies showing evidence that the obstetric management of pregnancy and labor tends to involve tests that lead to interventions and often to a highly managed labor and birth that otherwise would have been fine if left alone. 

This applies to ultrasound as well with the wide range of accuracy and high false-positive rates for certain tests/diagnosis. Meaning, the thing your provider may be looking for might not be detected at all or if it is, there is a good chance that there isn’t anything wrong with your baby in the first place.

Finally, there is the consideration that routine ultrasound use has NOT been shown to improve outcomes for birthing parents or babies or reduce the use of interventions. As mentioned by the American College of Obstetricians and Gynecologists in their 1997 review of ultrasound in low-risk pregnancies:

“In a population of women with low-risk pregnancies, neither a reduction in perinatal morbidity [harm to babies around the time of birth] and mortality [death] nor a lower rate of unnecessary interventions can be expected from routine diagnostic ultrasound. Thus ultrasound should be performed for specific indications in low-risk pregnancy.”

— American College of Obstetricians and Gynecologists 1997

What about benefits?

Being able to see inside your womb can be useful in certain situations such as to confirm miscarriage or estimate gestational age (if done before 20 weeks).

An ultrasound scan can usually identify multiples, baby’s position, as well as placement of the placenta within the uterus.

For detecting potential significant abnormalities, ultrasound typically detects about half of the 1 in 50 present (so 1 in 100 are detected).

For those who go with an elective ultrasound (one done without the intention of answering a medical concern) you have the option to get “keepsake” photo or video of baby and learn the sex as well. This can sometimes be achieved during an already scheduled diagnostic ultrasound scan without needing to schedule an elective ultrasound.

When estimating your due date, if the ultrasound dating is after what you had estimated this could help prevent you from being considered “postdate” by your provider. The more time you and your baby have to start labor spontaneously, the less likely you will end up with a cascade of interventions from induction.

Are there alternatives?

Absolutely. As a consumer of your healthcare you do have the right to decline an ultrasound and any other additional testing should you so choose.

This can also quickly show a provider’s (or birth location’s) true colors when it comes to aligning with your particular birth philosophy. If you encounter a lot of push-back, fear mongering, and threats to drop you from their care; they might not be the best option for you.

Of course, considerations must be made for what options are accessible and available to you in your area. Hiring a doula local to your area can really help navigate these options with you, often knowing if there are homebirth midwives available.

Whether you decide to decline all ultrasounds altogether or just the Routine Prenatal Ultrasounds and follow up ultrasounds seeking to detect and diagnose abnormalities: You have the option to request ALARA. Requesting acoustic output levels As Low As Reasonably Achievable (ALARA) as well as keeping the testing as brief as possible can help to reduce exposure.

For things like determining gestational age for your Estimated Due Date (EDD); you have the option of an early manual examination of your fundal height (most accurate before 32 weeks for dating) as well as looking at your Last Menstrual Period (LMP).

Fundal Height Measurement when done by a skilled provider early on in pregnancy can be an alternative way to estimate gestational age.

You’ll have a greater accuracy with determining when your baby was conceived by the use of a Fertility Awareness Method (FAM) because of the natural variability between people when they ovulate after their last menstrual cycle. Simply counting 14 days after your LMP does not guarantee that was when you ovulated! There will be more information on Fertility Awareness to come!

A Sneak Peak : Sperm can live up to 5 days in cervical mucus, and an egg during ovulation typically only has 10 to 12 hours to be fertilized. Hence the variations in estimating due dates! So knowing when you had sex, what your cycles typically look like, and if you follow a fertility awareness method that you KNOW when you ovulate; you have a much better chance of accurately estimating baby’s due date (at the very least; better than 2 whole weeks of variability!).

Basal Body Temperatures used with the Fertility Awareness Method can help determine day of ovulation

For other tests seeking to answer the number of babies, position of baby in the womb, and other such questions: Often a skilled practitioner can answer these by palpation (like the fundal height, a hands on feeling of your uterus from the outside of your abdomen).

An easy alternative for Doppler Ultrasound is to request your provider use a fetoscope or Pinard horn to listen for baby’s heart rate and tones. Basically a stethoscope designed for listening to fetal heart beats.

Sometimes blood tests are sufficient as well depending on the question you are trying to answer.

For example; Non Invasive Prenatal Testing (NIPT) of the birthing parent’s blood to screen for the probability of Down Syndrome in the current pregnancy rather than the invasive screening procedures of amniocentesis or chorionic villus sampling (CVS) that have the potential to trigger a spontaneous miscarriage.

Whether to confirm pregnancy, gestational diabetes, iron levels, or screening for potential concerns; a blood test can be a less invasive alternative with less risk for your baby and less exposure from ultrasound.

What are the recommendations for its use?

ACOG & FDA do NOT recommend elective ultrasound for “keepsake” photos & videos OR to determine baby’s sex. Both recommend ultrasound only when use is expected to answer a relevant clinical question or otherwise provide medical benefit to the parent. If you do want a photo/video or to know the sex of your baby, you’re of course able to talk with your provider to combine that with your scheduled ultrasound. If you are concerned about exposure risks you can still request ALARA ( Requesting acoustic output levels As Low As Reasonably Achievable) and as brief as possible.

The World Health Organization (WHO) recommends one ultrasound scan (US) before 24 weeks gestation to estimate gestational age (GA), improve detection of fetal anomalies and multiple pregnancies, reduce induction of labor for post-term pregnancy, and improve a woman’s pregnancy experience. The WHO does NOT recommend a routine US scan after 24 weeks gestation for pregnant women who had an early US scan.

The WHO also strongly endorses the principle of informed choice with regard to technology use.

“The health-care providers have the moral responsibility: fully to inform the public about what is known and not known about ultrasound scanning during pregnancy; and fully to inform each woman prior to an ultrasound examination as to the clinical indication for ultrasound, its hoped-for benefit, its potential risk, and alternative available, if any.”

— The World Health Organization

While the general consensus has been that ultrasounds are considered safe, there is an acknowledgement that we really don’t know. So the recommendations are to keep exposure to a minimum unless deemed medically necessary. Whether this includes a Routine Ultrasound Scan for every pregnant person at 24 weeks or not remains to be seen.

There is plenty of information to consider when deciding whether or not or how often to have an ultrasound done during pregnancy. When it comes down to it, this is your choice for you, your body, and your baby. If you do not have specific concerns for high-risk pregnancy or abnormalities, it might be worth finding a provider such as a midwife experienced in non-invasive evaluations should you have questions such as estimated due date or baby’s positioning and want to avoid ultrasound. 

Regardless of what your final opinion may be on ultrasound during pregnancy, I hope this provided you with some useful information and a springboard for further inquiry.

