Tag: doula

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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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Embracing Feeding Journeys

by Dr. Sophia Sokolowski, ND

Parenthood is a journey of many colors, and navigating the path of feeding your little one can bring both joys and challenges. If you’re facing obstacles along the way, remember that you’re part of a community that understands.

 

Here are 5 tips to support your journey:

 

  1. Connect with Supportive Hearts: Seek support from trusted sources, be it friends, family, or lactation consultants. Sharing experiences and insights can offer comfort and guidance.
  2. Find Your Unique Approach: Just as every child is unique, so is your journey. Explore different feeding positions, techniques, and schedules to discover what feels right for both you and your little one.
  3. Prioritize Self-Care: Taking care of yourself is a vital part of this journey. Nourish your body, stay hydrated, and rest when possible. A well-cared-for parent is better equipped to nurture their child.
  4. Build Confidence: Trust your instincts and choices. Believe in your ability to provide what your child needs, whether through lactation, bottle-feeding, or a combination of methods.
  5. Celebrate Every Victory: Progress takes many forms. Celebrate each successful feeding, no matter how small. Every ounce of nourishment shared is a triumph.

 

Remember, your journey is valid and unique, embracing the beautiful diversity of parenthood and feeding. Let’s uplift each other, sharing wisdom and support. You’ve got this!

 

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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How to Keep Breathing when The World is on Fire

by Dr. Dori Skye Engel, ND 

 

It’s pretty bleak out there friends.

The world is literally on fire. The atmosphere is heavy and ominous.

We must keep moving forward.

We also need to protect ourselves and our loved ones.

Even once the haze eventually lifts, which it definitely will, your body will need support moving forward to eliminate all the particles that have been inhaled.

And also, this will not be the last time. Let’s arm ourselves with tools and information.

 

We also need to protect ourselves and our loved ones.
 
 

Potential symptoms of wildfire smoke inhalation:

 

  • shortness of breath

  • wheezing

  • coughing

  • phlegm buildup

  • asthma attacks

  • chest pain

  • increased heart rate

  • headaches

  • exacerbated allergy symptoms

  • runny nose

  • sore throat

  • skin irritations

  • eye irritations

  • fatigue

  • depression

  • reduced immune function

  • reduced lung function

  • aggravation of any preexisting respiratory and cardiovascular disease

  • all kinds of things we just don’t want, need, have time for, deserve

 

Also, I’d be remiss not to highlight why this is happening. It’s not a fluke. It’s Climate Change. It’s not a theory. It is our current lived reality and it’s only getting worse. Rising temperatures, decreased precipitation – our ecosystem just can’t handle it. VOTE IN ELECTED OFFICIALS WHO TAKE CLIMATE CHANGE SERIOUSLY and are committed to meaningful change, renewable energy and regenerative farming to stabilize the atrocities we have committed to this planet.

And now, some ideas to implement right away…..

 

1. Hydrate.

Think of it as flushing and diluting all the nasty particulates out of your lungs and blood stream.

  • Water is always the queen of the fluids, add lemon if you can to really up the free radical scavenging.

  • Electrolytes also have their place – commercially made or straight up bone broth and/or coconut water

  • Herbal teas are another great choice, especially ones that are also cleansing and support your body’s innate detoxification – I’m talking Nettle, Dandelion, Burdock

  • Demulcent herbs – Slippery Elm, Marshmallow Root, Mullein – excellent for increasing the integrity of those mucous membranes while moistening and relaxing your lungs and esophagus

  • Don’t forget your plant friends – water them! Plants are what will help save our planet, don’t neglect

2. Rinse.

Target your mucous membranes directly by making them slippery and resistant to adherence. They are your first line of defense and the area that gets the most exposure to smoke.

  • Neti Pot nasal rinses – releases trapped pollutants in your sinuses, moistens your tissues

  • Saline Nasal Spray – flushes those particles out for immediate relief from sneezing and congestion

  • Steam inhalation with Thyme essential oil – easiest is to sprinkle on the floor of your shower. Diffusing works as well. Antimicrobial plant magic.

3. Food as Medicine.

It’s all about harnessing the natural detoxification and antioxidant power of your food

  • Ginger – natural detoxifier, anti-nausea, improves circulation. Use in food, tea or as a supplement

  • Vitamin C – natural antioxidant. Fruit is an excellent source, especially when in season. Supplementation can also be very effective

  • Broccoli & Broccoli Sprouts – this plant has robust evidence to support it’s ability to reduce allergic response to particulate pollutants in the air. Enjoy often.

