What is the difference between a doula and a midwife?

A doula provides emotional and physical support for the pregnant person and partner during labor. Doulas know about medical procedures and can provide information and education. They are also trained in relaxation methods and tools such as massage, acupressure, helpful position changes, and use of a rebozo.

Midwives on the other hand, are the most expert care providers for low risk pregnancies and normal births. Midwives monitor the physical, emotional, and spiritual wellbeing of the pregnant client , newborn, and family throughout the maternity care cycle. There is a wide variation of what is normal for pregnancy and birth. Midwives understand this and also know when a person is no longer in the healthy, low-risk category, and need increased monitoring or assessment. During labor, midwives encourage eating and drinking, movement, position changes, and intermittent monitoring of the baby with a hand held doppler (which is the gold standard for low risk clients). Midwives encourage skin-to-skin contact with the mother and baby, which causes breastfeeding. After the baby is born, midwives are trained to provide well-baby care for the first six weeks of life.

Are you wondering which would be best for you? Contact us to set up a free consultation. We’d be happy to provide you with more information!

Do you know your parental rights?

Take this quiz:

https://parentalrights.org/quiz/

Sadly, I’ve been a midwife long enough to see firsthand the abuse of power over parental rights. In the US if a medical provider believes their medical recommendation is superior the parent’s belief about what is best for the child, the medical provider has authority to remove the child from their parents. This happens disproportionately more to those in poverty, black families, and in families with an individual who has disabilities.

You know what’s best

for your child and family

How can you protect your family?

1. Research your family’s providers to find someone who aligns with your beliefs. You may be more vulnerable if you choose an alternative vaccine schedule, homeschool, or choose to give birth outside of a hospital, so find a provider who is familiar with these things. Local Facebook communities are often a good place to find recommendations

   2. Dress to impress. If you need to take your child to the hospital, you will be treated differently depending upon your outfit. Try to wear something clean and professional. You are more likely to be treated poorly if you look young, avoid adolescent clothing.

   3. Build community. Find a community of people who support you. Should you take your child in after they bumped their head? Is the illness worth a trip to the doctor? It’s great to have another experienced parent or nurse friend you can talk to who can give you perspective when you’re not sure what to do because you are in the trenches of new parenting or you’re emotional because it’s your child.

   4. Don’t go by yourself. Bring your partner, parent, sibling, doula, or friend who is a medical professional. It’s really hard and scary to have a child who needs medical attention. Going with someone who can support you, listen to staff with you, and help you navigate medical decisions can be invaluable. They can also help you avoid defensive language.

   5. Use negotiation skills and don’t be afraid to speak up for what you want. You are the best decision maker for your child! Thankfully the vast majority of healthcare physicians believe that and will support you in your decision making!

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Healthy Thanksgiving Recipes To Satisfy Your Sweet Tooth

Happy Thanksgiving!

Here are some of our suggestions for how to feast

It’s so easy to go overboard with the sugar around the holidays. Tips on how to keep your blood sugar balanced are to accompany sweets with protein and fats, keep hydrated (carbs require more water to digest), stick to serving sizes (think 1/2 cup for rice, potatoes, and higher carb foods), and eat lots of fiber from fresh and cooked vegetables (brussel sprouts, salad, carrots, slaw, etc), seeds, and whole grains.

Here’s some healthy recipes to try:

If you’re wondering how to make healthy desserts that avoid common allergens such as wheat and dairy see:

Magdalena Wszelaki’s gluten free and paleo friendly recipes that everyone will love

For desserts rich in nourishing minerals see:

Lily Nichol’s dark chocolate bark with raspberries and pumpkin seeds

Did you know babies born to mothers who eat chocolate during pregnancy cry less?

Rebecca Katz’s tripple tripple brittle

This recipe is rich in zinc and other trace minerals that balance hormones.

Post Zombie Apocalypse Pregnancy: Here's What you Need to Know

So you find yourself pregnant in a post-zombie apocalypse world.. What can you do to keep you and your baby healthy?

Having a healthy pregnancy post-zombie apocalypse can be a challenge. We’ve summarized a list of tips from some experts.

