I have a shiny new website!!!

Come on over to edensgardenbirth.com and check out my new website.

I plan to leave this site up as a blog only for now and gradually will be moving all articles over to the new site.  Thanks for visiting!

What is a Labor Assistant or a Doula?

Doula: δούλη 

From the ancient Koine Greek (Biblical Greek)

Definition:

 -a slave, bondman, person of servile condition

- devoted to another to the disregard of one's own interests; a servant, attendant

When talking to folks about doulas, I often hear the same questions, the conversation goes something like this:

Me: Hiring a doula can make a huge difference in your birth experience, especially if you plan to give birth in the hospital.

Them: What's a doula?

Me: A doula is someone who assists you during labor. She will help you with comfort measures...

Them: Oh, like a Midwife?

Me: No. A doula doesn't provide any medical care. She is there to provide comfort...

Them: Well, my husband/ partner/ best friend/ sister will be there so I don't think I need a doula.

I have tried to come up with a more concise quick answer to the "What is a doula?" question, but I fail at it over and over.

We can look at the evidence and see the obvious benefits of hiring a doula.

• 31% decrease in the use of Pitocin*
• 28% decrease in the risk of C-section*
• 12% increase in the likelihood of a spontaneous vaginal birth*
• 9% decrease in the use of any medications for pain relief
• 14% decrease in the risk of newborns being admitted to a special care nursery
• 34% decrease in the risk of being dissatisfied with the birth experience*

So, what does a doula *do*?

The answer to this question can different for every woman and in every labor, but here are a few things she will do:

She will offer some education about birth and labor.

She will be a guide through your labor, birth and the first hours after your baby is born.

She will help your partner be present and active in the labor.

She will come to your house to labor with you there if you want her there.

She will stay with you for your entire labor (we do have to pee sometimes, though).

She will use your birth plan as a tool to remind you of your wishes.

She may suggest positions that can assist progress of labor, optimal fetal positioning

     or provide some relief from pressure or pain.

She will work with the staff to meet your needs.

She may use massage, accupressure, aromatherapy, relaxation techniques to help

     you along.

She may act as your DJ (keep your music going).

She may pick up your camera and take photos.

She may translate medical terms into layman terms for you.

She will help you get started breastfeeding.

She will help you talk through your birth in the first hours and days postpartum.

Here are a few things you doula will not do:

She will not make decisions about your care.

She will not speak to the staff on your behalf regarding medical care.

She will not take your partner's place.

She will not do clinical tasks such as blood pressure, cervical checks, etc.

I hope that clears it up a little bit.  I know, it doesn't help much with those quick conversations in the grocery store line.  What about you? Do you have a concise answer to the "What is a doula?" question?

Testimonials: Labor Support

Labor Support

I am now offering doula/ Labor Support services.

You can check my availability to attend your birth HERE at Doula Match.

As your doula, I would provide:

- An initial meeting in person or by phone to determine if we are a good match.
- 2 prenatal visits (In addition to these, I am willing to attend 1 office appointment with your care provider if desired).
- Labor support at your home and the hospital/ birth center.
- Assistance in labor positioning and tools for helping your labor's progress and your comfort.
- Emotional and physical support for you and your partner before and during labor.
- Assistance in finding the tools and information you need to make informed decisions about your care.
- Assistance in creating and following your birth plan.
- Amateur photography as needed (often, I will pick up a camera to record something lovely).
- A discounted rate for Birth Education classes ($10 off per 2 hour session).
- On call availability for 2 weeks prior to and 1 week after your "due" date (or until your baby is born).
- Assistance in establishing breastfeeding during the hour after birth.
- 1 postnatal visit during your first week home.
- "Anytime" phone/ text availability before and after the baby's birth.


As of now, I am not a certified doula.  Do not think that I am lacking in knowledge or experience. My training and 6 years of experience as a birth educator has given me many of the tools to assist a family in the birth of their baby.  I have attended several births in a doula capacity and have gained good experience that will go far in assisting you in your birth.

My plans for the future include Midwifery School and specific doula training may also earn a spot on the list at some point soon.  For now, though, my rates reflect the fact that I am not certified.

If you would like a reference, I would be happy to provide you with that!

Birthing Theo

For what it's worth: after having a 5 hour labor and a 2.5 hour labor I am requesting a good 7-8 hours for the next one. Faster is not necessarily better in matters of bodily function (baby making and baby birthing, for example). This birth tried me in ways I can't explain and I know I haven't done the story justice because, 6 months later, I am still reeling from the experience. Here is my best recollection (after talking with Brandon and watching the video)...

The Birth of Theodore Xenophon.
June 25, 2009 4:52 PM
8 pounds 10 ounces, 20 inches


I had a midwife appointment Monday morning (the 22nd). I was 39+weeks, and had already told the baby it was welcome to come any time. I was ready, the house was ready, and we were just waiting (uncomfortably, I might add). When I saw Nadene that morning, I decided to have her check me. I was not disappointed! My cervix was dilated 3cm (and she mentioned that she could easily stretch me to 4cm), it was 100% effaced and the baby was at 0 station. I was happy that my body had done so much of the work of labor already. Nadene and I discussed that (especially with my history of a 5 hour labor with our daughter) this baby would likely come very fast, and to be prepared for that possibility. At my request, she swept my membranes and encouraged me to walk!

I had a pretty miserable day Tuesday. I was crampy and sore from the membrane sweep and had moments of regret for having her do it. Wednesday was great! I felt wonderful and got SO much done! We had the carpets and kitchen tile cleaned, I did some cooking and baking, I did a little bit of cleaning and had a great nap.

