A Doula’s Breastfeeding Plan

A Doula's Breastfeeding Plan
A Doula’s Breastfeeding Plan

Feed the baby.

It sounds so simple, and yet it isn’t. As a doula and childbirth educator, it seems to be understood that I will, of course, exclusively breastfeed this baby when he arrives.  I mean, in our training we are taught all about the amazing things that breastmilk and breastfeeding can do.  I have already had offers of support and help for when I breastfeed my baby. Not if. Not “what are your plans, how are you feeling?”  WHEN I breastfeed my baby.  I do plan to breastfeed my baby, but I have no set expectations on how that will go.  All I can do right now is prepare myself and my supports as best I can, then wait and see.

For those who are curious on how a doula plans and prepares to breastfeed, here are my plans:

I plan to rest as much as possible in the early days to allow my body to heal.

I plan to feed as frequently as my baby wants to, in order to help establish a good supply.

I plan to freeze healthy meals and plan easy snacks so that my body is nourished and better able to provide nourishment for my baby.

I plan to watch my baby for signs that he is getting enough milk.

I plan to arrange professional breastfeeding support if and when I need it.

I plan to breastfeed my baby as much as I can.

I plan to supplement any time I feel the need, for myself and my baby.

I plan to allow myself the grace to accept if I cannot breastfeed exclusively.

I plan to allow myself to feel any  grief I may feel if I am not able to breastfeed.

With my older boys, I had many challenges trying to breastfeed both of them. I felt immense pressure to breastfeed, and breastfeed exclusively.  I did not want to acknowledge the extreme grief I had over those struggles, and eventually not being able to breastfeed, it seemed to be so easy for so many others. Looking back at that time now, I wish I did not get sucked into the endless struggle over how my baby gets fed, so much so that I missed being present during those early days and weeks.

I was physically and mentally exhausted. Endless pumping, visits with lactation consultants, researching, buying herbs and (frankly, disgusting) teas, tracking down ingredients for and baking lactation cookies, washing pump parts in the middle of the night. It all took away from the only bits of time and energy I had to just… be.

Be with my baby.

Be with my new family.

Be with myself as I discovered how to mother (and again, and now again).

I wish I had had more non-judgmental, non-biased support.  Support that can see past the goal of establishing “breast is best” and look at the individual and their needs in this moment.  Sometimes that is not breastfeeding and that is ok.

This is nothing less than what I want for my clients as well.  I want my clients to feel supported and comforted as they work to reach their individual goals when it comes to feeding their baby.  Whether that is exclusively breastfeeding, supplementing, exclusively pumping, using donor breastmilk, using formula or any conceivable combination of these choices. My clients understand that I will not judge them for their feeding choices and/ or needs.  They know they can rely on me to help them get the information and any additional support they want or need to make the choices that are right for them.

Because we should all feel supported to do what is best for us and our families so that we can enjoy this fleeting time as best we can.

 

Birth!? Ew!

Birth can be gross sometimes.
Birth can be gross sometimes.

 

I recently came across a post in a Facebook group for doulas that was posted to discuss a recent Buzzfeed article about umbilical cord art. The article discussed how much the author thought that the idea of taking the umbilical cord and making art and keepsakes out of it (drying it, specifically), was gross. The doula’s in the facebook group were saddened and some were even furious that people can think it’s disgusting.

It has taken me a long time to learn this, but it is ok with me if you don’t like birth, or placentas, or umbilical cords! If you want your baby washed before touching them, I don’t want you to feel guilty because you read somewhere that it is good to wait before giving baby a bath, you won’t receive that judgement from me.  It can be empowering to some birthing persons to see or feel their baby’s head as it is being born and for others it could be traumatizing to force those options on them.

I acknowledge that I am one of the weird ones. I used to watch surgery shows with my family while eating dinner. “How’s your Mac and Cheese?” “Good. Did you see that vasectomy!?”.  Having grown up in a home with a mother with a disability, medical stuff was part of it. And some of it was pretty gross stuff. I am not phased in the least by the ick that comes with birth.

But, I realize that many people are.  Where I can see the beauty and wonder in a placenta, many others just see a disgusting piece of literally bloody grossness.  And while I love to gush and geek out about all things birth, I understand that not everyone wants to hear it.  (Though I am still working on not oozing birth talk all the time!)