  • Fermented Foods – key. If you’re local try this incredible resource for all things fermented.

4. Supplement

  • NAC – a precursor to Glutathione – the body’s master antioxidant – crucial for detoxification and respiratory health. Liposomal is a liquid suspension extremely effective for kids as well. This one comes in a tasty strawberry flavour.

  • Vitamin C – aforementioned antioxidant capabilities. Protects vessels from particulate matter exposure. Essential.

  • CoQ10 – free radical neutralizer able to rebuild the damage caused by environmental pollutants. Our natural production decreases as we age.

  • Respiractin – an herbal tonic safe for children and adults that relieves coughs, soothes airways and provides clearer breathing.

5. Acupuncture

If your lungs, sinuses or head are aching and you are having trouble bouncing back, get some acupuncture for hands on support in moving stagnation through your body and opening up your channels for smoother flow of air, blood, energy, life force.

 
 
 
 
 

6. Castor Oil

Rubbed over liver and lungs – front and back – helps bring circulation to the area, supports your body’s natural detoxification abilities – get those particles out!

 
 
 
 
 
 
 

7. Greens

  • Chlorella and Spirulina are nutrient dense algae that bind to toxins in the body and evict them effectively. They are so rich in powerful chlorophyll they can cause unpleasant detox symptoms if you take too much at once without regulating to it first. Start low and go slow.

  • Cilantro and Parsley can be helpful food additions as well.

  • A high quality Greens powder makes access particularly easy

You can find many of these supplements on Fullscript. Links above or here

 

As always, this is not a replacement for individual care or personal medical advice. Please see your own practitioner for personalized advice.

 
 
Dr Dori Skye Engel is a Naturopathic Doctor and Birth Doula practicing in the Toronto area. She is a mama of 3 wild and wacky boys and is an avid traveller. Dr Dori believes strongly in the body’s innate healing ability and works to find the right combination of support to guide her patients in attaining optimum health, vitality, resilience and vibrancy. Through a combination of tools including clinical nutrition, lifestyle counselling, botanical medicine, homeopathy, traditional Chinese medicine, acupuncture and hydrotherapy, she creates personalized treatment protocols for each individual.

Dr Dori has a special interest in the Perinatal period of a family’s life; Fertility support, Preconception Care, Pregnancy, Labour & Birth, Postpartum support as well as Babies & Children. Treating the whole person, as well as the whole family, she is honoured to support men & women through further life changes such as menopause, thyroid dysfunction, diabetes, heart disease, skin conditions & all the curveballs life throws. She is certified in Facial Rejuvenation Acupuncture and is a trained Birth Doula.
Dr Dori is also the co-host of Beyond Beautiful Birth a Podcast about the messy, intense and powerful and all-encompassing beauty of birth and beyond.

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

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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Let’s get real about Postpartum Bodies

by Dr. Sarah Winward, ND IBCLC

What’s the biggest mistake to make after giving birth?

Rushing to lose weight.

A real postpartum body

It is my biggest pet peeve, as a women, that so many of us feel such intense pressure to look model ready 24/7.

If you don’t like the way you look after spending 9 months growing your baby, I get it. Your body has been completely taken over by the process. It’s not just yours anymore. And if you believe what you see in the media, you’d think that you should have your old body back immediately after your baby is born. That plus the lack of sleep of new motherhood can leave anyone feeling like they aren’t adequate.

 

 

But what you see in the media is not reality.

Let me break it down:

Your weight gain during pregnancy consists of this:

  • Baby ~7lbs
  • Uterus 2 1/2 lb gain
  • Placenta 1 lb
  • Mother’s breasts 3 lb gain
  • Mother’s blood 4 lb increase
  • Mother’s fat 5 + lb increase
A real postpartum body

So, most of this weight isn’t even fat! It will come away on its own. You just need to give it time.

Remember too that your core has undergone significant changes. Even if you don’t have a vaginal birth, your pelvic floor and abdominal muscles have a lot of stress just from carrying baby for so long. These muscles and ligaments need time to heal.

Basically, your body needs rest and rehab. I truly believe that every pregnant person should see a pelvic floor physiotherapist.

Rushing into exercise can lead to injury, including pelvic floor complications like incontinence. No physique is worth peeing yourself.

Coming from a kinesiology background and a competitive athlete background I always tell people there is no such thing as over-training its actually under-resting.

