Tag: birth support

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A Birth Partner’s Guide

Pregnancy, labor, and delivery can be an exciting time for the pregnant person, as they gear up to meet their new bundle of joy. However, there is also another key person involved in the journey of birthing a newborn baby – the supporting birth partner.

The birth partner could be a doula, romantic partner, parent, sibling, or friend of the pregnant person. A support person plays an integral role in the whole birth experience. Partners help set the tone during labor and delivery, by allowing the expecting person to feel happier and less stressed during labour and in the postpartum period.

What can a birthing partner do to prepare?

There are several things a support person can do to prepare for labor and delivery:

  1. Attend birth classes & read books on pregnancy, labor, and delivery – This gives the birthing partner an opportunity to learn and understand the process of labor and delivery before the day. This includes knowledge about the stages of labor and delivery, as well as relaxation techniques they can offer to their partner.
  2. Go to prenatal checkups with the pregnant person – It is important to keep up to date on the health of the pregnant person and baby.
  3. Go over the birth plan – Being informed about the birth plan will allow you to advocate for the pregnant person during labor and delivery. It is important to bear in mind that things do not always go to plan, so it is important to be flexible and prepared for changes to the birth plan.

Support role to the birthing person

As labor and birth progress, the support person can help by:

  1. Have a copy of the birth plan – You can help inform the maternity team on how you and your partner have planned for the delivery, as this will allow you and your partner to feel more in control of the birthing process
  2. Help keep track of contractions
  3. Applying relaxation and comfort measures such as a massage or counterpressure techniques to relax the birthing person
  4. Be on stand-by for ice, drinks, and snacks
  5. Stay with the birthing person so they are not alone

How to feel closer to the baby

Ways a birthing partner can feel closer to the newborn include:

  1. Help cut the cord
  2. Cuddles and skin-to-skin time with the baby
  3. Perform baby massages as babies respond well to touch
  4. Learn how to feed and bath the baby
  5. Help settle the baby when they are crying or are fussy
  6. Sing and talk to the baby
  7. Go for walks with the baby
  8. Be a key part of the bedtime routine

How to take care of yourself as the birth support partner

As a supporting partner, it is also imperative that you look after yourself as well. Some tips to stay well and healthy during and after labor is:

  1. Find relaxation techniques for yourself as the process may feel overwhelming to you
  2. Make sure to take adequate rest breaks when it works for your partner
  3. Bring snacks and drinks for yourself

 

Hi, I’m Racheal! I’m a 4th-year Naturopathic Intern at the Canadian College of Naturopathic Medicine. I attended York University and obtained a Bachelor of Science degree with Honors in Biology. While working in healthcare, I discovered naturopathic medicine, and I learnt how NDs focus on the root cause of diseases and use natural interventions to treat ailments. From there, I joined CCNM, to study Naturopathic Medicine. As a part of my clinical rotation, I have a one-weekly pediatrics focus shift, where I see mothers-to-be, mothers, and baby’s during that shift. I have always had a keen interest in pediatric and family health, which is why I became an executive member of the CCNM pediatrics club. I went on to explore my interest in womxn’s health and pediatrics by publishing two papers that were related to the role naturopathic doctors can have in supporting pregnancy and outdoor education for children. I am working towards becoming a Naturopathic Doula because I believe there are several ways Naturopathic Doctors can support pregnancy, labour, and post-delivery.

Want to get prepared for pregnancy, birth and postpartum? Grab our free Bump to Baby Checklist! This clear and thorough guide walks you through everything to expect from your first trimester to past your 6 week postpartum check up.

  • What tests and screenings will be offered and when
  • When to sign up for prenatal education and what types to consider
  • Things you should think about that your care provider may not mention
  • Links to helpful resources
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Informed Consent

by Dr. Alisa Murli, ND 

Congrats, you’re pregnant!

Pregnancy is such an exciting time as you’re preparing for your newborn to arrive, but it can also be confusing or overwhelming. Whether this is your first pregnancy or subsequent, there is often so much to learn. In this article, we focus on informed consent and will go through all of the choices you may be faced with during pregnancy (and perhaps didn’t know you had?). By the end of this article, you should feel educated and empowered to seek out more information about your pregnancy and labour options.

What is informed consent?

Informed consent is when a healthcare provider presents you with all of the pertinent information necessary to make an informed decision. This means that they educate you about the benefits, risks and alternatives to any intervention or procedure. For informed consent to be valid, the patient must also be in a fully competent state and able to make a voluntary decision about said intervention (1).