I believe that part of being a doula is accepting that.  Coming to my clients where they are, instead of trying to persuade them to see things my way is integral to my mission of nurturing a culture of doula work that offers truly non judgmental support. 

Whether birth grosses you out or not, I support you!

 

If you liked this article and want to book a consultation with Amanda, you can contact her here.

Doula Support for ADHD?

Managing a new diagnosis with doula like support
Managing a new diagnosis with doula like support

My family has recently been thrown into the world of ADHD diagnosis. Needless to say, the last few days and weeks have been a whirlwind of different doctor and counselor appointments, looking up information online and discussing with friends and family what this means for us.

As I sit here trying to sort out all the information being thrown at me and my family, I am left wondering “Is there a doula for ADHD?”. With what I know about what a doula can do for a family that is expecting, I find myself wishing for the same kind of support in our family’s new journey.

Oh, just imagine what help an ADHD doula would be!

Informational support

I need one source that knows which resources are available in the community. I am feeling frustrated with the lack of knowledge that different people have about what is out there for support. One counselor recommends a program that my doctor has never heard of. A friend went to a support group that the counselor didn’t know about when I asked. Just as I know about many different resources within our community for families that are expecting, an ADHD doula would know about all the different kinds of resources available, from reliable websites (not the ones that tout impossible cures) to good books to read and also in person support within our community. They know what resources and solutions that are available here, locally, and what things we may read or hear about that aren’t.

They would also be able to personalize everything to our family’s preferences and needs. If we are open to medication for treatment, they could discuss with us what they know about the different kinds, side effects and even suggest ways to help kids learn to swallow pills (we got that sorted out now)!

We would not need to jump from person to person, resource to resource trying to track down what works for us, rather our ADHD doula would be able to help us weed out the best sources of information for us so that we could get straight to work learning!

Non-judgmental support

Just as my clients don’t need anyone putting their beliefs about birth on them, I would greatly appreciate sources of support and information that don’t have specific beliefs about the best way to treat and manage ADHD. For some, it may be purely natural therapies and other families would prefer to try medications first. Most will resonate with a combination and so pushing one agenda or the other is not helpful or supportive. Having someone to provide the information in a way that does not lend judgement and then simply support our choices on what is best for us would be amazing.

And even when a course of action is debated upon, chosen and tried; it is then abandoned for a different option, our ADHD doula would support that too. They would not try to remind us of our original plan (unless that was part of the plan), but would change trajectory themselves and continue to support while we ourselves managed the unexpected or unplanned.

Practical support

An ADHD doula would know many different ways to help someone learn practical ways to support their strengths and manage their weaknesses. Organizational skills, time management, and maintaining the home all have to be learned anew and an ADHD doula would be able to come to our home and show us different things to try. Since they have helped others with ADHD before, this new kind of doula would be able to pull from a vast array of other people’s experiences for new ideas that we may not have thought of or heard about before.

Someone to listen

My imaginary ADHD doula is passionate about supporting people through this time and would not get sick of listening to me process this newfound information. If anything, they love the subject so much, they continue to be as excited about discussing it as I am right now. Rather than blasting all my friends and family with everything that is going on, an ADHD doula would patiently listen and just let me get it out. With their experience supporting others, there is probably little they haven’t heard about the good and the bad parts of this journey. They would be able to help me explore new ideas and discover my own thoughts about what is happening, what needs to happen next and how that may be different from my ideal.

Support my partner

While we discover what our family’s needs are, a doula could help my husband support me through this. Discussing ways to help me manage and verifying what I must be going through as well. Having someone outside our relationship explain things in a way that he can relate to would be a great bonus. It would make my concerns and questions seem normal to have someone else say “Yes, that’s a very common and normal concern.”

 

I think an ADHD doula would be a great idea! Who wouldn’t want that type of personalized help and support through a very new (and truthfully, sometimes scary) life event?

(I have found an ADHD coach though!  I will have to see if it is very similar.)

An Un-Doula Experience?

Not your typical doula!
Not your typical doula!

“I thought doulas don’t eat hot dogs? Ha ha.”