A real postpartum body

Cutting back on calories or “dieting” can be a big problem too. Breast milk production may also be affected, but more often we see exhausted women exhausting themselves even more. Your baby needs you as nourished as possible, that means eating nourishing foods. In nourishing amounts.

Growing your baby took you 9 months, assume it will take at least that long for your body to adjust afterwards.

So, give your body the rest and nourishment it truly needs.

Your body, mind and soul will thank you in the long run.

 

A real postpartum body
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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!

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Breastfeeding and Caesarian births

by Dr. Melanie Jacobson, NC IBCLC

Did you know a c-section birth can affect your breastfeeding experience? 

Caesarian births are associated with delayed lactogenesis II, meaning, a delayed transition of colostrum to breast milk or breast milk ‘coming in’.  Also, it can often lead to a delayed initiation of breastfeeding, due to the birthing parent’s recovery, comfort, and stress levels.  Under these circumstances, a parent’s commitment to breastfeeding plays a major role in its duration. And let us not forget, a caesarean birth is major surgery, and therefore the parent’s post surgery recovery and mobility must also play a role in the breastfeeding experience.  These challenges can be even more impactful if the caesarian birth came after a long exhausting labour.

But the good news is, there are ways to prepare for a c-section birth that can support your breastfeeding journey, as well as steps you can take after the birth!

Below are a few recommendations that parents can use when prepping for their caesarian birth and actions to take afterwards.

Before the birth:

 

1-Get educated on how breastfeeding works and the steps that you can take to support your experience.

Because of the potential challenges in breastfeeding after a c-section birth, it is so important for new parents to get educated before the birth and understand breastfeeding specifics so that they can pick up where the birth left off, no matter what kind of birth they have.  This detailed prenatal breastfeeding education can ideally be done in the third trimester.  Regardless of the kind of birth you have, breastfeeding education is invaluable for first-time parents.

Click here to learn more about our Prenatal Lactation course or book in for a prenatal visit with a Lactation Consultant.

2- Have your supports ready to help!

Regardless of the type of birth you have, you will need help.  Keeping your supports up to speed with your breastfeeding intentions, will also help them understand where your priorities lie once the baby arrives.  They will understand the importance of supporting the parent during the first 2 weeks postpartum as breastfeeding is being initiated. Remind them that you will need extra support with meals, everyday household chores as well as changing, diapering and bathing baby while you rest and work on breastfeeding.

3- Rest, eat and drink healthily and enjoy the days leading up to the birth.

Going into the experience feeling calm and rested may set the tone for your birth experience and certainly help with recovery. If you are having a planned c-section, speak to a birth professional to find out how your recovery can be best supported.

4- For planned caesarians, consider speaking to your OB and local IBCLC about colostrum harvesting.

Colostrum harvesting is when you hand express and freeze colostrum before the birth.  This may allow you to use the harvested colostrum at the hospital after the birth to feed baby, along with breastfeeding.  Colostrum harvesting must only be done after 37 weeks gestation and must be done under the guidance of your birthing team.

After a c-section birth:

 

1-Place the baby skin-to-skin with you in the operation room and in the recovery room whenever possible.

If you are feeling drowsy, be sure to have someone with you to help. Otherwise, the baby can be skin-to-skin with the other parent or closest support. Skin-to-skin offers both physical and emotional benefit to both the baby and the birthing parent.

2-Don’t rush your recovery.

The hospital staff will be monitoring your level of comfort and awareness until you feel confident in holding your baby on your own.  You may need some time to sit up comfortably to hold your baby.  Take your time.  Do not rush your progress.  You will be able to hold your baby comfortably, in several breastfeeding positions in a couple of days.

3-Allow baby full access to your breasts.

Along with skin-to skin, the suckling, bonding and oxytocin released by having baby latched will help to initiate your breastfeeding journey and feel calmer.

4- Support milk transition and your breast milk supply by:

  • Frequently stimulating your breasts via breastfeeding.
  • The football hold may be your best position for the first couple of days if the other holds (cross-cradle, cradle or laid back) hurt your incision. But not to worry, you will be able to try these new positions in a few days.
  • Be well versed in hand expressing. You can express colostrum even after baby has breastfed and especially if baby was not very active at the breast. A baby born via a surgical birth may be more lethargic, especially if the birth followed a long labour, so expressing your milk might be necessary in the early days.
  • Skin-to-skin is especially important in the early days so maintain this whenever possible

5- Be gentle and kind with yourself.