Until next time, Happy Birthing! 

JB

TLDR;

I’ve included several resources for your consideration. I found articles by Midwifery Today as well as Dr. Sarah Buckley to be particularly informative as well as providing several links to additional research articles. We’re lifelong learners, so this is my starting point. As I learn more I will continue to share so we can learn and grow together!

Resources

https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/10/guidelines-for-diagnostic-imaging-during-pregnancy-and-lactation

https://midwiferytoday.com/mt-articles/ultrasound-harm-good/

https://www.mayoclinic.org/tests-procedures/fetal-ultrasound/about/pac-20394149

https://sarahbuckley.com/ultrasound-scans-cause-for-concern/

https://sarahbuckley.com/ultrasound-scans-in-pregnancy-your-questions-answered/

https://metromidwifery.com/2019/10/15/ultrasound-in-pregnancy/

https://wellnessblessing.com/blog/prenatal-ultrasound-fetoscope

http://apps.who.int/iris/bitstream/handle/10665/259946/WHO-RHR-18.01-eng.pdf

https://obgyn.onlinelibrary.wiley.com/doi/10.1002/uog.6328

For those who do not already know, I read a lot of birth books. Like a lot. Not just birth but all things women’s health, pregnancy, birth, postpartum, parenting, the works!

If you have seen my Amazon wishlist, you’d realize I have no shortage of books in this particular genre and field of study to read. The habit began when I worked through my DONA Doula certifications and will continue throughout my Midwifery studies through the Ancient Art Midwifery Studies Program.

As someone embarking on a Life Long Learning Journey, I figured I would share as I go!

Henci Goer’s The Thinking Woman’s Guide to a Better Birth was the most recent read I have finished so I’ll be starting here (I’ll add from previous reads later on as well, just need to start somewhere!). 

Henci Goer

“Award winning medical writer and birth activist Henci Goer gives clear, concise information based on the latest medical studies.

Goer will help you compare and contrast your various options and show you how to avoid unnecessary procedures, drugs, restrictions, and tests.”

About the Book

Right off the bat, this book covers an extensive list of options for an expecting parent to consider when it comes to their childbirth experience. 

The Book Covers:

• Cesareans

• Breech Babies

• Inducing Labor

• IVs

• Electronic Fetal Monitoring

• Rupturing Membranes

• Coping With Slow Labor

• Pain Medication

• Episiotomy

• Vaginal Birth After a Cesarean

• Doulas

• Deciding on a Doctor or Midwife

• Choosing Where to Have Your baby

• And much more

As a doula, these are the topics I like to go over with my clients to prepare them for birth. Like I mentioned in my What is a Doula Series | Knowing Your Options; having a solid foundation of knowledge to work with is HUGE in having the birth experience you want. 

Motivated to educate and reduce the overwhelming number of cesarean births (and their resulting complications) Goer is upfront in her desire to reduce this epidemic by providing the resources for the expecting parent to navigate what options are best for them.

While initially the idea of going through each option and intervention may seem overwhelming; Goer breaks them down into manageable bites.

Each chapter has the same pattern for presenting you the information: 

Beginning with an overview and critique of mainstream belief and practices. Again, she does not hide that she typically disagrees with standard practice because the research she shares has shown that standard practice is not supported by the evidence.

A description of the procedure or intervention is provided to give you more context. For a lot of first time birthers, this is really helpful! Oftentimes care providers function from this “assumption of knowledge” mindset from being experts in their field that they can forget to meet you where you are at and provide information that you might not have even realized you needed. This description can help to demystify these aspects of birth interventions. 

Next is “The Bottom Line,” where you will find the pros and cons of each approach or intervention as well as strategies to help you avoid a potentially unnecessary intervention. These are presented in an easy to understand and approachable way. 

Closing with “Gleanings from the Medical Literature,” Goer makes a point to reference evidence based studies to support her Bottom Line comparisons of each procedure. Here she summarizes those points that are taken directly from the medical literature she has drawn from. 

Appendices - Literature Summaries 

As a bonus, Goer provides literature summaries of the medical literature and studies she reviewed and drew from as well as a complete list of references so you can go and review the full study on your own if you’re so inclined. 

My Thoughts on The Thinking Woman’s Guide to a Better Birth

The format is again, very approachable, and backed up with the research she has done. I really appreciate that while this is essentially a summary of medical procedures, studies, and academic writing; it has been written for those who may not have an academic background. 

A common misconception is that someone who is a “thinker” has to be an “academic” minded person. This is simply not true! Anyone who takes the time to learn what they can before making a decision is a “thinker.”

While this book was published in 1999, it is still exceedingly relevant today. Which is honestly upsetting. Goer was reviewing research done in the 80’s and 90’s, aware of this increasing crisis of cesarean rates, maternal deaths and injuries, and overall traumatic birth experiences rising.

Sadly, these interventions and their “justifications” and high rates should not be relevant today, but they are. There are still hospitals in 2021 that go down this list of interventions not supported by the medical literature, checking each one off like it’s still 1999.

So while this publication is older, and does not currently have a more recent edition available; it is still relevant.

I would recommend this book to expecting parents that would like some foundational knowledge in the types of interventions as well as some options for a different type of birth experience. 

Many people are not familiar with out of hospital options such as birth centers or home births as well as the benefits of having a doula present (regardless of where you birth). Goer does not just provide you a road map to navigate hospital birth, but the option to birth with a provider in a location that supports your values and vision for birth.

I particularly enjoyed how her research debunks a lot of myths that providers may use as justification for interventions such as:

“We’re a high risk hospital, so our cesarean rates are going to be higher.” National hospital statistics show the rates to be wildly inconsistent with whether the hospital is considered high risk or not.

“My cesarean rate is right on the national average.” Her responding sass that this argument amounts to “All the other kids are doing it,” was highly satisfying. Because yes, your rate may be at the national average (currently 31.7% as of 2019 compared to when this book was published at 21.2%) but the World Health Organization, the international healthcare community, and the Mother-Friendly Childbirth Initiative recommend getting cesarean rates down to 10-15%. 

All in all, I appreciate the frank approach to discussing these interventions. Some have a purpose and can be life saving. The issue arises from the widespread use for every birthing parent. Disregarding your individualized health factors and your birth journey as more than a comparison to a skewed “average,” is what perpetuates this birth culture that thinks we need to “Save the Baby” from its mother’s body. 

For those in the back, your baby does NOT need to be saved from your Body! 

More often than not: you, your body, and your baby are more than capable of birthing when interventions are kept to a minimum and you are allowed to move through that process of birth at your own pace.