Think back to a time you went to a medical provider; do you recall being given all of this information? You have the right to have all of the information clearly explained to you in a manner that you can understand, and you have a right to be given ample opportunity to ask questions and consider your options before making a decision (time may be limited in the event of an emergency).

Although this is something that all healthcare providers are aware of, in reality, informed consent is really lacking. This is particularly true of the interventions and procedures used for pregnancy and birth. This can be for many reasons, and more often than not healthcare providers are acting in your best interest and believe they are offering choice. What the lack of informed consent truly results in is the birthing person having a limited role in decision making of not only
their health but their baby’s as well. What this really means is the birthing person is void of basic human rights and bodily autonomy (2).

Informed consent is when a healthcare provider presents you with all of the pertinent
information necessary to make an informed decision.

Choices during pregnancy

Every choice during your pregnancy is ultimately up to you. Healthcare providers, whether it be your OB, family doctor, midwife, naturopathic doctor or doula, are there to guide you to make the best decisions for your health and safety. It is important to take their recommendations into consideration, however it is equally as important to understand that you have a choice and are provided with the benefits, risks and alternatives to each medical decision.

Let’s dive a little deeper into the choices you may be faced with during pregnancy and labour.

Birthing environment

Choosing your birthing environment is dependent on how you view your labour and birth and your choice of practitioner. If you would like a home birth or to give birth at a birthing centre near you, a midwife would be your best choice (TIP: apply for a midwife as soon as you know you are pregnant). If you’d prefer a hospital birth, you’re often able to choose between your family doctor, an OB or a midwife.

Did you know you have the right to manipulate your birthing environment to suit your comfort? For example, you are able to ask them to lower the lights, use essential oils and music, bring your own blankets/pillows from home.

 

Physical examinations

Consent for physical exams might look something like this, “I would like to perform a cervical check for you right now in order to assess the progress of your labour. I will be checking for the effacement (how thin your cervix is), the dilation (how wide it has opened) and the position of baby. This will help us to determine the best next steps for moving forward. The risks of a cervical check would include bleeding, discomfort, vaginal infections and premature rupture of membranes. If you do not wish to do a cervical check, we can proceed without one. Here are the alternatives…”

Interventions

Interventions during labour are used to start, support or assist with the progression of labour. Interventions can be anything from pain management to induction/augmentation methods to episiotomy to assisted birth techniques (ie. vacuum or forceps) and caesarean section. Believe it or not, you have a choice as to whether any of these interventions are used on you. For more information on alternatives to pain medications, visit https://yourdowntowndoula.com/alternative-options-to-pain-medications/

Labour positions/pushing

During labour, we often recommend various positions that can help with comfort and progression of labour. Here are some positions that are recommended for the various stages of labour.

People usually believe that the only way to birth is by laying on your back. While this may be the preferred option for some, it’s not necessary. There are several options for pushing positions and you may even use multiple positions. Some positions are better suited for your perineum and may lessen the effort needed to push (thank gravity). These are positions that tilt your pelvis in such a way that the birth canal is perpendicular to the ground rather than parallel.

Keep in mind that getting an epidural will limit the positions available to you, but that is okay! You can still use the peanut ball, sit up, turn from side to side and even try a supported squatting position for pushing.

 

Eating and drinking throughout labour

Contrary to popular belief, you are allowed to eat and drink through labour, even with an epidural. In fact, eating and staying hydrated through labour is necessary for increasing endurance. Imagine running a marathon without snacks and hydration! Of course it is not recommended to eat heavy meals, as this can increase risk of nausea, vomiting and increase your needs for digestion (and thereby shutting blood flow to your intestines).

The hospital might offer you jello and clear fruit juices for nutrition during labour, but here some great options you can bring yourself:

● Smoothies
● Bone broth
● Fresh fruit juices
● Natural electrolytes in water
● Coconut water
● Fruit
● Cheese
● Nuts
● Dark chocolate
● Protein bar
● Honey

Placenta delivery

Delivery of your placenta is often a passive experience that happens after your baby is born. Your doctor or midwife will be monitoring your placenta delivery and their job is to ensure it is completely removed.

Active vs expectant management of placental delivery:

In active management, the doctor or midwife may give you an extra push of pitocin to promote more contractions to help separate and push the placenta. The doctor or midwife may ask for a little push or may push on your uterus to help expel the placenta (and ask your consent first!). Active management was introduced to reduce the risk of postpartum hemorrhage, as the added contractions help to close off the footprint left by the placenta (3)

In expectant management, the practitioner will wait for the placenta to detach and deliver on its own, without the use of any added drugs.