It was a comment that was said off-handedly and was not sincere, but the truth behind the comment was there. It said: Aren’t doulas supposed to be all-natural, no bra, burning herbs, and get in touch with your inner goddess type people?

No, we’re not.

I eat hot dogs. And dairy, even if I am lactose intolerant. I don’t make sure everything I eat is organic, and I need to wear store bought sunscreens. I don’t know an herb from a spice. I love my underwire bras and I don’t care how many studies you show me that say sugar is evil, I love my sweet treats.

It comes down to what works for me.

Which is nothing more than what I want for all of my clients. To be able to take the information about their options and decide what works for them. My job is to support that, not what my idea of what their birth should be.

Maybe that makes me a bit of an Un-Doula, but I don’t think that’s a bad thing.

Let’s un-do some of the stereotypes about doulas that exist out there.

There are all kinds of doulas.

I am the kind that can provide you with information about different options and support you through the preferences you choose. This is your show, not mine.

So if you have been apprehensive about contacting a doula because you feel like they only support a “natural” birth, contact the Birth Nerd Kelowna for a truly personal and professional experience.

When Evidence Based Means Squat

Sometimes an evidence based choice is not the best choice.
Sometimes an evidence based choice is not the best choice.

Recently we had been having some troubles with my youngest son having emotional outbursts. We finally went to the doctor and his diagnosis (from seeing us for all of five minutes, after sitting in his boring office waiting room for over an hour right after school with no chance to grab snacks) was a lack of consistent parenting. Thanks. That made me feel awesome. He “prescribed” an over the phone one on one parenting course.

A few months later we finally made it in the next round and started this program focused on positive parenting, with lots of charts and rewards systems for encouraging good behaviour. We had difficulties using many of the tools offered and when that was expressed to our coach, I was repeatedly told “This program is evidence based.”

When the program ended and our little guy kept having these outbursts (though a lot less frequently and less severe), I decided to try another plan of action and took him to a free drop in counselling program I had heard about. After a more thorough discussion with me, the counsellor and my son, it was suggested he had a learning disability. But not your typical reading or math type. He was having troubles learning how to manage disappointments, frustrations and changes in routine. The more I learned, the more I felt it described him to a “T”.

It was frustrating to learn that we had spent that much time and effort (15 weeks!!) in a program that didn’t really address the problem, but as I learned more about his needs, it was clear that that type of parenting program could have the opposite effect. A child with this type of disability can become so focused on the outcome that they ignore the method to get there (behaving appropriately). By setting up charts and rewards systems for good behaviour, you can actually trigger an explosive response when the child doesn’t get the reward at the end.

What this has taught me about evidence based care is that it doesn’t mean shit if it doesn’t apply to your situation. This evidence based program was not designed for us in our circumstances. And so, it was useless (for us). Having someone repeatedly tell me that it would work if I just did it right was degrading, frustrating and made me feel like a bad parent, when I was doing nothing wrong.

Evidence is a collection of information that we look at as a whole. If a treatment works for 80% of people when used correctly, guess what? It doesn’t work for the other 20%. That is a big deal if you are one of the individuals that are the 20%.

Doulas like to tout “evidence based” this and that. I have been guilty of this myself, and may still do it now and again to be honest. Old habits and all that, and I apologize. We do this as if somehow, knowing the evidence is going to change the actual situation. Knowing the evidence that vaginal breech birth is as safe as cesarean delivery for the baby and safer for the mom, does not change the fact that for many women, they do not have access to a provider that will support that. Evidence will not change the mind of a woman who was sexually assaulted and does not want to have a vaginal birth, or breastfeed. And many times, the reasons why are none of our business. Evidence also cannot change a deeply ingrained culture around birth overnight.

Evidence based care is still needed. Having care providers basing recommendations on what is proven to be true is definitely preferable to the alternative. But, it is also important to remember the individual and their situation. And to respect when and if a client is requesting information, or would prefer to not know.

I am committed to learning and offering only evidence based information, but I am working to do so only when requested, and I even better understand now when my clients may choose not to follow it. You know what will and will not work for you better than I do and I fully respect and support your choices.

If you are looking for unbiased and non-judgmental support during your pregnancy and birth, contact The Birth Nerd Kelowna today.