You just went through major surgery.  Your body will have an easier time to pick up where the birth left off by:

 

  • Resting
  • Nourishing yourself with healthy food
  • Hydrating with water and warm drinks
  • Most importantly, having your little one close by to snuggle

Lactation 101-The BEST thing you can do to prepare for Breastfeeding

An online prenatal breastfeeding course that gives you all the tools you need so you can nurse your baby confidently from birth to weaning.

Do you have a Health Benefits Plan? This course may be covered.

Click HERE to book a 15 minute call with me to find out more

 

DR. MELANIE JACOBSON, ND IBCLC Hi! I’m Melanie Jacobson. Professionally I am a naturopathic doctor and lactation consultant. Personally, I am a wife and mother of 2 amazing girls. I believe that prenatal education and early hands-on support can help new parents feel confident, connected, and empowered through their postnatal and breastfeeding journey. Background and Experience After studying at the University of Toronto and the Canadian College of Naturopathic Medicine to become at naturopathic doctor, I gained valuable international experience in the United Kingdom and Australia. The knowledge and experience acquired from working and living abroad has been indispensable to me as a practitioner and mother. Upon my return to Toronto, I practiced for many years as a Naturopathic Doctor. After having my own children, I received my IBCLC designation to provide lactation consultations and expanded my clinical practice to focus on postnatal wellness and lactation support to families in the west end of Toronto.

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Considering a VBAC*? You Need to Read This!

Dr. Ee Von Ling, ND

*There is a shift towards using the term TOLAC (Trial of labour after C-section) instead of VBAC (Vaginal Birth after C-section). In many ways this term is preferred, less emotionally loaded and less cumbersome than using VBAC. Thus, I will be using both VBAC and TOLAC interchangeably in this post. 

One of the very first births I attended as a new doula was a home VBAC. The parents had taken my HypnoBirthing classes and requested me to be their doula. At the time I was just so excited to be going to a home birth that I didn’t even think about the significance of this being a TOLAC.

The mother told me her birth history and the events that had led up to her c-section – “failure to progress at 9cm”. I took all her info and simply reassured her, “every pregnancy is different and so this will be a different experience than your first one”. And it was different. Amazingly different. The labour and birth progressed just like any other normal labour and birth and the mother had her successful home VBAC!

This VBAC homebirth imprinted on me that VBACs were no big deal and they were just like any other birth.

It wasn’t until I started having more conversations with pregnant clients and doctors and reading comments in mommy forums and news articles that I would realize that VBAC’s were seen as A. BIG. DEAL. Words like “highly risky”, “uterine rupture”, “endangering baby”, “dangerous for mom”, “irresponsible” almost always accompanied the VBAC discussion. It was bad enough that women had fear of normal labour and birth itself, but having a past c-section somehow put a whole other layer of fear and worry on top of that.

So I double checked the evidence and the statistics around VBAC and risks and benefits.  Contrary to the conversations, the numbers showed that a vaginal birth after a previous c-section was a reasonably safe and healthy choice for most women. The absolute risks were very low and the success rates for attempted VBACs were actually quite high. In fact, the risks for a planned repeat c-section were worse. If you’d like to learn more about the pros, cons and risks around attempting a VBAC, you can read this very excellent handout created by the Ontario Association of Midwives here.

✎ Edit

Over the last several decades VBAC rates have gone up and down. According to US statistics, In the 1990’s about 30% of those who had a previous C-section attempted a VBAC. Today that number is about 13%. These numbers have fluctuated because of changes in the practice guidelines of obstetricians. VBAC births themselves did not become more dangerous, but practice guideline updates recommended more medical requirements in order to offer them. These changes influenced the perception and accessibility of attempting VBACs – OB’s became less supportive of them and the public developed a bigger fear of them. Understand that the risks and outcomes for those who attempt VBACs did not change in the last 40 years. 

Being able to go through a trial of labour after C-section might be a very significant and impactful choice. For some, being able to vaginally birth helps them to heal a previous birth trauma and reclaim the birth experience for themselves. As a medical industry, we should not take the personal decision to try for a VBAC lightly and we should provide unbiased information and support for that person. 

If you had a previous C-section and are now considering a VBAC for your next childbirth, here are 6 things you can do to help improve your chances of birthing your baby vaginally: 

  1. Choose a supportive provider: This might be the most important factor of all. Having a midwife improves your chances of giving birth vaginally and with fewer restrictions around VBAC. If you are not able to get a midwife, make sure your OB is VBAC supportive. How will you know if they are VBAC supportive, ask them outright: 

  • Are you supportive of VBAC?
  • What is this hospital’s TOLAC rate? How many of your own patients chose TOLAC and how many of those result in VBAC?
  • What would be your advice around increasing my chances of achieving a VBAC?