Newborn management

After you give birth, there are several choices in which you may be faced with.

Cord clamping

The umbilical cord is meant to provide nutrients for baby in utero. Immediately after birth, the umbilical cord actually continues to provide nutrients until it stops pulsing (usually takes a couple of minutes). It used to be routine to clamp and cut the cord immediately. You now have the option of delaying cord clamping, which can be beneficial for the reasons stated above. The World Health Organization recommends delayed cord clamping in all normal birth outcomes (4). Keep in mind that you cannot do delayed cord clamping if you plan to donate or bank the cord.

Skin-to-skin

The World Health Organization recommends 90 minutes of uninterrupted skin-to-skin contact with mom after birth. This maximizes positive breastfeeding outcomes, fosters bonding and increases oxytocin levels in both baby and the pregnant person(5).

Vitamin K administration

Babies are born with very little vitamin K. Vitamin K is necessary for blood clotting and is not available in significant amounts in breastmilk. It is a regular procedure for babies to receive a vitamin K shot after birth to decrease the risk of a spontaneous bleed in the first 6 months of life. You do have options and alternatives for this, such as a preservative-free shot or an oral option.

Erythromycin eye ointment

This antibiotic eye ointment is given to every baby in the event that baby gets conjunctivitis (ie. pink eye). Most commonly pink eye can occur when the birthing person has an untreated infection with a sexually transmitted infection (chlamydia, herpes or gonorrhea), however other bacteria can cause this infection and can be picked up during birth or from exposures in the hospital or home (6).

 

Bathing of baby

The World Health Organization suggests wiping the newborn clean and delaying the first bath for 24 hours (7). This is because when babies pass through the birth canal, their skin is populated with beneficial bacteria that are needed for optimal health, including immune function, gut health and dermatological health. However, the decision is still yours!

Evidence Based Birth is a great resource for learning more in depth information about these management practices. I encourage you to read through the evidence surrounding thesepractices before making your decision. It is recommended that you review all of these choices and have them made as a part of your
birth plan before labour.

Informed consent and doula care

A lack of informed consent is one of the reasons that pregnant people seek out doula care. As naturopathic doctors and doulas, we truly understand the need for informed consent and see the negative effects of lack of informed consent in everyday life. Uncertainty can cause a lot of anxiety around pregnancy and birth. There is a universal lack of knowledge and education around pregnancy and labour. We are firm believers in evidence-based maternity care, and we strive to educate and empower our patients to remove this uncertainty and fear and make the best decisions for themselves and their babies.

Tips for prompting informed consent from your healthcare provider

Here are some ways you can ask for informed consent or more information from your healthcare providers (including your doulas!). Understandably, some patients are afraid to speak up because they are afraid of affecting the relationship. Don’t worry! There are respectful ways of asking for more information, and most often practitioners are happy to answer your questions.

● Can you please explain the benefits and risks of this intervention?
● Are there any alternatives to this?
● What happens if we do not do this intervention?
● How long do I have until I have to make a decision?
● Are you able to send me resources where I can find more information about this?
● Can you please ask my permission before doing physical exams?
● Are you able to explain the process of this procedure?
● I am feeling a bit nervous about this, can you please help me understand why it is
necessary for me/my baby?

Overall, the main takeaway from this article is that the choice is always yours! Advocate for yourself and never be afraid to ask questions about your body, your health, and your baby.

This article is meant to provide information only, it does not substitute for personalized medical care.

DR. ALISA MURLI, ND
Hi, I’m Alisa! I am a Naturopathic doctor, birth doula and pelvic floor therapist. Pregnant womxn are my favourite population to work with, both as an ND and a doula. Being a doula is exciting and meaningful to me. I love being able to share such a memorable time in your life with you. I pride myself in providing personalized care and supporting you in the ways that you need. Education about the birthing process is key, and providing parents-to-be with informed healthcare is an integral part of what I do. I have experience with various types of births and birthing practitioners (OB, midwives) and am there to advocate for you.
Background and experience: I am a licensed Naturopathic Doctor, who graduated from the Canadian College of Naturopathic Medicine. Prior to this, I achieved an Honours Bachelor of Science in Life Sciences (minor in psychology) at McMaster University. I completed my naturopathic internship with a focus in pediatric health, where I gained experience treating infants and children. I have additional training and certifications as a birth doula, in prenatal acupuncture, and in pelvic floor therapy. This allows me to help you with preconception to postpartum and beyond. Pregnancy and birth is beautiful and meaningful and it brings me joy to be a part of your journey!