To The Client Who Quit

I saw it in your eyes long before. The fight was gone. Almost every single one of your hopes for your birth had gone exactly the opposite of your wishes. And still you soldiered on, hope lighting the fire of your determination to keep trying.

Then suddenly the fire in your eyes just died. That was it, you were done. And we tried to encourage it to catch again, but it was no use.

It struck me suddenly as I listened to everyone in the room tell you how well you were doing and to just keep on keeping on. What are we doing? I looked at your face and realized that continuing to encourage you to keep trying at this point could be traumatizing. We were just trying to help.

And then quietly, you surrendered “I can’t. I just can’t do this anymore.”

At that moment, I couldn’t have been more relieved and more proud.

What I want you to know is that sometimes a quiet surrender is more courageous than a loud roar of power. Knowing where your limits are and having the courage to say it to a room full of people telling you otherwise will serve you well on your journey as a parent. For there will be many times that others will tell you what you should do and making a decision from within is probably the most valuable parenting skill there is.

Not to mention, having the courage to speak it to people who are trying to change your mind, especially to those you respect, love and care for.

So, to my client who quit; you got this. Trust yourself. I believe in you.

 

Your Doula,  Amanda

A Doula for Camping?

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This summer my family went on a trip to Alberta to visit friends and family and to see some sights (you can’t have a six year old who is obsessed with dinosaurs and not visit the Royal Tyrell Dinosaur Museum!). Originally, we had planned on going with my sister and brother in law and camping our way around. It seems almost sacrilegious to admit, living in BC; that we don’t go camping. We have such beautiful mountains and valleys and places to go that it seems a shame we never camp outdoors. So, when we couldn’t arrange all of our work schedules to coincide, my husband and I decided to just book a hotel because we have only a very basic idea of how to camp, so really we have no idea what we’re doing.

Besides knowing that we would need a tent, some sleeping bags, some hot dogs and s’mores, we really have no clue about the real things we need to have and know in order to go camping. I’m pretty sure you need to book space to camp in, that you can’t just show up in the woods and camp, or that there are places that aren’t good to camp in. And what do you do if it rains? See, I have no idea. At least we know enough to know we don’t know. Y’know?

So anyway, the plan was to all go together and my sister and her family could teach us what to do and show us the ropes. They were going to be our camping doulas.

Now, I’m sure we could have just googled what we needed to know, bought some stuff, booked a place, shown up and figured it out and had a good time. But, we decided not to chance it so if they couldn’t come with us, we weren’t going either.

Camping for the first time is a lot like having a baby. You kinda know you need some clothes, diapers and they don’t sleep through the night, but you don’t really know what it’s like to have a baby until they’re there. Especially in our society that frowns on sharing birth stories. You’re taught that there’s some screaming, some swearing, some asking for pain medication and then poof there’s a baby.

But, what about all the other stuff? Wouldn’t it be nice to have that person that can hold your hand and walk you through it? Can tell you the ins and outs, that one person you can go to who has helped others through this before? Well, you can!

As a birth doula, I am experienced in helping families understand the process of birth and prepare as much as possible. I can help them understand their preferences, prepare for the unexpected and am an unwavering support of their choices. I understand the unique benefits of different types of care providers, places of birth, pain management options, community resources and more. Having supported many clients through each of these, I have firsthand knowledge of how birth “works”.

For postpartum support, it is about having someone to tell you, unequivocally, that you are doing alright. And I know, because I’ve supported others through this time as well. I can help families through the first diaper changes, learning how to dress and swaddle baby, bathe baby and tips to help with feeding. How to clean bottles, as well as offering tips and tricks on caring for yourselves.

It’s hard to know what you don’t know until you’ve been there. If you feel like you have a million questions or blank areas of knowledge, it can be good to know that you can ask your doula because they have supported someone else through it. And if they don’t have the answer, they definitely know where to find it.

One day we will go camping with my sister and brother in law and have them teach us what we don’t know. But in the meantime, we’ll stick to hotels and restaurants for our trips. However, having a baby is one trip you can’t cancel. Consider hiring a doula for support.

 

Thanks to the Birthful Podcast #37: Birth Prep Essentials for the inspiration for today’s blog post!