You will get a sense of their own attitudes and biases based on how they respond to these questions. 

  1. Learn techniques so you can labour at home for as long as possible: Choose a program that includes learning and practicing breathing exercises, visualizing, releasing past fears. Our clients who have been able to VBAC took HypnoBirthing classes, listened to positive birth podcasts, read books about empowered birth by Ina May Gaskin and Penny Simkin. From our own collective experience supporting our own VBAC clients, we teach a special condensed version of our  Confident Birth Prenatal Program that focuses just on the relaxation exercises and techniques to help you be calm and confident during labour.  

  1. Ensure the baby is in a good position: Head down is not enough!  Baby’s position with their back on the left side so you feel kicks or the big movements on the right (referred to as LOT) or baby’s back is in the front so you don’t feel a lot of kicks or movement elsewhere (referred to as OA) are the ideal starting positions for baby. A baby in the posterior position (or OP or “sunny side up”) may have a harder time being born vaginally. Perhaps during your previous birthing the baby was in this posterior position, which can lead to slow or arrested labour. 

There are ways to help encourage a baby to get into the ideal starting position for birth. Daily positional awareness, acupuncture, massage, chiropractic, osteopath and physiotherapy treatments may help. 

  1. Get your labour to start naturally: If you labour starts naturally, this will help you avoid further interventions that might increase the risks of a TOLAC. Speak with your midwife or doula about ways to start labour that are safe for those who’ve had a previous c-section.

  1. Try to avoid an epidural: An epidural can limit movement and slow down labour (if started early in labour). If labour slows down, then artificial oxytocin will be needed to help progress the labour. But using artificial oxytocin in someone who had a C-section increases the risk of having a VBAC (ie. scar separation). This is why learning good coping techniques and having a doula can be very helpful. That said, if you need an epidural to help you have a positive birth experience, then by all means, choose that for yourself! 

  1. If you have an epidural, use a peanut ball: Even if someone has an epidural, there are tips and tricks to help increase your chance of a vaginal birth. A peanut-ball is a peanut shaped exercise ball that can be used in a variety of positions to help open up the pelvis and positively influence the positioning of the baby as it’s being born. 

Beware the “VBAC calculator”! Recently, I have been hearing about care providers using a “VBAC calculator”. Different factors about the pregnant person are inputted into an algorithm that is supposed to predict the percent chance of having a vaginal birth. The use of this is a HUGE RED FLAG to me, and if this becomes part of routine OB and midwifery practice I fear that VBAC rates will decrease even further. 

What is wrong with these calculators? 

First, the database of information that these calculators use is from observational data of a specific patient population. The one that care providers in Toronto have been known to use is from a patient population in the United States. American birthing patients and American birth management practices are very different from the birthing patients and birth management practices in Canada. VBAC rates in the US are much lower than VBAC rates in Canada. A hospital with low VBAC rates will produce patients with low VBAC rates and vice versa. So you can already see a discrepancy in applying such a calculator on a random patient. 

These calculators are not evidence based, meaning no study has been done to test the impact of using these calculators to accurately predict actual VBAC success, we also need to study how these calculators impact decision making in both the OB and the patient. 

We are well aware that there is bias in the practice of obstetric medicine, meaning, if a care provider is personally biased in the management of a particular patient, it greatly influences the outcome for that patient. For example, if this VBAC calculator happens to calculate a low success rate, then that can influence the OB to assume that the patient’s attempted VBAC will end up in a c-section. 

Here is a link to an article that explains the research that critiques the use of VBAC calculators.

In any case, the American College of Obstetricians and Gynecologists had this to say about VBAC calculators: “… population-based statistics cannot accurately predict an individual’s VBAC success odds….It is ill-advised to use statistics as a primary indicator when making VBAC decisions.”

The role of a doula in your plan to have a TOLAC: The good news is, a doula can navigate at least 5 out of 6 of the positive factors listed. Having the presence of continuous and on-going support from a doula is supported by research to help you avoid a c-section (whether it’s your first childbirth or an attempt at a VBAC). If you are interested in learning more about how a doula could be an integral part of your VBAC team, book a free meet and greet with us today!   

Dr. EeVon Ling, ND

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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Birth without fear

Think about the last movie you saw that featured someone giving birth. I’m guessing there was a woman screaming, a man freaking out, and a doctor yelling “Push, push push!”

