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What is a Doula?

by Maxine
Posted July 7 2010 12:10pm

Doulas provide a range of services, which may start prenatally and continue after the baby comes home from the hospital. Check with the association below for the complete range of services.

The Canadian Doula Association defines a “labour doula” or a “birth doula” as “a woman trained and experienced in childbirth, who provides continuous physical, emotional and informational support to a woman during labour, birth and the immediate postpartum period. Postpartum doulas care for new families in the first weeks after birth—providing household help, advice with newborn care and feeding and emotional support.”

Doulas do not provide medical care to mom or the baby and do not deliver the baby. Parents would use a doula as a coach/support during labour and delivery along with their physician or midwife. OHIP does not cover doula services. Many doulas have a sliding fee scale.

Read this article about finding a doula, or use the contacts below to find a doula or other childbirth professional:

Childbirth and Postpartum Professional Association
Phone: 1-866-236-2478

Doulas of North America (DONA)
Phone: 206-324-5440

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Creating Your Birth Plan

by Guest
Posted August 25 2010 10:12am

Expectant parents have to make many decisions during pregnancy. Creating a birth plan can result in a satisfying experience for both of you. It allows you time to think about the options available during labour, delivery and postpartum, how you would like your baby's birth to be handled plus it gives you an opportunity to discuss things with your healthcare provider. Through your birth plan, you'll be able to share your wishes with other medical staff who may be caring for you during labour, delivery and the recovery period.

Birth plans need to be flexible and realistic. If an unexpected situation occurs, you may need to change your plan quickly. Birth plans should be discussed with your doctor or midwife well in advance of labour; some of the options listed may not always be offered by all care providers and hospitals or birth centers. Have copies of your birth plan with you when labour does start to share with the staff at the hospital or birth centre.

Getting Started

There is plenty to consider when creating your birth plan. Keep the following tips in mind.

Learn as much as you can. That way, you're informed about the different options available during labour, birth and the time following birth. Read books and articles with reliable information. Ask questions in your prenatal class; at hospital or birt h centre tours; and in your appointments with healthcare providers.

Prioritize. In your birth plan, list your choices in order of priority with the most important choices first.
Keep it short and sweet. Keep your birth plan as short as possible. It is easier to read two clearly written pages, rather than four or five.

The Society of Obstetricians and Gynaecologists of Canada (SOGC) suggests your list include the following:

  • Your support people
  • Your preferences about pain relief
  • Medical procedure preferences during labour
  • Second stage labour and delivery preferences
  • Most important issues for you
  • Concerns and fears
  • Infant feeding preference

There may be other issues that are important to you, based on religion or family tradition, for example. Be sure to talk about any of these concerns and note them in your birth plan.

For a more detailed outline of things to consider in your birth plan, read Birth Plan Guidelines.

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Birth Plan Guidelines

by Maxine
Posted August 25 2010 10:13am

The following guidelines have been developed to help you create your own personalized birth plan. Use this information to determine the type of birth experience you would like to have.

Support People
Decide who will be with you to provide support during labour and the birth. Some birth centres and hospitals allow more than one support person to be present.

  • Partner
  • Friends
  • Relatives
  • Midwife
  • Doula

Pain Relief
Settle on when you would like staff to offer you pain relief:

  • Only if you ask
  • Offer if you are uncomfortable
  • Offer pain relief as soon as possible

Non-Medical Pain Relief
Consider which of the following non-medical pain relief options you might want to try during labour. Some of the available options follow, or you may have your own methods that work for you.

  • Relaxation
  • Paced breathing/distraction
  • Walking
  • Positioning
  • Water (shower or tub)
  • Heat or cold therapy
  • Massage
  • Visualization
  • Focusing
  • Music

Medical Pain Relief Options
The following pain relief measures are offered in hospitals. Decide which you would prefer or might find helpful.

  • Medications like narcotics, usually received through injection
  • Nitrous oxide gas
  • Regional epidural analgesia

Food & Drink
Do you wish to eat or drink during labour? Some of these options may be available:

  • No restrictions on what you can eat or drink
  • Clear fluids (such as water, Gatorade, Jell-O, Popsicles, Freezie Pops)
  • Ice chips
  • Intravenous (IV) drip (You automatically get an IV if you opt for an epidural.)