1. “Any water is better than no water. Any filter is better than no filter. A filter that takes out heavy metals and bigger toxins is better than one that only takes out heavy metals. A filter that takes out all of that and hormones is better than one that does not.” We recommend the Berkey filter https://www.berkeyfilters.com/ -April Kline, midwife, author of Small Changes, Profound Results

2. “Get yourself in community. Anytime you experience multiple major life events in one year (moving, losing a job, starting a new romance, losing a relative, having a baby), it puts you at greater risk for depression and anxiety. Since everyone has been affected by this, be gentle with yourself and realize you are under a tremendous amount of stress. But if there’s anything good that’s come from this, I can say Americans finally get how important it is to have a tribe and receive support. Before the apocalypse, many Americans really struggled to find the support they needed and I’m thankful to say that’s not the case anymore.” -Meghan Nowland, midwife

3. “Emphasize protein foods, especially fresh fish and wild game. Eat the organs such as heart and liver, these will provide you with essential nutrients, iron and b vitamins, that may be lacking in your diet. Try to avoid a diet based on canned foods.” -Association of Nutrition Experts Post-Apocalypse (ANEPA)

4. “Forage for dark leafy greens. Thankfully, dandelion greens, nettles are plentiful in our post-apocalyptic world, are high in iron, and support your liver. Red raspberry leaves, mint, and strawberry leaves can be harvested and brewed into a nourishing prenatal tea. Oregano and garlic are go-to antiviral, antifungal, antiparasitic herbs.” -Herbalists After Apocalypse Heal (HAAH)

5. “Really listen to your body. Remember, you know what’s best for you and your baby. Having a baby post-apocalypse may not be ideal, but remember, your body was made to do this! People have been having babies outside of the hospital for thousands of years. Harness strength from your ancestors” - A local Priestess and healer

6. “Find time for yourself. You likely spend most of your time doing things to survive, such as hunting, cleaning your gear, and keeping your feet dry. Take a minute or two each day to meditate and ground yourself. Find a tree to hug. Focus on your breathing. Tune into your pregnancy and talk to your baby. This will really help you carry your baby to term” -Guide and former yoga instructor

7. “The baby is born, the placenta is born, the milk comes in, and the sun rises in the east.” -Linda Smith, breastfeeding expert. In other words, you’ve got this!

Younger people imagine what this building would have looked like before. Maybe it was an important area of commerce? Perhaps a marketplace or center of community?

Go into your bathroom and do this now

Go through your toiletries. Read every label. Each ingredient you can’t pronounce or recognize search in the EWG database (https://www.ewg.org/skindeep/) . Throw out everything that is toxic.

What my midwife mentor taught me

“My best tools are my hands. ”

— Janet Dirmeyer

Janet Dirmeyer had been practicing for over 30 years when I started my clinical placement with her. She served on the Texas Board of Midwives and required her students to attend meetings. Here are the three most important things I learned from her:

How to balance work and play

1. Enjoy life. Janet Dirmeyer loved the beach. She would go down every chance she had. She showed me how to enjoy life and lighten up in the midst of busy midwife life and being on-call.

2. If you aren’t going forward in your profession, you are going backwards. If you don’t get involved in the rules and legislation, somebody else is going to do it for you and you won’t have a say. There are things I learned sitting in those meetings that are burned in my mind and changed who I am.

3. Midwifery pure and simple. My first home birth attended with Janet was for a 10th baby. She had a lot of clients from a variety of backgrounds and a lot of them had many children. Janet Dirmeyer showed me how simply a midwife could practice, without fancy technology, electronic charting, or bags and bags of equipment. Her best tools were her hands she said.

Why does my side cramp? What your round ligament may be telling you

Do you feel it? Sharp and tender, on your side, near your hip. It may feel very deep.

Perhaps you wince or gasp. Or feel a dull ache in your belly after a stressful day.

Follow the top of your hip inwards toward your ovaries. Really get in there. Close your eyes and breathe into that space till you feel it. Those are your ligaments. The round ligaments are actually muscles attaching your uterus to your pelvis. Towards the end of pregnancy especially, your ligaments can become tight and tired from all the weight of your pregnant belly.

A woman’s nervous system is more in tune and connected down the spine. When we feel stress or anxiety, it travels down to our bottom, pelvic floor area, and lower abdomen and tells those muscles to tense up. It’s a protective mechanism for our most vulnerable parts. For certain women, especially who have experienced trauma, are in the midst of stressful life events, or who struggle with anxiety, the muscles of the pelvis, lower back, and abdomen can become especially tight and uncomfortable. Often, just an awareness of these muscles can bring us back to the present and help to release the tension. But it’s also nice to have a little help. Here are a few suggestions…

Schedule a prenatal massage.

You deserve it. Go to a massage therapist who is trained in prenatal massage so she can work on your round ligaments.

Take deep breaths.

Walking helps because it requires deep abdominal breathing, which engages our central nervous system and deep abdominal muscles. Yoga and warm baths also help.

Ask your partner, doula, or friend

to do the round ligament release for you at the end of pregnancy or in labor. It feels SOOO good!

Are there any things you have found especially helpful to soothe those muscles? We’d love to hear them in the comments!

How to know if you can trust your midwife or OB

Trust is built little by little by small actions. It’s all the times you make yourself vulnerable and are received with connection

Trust. It’s a big one. How should you know if your provider is trustworthy? According to researcher and author Brene Brown, it can be broken down into 7 key points.