More about the Author

Henci Goer

If you would like to learn more about Henci Goer and her works please visit her website http://www.hencigoer.com/ 

Henci Goer, award-winning medical writer and internationally known speaker, is an acknowledged expert on evidence-based maternity care. Her first book, Obstetric Myths Versus Research Realities, was a valued resource for childbirth professionals. Its successor, Optimal Care in Childbirth: The Case for a Physiologic Approach, won the American College of Nurse-Midwives “Best Book of the Year” award. Goer has also written The Thinking Woman's Guide to a Better Birth, which gives pregnant women access to the research evidence, as well as consumer education pamphlets and articles for trade, consumer, and academic periodicals; and she guest posts on Lamaze International’s Science & Sensibility. Goer is founder, director, and faculty member of Childbirth U, a website offering narrated slide lectures at modest cost to help pregnant women make informed decisions and obtain optimal care for themselves and their babies.

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This concludes our first book review! What did you think? Would The Thinking Woman’s Guide to a Better Birth be something you would be interested in reading as you prepare for your birth? 

As a birth worker I think this is also a valuable book. A great reference to use when reviewing interventions and the concise Risks and Benefits to share with clients. As well as a poignant reminder that even in 2021 we still have a lot of work to do to achieve that Mother-Friendly Childbirth Initiative and Midwifery Model of Care to reduce the rates of cesarean births, interventions, maternal injuries and death, and instances of traumatic birth experiences.

Birth Matters. So understanding what an intervention is, why it’s recommended, if it’s supported by evidence, and when it is necessary and when it is not: these are all crucial to being able to make informed decisions regarding birth and supporting our clients during this process. 

For all my reader friends out there : What is your favorite birth/parenting/women’s health book? I’d love to add it to my reading list! 

Until next time, Happy Birthing & Happy Reading!

JB

Our time with the “What is a Doula Series” is coming to a close. 

Here, I would like to offer you a little summary of the topics that contribute to how a doula encourages parents to feel “Capable of Anything,” when it comes to birth and immediately postpartum. Of course, if you want more in depth information on the topic, the corresponding blog posts and podcasts are available as well!

What is a Doula?

A trained support professional who specializes in birth (and sometimes postpartum too!), providing nonjudgmental guidance for parents through the childbirth process. 

Filling a gap in our society where the transition to parenthood has been very isolating, leaving parents feel adrift and often lost. 

Skilled and experienced in multiple facets of the childbearing years: doulas can provide education and support regarding pregnancy, laboring & birth, the early weeks postpartum, newborn care, breastfeeding, bonding, and a compassionate understanding of how difficult these transitions can be.

This support typically begins during pregnancy through the first hours after birth, or if you have hired them for your postpartum period; weeks after birth. 

During birth, the doula provides continuous uninterrupted support. This means they do not have a shift change where you will have someone you’ve never met come in during this special and personal time of birthing your baby. 

Preparing you during pregnancy by meeting you where you are at to help you develop your vision for birth and the steps to get there. This includes letting you know what your options are so you may make informed decisions that are best for you and your family. 

During labor, we draw on the preparations we made during pregnancy by using your preferred coping styles from the “tool kit” we developed together. This can range from hands-on physical support of hip squeezes to emotional support of affirmations and reassurance with many things in between. This is the beating heart of moment-to-moment support, moving with you where you are at and helping to guide you through intense moments when you need it most.

Allowing yourself the peace of mind that you and your partner have a grounded and calm rock to draw support from as needed. 

The FIVE Aspects of Support:

Informational Support 

What do you think of when you think of birth? Is it Rachel from Friends? Is it a dramatic breaking of the waters, rushing to the hospital with lots of yelling and screaming, ending with someone shouting “PUSH” and then baby is born? 

While a very common conception of birth, it’s rarely like this and absolutely does NOT need to be this way. 

During your prenatal period, your doula will meet you where you are at in your knowledge of birth. Providing suggestions for options and seeing which ones match up with your values for your birth experience. 

You’re prepared for variations and the unexpected. You have an idea of your values and decisions for certain choices that may come up such as your provider wanting to do an intervention like breaking your waters or starting you on synthetic oxytocin (Pit or Pitocin). 

Giving you the tools to make your own informed decisions for you and your family. 

Plus letting you know that, yes, you do have more options than aggressive yelling of “PUSH” while on your back in a hospital bed. You CAN labor out of bed. Move around, dance, walk, shower, bathtub and so on. You CAN push in more positions than on your back. You can squat, side lay, or hands and knees. 

You also have more choices than a hospital birth with obstetricians. There are hospitals with midwives, out of hospital birth centers with midwives, and home births. 

You have options and you deserve to be aware of them so you can make the informed choice that is best for you. 

Interpersonal Support

Otherwise known as Mediation. Which I prefer over Advocacy, because we want you to be your own advocate during birth. Your doula is not there to speak for you or decide for you. We want families to be empowered and encouraged to make their own informed decisions and voice them. This is a skill you will need throughout your child’s life.

Your doula won’t leave you hanging if words are hard though! 

Having already prepared a Birth Vision with you and your partner, we have a general idea of your preferences. Yes, these preferences can change as can the course of labor. 

With mediation, your doula can help give you and your partner more time to think over a sudden suggestion for an intervention before making a decision. Your doula can speak up with questions to prompt more information that you could use for those decisions. 

We are there to hold space with you, and protect that space. You should not be rushed into decisions (pending a true emergency, which is very rare) and you should be given the time alone with your support team (or solo if you prefer) to make decisions. 

You doula, as a mediator, is a buffer between you and other parts of your birth team. Making sure we all are on the same page and honoring your thoughts and feelings on how your birth goes. 

We bear witness to your birth, your experience, and your treatment. We support your decisions, and help to ensure you get the time and information you need to decide. 

Physical Support

Typically the post child of what a doula does is physical support. We know the tips and tricks to non-medicated pain relief and ways to encourage baby down and out. Masters of the Hip Squeeze and Counter Pressure, we love showing partners how to do these comfort measures as well. 

Anything to help you labor longer at home before going to your birth location to reduce the chances of interventions to “speed up” your labor. 

Then at birth, we are with you every step of the way. Adjusting from contraction surge to surge in what brings you the most relief. A continuous presence to give you that continuity of care throughout your childbirth process. 

There’s a reason continuous physical support is emphasized so much to expecting parents. Birth is a very physical process that requires dedicated attention and effort from your support team to help you move through the waves of this marathon.

While the tangible benefits of physical support are amazing, your doula draws from the other four types of support to give you a holistic approach to birth. 

Emotional Support

Beginning during the prenatals while we work on informational support, we are laying the groundwork for emotional support. We get to know you and your partner. Your preferences for how to cope and tap into any fears or concerns you may have. We want you to feel confident and capable when approaching birth. 

