A Doula’s Perspective On How To Have A Baby The Right Way
A guide To Finding The Right Health Care Providers For Your Birth
If you happen to be pregnant or planning to become pregnant in the future and even if you plan on adopting, you are reading the right blog.
Babymoon Concierge would like to help you navigate going from the wonderful world of maternity on to the 4th trimester of postpartum. I know this birth and baby stuff may seem a little confusing, but I want to help you on your journey to support you on all the things you will ever want or need to know about, growing a baby, having a baby, feeding a baby or hiring a baby nurse or a postpartum doula to take care of baby when you get home. And later we will discuss baby item must haves in the future.
Many mothers are unprepared for birth.
Why are so many women unprepared for birth?
Let's get started. One the things that puzzles me the most is that many mothers are unprepared for the birth of their babies and sometimes have bouts of anxiety about their upcoming birth because they may not get the birth of their dreams. Here are some tips that I hope will help you to be prepared.
When you first find out that you are pregnant do not try to find and hire an obstetrician unless you have had several miscarriages in the past. The reason I say this, because I want you to imagine what you want your birth to look like before your hire an OBGYN. My suggestion is to seek out the advice of a well-established birth doula first. Now, you may or may not wish to employ a birth doula for your birth, but did you know you can hire one to help you navigate the birth world as a birth consultant? Like a coach, birth doulas know and have a wide range of resources at their disposal. They know and may have worked with many of the OBGYN’s, midwives’, chiropractors, pediatricians, postpartum, psychologist and other healthcare professionals in your area such as lactation consultants, nutritionists, sonographers and more. When I said to imagine what you wanted your birth to look like, that is the first step to mentally prepare for your birth. A good doula can help you map out a birth plan that is right for you.
Once you figure out want you want, your doula can guide you to the best care out there. They should know about the best doctors and hospitals who specialize in the kind of care you are looking for. They can discuss with you whether you want a more natural child birth or one that contains some or more pain medication. They also can talk about cord blood banking, delayed cord clamping, skin to skin and a Midwifery Model of Care vs a Medical Model of Care.
Imagine if you just found out that you were pregnant, you went ahead and found a obstetrician that you like but in your mind, you want to have an all-natural birth. However, when you are in labor, the hospital that the doctor practices in pushes medications on you as soon as you get in the door and won’t respect your choice to not take them. How would that make you feel?
If you hire a doula first, they can guide you to doctors who have practices at more mother and baby friendly hospitals. A doula could have also suggested you reach out to a local midwife and explain the Midwifery Model of Care.
There are midwives that have privileges delivering in certain hospitals. I know where I live in the Dallas, Fort Worth, Texas area and there are many that do.
Doulas are here to guide and educate you so that you have a smooth and enjoyable birth experience. I personally know that this happens every day. A current birth client of mine, who is a first time mom, said her doctor is putting thoughts into her head about the possibility of induction. My client happens to be only 20 weeks pregnant. Doctors please stop the manipulation. It’s wrong and evil!
If you were going to get married, you would not think about the most important day without planning and preparation, yet many are having babies without the one person that could help make your birth transition effortless. A good doula should help you with a birth plan, educate you on the difference between Medical Model of Care vs a Midwifery Model of Care, and make sure you are enrolled in a good sound Child Birth education class (preferably outside of the hospital walls). Most classes at the hospital teach you how to be a good patient and you are not a patient you are going there to poop out a baby!
They should also educate you on skin to skin (kangaroo care), your rights in the hospital environment, and tell you about the 100 or more options you have including your right to keep your placenta for encapsulation. Doulas should give you a voice to make sure you are not a guinea pig. Doulas help you and your partner advocate for yourself to avoid being forced or coerced into getting an unnecessary C-section.
Please read the blog: Top Ten Signs Your Doctor Is Planning to Perform an Unnecessary Cesarean Section on You by Dr. Jonathan Weinstein MD. I am adding this important blog below because he is a well known respected doctor telling you their secrets.
And speaking of Childbirth education, there are so many to choose from. Your birth doula will help you find the one best for you. There are many companies to choose from, do your research.
Once you have hired your doula, midwife or OB and you are enrolled in a good Child Birth Class, it is time to find a Pediatrician. Find one before the birth of your baby. If your doula is on the job, they should assist you finding the kind of doctor you are looking for. There is so much talk about immunizations in infants, breastfeeding vs bottle feeding. This makes a new parent want to freak out. A doula should give you a list of all the pediatricians who are pro or against breastfeeding, pro or against delayed shots and so on. I bet you did not know that all pedestrians where not created equal; imagine that? The are some pediatricians, I am told, that have been hostile to breastfeeding mothers so choose one wisely. These are the things that should be discussed early in your pregnancy.
Before your baby is born your doula should explain the benefits of postpartum care after the baby is born and direct you to postpartum doulas that can assist you and your baby after the birth. They talk about safe sleep, self-care, newborn care, sound machines for babies, proper bottle feeding, swaddling, co sleeping, baby monitors and baby equipment like car seats which incidentally, you will not be allowed to bring your baby home without one if you are planning to deliver in a hospital. Doulas are not just for birth they are your Encyclopedia or Wikipedia’s of birth. A good one is a gem. So, go ahead and hire a doula to help you navigate the birth world. They are so worth it!
Top Ten Signs Your Doctor Is Planning To Perform An Unnecessary Cesarean Section On You
Posted on November 14, 2012 by Jonathan Weinstein
I have been a practicing OB/GYN for fourteen years. I live in Frisco, Texas, one of the fastest growing cities in the United States, and I truly enjoy living and working here. It is a great place for my family and, for the first time, my office is attached to the actual hospital I practice in. This is the third and final place I will practice medicine. I trained with some of the most respected academic OB/GYN’s in the country. These physicians have contributed to books on Obstetrics, created practice guidelines for the American Congress of Obstetricians and Gynecologists (ACOG), and taught me to practice medicine based on scientific evidence.