 

Orgasmic Birth – Audiobook review

La maison

As a Birth Nerd, I love to learn about birth.  I like to read articles online, books, magazines – anything birth related I can get my hands on.  One of my new favourite things is podcasts and audiobooks.  These are great to listen to while cleaning, tidying or even driving around doing errands or going to meetings with clients.  For audiobooks, I have subscribed to Audible.com and I have yet to be disappointed. (While audiobooks are great to listen to when you are busy at home cleaning or in the car driving, I will always love a good hard copy for reference).

My latest listen was Orgasmic Birth, written by Elizabeth Davis and Debra Pascali-Bonaro, and narrated by Aimee Jolson.

When I first heard of this book, it sounded to me like a “manual” type book, an instruction manual on how to have an Orgasmic Birth, as in actually orgasm during labour and birth.  I was interested in reading it one day, but it never became a priority.  Then, I was bummeling (boom-eh-ling, a term my family uses for “window shopping, wasting time”) around in the app on my phone, looking for birth related audiobooks when I found it, and decided now was a good time to try it!

The narration of this book was very well done.  It was a lot like listening to a friend discuss a topic they are passionate about, which was great.  The only issue I had was some of the pronunciation of birth specific words.  Episiotomy was pronounced Eh-PISST-ee-ah-toe-me.  That threw me off so badly the first few times that I had stopped listening to try to figure out what the narrator was saying.  Also VBAC is actually pronounced vee-back, not vee-bee-ay-see as done in the audiobook.  Other than that, it was easy to listen along and not get too lost.  The tone was very conversational, and not monotone or “instructional”.

As for content of the book, I honestly don’t know why I waited so long to check this book out.  I cannot wait to get my hands on a hard copy of this book to add to my reference library.  Like I said earlier, I had delayed reading this book due to concerns that it was a manual on how to achieve an orgasm during birth.  However, the book explains that they interpret “Orgasmic Birth” as any birth where the mother felt powerful, supported, and joyful, and not frightened or suffering.  It is filled with great, practical information on pregnancy, how to have a more mindful approach to pregnancy and birth, setting up your village of support, ideas on accepting, enhancing and maintaining intimacy (not just sex) with your partner and more.  Tips on nutrition, exercise, as well as mental preparation for birth and parenting.  Debra Pascali-Bonaro explains in detail the hormonal changes of each trimester of pregnancy and how they affect the pregnant woman, physically, emotionally and mentally.  There were also some great activities included to help prepare for birth that I can’t wait to share with my clients!

Then there are the birth stories.  There were some beautiful, inspiring birth stories in this book.  If you get this book for one reason, I hope it is to immerse yourself in the positive stories at the end of this book.

Altogether, this is a very well written, and well-read audiobook that I will recommend to my clients.  It will be making a debut in my lending library soon!

My overall recommendation: Highly Recommend – one of The Birth Nerd’s Top Picks!

If you are a client (or want to be) and are interested in this or other books in my lending library, please let me know!

Have you listened to audiobooks?  What is your favourite time to listen?

Is Doula Support For Me? Birth Edition

How can a doula help me_

Pregnancy brings many questions, and one is a particularly common concern; what kind of support do doulas provide?  Here I will break down different kinds of support I give all types of clients.

If you want information: If you are looking for reliable information on different topics related to pregnancy, birth, and baby; I can provide suggestions on books, reliable websites, and local resources such as classes and support groups.

If you want no information:  If you are simply seeking support for your choice to rely solely on your care provider for the information you need to make decisions about your care.  You have chosen your care provider carefully and trust their suggestions completely.  I will be a listening ear and unwavering support of your choices.

If you want no interventions: You are seeking support to help have an intervention-free birth and are wanting support and care for your choice.  Someone who will listen to your concerns and help you understand your options.  I can provide experienced support, I know what to expect and can provide suggestions for discussion with your care provider to help you stick to your birth plan.

If you want support for wanted/needed interventions (including planned cesarean): You are looking for someone to listen and understand your choice to seek out/ accept interventions that will help keep you and your baby healthy.  I will not convince you it is right or wrong, but will provide evidence based information as is appropriate and non-judgmental support.