1) It all starts with boundaries. What is yours and what is mine.

Is your doctor or midwife clear about their training, skills, and what they can and cannot do? Are they able to give you firm answers to your questions about their practice style, or do their answers vary significantly week-to-week? For example, does your doctor affirm that they want you to attempt a vaginal-delivery-after-cesarean (VBAC) when you ask one day, but another day suggest you schedule a repeat cesarean? Do they hold their boundaries and respect yours? Does your midwife disrespect you if you want to circumcise your son?

2) Reliability. They say what they are going to do and do it, again and again. This means setting limitations to avoid burnout.

In those small insignificant moments in your pregnancy, your provider shows kindness.

Meeting your parents, listening to your questions, celebrating your gender-reveal, laughing with you about gobs of mucous, inquiring after your sick parent, asking for clarity over difficult questions, spending extra time with you to discuss and understand your birth plan.

3) Accountability.

Does he or she participate in continuing education and strive to incorporate the most recent evidence into their care? Do they participate in ongoing peer review? Due to the litigious nature of our country, most providers I know put tremendous pressure on themselves to be perfect. Reality is perfect does not exist. The best we can do is to have accountability. When we make a mistake, we own it, apologize, and make amends. Litigation is scary for providers think about, but people don’t pursue litigation purely because of the outcome. They do it because they feel unheard.

4) Confidentiality. Your story is yours.

The Health Insurance Portability and Accountability Act (HIPPA) of 1996 regulates privacy and security information. This act makes it illegal for health care providers to share your personal information with identifying information to the public. When you sign your HIPPA form, it does allow providers to consult with other people involved with your care for health reasons (for example, your primary care physician, therapist, or endocrinologist), to bill your insurance, and to use your case in a confidential peer review process. In the age of social media, it should be said it can also be appropriate to share your information with your specific permission.

Sadly, confidentiality is not always kept. Midwives, especially, are notorious for posting on social media in a way that betrays confidence. Some people love to gossip. I have personally heard horror stories about providers breaching confidence by telling the home birth community about so-and-so’s birth story in great detail.

5) Walking in integrity and encouraging others to do the same. Brene Brown defines integrity as “choosing courage over comfort, what is right over what is fun, fast, or easy, and practicing your values, not just professing them.”

This looks like a provider who stays and continues to provide care when their patient is refusing their recommendation. Not rushing to break waters. Doing slow inductions. Volunteering and doing pro-bono work to change health outcomes.

6) Non-judgement. You can weep in front of your provider because you didn’t know the contractions were going to be so hard. And you can ask for help, without being judged.

It goes without saying that being shamed for your parenting choices or weight during pregnancy does not build trust. Trust is built when you can ask for help and you have to be able to ask for help to keep your sanity as a new parent.

7) Generosity

Life is hard. Perhaps you failed to do your glucose tolerance testing. Your provider is worthy of trust when you are given grace if you slip up on something and are given appropriate time to explain what happened.

You and your provider can assume the most generous thing about your words, intentions, and behaviors, and then check-in.

Finally, are you able to trust yourself that you found the provider you want? If you’re not sure you can use this same kind thinking with yourself. Check in and see if you’ve been trustworthy. Do you agree with this list? Are there other things you would add to this list? We would love to hear your answer in the comments.

Guide to Essential Oils for Birth

Aromatherapy has been used by healers and priests for hundreds of years to promote relaxation and create a sacred space. In birth, aromatherapy can promote physiologic birth by creating a calm, peaceful environment.

When a calm and peaceful environment is created, it allows the pregnant person to let go of their “thinking” brain and go into a more primal space. It allows the nervous system to do it’s job and the hormones to work in harmony with each other.

Aromatherapy uses during labor:

Essential oils that promote labor contractions:

1) Lavender. The most common and basic blend for labor is to diffuse lavender and clary sage together, to promote relaxation and contractions. Lavender is safe during labor and can be added to a carrier oil for massage. Alternatively, you can find lavender room sprays to pack in your hospital bag. Some local hospitals, such as Mercy Anderson and Mercy West, carry lavender essential oil.

2) Clary sage is powerful, causing uterine contractions, and should be used with caution. It should NOT be rubbed directly onto the skin. Some local hospitals, such as Mercy Anderson and Mercy West, carry diffusers and clary sage essential oil. Additionally, many doulas and midwives carry this essential oil.

3) Ylang ylang is a feminine, floral scent. It’s known to help reduce stress, muscle tension, and pain. Ylang ylang contains a component called linalool, which reduces anxiety. During labor it may be diffused, or placed in a carrier oil for massage. Because it is a delicate flower oil, it is more costly than citrus oils or wood oils.