REFERENCES

1.https://www.ncbi.nlm.nih.gov/books/NBK430827/#:~:text=Informed%20consent%20is%2
0the%20process,undergo%20the%20procedure%20or%20intervention.
2. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-03023-6
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372362/

4. chrome://external-file/WHO-MCA-17.07-eng.pdf
5. https://www.who.int/westernpacific/news-room/feature-stories/item/skin-to-skin-contact-
helps-newborns-breastfeed
6. https://evidencebasedbirth.com/is-erythromycin-eye-ointment-always-necessary-for-
newborns/
7. https://www.who.int/tools/your-life-your-health/life-phase/newborns-and-children-under-
5-years/caring-for-newborns

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5 Comfort Measures (you might want to try during labour)

by Laura Hill (YDD Back Up Team Member)

Labour can be a daunting experience, but with the right planning, aids, and support, it can be a more comfortable one. Comfort measures during labour can help alleviate pain, reduce anxiety, and promote relaxation, making for a more positive birth experience. These measures are non-pharmacological techniques that aim to enhance the birthing person’s sense of control and well-being during labour. It is also important to have a support system in place, such as a partner or doula, to help with relaxation techniques and provide emotional support.

These measures are non-pharmacological techniques that aim to enhance the birthing person’s sense of control and well-being during labour

1. Baths and Showers

Hydrotherapy is a safe and effective method of relaxation and pain relief that has been used
for centuries. The warmth and buoyancy of the water in a deep bath causes a decrease in
stress hormones and increase in production of oxytocin.

 

 

2. Touch and Massage

Find out what kind of touch you find comforting and use that during labour. Light touch,
counter-pressure techniques, acupressure points and massage can help to release tension in
muscles and promote relaxation. Massaging with oils containing scents like lavender or
peppermint can also be helpful in promoting relaxation and reducing anxiety.

 

 

3. Peanut Ball

A peanut ball is an exercise ball used to help open the pelvis and increase the progress of
labour. It is especially helpful for positioning and pushing with an epidural.

 

 

4. Heat and Cold

Both heat and cold can provide comfort during labour and afterwards. Heat or cold (or an
alternation of the two) applied to the low back may help relieve pain. And a warm compress
on the perineum can be used to relieve pain and soothe the area.

 

 

5. TENS Unit

A TENS (Transcutaneous Electrical Nerve Stimulation) unit is a battery-operated device that
delivers electrical impulses through electrodes to your skin. These impulses are thought to
stimulate the release of endorphins, which when used during early labour, can build up to
reduce the sensation of pain.

 

 

 

 

Want to get prepared for pregnancy, birth and postpartum? Grab our free Bump to Baby Checklist! This clear and thorough guide walks you through everything to expect from your first trimester to past your 6 week postpartum check up.

  • What tests and screenings will be offered and when
  • When to sign up for prenatal education and what types to consider
  • Things you should think about that your care provider may not mention
  • Links to helpful resources
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Postpartum Anxiety

Postpartum anxiety is a common mental health condition that affects many new mothers. It is characterized by excessive worry and fear that can interfere with daily activities and make it difficult to care for yourself and your newborn. While some degree of worry is normal for new parents, postpartum anxiety can cause a level of distress that is not typical and can lead to feelings of guilt, shame, and isolation.

 

It is characterized by excessive worry and fear that can interfere with daily activities and make it difficult to care for yourself and your newborn.

Unlike postpartum depression, which is well-known and discussed, postpartum anxiety is often overlooked and misunderstood.

 

The symptoms of postpartum anxiety can vary from person to person, but may include:

  • Constant worry and fear about your baby’s health and safety
  • Difficulty sleeping, even when your baby is sleeping
  • Racing thoughts or an inability to turn off your thoughts
  • Physical symptoms such as rapid heartbeat, sweating, and trembling
  • Panic attacks
  • Obsessive-compulsive behaviors, such as excessive cleaning or checking on your baby
  • Avoidance of social situations or fear of leaving the house

 

There are several treatment options available for postpartum anxiety, including:

  1. Cognitive-behavioral therapy (CBT) is a type of therapy that has been shown to be effective in treating postpartum anxiety. CBT focuses on changing negative thought patterns and behaviors to reduce anxiety.
  2. Certain herbs, supplements and medications can also help manage symptoms. It’s important to work with your healthcare provider to find the right treatment and dosage for you.
  3. Self-care is an important part of managing postpartum anxiety and often overlooked. This can include getting enough sleep, eating a healthy diet, getting regular exercise, and practicing relaxation techniques such as deep breathing or meditation.
  4. Joining a postpartum support group can be a helpful way to connect with other new mothers who are experiencing similar challenges.