I follow a few simple rules: do no harm, give your patients options, and provide information so they can make informed decisions. So, last night I was sitting in my office looking at the fourth Cesarean Section (C/S) operative report of the day for yet another patient who wants to have a vaginal delivery following a previous C/S. I am frustrated and feel like I am fighting a losing battle.
When did Cesarean Sections (C/S) and elective inductions at 39 weeks become the standard of care? That is not what I was taught, and that is not in any textbook or ACOG practice bulletins. So why in Dallas, Texas do people have to drive more than an hour to find a doctor who actually has no desire to do an unnecessary C/S? It has become obvious that I cannot attend every vaginal birth a patient wants to have after their traumatizing C/S experience. If close to 50% of the patients are getting a C/S each day and there are hundreds of practicing OB/GYN’s in the Dallas Metroplex, the math is not difficult. I know at least one physician who only does C/S’s, and vaginal delivery is not even an option. If one of his patients delivers vaginally it is only because the baby came faster than he could get to the hospital.
This is the only place I have lived where C/S and elective inductions are king. So, women of the world, I am giving you the knowledge to stand up for yourself before you get that first C/S!
Top Ten Signs Your Doctor Is Planning To Perform an Unnecessary Cesarean Section on You
1. Arrives to L&D immediately after office hours and says, “I just don’t think this baby is going to fit.”
2. Third Trimester, Routine Office Visit, “I think this is going to be a big baby. You should just have a C/S” – Did you know? ACOG has very specific guidelines for when it is appropriate to offer a patient an elective C/S for MACROSOMIA (fancy word for large baby). ‘Prophylactic (elective) cesarean delivery may be considered for suspected fetal macrosomia with estimated fetal weights greater than 5,000 gms (11 pounds) in women without diabetes and greater than 4,500 gms (9.9 pounds) in women with diabetes.
3. “We should induce at 39 weeks because your baby is getting too big” – Did you know that, according to ACOG:
‘Induction of labor at least doubles the risk of cesarean delivery without reducing shoulder dystocia (rare situation where baby’s shoulder can get stuck at delivery) or newborn morbidity(complications). Suspected fetal macrosomia is not an indication for induction of labor, because induction does not improve maternal or fetal outcomes.’
4. Performs routine ultrasounds at end of pregnancy to see how big your baby is. Did you know that ultrasounds at the end of the pregnancy can be 1-2 pounds off? Ask some VBAC patients who were talked into a C/S for this, then had a vaginal delivery of a bigger baby the next time.
5. “You have a positive herpes titer (or history of herpes); the baby will get it if you deliver vaginally.” Try some Valtrex for the last month of the pregnancy that is pretty much standard of care now. It prevents outbreaks and allows for a normal vaginal delivery.
6. “Your baby is breech. You need to have a C/S” Ever heard of or performed an External Cephalic Version (process by which a breech baby is turned to the proper position)? It really does work.
7. “You have pushed for 2 hours” (with an epidural that prevents you from feeling anything so you are probably not pushing effectively; this is evident on exam because the baby’s head is still perfectly round, but you do not need to know that) “It’s just not going to come out”
8. “I scheduled you for an induction at 39 weeks. It is just soooo… much more convenient for you!” (and so much higher risk of ending in a C/S, especially if you are not dilated when you start the induction). At least 80% of my VBAC patients were induced the previous pregnancy. For whose convenience was the induction?
9. First Visit (7 weeks), “Congratulations you are having twins. I will go ahead and schedule your C/S at 38 weeks, but don’t worry if you go in to labor early I will cut you right away!” Translation, “I am scared out of my mind for you to deliver your babies vaginally because I am not trained on what to do when the second baby is coming, plus it pays more to cut you open. Oh yeah, I don’t have that great a rapport with you because I only spend 2 minutes (fundal height, heart beat and ‘I’ll see you next time’) with you each visit, so I am afraid I will be sued for trying to do the right thing.”
10. First Pelvic Exam in Office (7 weeks), “Hmm, your pelvis is pretty narrow”.
Bonus Tip:
11. 38-week visit, “Your blood pressure is a little high today. You are probably developing preeclampsia or toxemia. That can cause you to have a SEIZURE! The treatment is to deliver the baby. You need a Cesarean Section, as this is the quickest way to resolve it. Let’s get you up to L&D NOW!” Translation – Preeclampsia or Pregnancy Induced High Blood Pressure is a pain in the butt. If I induce you, it could take 24 hours or more and then I would have to manage your blood pressure, and put you on Magnesium. This is way too inconvenient. Do not worry you can try to have the baby vaginally next time. Yeah right!
Well, I hope you future moms find use for these tidbits of info. If anyone wants to add anything, please feel free. Your experience may help other women in the future. Remember, there are only a few emergent reasons for a C/S such as fetal distress, unexplained heavy vaginal bleeding, etc. It is okay to ask your doctor questions. We are not supposed to bite.
Jonathan Weinstein, MD, FACOG
Obstetrician/Gynecologist
Cheryl Abrams has been working as a Postpartum doula and Newborn Care Specialist in the Dallas Metroplex since 2009. She has worked for MotherMe Doulas, Gibson Newborn Care, Hush Little Babies and Harmony Baby Concierge. She is a Certified Newborn Specialist through The Newborn Care Training Academy and Upgraded her Postpartum Certification with Austin Baby Guru. She is also a member of the Newborn Care Specialists Association
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