Now tell me how many of your friends are terrified by the thought of giving birth? Maybe you’re included in that group!

Popular culture does a really good job propagating the culture of fear around birth.

And that translates into our everyday lives.

You hear negativity about birth all the time. Even friends who haven’t had kids say things like “oh, you’ll be screaming for the meds” or “are you ready for your body to be destroyed”. Seriously, Sarah heard both of those things while she was pregnant.

I remember in my first maternal and newborn care class, so many of my friends whispered to each other during lecture about how scared they were.

I was scared too - how could I block out all that negativity?

But those lectures taught us about physiology. About how pregnancy is not a medical condition, it’s normal.

This drove me to look further, to learn more.

So, I dove head first into the birth world. Reading books, articles, watching videos. This lead me to a doula training. Everything confirmed what I learned in those first lectures.  

Birth doesn’t have to be scary. It doesn’t even have to be painful!

My education and understanding of physiology took away my fear.

It also got me incredibly excited! I NEEDED to learn how to help parents achieve empowering birth experiences.

Get our Top 5 Tips for LOVING Your Birth!

This lead me to HypnoBirthing. This training taught me techniques that help parents remain calm and relaxed. Techniques that work WITH our physiology, to facilitate empowering birth regardless of circumstances.

How we view things matters.

So, that crazy pop culture birth scenario doesn’t have to be my experience. It doesn’t have to be anyone’s experience.

The more I go to births, the more I see how beautiful these moments could be. Labour can be a sacred space. Parents can connect with each other and welcome their babies into warm, nurturing environments.

All of these experiences have completely change my outlook about birth. Now, I look forward to becoming a mother and naturally birthing my baby. There is no more fear.

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Reasons why you SHOULD have a doula!

What is a doula anyway? 

Doulas are companions who provide non-clinical support and care to a person during their pregnancy, childbirth and the postpartum period. Doulas work with people in labor, their families, and their health care team to ensure effective communication and understanding of their bodies and the many different elements of the pregnancy and birthing process. Doulas have a collective motivation to ensure that families have a secure, comfortable, positive birth experience.

Why should you consider having a doula?

Your doula’s main priority is YOU.

You may already have a few people in mind to support you on your upcoming labor and birth and the weeks and months leading up to it. Your partner, your family members, your midwife, your doctors, your nurses; they all have a role to play on your big day. However, they may not always be with you to ensure you are comforted throughout your labor and birth. A doula’s job is to provide you with physical, emotional, and informational support. Doulas make sure that expecting parents (1) feel safe and comfortable, (2) they are aware of their choices, (3) and that they are making fully informed decisions when it comes to their birthing experience. 

The same can be said for a full-spectrum doula or a postpartum doula. A full-spectrum doula offers support to people during the full spectrum of pregnancy – from preconception, to birth, to abortion, to miscarriage, to adoption, to postpartum. A postpartum doula can help people feel comfortable and confident in caring for their newborn and make sure they get enough sleep, be nourished, and take enough time for themselves to fully recover. Doulas help parents transition smoothly into parenthood.

Your doula can be a personal resource guide.

You will likely be in touch with your doula well before labor even begins. Doulas can help expectant parents process conflicting pregnancy, labor and birthing, postpartum advice and figure out what is best for them and their family.

Doulas are educators. While it can be easy to simply go online and find answers quickly, doulas are more hands-on and offer non-clinical advice that is thoughtful, non-judgmental, and specific to their clients’ pregnancy experience.

You deserve to feel confident and have constant support

Having doulas in birth and in postpartum is associated with many benefits such as (1) reduction in the incidence of C-sections, operative vaginal deliveries, and likelihood of birth complications involving mothers or children; (2) reduction in the number of low-birth weight babies; (3) reduction in the duration of labor; (4) reduction in the need for pain-relief medications; (5) increase success of breastfeeding; (6) increase parents’ satisfaction of the birth experience; (7) reduction in the incidence of postpartum mood disorders; and (8) increase new parents confidence in the care of their newborn.

While no one can possibly predict how birth unfolds (no matter how much planning and preparation are done), having continuous advocacy provides a whole other level of comfort and confidence in a person’s ability to cope and thrive. Everyone is deserving of a chance to get the support they need.

 

If you have worked with doulas before, do share with us and help spread the word. If you have questions and/or are curious about how doulas and naturopathic medicine can help you have a positive birthing experience, don’t hesitate to reach out!

 

Dr. Kim Abog, ND