In tandem with physical support, the emotional support is right there with you during the nitty gritty of birth. Continuous, mindful, and grounded support that meets you where you are at. The shifts in mood and coping in labor often take parents by surprise, and having your doula there to guide and support you can make a huge difference. 

Holding space, your feelings are valid and so are your fears. Met with reassurance that you ARE doing well and that what you are feeling is normal. While your body may feel in danger, you are in fact safe. Your partner and I have your back, you are supported and cared for. 

Your doula’s role is to be emotionally present for you and your partner. On the surface this may not seem as useful as physical support, but the impact is huge. 

To feel seen, heard, and respected can help ensure you remember this experience with pride and satisfaction. Because you will remember your birth for years to come. Particularly the way you felt and how you were treated. 

Spiritual Support

Regardless of your faith or lack thereof, we are all human. We are inhabiting this birth space together. 

You are not alone. Millions of parents are going through these big feelings and transitions at the same time as you across the world.

Your doula is with you through this. Whether as a woman to woman connection or simply person to person

You are seen. You are heard. 

We are in this together. 

We can pray together, chant, dance, breathe, embrace. However this feeling of connection manifests for you, your doula can meet you there.

Birth is a significant life transition. It is transformative. It is a rite of passage.

This is NOT just another day for you. This is the day you meet your baby Earthside.

Your birth matters. 

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Often the role of a doula is confused with that of a Midwife. I would like to clarify how a doula is NOT a Midwife by what we do NOT do. 

What a Doula Does NOT Do:

Provide medical advice or diagnosis

Perform medical procedures

Act as a Midwife, OBGYN, or other health care provider

Act as a nanny, babysitter, or housekeeper

Make decisions for you or your family

Replace members of your family or support team

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In summary, your doula is a touchstone and guide throughout the birth process. We meet you where you are. Provide the tools you need to make your own informed decisions. Support those decisions, and help hold space for you and your birth. Providing continuity of care from pregnancy through to immediately after birth. We stand, squat, dance, sit with you, providing continuous, uninterrupted and nonjudgmental support. 

If your partner is present, we support them too. We work together as your team.

This is your birth, and how you feel and experience it matters. 

You matter. Your baby matters. Your birth matters. 

Is there anything you still want to know about doulas and how they can support you?

Until next time, I wish you all the best and happy birthing! 

JB

Blog | Website | Podcast | Instagram | Facebook | Linktr.ee/jbdoula/

In previous posts I have mentioned the FIVE aspects of doula support : Information, Interpersonal, Physical, Emotional, and Spiritual Support.

We’ve touched on the value of information in knowing your options prior to the start of labor. As well as how a doula’s superpower of Mediation & Time (your interpersonal support) tend to provide you better outcomes and overall experience during your birth.

The final three tend to flow with each other in a moment-to-moment type of support with each contraction and breath. Rarely do you have one without the others close by.

To give them some individual attention for clarity:

Physical Support can be anything from those Hip Squeezes I’ve mentioned to simply hugs, rubbing your back, or stroking your hair. Even just the physical presence of a support person throughout the entire birth process has been shown to alleviate birthing parent stress, fear, and pain. Often giving them a sense of confidence that extends to their partner!

Emotional Support can be affirmations and words of encouragement, holding space for your feelings (the good, bad, dramatic or subtle: your feelings and experiences are VALID). Physical support can easily share space with emotional support like a kiss to the forehead or stroking your hair. Something that can be deeply comforting for some birthing parents. Which leads me into the final aspect of support.

Spiritual Support can seem esoteric and misconstrued for our secular friends. This does not mean your doula and you have to share the same faith, if any. This is “simply” at it’s core the connection between people experiencing something together. Being present, open, and willing to be seen. Whether it is woman to woman or if both of you have had children before and any other combination in between:

We are all human and we are sharing this birth space together right now. We are in this together.

In order for a doula to tap into these three aspects of support; to truly be present and grounded during a birth she needs a great deal of TRUST.

Trust in the birth process. This allows a doula’s experience and knowledge to shine through.

Familiar with the various degrees of “normal” and confidence in you, your body and your baby’s ability to birth allows them to be a grounded and calm presence during a birth.

A parent’s touch stone for reassurance and guidance as needed. (That’s for both the birthing person and their partner!)

This confidence in the birth process allows a freedom to move into the space of hands-on physical support and to hold space emotionally. 

Let’s face it, when you’re feeling uncertain, anxious, or afraid; it is really hard to problem solve or sit within the present moment. Everything feels BIG and A LOT. 

For a doula, she can settle into that space of calm clarity because she trusts the process.

Your doula believes in you, your baby, and your body’s ability to birth.

Hiccups may happen along the way, and they are prepared for those too. Able to adjust course to provide the support you need for when you need it. 

That trust alleviates the fears and anxieties; allowing a clearer mind to help find what works best for you during a particular phase of labor. 

So what does that look like during birth?

Perhaps bouncing on the ball no longer brings the relief it did before. When something has been helping for so long, these changes can be a trigger for anxiety and uncertainty. 

Your doula knows it is absolutely normal for coping techniques during one phase of labor to not necessarily bring relief later on. And vice versa. Chatting to distract from the contraction surges may have helped during your early labor, but now as things get more intense you can’t stand the chit chat. And that’s okay!

A doula is tuned into the birthing person and their partner. They can read the room as well as feel out when something is no longer working. When you trust the process, it is easier to let go and try other options. Like leaning over the birth ball and seeing if it provides more relief instead of bouncing.

Little adjustments can make a huge difference. 

In the midst of labor and feelings of uncertainty, it can be difficult to realize a small change could help. Even trying to recall positions and coping techniques in the moment can be challenging during a birth.

The doula is well-versed in these little adjustments and has an extensive tool kit of things to try! 

One of the advantages of having a doula meet prenatally with you goes beyond the sharing of information and education, but also preparation of this tool kit. Finding what tends to work best for you when you are coping with stress or pain. 

Not everyone is touchy feely or feels reassured with words of affirmation. Exploring those preferences prior to labor helps develop this took kit specifically for you and your birth. Reducing how often a birthing person needs to be drawn away from “laborland” or their more primal brain that they need for birthing tends to make the birthing process easier. 

That’s why it’s so important to discuss options and practice coping techniques prenatally. 

Birth deserves the time and attention to prepare yourself and your partner beforehand so you both can sink into the moment-to-moment experience.

Having your doula there adds to that reassurance and relief that allows you to be present in the moment. Let your doula do the problem solving of suggesting different things to try. We trust in you and the process, and trying different methods and techniques is a part of that process. 

Future blogs and podcasts will go more into detail of the specific coping techniques. To give them their time to shine. In the meantime, you are always more than welcome to reach out to see how a doula could benefit you and your birth and postpartum experience.

