Thursday, December 29, 2016

Midwife or Doula?

Midwife or Doula? That is the million dollar question.. As a Midwife, I get this question all of the time.. “What's the difference?” In the past I just never understood why people didn't know, but obviously because I knew and everyone around me knew too. The problem is a good majority of people don’t really know and this includes some health care professionals. Well, let me break it down in easy terms. Here is what Google says, A midwife is a health care provider while a doula is more of a childbirth coach. You might choose to have a midwife instead of an OB for prenatal care and to deliver your baby —midwives can deliver babies in hospitals, birthing centers or even in your home. Thank you Google, that clears it up! Even then people still don't understand why they need one over the other.. It’s not that difficult to understand when you know our backgrounds and what we can do. As a midwife, we specialize in prenatal care, childbirth education, labor birth and postpartum care. We are the health care provider for mom and baby. We do support and comfort mothers throughout the process and of course we will rub your back in labor but, we at some point need to take a step back to make important health related decisions. Imagine this, you're in labor and your midwife is coaching you through every contraction, rubbing your back, taking your vital signs, listening to baby's heart tones, charting and making sure not only you but your family is doing well throughout the process too. Let's say this goes on for 20 hours. Lets also say something unplanned starts to present, like your blood pressure starts to rise or you're running a temperature. If we are managing all of those other things and we need to make a medical decision it may be very difficult to do while also being emotionally in the moment. I always tell moms, at some point we need to step away so that we can look at the scenario from the outside and make a clear  responsible decision. If you’ve ever been to a birth in the hospital, the Doctors are usually making decisions from everywhere else but there. The nurses are reporting everything and they are giving orders based on that. Now, we are not like doctors and do not like to be compared in no way, but it’s just an example. Now on the other hand, A doula, also known as a birth companion and post-birth supporter, is a non-medical person who assists a person before, during, and/or after childbirth, as well as her spouse and/or family, by providing physical assistance and emotional support. The word doula is a Greek word meaning women's servant. Women have been serving others in childbirth for many centuries and have proven that support from another woman has a positive impact during the process .This means, they will rub your back, breathe with you through every contraction, make sure your family is doing well through the process and the list goes on. When Midwives work with Doulas, it’s like the mom has her own Justice League! Defenders of Natural Childbirth!! ( I have boys so I think in Superhero terms)  The Doula is comforting her while we are using our Midwife skills to encourage a smoother and hopefully faster delivery. If the Doula needs a break, we are there to take over so that mom always has her team supporting and encouraging her. It’s what we like to call “a win win”!! Evidence shows that having both a Midwife and a Doula present at a birth GREATLY reduces the need of unnecessary interventions and c sections.  When the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) released their groundbreaking "Safe Prevention of the Primary Cesarean Delivery" Obstetric Care Consensus Statement in February 2014, one of their key recommendations to reduce the primary cesarean rate in the USA was the continuous presence of a doula at a birth. (Caughey, 2014) Having a doula present at a home birth often means that two heads are better than one when it comes to suggesting coping techniques and offering comfort  that allow the labor to progress. So, now that we’ve cleared that up, I hope you’ll have your own Justice League at your birth.. We’ll be here waiting for the call to defend Natural Childbirth!!!

Friday, December 23, 2016

Knowing the facts on inducing labor...

More and more births are being induced lately and a good majority for no medical reason. Some reasons are because of the holidays some maybe because of vacation’s that have already been scheduled. In some cases the mother wants to be induced because she has family that came from out of town to see the baby. I have even heard of trying to have the baby before the end of the year for taxes!! In any case, still not a good enough reason to be induced. Experts are learning that this can cause problems for both mom and baby. Some problems include, the induction not working because mom's body doesn't respond or may not be ready and in turn can lead to an infection and possibly a c-section. Babies born vaginally have an edge over those born via cesarean section. They pick up bacteria from their mother's birth canal, which scientists believe helps protect them from asthma, obesity, and other health issues as they grow older. This is called the microbiome and it helps baby develop an immune system that will aid in their overall health. Squeezing through the birth canal also helps drain all the fluid from their lungs. Another thing to consider is how baby will handle the induction. Some are fully developed and are ready for the outside world but some may not be. If the estimated due date is a little off and lets say baby is younger than 39 weeks, studies show that a few things might not be fully developed for outside the womb. Important organs, like his brain, lungs and liver, get the time they need to develop. Baby has time to gain more weight.  This is important because Babies born at a healthy weight have an easier time staying warm than babies born too small. Babies can suck and swallow and stay awake long enough to eat after they’re born when they are full term. So if your provider is talking about inducing and especially before 39 weeks, you can discuss the importance of vaginal birth and ask them is there is a medical reason that would require an induction. We all know how exciting it is to want to meet your baby and how anxiety takes over those last few weeks. Just think, a few more weeks of waiting is nothing to a lifetime of love and joy your new baby will bring.