Moms Mobility
Decide if you want to be as mobile as possible with the option to walk, sit in a rocking chair or on a birthing ball, go to the bathroom, etc. or do you just want to move from the bed to the chair?

Medical Procedures

Various medical procedures will be available to you when you are in labour.

Fetal Monitoring. The various types of devices that your healthcare providers may use for fetal monitoring are as follows:

  • Intermittent monitoring, using a fetoscope
  • Doppler
  • External electronic monitor

Induction. Discuss together which of a variety of methods you would prefer to induce labour. Here are some of your choices:

  • Natural methods, such as nipple stimulation or breast stimulation.
  • Prostaglandin gel or suppositories which are absorbed and cause the cervix to soften and contractions to eventually begin. 
  • Mechanical methods, such as stripping the amniotic membranes. Membranes are stripped by inserting a gloved finger through the opening of the cevix and loosening the amniotic membranes that are attached just above the cervix. This causes a release of prostaglandin and slight opening of the cervix which may start labour.
  • Amniotomy
  • Medication, like Oxytocin, given through an IV drip which causes the uterus to start contract .

Augmentation. Consider which of the following you would prefer to use to augment labour:

  • Increased mobility, such as walking.
  • Change of positions, such as standing, sitting, leaning against your partner or the wall, or slow dancing.
  • Natural methods, such as nipple stimulation or breast stimulation.
  • Amniotomy
  • Medication, like Oxytocin or another drug that causes the uterus to contract

Here are more Birth Plan Guidelines for:

Second Stage of Labour

Post Birth

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Birth Plan Guidelines: Second Stage of Labour

by Guest
Posted August 25 2010 10:15am

Now that you have completed your plan for the first Stage of Labour, you will want to consider some of the planning for the second stage of labour.

What position do you want to be in to push? Under what conditions will your doctor use forceps or a vacuum extractor? If you end up having a Caesarean, do you want to be awake during the procedure? There are many important things to think about.

Pushing

You have many choices for how you want to push your baby out. It's better to decide what you will do now, instead of waiting until it's time to push. Here are some of your options:

  • Choice of position: You can use different positions to aid her pushing efforts, such as squatting, lounge position, on hands and knees, etc. Your labour and delivery nurse may suggest other positions that can also be used for pushing.
  • Squatting: You can use a birth or squat bar to help push your baby out.
  • Leg Support: Your support people or the nurse support your legs.
  • Foot support: You can put your feet in foot pedals or stirrups.
  • Spontaneous bearing down: Once the healthcare providers have said that the cervix has opened fully; you listen to your body and pushes only when you have the urge to push. 
  • Directed pushing: Sometimes your only option for pushing is to do it only when directed to push by one the healthcare providers.
  • Mirror: The staff can position a mirror so your can see your baby's head emerge.

Episiotomy

You should both talk with your doctor or midwife in advance about when an episiotomy might be needed. Maybe you would prefer a small tear which may also be stitched after the birth. Also, decide if you want local anaesthesia for the episiotomy and its repair. This is usually given by a local injection in the area to be repaired.

Assisted birth

Some babies need a help to be born because of a medical concern that has developed with either you or your baby. In such situations, the doctor may assist in the actual delivery with one of the following devices.

  • Forceps
  • Vacuum extractor

Vaginal Delivery

If you have a vaginal delivery, consider the following options that may be available to you.

  • Choose a position in which to deliver your baby
  • Touch your baby's head when it crowns
  • Have your baby placed on your abdomen or chest right after birth
  • Have either your or your partner cut the umbilical cord 
  • Collect the cord blood (If parents have registered for a cord blood program, they need to bring the collection materials with them.)
  • Have you hold your baby during the delivery of the placenta
  • Breastfeed after the delivery
  • Take the placenta home (Some cities or towns may require you to obtain a special hazardous waste container.)

Caesarean section

If an emergency occurs, a Caesarean birth might be necessary. If this happens to you, what will you do?

  • Get a second opinion if time allows.
  • Have your designated support person with you during the Caesarean.
  • Ask if it is possible for to have an epidural so you can be awake for the birth.
  • Have your designated support person hold the baby after the delivery.
  • Breastfeed in recovery.

Continue reading Birth Plan Guidelines: Post Birth

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