Before that, our next installment of the What is a Doula Series is the Wrap Up! A lovely summary in one spot of the various topics of the series and clearing up an additional questions that may have come up along the way!

Until then, Happy Birthing!

JB

We’ve entered a curious time where partners are expected to be in the birthing space with their birthing partners, to attend childbirth classes and serve as their partner’s birth coach and cheerleader. Not to mention welcoming their new baby and being emotionally present!

So when a doula enters the mix, knowledgeable in birth and often confused with a birth coach, it can leave partners wondering what their role is during birth. 

A common feeling partners can have is that the doula “replaces” them in the birth room. This is simply not true. 

Here I would like to air out some misconceptions about partners & doulas as well as share how a doula can help the partner too! 

Most importantly, a doula NEVER replaces a partner in the birth space. (Early COVID hospital protocols aside. That’s a WHOLE other topic). As a partner, you bring something to the birth that a doula simply cannot. 

Personal history, love, and intimate connection. 

This intimacy is something a doula does not provide, nor tries to! This is something wholly special and necessary that the partner can provide. 

With this perspective, the doula takes on more of the responsibility of the “birth coach” or I prefer the “birth guide.” The doula holds extensive knowledge on the birth process and often can be seen as a touchstone for the parents to reassure that “yes, this is normal. You’re both doing great.”

Let’s face it. It’s hard watching a loved one struggle and experience pain that you cannot fix for them. Partners tend to be doers and birthing can leave them feeling off balance and overwhelmed. 

You can't give birth for your partner! 

What you can do is be as present and supportive and loving as possible. This is different for everyone and every couple. Some partners are excited and more than ready to get in the trenches of emotion and provide hands on support to their birthing partner. Others are unsure what to do and also feel overwhelmed that their partner will be giving birth to their baby soon!

It’s hard to be present and supportive if you yourself need some support. And that’s okay!

Here is where a doula shines with partners. For the more involved partners, doulas can give gentle suggestions of where to place hands or when to try something new to keep that “Gate Theory” as effective as possible for the birthing partner. With this partner, a doula will typically work in tandem to support the birthing partner. 

Having the birthing person face their partner and leaning on them to slow dance while the doula provides hip squeezes or back massage. For when they are handling things beautifully on their own, a doula can step back to give them space to find their groove and offer suggestions or answer questions as they come up. She fills in the gaps and builds on what the partner is already bringing to the table. 

For the more anxious and unsure partners, the doula may do a lot more of the heavy lifting so to speak with the hands on and emotional support. Giving the partner space to center themselves and encouraging them, when they are ready, where to place their hands or suggesting special moments of hugs, kisses and encouragement. 

This partner might need to be able to step out of the space to gather themselves or extra time to adapt to the intensity of birth before joining in when their partner needs them most. 

A partner has personal history, love, and intimacy that a doula would not try to replicate. This is something wonderfully yours between the two of you.

With both of these types of partners (and the many in between), the doula is a constant. Either partner can step away for a bathroom break, coffee, or fresh air without being worried (or feeling guilty) about leaving their partner alone. With a doula, their partner will always have someone by their side. 

The doula meets these partners and couples where they are at. During prenatals they’ll gauge knowledge, comfort levels, and both parents’ desires for the birth. That way each birth is tailored to each couple and every birth is unique. A doula flows to fill and support spots that need extra attention and help guide both parents on the journey should they want it. 

There is reassurance that everything is okay based on her knowledge. 

There is comfort in knowing that the birthing partner will have continuous support between the two of you. 

There is peace of mind when working with a doula who guides you through not only the birthing person’s experience of birth but the partner’s as well.

A family centered moment. 

There is confidence from practicing skills with a doula and using them together to support your birthing partner. Like with any sport, practice is key for muscle memory and confidence! 

Are you a partner and concerned about your role during birth with a doula present? Reach out and let’s explore some ways to work together so this birth experience is memorable for both you and your birthing partner. 

Next time I’ll elaborate on how doula’s being the experts in “normal,” translates to intuitive support during labor and birth. 

Until then, Happy Birthing!

JB

Last time we touched on the importance of knowledge and a doula’s role in providing the information you need to make informed decisions. Decisions made by you, for you, that are best for your family. 

This time, I’m uncovering an often overlooked superpower of a doula. 

Imagine breathing with each surge, riding the waves of intensity and relaxing into the ebb and flow. Your partner beside you, rubbing you back as your doula breathes with you while she massages your hands, arms, and legs. You have been working hard, and have finally found a sense of rhythm. 

Now enter your provider. You’re feeling a little disrupted, but your partner and doula are beside you to help maintain a semblance of the rhythm and ritual you had moments ago. Your doula knows laying on your back for a cervical exam can be uncomfortable and painful so she pays close attention to your changing needs. Providing continuous contact and massage to help relax you as much as possible between surges. 

You feel confident that surely you have progressed this time, it’s been a long labor so far, but you found your rhythm! This confidence shakes with the shake of your provider’s head. You’re “still” x- centimeters. They think you should be put on Pitocin (artificial Oxytocin used to increase the intensity of contractions). Suddenly you feel tight, discouraged and maybe even scared or frustrated. You thought you have been doing so well! (P.s. You definitely are! Don’t doubt that!)

For those who have birthed before or have already started having prenatals with your care providers, you have probably encountered this feeling. 

Often birthing parents and partners can feel swept up by “White Coat Syndrome” that goes beyond an increase in blood pressure brought on by anxiety. Many people, when told by a doctor or nurse that something needs to happen or that they are going to do something (to your body), feel pressured to go along with anything they say. Even if what they are suggesting does not need to happen as urgently as it may seem. 

For our example above, the provider thinks you are taking too long to dilate and progress. Many providers are taught that birth should follow a strict timeline, but that is only an average of how a birth can go. There are plenty of safe variations on either side of that average or what they deem “normal.” 

With any unexpected and often sudden suggestions of interventions is when a doula’s superpower shines. 

Rather than immediately prep you for Pitocin or an Epidural or a Cesarean, your doula can calmly (and respectfully) suggest giving the birthing parent (you) a few minutes to think it over. For any intervention that is suggested, you are allowed to have time to think about it and have the right to say no. The only time that time is not allowed is when it is a true life or death emergency and you’re unable to respond to give consent (this is implied consent). Which is rarely the case. More often than not, you have time to think and decide. 

Doula’s help keep TIME on your side

If you decide you would like to hold off on the Pitocin, your doula can suggest requesting a time limit with your provider. 30 minutes here or 60 minutes there to get up and walk around or try something new to move labor along. 

Time is your greatest resource during a birth.

The more time and space you can have, the easier and less pressured your birth experience will tend to be. 