If you or someone you know is experiencing postpartum anxiety, don’t hesitate to seek help.

 

It’s important to remember that postpartum anxiety is a treatable condition. With the right support and treatment, most women with postpartum anxiety can overcome their symptoms and enjoy their new role as a mother. If you or someone you know is experiencing postpartum anxiety, don’t hesitate to seek help. If you are experiencing any of these symptoms, it’s important to talk to your healthcare provider right away, and they can help you determine if you have postpartum anxiety and recommend appropriate management options.

Are you preparing for your best possible birth? 

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A Meet and Greet with Your Downtown Doula

 

Common questions we get and our answers….

by Dr. Olivia Chubey, ND

How long have you been practicing? How many births have you attended?

Our team is a mix of varied experience from those practicing since 2002 to newer graduates.  Our collective prides itself on our collaboration and mentorship focus.  Which means that even if you work with a newer graduate, they are under the direct mentorship of a more experienced naturopathic doctor and doula, with access to them during your birth.  So no matter who you work with, you will get the benefit of the experience of our whole team.

 

 

 

What techniques do you use to help me through labor and birth?

Through our team’s experience we have created CONFIDENT BIRTH prenatal class.  This class focuses on the techniques we have found work wonders for clients. 

Additionally, as we are all naturopathic doctors we may use tools specifically under our regulated scope of practice including but not limited to: acupuncture, botanical medicine, homeopathics.

 

 

How do you involve/include my partner during labor and birth? 

It depends on their comfort level of desire in participation.  We have intake processes for both parents to see how we can best serve families in creating inclusive and family first births. Our role is not to replace your partner, but to assist them in helping you and filling in the gaps of care. 

 

 

 

Have you attended births at my birth location and what were your experiences there?

Currently we cover the following cities: Toronto, Etobicoke, Mississauga, Oakville, Brampton, Vaughn, Aurora, Newmarket, North York, Markham, Scarborough, Ajax, Whitby, Oshawa.

 

 

 

 

Do you have any other clients that have due dates near mine? Do you have a backup doula? If so, may I meet her? How often is your backup doula used?

Sometimes we do!  It depends on our caseload that month. Although it is unlikely that you will go into labour at exactly the same time as our other clients, we do have a backup team dedicated to ensuring smooth coverage in the case where your primary doula can not be present. During your on-call period you will receive information regarding who are your backup doulas, their contact information and an opportunity to meet with them.  The backup team is SO great we wish they could attend more births, but the reality is that your primary doula is highly likely to be at your birth. 

 

 

At what point in labor would we meet up? How should I contact you during labor and at what point? Is it okay if it’s in the middle of the night? Are you always on call?

We are on-call for you 24/7 starting at 38 weeks gestation. So yes – please do call us at 3am if your labour has started!  We will go over the specifics of how best to mutually communicate and reach us during your appointments.  While each client’s care is specific to them and their labour, generally, we will provide virtual support in early labour and meet with you when you are in active labour.

 

 

 

Do you stay for the entire labor and childbirth, or do you have a time limit for long births? How long do you stay after the birth?

While each client’s care is specific to them and their doula, if we are able to connect in active labour we are there until 1-2 hours after your baby is born.  We will not leave you high and dry, but we try to aim for 24 hours (without sleep…can be longer if the doula has an opportunity to rest) maximum for safety purposes. 

 

 

 

How do you feel about epidurals or any pain medication?

What matters is how you feel about them.  Our role is not to choose for you, but to learn about your needs and desires and to assist in creating a positive experience through education, emotional and physical support and advocation. 

 

 

 

 

Do you help with breastfeeding? What’s your experience and training with breastfeeding?

We do!  Your birth doula will be able to support you getting started in immediate postpartum, however we also have a dedicated lactation team, including IBCLCs that do home visits. Our lactation team are also available for prenatal lactation education.  Let your doula know if you’re interested in more support from a lactation consultant. 

 

 

 

Do you have MORE questions? Bring them to your free Meet & Greet – book here!