Aromatherapy which can be used to create a more physically comfortable space during labor:

These include essential oils for nausea, to help with urination after the baby is born, to help with energy, and to prevent tearing.

1) Citrus oils are best for energy, reducing nausea, and are very safe. Lemon is nice because it’s affordable and reduces pathogens. You could purchase lemon essential oil or even just slice up a lemon to smell. Many doulas and midwives carry a citrus oil in their bag.

2) Peppermint essential oil drops can be placed in the toilet to help make it easier to urinate after the baby is born. Peppermint is NOT safe for infants, so should not be used in the room after the baby is born. Peppermint can also be used as a stimulant to help prevent fatigue and fainting. Your doula or midwife likely carry this in their bag.

3) Frankincense essential oil promotes skin integrity. It can be used in a salve or oils at the end of pregnancy and during birth to help prevent tearing.

Aromatherapy to create a sacred space:

In the Catholic tradition and many others, heaven, or the spiritual realm, is considered to be all around us, whether or not we are aware of it. When we do things to create a sacred space, it brings heaven down to earth and brings awareness to this reality. Depending upon your spiritual tradition, for your birth this may look like setting up crystals, placing a cross, rosary, or an icon in your space, lighting a candle, or a having a photo of a loved one who has passed.

Aromatherapy helps to create this sacred space because it sets apart, by engaging our senses and unlocking different parts of our brain. Here are some suggestions which have been used to create this atmosphere:

1) Frankincense has been used in Ethiopia, Israel, and in churches around the world for hundreds of years for this purpose. It can be diffused or placed on a piece of cloth in the room. In Ethiopia, they burn the sap as incense.

2) Sage. Smudging has been done for centuries to cleanse the air. It’s thought to remove negativity, but also has been shown scientifically to remove germs. This can be done in your home to prepare the space prior to birth. If you are planning a hospital birth, a substitute would be diffusing clary sage essential oil.

3) Vetiver essential oil or sweet grass smudging. Vetiver is the “oil of tranquility.”

Roses help to move energy

4) Rose petals. Rose is a gentle, balancing female herb. It can help to move energy. I like to sprinkle rose petals in a bath, or drink tea with rose petals (another benefit is roses are rich in vitamin C).

Think about the last time you took a walk in a forest…

5) Wood oils. Trees and tree oils are very grounding and sacred. Cypress, pine, sandalwood, and cedar are grounding scents. For people who are on a budget, oils such as cypress, cedar, and pine, are more affordable than frankincense and sandalwood. You could diffuse these oils in your labor space during birth. Alternatively, you could find some pine cones, a cedar chest, or another item of wood to place in your space to ground you.

What are postpartum visits like with the Cincinnati Birth Center?

We believe quality postpartum care is crucial and America’s maternity care system is sorely lacking in this area.

Instead of offering just one or two postpartum visits, we offer five postpartum visits for home birth and birth center families. This includes a one day and three day home visit, a visit between 1-2 weeks, a one month visit, and a six week visit. If a family is struggling with breastfeeding or postpartum issues, we will add additional postpartum visits.

What do postpartum visits look like? We believe the mother and baby are not a separate unit, but exist as a dyad. This means you can’t separate the health of one from the other.

Our visits involve an evaluation of your health, including vital signs, bleeding level, and healing of your bottom. We ask about breastfeeding and provide education and support. Additionally, we review the birth and talk about how everyone is processing it. There is a lot of time given for emotional support, whether it’s for the transition from going from a family of two, to three, or extended family relationship dynamics, or fears that can arise.

“We offer five postpartum visits for home birth and birth center families. This includes a one day and three day home visit, a visit between 1-2 weeks, a one month visit, and a six week visit.”

We check over baby and discuss weight gain and signs of appropriate growth. Most of the visit is done right where the newborn should be-in one of the parent’s loving arms. We may provide the routine newborn heart defect and metabolic disorder screenings at the one day and three day visits, as well as file your baby’s birth certificate.

Midwives use herbs for a variety of uses postpartum, including healing herbal sitz baths, help with breastfeeding issues, and for emotional support.

What sort of tools do we offer which are different from the American medical model? Firstly, we offer a listening ear and open heart. We want to hear your story because we know it matters. We want to give you enough time to tell it.

Secondly, midwives and lactation consultants work with a variety of modalities. We provide education about nutritional support for healing or through anxiety and stress. When a person is suffering from pain due to hip or postural alignment, we can make appropriate referrals for physical therapy and chiropractic care. We take mental health seriously and have a lot of available resources for those who are struggling with feelings of guilt, anxiety, or sadness.

In addition, we may use traditional and ancient methods of postpartum healing, such as herbal baths, massage, or teas.

So, what are you looking for in your postpartum? How can someone set themselves up for a postpartum experience that leaves them healthier than ever? We’d love to hear your thoughts in the comments!