Here, your doula does not speak for you in that they are not making decisions for you. They are there to act as a gentle buffer between you and feeling rushed or pressured. If it seems like your medical birth team is ignoring or acting against the choices you made for your Birth Vision, your doula can be more firm in protecting this space with you. 

Your Body Your Choice | Informed Consent & The Time To Make Decisions

You have the right to birth the way you want within the limits of safety to yourself and your baby. In the event of something like increasing blood pressure, fever, or other indicators something may be wrong, an intervention is likely necessary. 

However, pending a truly urgent matter, you have the right to know what is going on, to ask questions, to have a few minutes on your own (or with just your partner or doula) to process these changes, and to give your consent (or not). 

Just because something unexpected is happening, does not mean you lose autonomy. 

A doula is here to help mediate when communication is difficult between the birthing parent and her partner or her birth team. A doula is there to suggest privacy for you to think and decide. To provide you the option of time to try something different. To ask questions to clarify what the provider would like to do. To encourage communication between you and the provider, such as asking them to explain your options or why something is necessary. 

I care deeply for you, your choices, and your rights to a positive birth experience.

As a doula, I have the benefit of being a third party outside of the scope of the care provider and outside of the intimacy of your relationship or family. I care deeply for you, your choices, and your rights to a positive birth experience. However, I am not as emotionally embedded in this birth as you and your partner are. I can step back and see what is happening, reassure you things are progressing normally, and act as a calm third party mediator. 

This is a key strength to the doula. They care deeply while being able to remain calm and grounded during highly emotional moments. 

This is also why partners and doulas make a perfect team. Your partner has that deep emotional intimacy with you and your baby. They provide the love and familiarity you need. While a doula provides a touch stone when you need reassurance this is normal or to suggest a different coping technique. Having someone there as a constant source of support and information can allow partners the space to be a part of the birth as much as they are comfortable.

Partners are a crucial part of your birth team!

Next time I’ll dive deeper into how partners and doulas make a perfect team. As well as how a doula can help the partner during birth more than you might have thought. Partners need doulas too. I want both you and your partner to “feel capable of anything!” 

Until then, I wish you all the best and happy birthing! 

JB

What a doula does so you feel like “I am capable of anything” 

As mentioned in the previous blog, part of preparing you for birth is education of your options. This ranges from your choices in birth provider: midwife or obstetricians; where you plan to birth: home, birth center, or hospital; and the many ways that describe “how” you give birth. 

Each pregnancy and birth is unique, and with that so are the variations that can occur. Maybe you are considered “high risk” whether it be because of a preexisting health condition or the development of hypertension during the pregnancy. 

Your current situation impacts your options, but does not necessarily exclude you from your original birth vision. For example, just because you are pregnant with twins does not mean you cannot safely and confidently birth at home with a midwife. 

Twins?

Twins can be safely born at home. More information is needed before ruling out the possibility of a homebirth.

So understanding what your current health situation is can provide a foundation for your options (such as encouraging you to get second opinions and greater education on how x,y, or z impacts your choices in birth). 

There is also the very real aspect of financial or social factors. Maybe you want to have a home birth, but there simply isn’t a midwife nearby or you don’t feel totally comfortable with that option but still want that midwifery model of care. From there you can look into local midwife centers or hospitals that provide midwifery care. 

Your insurance might not be accepted at the hospital you would prefer to go to. While insurance itself can be finicky especially in regards to reimbursement for doulas or midwifery care at home, often even paying out of pocket for these services would still be cheaper than a hospital birth with poor coverage.

A doula helps sort through the feasible options with you, helping to refer you when possible if your current provider isn’t a good fit or you had no idea there were midwives accepting clients near you.

Have your best ideas in the bath? You might enjoy laboring in water!

Part of deciding on your birth provider or location is considering how you imagine your birth to be. 

Do you want pain medication? Are you afraid of needles? 

Do you want to be able to get up and move around? Does a shower or bath sound like the perfect way to cope with the surges during labor?

Do you want privacy or do you not mind medical students/residents/interns being present for exams and the birth? 

How about being able to eat what you want or go for walks outside? 

Do you feel more comfortable at home or in a hospital?

Exploring these preferences can help narrow down what sort of provider and birth location is best for you. From there we can dive deeper into those specific options with that provider and location. 

Such as, if you want an epidural you will need to be in a hospital rather than a birth center or at home.

When would you want that epidural?

How soon or late will a hospital administer it?

Do you want to try other coping techniques first such as a shower, bouncing on a birth ball, or hands on comfort like massage to where you are feeling the most tension?

Does your birth location allow a lower dose of the epidural so you can still move your legs and potentially get up at a certain point?

If you’re going to be bed confined throughout, what positions can you try to help move the baby down or relieve any lingering pain you may have? 

It’s ok to feel overwhelmed

There are a lot of potential options to consider and choices to make. Talking it through with your doula can help the process be more manageable.

While we cannot plan everything that will happen in a birth, we can prepare and educate as best we can so you feel comfortable with the process. By knowing your choices, and options within those choices, you will be able to feel like a participant in your health care. 

You aren’t just being swept from one intervention to the next with little time to ask questions as to the reasoning behind the provider’s choice and if there are other options. 

This way you have done some research ahead of time, you’re aware of your options pending emergency complications. And even then, you will have been prepared with your options as well, such as if you need an unexpected cesarean will your partner or doula be allowed in?

Will someone be with you while they administer the epidural or spinal?

Will the doctor talk you through the procedure so you still feel a part of the birth? 

Feel Capable

A little preparation can go a long way to feeling capable of rolling with the unexpected

Unexpected surprises can happen, it does not mean you have to be blindsided. 

Often a birthing person can feel overwhelmed and like they have no control when their provider starts suggesting interventions like Pitocin or a cesarean birth. Especially if there had been little warning before being prepared for these procedures. 

Next time, I will explore the doula’s role in giving you time and space to decide so you feel “capable of anything,” during your birth. 

Until then, I wish you all the best and happy birthing! 

JB

The long awaited moment is here!

While it may not have seemed all that long for those who just saw my announcement; it has been quite the minute for me. I’ve wanted to create this platform for honest open discussion, education and women supporting women for the last two years. I’m so grateful things have finally come together to make it a reality!

The heart of this is inspired by a desire to not only connect parents and their stories, but to also invite care providers to the table so we may work toward a more collaborative future in maternity care.

Birth Matters and I want to help encourage that positive change.

So, here is the first of many episodes to come! I hope you enjoy and if you’d like to share it with others I’d be so grateful!
Additionally, If you or someone you know would be interested in being on the podcast don’t hesitate to reach out! Socials linked below ~

Happy Birthing!

JB

What is a doula series: the basics.