If you want no medical pain relief:  You are wanting to experience birth with no pain relief and understand that doula support can help you reach those goals.  As a trained and experienced doula, I can provide suggestions for “natural” pain relief options that you and your partner can try.  We will practice a few at home during your prenatal appointments that will work well for early labour.  I will also provide in person support for these techniques during active labour, whether at home or your chosen place of birth.

If you want all the pain relief:  Experiencing the full range of childbirth sensations is not on your to-do list.  Your expectation is to accept pain relief as soon as possible and be able to relax and enjoy the birth of your baby.  I will provide non-judgmental (there’s that word again!) support, as well as help make your pain relief choices work optimally through suggestions of questions to ask your care providers, position changes and more.

If you are planning on your partner being your main support:  You (or your partner) are planning on them being right in there doing as much as possible to support you.  I will coach your partner with ideas of things to try to provide the best support, and fade in to the background when you have found a rhythm that works for you.  Then I will best assist by making sure you have everything you need when you need it, and allowing your partner to take breaks as necessary so that they are rested and at their best to be able to better support you.

If you are planning on little to no additional support:  You are wanting someone to provide that primary support.  As an experienced doula, I have supported families in this role before.

The list goes on and on.  As you can see, doula support is for every kind of pregnancy and birth experience.  If you feel your situation is unique and are looking for information on how I can best support you, please feel free to contact me.

The “You’ll just know” Debate

Disclaimer: do not take any information here as medical advice, always check with your care provider (Dr, midwife, OB) before trying anything and definitely check in with them or visit your L&D department if you have a feeling something is wrong.

woman labour

Can we talk labour for a minute?

One common question that expecting women and their support people have is: “How will I know I’m in labour?”.  And, honestly, this is one tough question to answer.  Many people will say that “You’ll just know.”  “When it’s time, you know.”.  We are trained from media (TV, movies, etc) to expect a big gush when our water breaks, then hard and fast contractions, rushing to the hospital, being wheeled down the hall in a wheelchair and then furiously pushing for a few minutes before baby comes.  These are some of the very obvious signs of labour.  The truth is that labour signs can build up over days or weeks and once things get rolling, you may not recognize the signs until you are well into the active phase of labour.

But this can be a good thing!  Evidence tells us over and over that the healthiest births are the ones that are least tampered with, and a slow, steady (and sometimes sneaky) start to labour can help prevent us and our care providers from jumping in too early with unnecessary interventions.  Having a slow start to labour can help mom and baby adjust to the rhythm and flow before things get intense.

Some early signs (days and weeks before baby is born) that your body is preparing for labour include:

– Baby “dropping” or engaging.

– Losing your mucus plug.

– Nesting.

– Braxton hicks practice contractions.

– Frequent and/or watery bowel movements.

Early labour is characterized by regular contractions that get progressively closer together and stronger.  The trick with these is that they may feel like cramping or just an annoying back pain for some women and they may not recognize them as labour (I was one of those!).  If you are feeling like you may be in early labour try laying down, having a relaxing bath or shower and drinking some water (see Disclaimer above).  If you are dehydrated, it can increase the level of oxytocin in your system, causing irritable but not labour contractions.  If the cramping does not subside once you have had a drink of water and relaxed, you may be in early labour.  Do not be surprised if this early labour comes and goes, or persists for days; it can be absolutely frustrating, but completely normal for some women.

Now, back to the original question: “How do I know it is labour?”.  Labour signs are sneaky and don’t always start the same way for every woman.  For one woman, labour signs may start with Nesting, progress to back pain and then jump right into full on labour.  For others, they may just wake up one day in full blown labour without any other signs, and others still will trickle along, having lost their mucus plug weeks before labour starts, or even having any other signs.

As a doula, I can give you information to help you assess the signs, we will discuss how you are feeling and whether it is appropriate at this time to assume labour has started (it is always best to discuss with your care provider what signs they are looking for and when they want to be called), and support your choice for the next steps (wait some more, give some coping suggestions over the phone, have me come over and see how you are managing in person, meet you at your planned place of birth, etc).

The truth is, it is sometimes not until labour is over that you can look back and go “Oh, so those middle of the night cramps that were waking me up every 30 minutes was the real start of my labour”.  When deciphering labour signs, hindsight is 20/20 after all, even for us doulas.

But, my clients will always be able to call me to listen, help them understand and support them when (and if!) these early signs start to appear.