So, you’re looking for a doula? Or perhaps you’ve just recently heard this odd term and want to learn more. 

You’re in luck, because this is the start of my “What is a doula” series where I will shed some light on what a doula is, does, how they benefit you, as well as other fun tips and tricks. 

Founded in tradition of women coming together to support the birthing person through a powerful rite of passage.

First off, “doula” was coined in the 1960s derived from the Greek word meaning “women who serve.” However, women have been serving each other in birth long before the 1960s, this was simply when women began pushing for more birth support. Particularly in areas where western medicine was prevalent, such as the United States. 

Women wanted birth to be less frightening, isolating, and overwhelming. Considering as a species, women typically were supported by a local midwife and women of their community usually a mix of family and friends. For countries driven by western medicine, this community based support was pushed further and further away. 

Connection & Community is a Cornerstone

From the 60s to today, we are generally pretty isolated from community and even family. It is common for a couple to marry and move across the state, country, or even overseas from their parents and grandparents. This distance plus needing to make new friends in your new home often leaves couples that are expecting their first or even fifth baby feeling alone and unsupported. 

When family and friends are too far away or too swamped with their own obligations (whether jobs or families of their own), a doula is available to fill in this gap. 

Living closely with multigenerational families is not always feasible, so that essential aspect of community support needs to come from somewhere to ease the transition of pregnancy to birth to parenthood. 

A doula provides that stability of availability, as well as education in the birthing process, newborn care, and breastfeeding. Often sharing local resources or information so the parents, who may have never been around newborns before, have a chance to become educated on the basics so they feel more confident in becoming parents. 

As well as providing education on your choices for your birth and in parenting so you can make your own informed decisions. Much like how I felt in regards to hormonal birth control by not being educated in the potential for health risks or prolonged infertility later in life, a similar tendency for not providing necessary information and education occurs in our maternal health care system. 

“Wait, I have options?!”

You don’t know what you don’t know, so how can you be expected to make informed choices on your health care? As consumers of our health care, which is how our medical system is set up, you have the right to know your options, to get second or fifth opinions on the right course of action. Just because one doctor or hospital says you cannot try for a VBAC (Vaginal Birth After Cesarean) does not mean it isn’t a safe and feasible option for you. It may mean you need to look into another care provider before accepting a scheduled cesarean. 

It is important for me to emphasize that as a doula, I do not have an agenda for what your birth should or should not look like beyond being your choice.

Whether you want a drug-free home birth to a planned cesarean, I am simply here to provide you with options, resources, and support so you feel confident in your informed decisions. 

Whatever your ideal birth looks like, I want to be there with you to help make that a reality. 

Sometimes twists and turns and unexpected hiccups happen. Part of my job is to help prepare you for those potential variations from your ideal vision of birth. Even if you fully intended and desired to have a drug-free birth, you may find yourself thirty hours in and exhausted. You may change your mind and decide medication to allow you to rest before it is time to push is the best option for you now that you have been laboring. 

And that is okay. 

I will help you try everything we can prior to that point, and support you if you change your mind. You know what is best for you and your baby and what your limits are. I can also reassure you that you can absolutely change your mind, but let’s have the nurse or midwife check you first. 

Sometimes all you need in that moment when you feel like you cannot do this anymore, is to be told that it’s almost time to push. Because many times when a mamma reaches that wall where they just cannot go on, it’s because their baby is about to be born. 

And other times, it is simply a long labor and you could absolutely use a rest for a couple of hours. Then when it is time to try getting up and encouraging that baby to move down and out you feel more capable and ready.

Every birth is different for every mamma, and I want to hold space for that uniqueness. 

Your birth matters, and so does your memory of it. I would like to honor that core aspect of birth with you. No matter what twists or turns may happen, I want you to feel at the end of the day and twenty years from now satisfaction with yourself and your birth experience. To leave you with a feeling of empowerment and pride that you did this awesome thing and feel like you are capable of anything. 

That’s what I want for you.

Next time, I will go more in depth into exactly what a doula does to help you have that feeling of “I am capable of anything.” 

Until then, I wish you all the best and happy birthing! 

JB

The time of New Year's resolutions is upon us. With that comes crash diets and goals unfulfilled. 

Nothing like starting the year off with disappointment am I right?

Pessimism aside, it really is a popular time of year to make positive changes for yourself.

Last year, instead of one resolution like "lose 10 lbs" or "quit sugar" I joined my friend Jen in Gretchen Rubin’s 19 for 2019.

With this we each listed 19 things we wanted to accomplish, with an emphasis on actionable items rather than 19 goals. For me, it was difficult to not use overarching goals.

I'm an INFJ and love big picture future oriented focus. With that comes an absent mindedness for daily tasks and getting overwhelmed by wanting to do everything at once.

So the 20 for 2020 is helpful because you can break down a big goal like lose 10 lbs with the actions you want to take to get there like walking 20 minutes every day and eating vegetarian at least one night a week.

Here’s my 20 for 2020!

• 1 podcast a month JB doula

• 1 to 3 posts a week

• Meditation 5 minutes every morning

• Gratitude practice 3 things a day every morning

• Classics reading list!

• 1 networking meeting/orientation a month

• Spin bike /jog 3 days a week

• Lift weights 1 x a week

• 1 day hike a month

• Walk 20 for 2020

• Date night out/in once a month

• Cleanse !

• Attend 6 births

• Attend a home birth

• Provide postpartum care to 6 clients

• Podcast with Jen #thedynamicfeminine

• Move to a new rental

• Hold orientations for 4 businesses

• Join Indiana Chamber of Commerce

• Save $3600 for down deposit  ($300 a month)

My 20 for 2020 has a heavy focus on my business. JB Doula Services is still in it's infancy and needs attentive love and care to get off the ground. Many of my items are aimed towards keeping me on track to help my business grow and thrive.

Wellness is also important to me, physically and mentally, as a result a few of my points will also focus on ways to be healthier. I do want to lose that elusive 10 lbs from my freshman year of college along with fostering better habits for sustaining my mental health.

I want to be the best version of myself, and each year (or sometimes every few months) I take the time to reevaluate and readjust my approach.

I'd love to hear what your goals are for 2020 and if you're interested in joining me with a 20 for 2020 list! Comment below or shoot me an email and we can connect.

I'll be checking in periodically throughout the year to share how I'm progressing in staying on track.

If you want to learn more about the 20 for 2020 checkout Gretchen Rubin’s Happier podcast.

You can also join my friend Jen and I as we discuss our 20 for 2020 lists on our podcast The Dynamic Feminine. This is where we talk about all things womanhood and stardust.

Happy New Years Eve!

Caution: No matter how pretty and sparkly, don’t drink glitter lol

Can you believe it’s almost 2020? That feels like something from a sci-fi movie and I half expect cars to fly or my dog to speak with a dapper accent. 

While I doubt that is going to happen (yet…) there has been more research coming out on drinking habits and their effects on pregnancy, fetal development, and breastfeeding. 

To take it back to the early 2000’s: I can recall from my high school health class being told explicitly that women who are pregnant or breastfeeding should never, and I mean NEVER, drink alcohol. That even one drink could endanger your growing baby to suffer from Fetal Alcohol Syndrome. Also, when you’re breastfeeding and you drink, it was akin to pouring that glass of wine directly into your newborn’s mouth. 

That’s scary stuff.

 I remember feeling really anxious even as a teenager about alcohol. Then as I started college and entering drinking culture, I became more aware of the timeline of conception and when someone might realize that they are pregnant. 

Often women who are not trying to get pregnant may not even be aware that they are until they miss their next period. This could be two weeks or even months if they typically don’t have regular cycles. 

Now introduce the fact that many women in their early twenties enjoy hanging out with friends and going to parties. Many of them enjoy drinking, whether it be one or two or binge drinking. 

Enter my fear of becoming pregnant unknowingly and then partaking in an enjoyable event and having a few drinks. I have had this fear response conditioned into me due to the research of the time from ten years ago. Anxious about accidentally harming my unborn baby when I’m not even trying to get pregnant. To be honest, it was an unnecessary amount of anxiety to have. 

Bringing it back to this upcoming new year of 2020, my fears around unplanned pregnancy and drinking have been assuaged. 

For one, I chart my cycles now so I’m much more aware of the time frame in which I can become pregnant. Partner that with consistent condom usage and I am confident in my ability to avoid an unplanned pregnancy. In a later post I will discuss more on the topic of fertility awareness and how it applies to anyone whether they are trying to get pregnant, trying to avoid it, or simply want to better understand their bodies. 

For two, whether you are eating or feeding for two, there has been more research that compares the effects of limited and heavy drinking during pregnancy. Before it was an all or nothing approach, which quite frankly is probably as effective as abstinence education in our youths. Again, a topic for another time. 

The research has begun to indicate little risk with an occasional drink. The high risk for Fetal Alcohol Syndrome have been most closely linked with alcoholics that are heavy drinkers most days while pregnant. 

“There is no evidence that an occasional drink is harmful. Women who drink heavily throughout pregnancy may have smaller babies with physical and mental handicaps. However, women who drink moderately may have babies with no more problems than those women who drink rarely or not at all.”

— The American College of Obstetricians and Gynecologists

As for our breastfeeding families there is similar evidence that shows the lack of harm when consuming alcohol in mindfully moderate amounts.

“Reasonable alcohol intake should not be discouraged at all. As is the case with most drugs, very little alcohol comes out in the milk. The mother can take some alcohol and continue breastfeeding as she normally does. Prohibiting alcohol is another way we make life unnecessarily restrictive for nursing mothers.”

— Dr. Jack Newman

Some Peace of Mind in 2020

I for one, am always looking for ways to make life easier for parents with newborns. From the point of conception until after your child is fully grown, there is so much on a parent’s plate in caring and making decisions for their family. To then add layer upon layer of prohibitions, and if you break a single one you are automatically a terrible parent, that is unfair and makes like unnecessarily difficult. 

So I am happy to say that here is one less thing to agonize over. 

For those who only drink occasionally and avoid binge drinking, you may toast with a glass in the spirit of the holidays with some peace of mind.

The general advice is to avoid alcohol. More specifically; avoid breastfeeding until 2-3 hours after drinking. 

The level of alcohol in your milk metabolizes at the same rate as your blood. So if you had one drink to toast at midnight on New Years Eve; then try to wait until at least 2 am for your baby’s next feeding. You can also avoid timing concerns by having pre pumped milk already thawed and ready if you plan on drinking tonight.  

Fed is Best

A common myth is that you can reduce the alcohol content in your milk faster by “pumping and dumping.” 

This is simply not true.

Just like drinking more water, coffee, or resting won’t sober you up any faster. 

Much of this will come down to how your body processes alcohol, if you ate, what your weight it, and how old your baby is in their ability to metabolize your milk right after having alcohol. 

When in doubt: if you’re sober enough to drive, you’re sober enough to breastfeed. 

Disclaimers

Alcoholism & Binge Drinking

Some Disclaimers for alcoholism and binge drinking:

This does not include binge drinking, drinking to the point of vomiting, or being intoxicated. Your milk’s alcohol content will be as high as your bloods: aka Too High! 

You will also be too impaired to safely feed or care for you baby, and it is recommended to have a sober adult attend to your child’s needs while you get sober. 

Never co-sleep after drinking: you will not be as responsive to sharing space with your baby. 

Alcohol can also reduce milk production, so if you’re already having trouble with maintaining your supply consider avoiding alcohol. 

As with all things regarding your body, your pregnancy, and your baby: use your best judgement for what works for you. 

If you ever feel overwhelmed by conflicting information and are having trouble with the anxiety that can come with expecting a baby; you can always abstain from participating. There are plenty of mocktail or sparkling cider options that feel festive without alcohol. 

Parenthood will consist of a lot of these decision making moments and sometimes you won’t have the time or the energy to drudge through Google to find out the answers to all of your burning questions. 

In these times I find it helpful to follow my gut. You can always change your mind later if more helpful information comes to light. Nothing is set in stone, and being a parent is already stressful enough as it is. So why make it harder by agonizing over a sea of “what if’s?” 

For me, if I’m still anxious and unsure which direction to go; it helps me to be on the safer side until I’ve had a chance to do my own research or consult with trusted individuals. This is how I approach difficult choices, but I also have struggled with anxiety for years. So these are the tools that work well for me. 

Through trial and error and often a good talk with your therapist; you too can find what tools work best for you in navigating the uncertainties of parenthood.

There will be links down below to helpful articles from sources such as the CDC, La Leche League, and Kelly Mom 

Contact me if you have any questions or are interested in being connected with resources in your area such as your local La Leche League or therapist. 

If you or someone you know struggles with alcoholism or substance abuse: See my resources page for more information. You can also contact me for a direct referral.

JB Doula Services wishes you and your loved ones a very happy New Year!

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https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/vaccinations-medications-drugs/alcohol.html

https://www.llli.org/breastfeeding-info/alcohol/

https://cdn.shopify.com/s/files/1/1970/0557/files/0405-more-bf-myths.pdf?13823050296189251268%20--

https://kellymom.com/bf/can-i-breastfeed/lifestyle/alcohol/

https://www.alcoholproblemsandsolutions.org/fetal-alcohol-syndrome-fas/