Brandon had the next day off and I told the baby that Thursday would be a great day to be born! That morning, we took Eden up to the playground at the elementary school to play while I walked laps at the track. I was determined to “walk the baby out” that day! I walked until I ran out of water. It was already SO hot outside. I went and hung out on the swings with Eden. I had heard that swinging could also help bring on labor, so I swung!

We went home and had some lunch, put Eden down for a nap and I went to take a nap myself. I was only in the bed for a few minutes when I had some menstrual-type cramps. I looked at the clock and noticed the time (2:20 pm). After a couple of “cramps” I realized that they were coming in waves and I went downstairs to get Brandon’s iPod. He had just put the Contraction Master App on it and I was excited to try it out. I went back upstairs to get back in the bed and time my “cramps.” They ended up being about 3 minutes apart and lasting between 45 and 60 seconds each.

I let Brandon know that this may be the start of something and gave up on the idea of a nap. My friend Julie was on her way to deliver my “birth bracelet” made with beads chosen by my friends. She had just gotten the final bead and put it on the bracelet in my front yard. I confessed to her that I was pretty sure I was in labor. I put on the bracelet and called my doula. She encouraged me to call Nadene and told me she would get her stuff together in case I needed her to come soon. I talked to Nadene and she said to come straight to L&D. Honestly, I was a little bit surprised that she wanted me to come in, but relieved to have some affirmation that labor may have actually begun. Within minutes, my labor began to intensify. I called my mom to come get Eden (who was still napping) and called Sara (our doula) to meet us at the house. Labor continued to gain intensity and I was vocalizing loudly through the contractions by the time my mom arrived. Not wanting Eden to hear me or see me (though I think she was well prepared), I went into the kitchen to have a contraction and ran back in to kiss her goodbye. My mom quickly got her out of there and I immediately felt “pushy.” I told Brandon that we could not wait for Sara and we needed to leave for the hospital now.

We called Sara on the way to the hospital and told her to meet us there instead of the house. It is only a mile and a half to the hospital from our house, but it was rough. I was not coping well with my contractions while belted into the car. I had the feeling that they were bigger than me. When we got to the hospital, and out of the car, I felt like I got a better handle on them and we made our way in. The loser they sent from the ER to “help” us up to L&D is lucky I was beyond exerting myself physically for anything other than getting the baby out, because he needed his teeth knocked out (or at least that is how I felt at the time). I declined the wheelchair and he told me I had no choice! Um, no, I will not sit in your wheelchair. I will walk. His response, “It’s going to take forever!” So? He then proceeded to time my contractions and announce to me how long they were lasting and how many minutes apart they were. He seemed very disapproving when a couple of them only lasted 30 seconds. His comment, “Well, they are only about 30 or 40 seconds.” As if they couldn’t possibly be “real” or effective.

We arrived on the L&D floor (ER guy’s teeth intact) and I had the biggest, hardest contraction with 2 peaks that lasted 2 ½ minutes (thanks ER guy). At that point, I was thinking that this had better be the really super-fast labor we were all expecting because I was feeling out of control. Brandon and Sara (who arrived at L&D about the same time as us) said it didn’t show on the outside, but I was not feeling like I was coping at all. During the few seconds I had on the downside of a contraction (because there was no time in between) I tried to re-gain focus on the baby and breathe and relax my jaw and shoulders and the next contraction would carry me away from any thought at all, of anything. My mind was numb. At this point I was pushing with the peaks of the contractions.

Because I was pushing, Nadene had me get on the bed so she could check me. I was dilated 6cm, but she said when I pushed, I was 8cm. I had been fully effaced since my appointment the Monday prior, so Nadene encouraged me to push open my cervix. I got on my knees and had a few contractions. I do recall that the smell of imminent birth was strong. I also remember that Nadene was rubbing my feet and Sara was rubbing my back while Brandon was covering me in cold washcloths. The contrast of those things with the pain of the contractions was a special kind of bliss. Nadene had me move up the bed to get me more upright and let gravity help. I held the top of the bed frame (the back of the bed was upright) for leverage. At this point I still felt like I was going to be doing this for a while, but with the next push I felt the ring of fire and Nadene said that the baby’s head was almost out! So close! I panted through the next contraction because the burning was so intense. Brandon said that the baby’s head was halfway out for what seemed like forever and it looked “uncomfortable.” Ya' think? I thought that was funny… With the next contraction I pushed the baby’s head out and I was overwhelmed with excitement (partly to meet the baby, but mostly that the labor was done)! I pushed the baby out before that contraction was done. Brandon was obviously excited as he let me know (almost squealing) that it was a Theo! My first words were “I want him!” Nadene passed him to me between my legs. He was beautiful and I couldn’t stop kissing him! I kept saying “I am so glad that is over.”

Theodore Xenophon was born at 4:52pm after 2 hours and 32 minutes of labor (from my first “cramp” to holding him in my arms) and only 40 minutes after arriving at the hospital. He weighed 8 pounds 10 ounces and was 20 inches long. Praise the Lord for His miracle of life and for blessing our family with Baby Theo!

Testimonials: Classes

Alyssa & Brian E.

Dr. Laura Pendlebury

Henrico Doctors Hospital

Our classes with Amy were extremely informative and enlightening. She has an obvious passion for childbirth education and is quite effective at communicating. We believe after taking her class we were as knowledgeable as untrained people could be about the pregnancy and the birthing process. The books she recommended to us were useful both before and after the birth of our son. We planned a natural childbirth and she was a great resource for our birthing plan and preparation. When our baby turned breech, she gave us contacts and information to help us through the uncertainty. When we ended up having to have a c-section birth, but she was able to guide us through different questions we should ask and different things we might experience post-partum. Because of this (and extremely good care by our OB-GYN and nurses) we were able to have a very smooth recovery. She was (and remains) available for questions at any time.

*****

Jeanette & Mike C.

Dr. Sumac Diaz

CJW Chippenham Medical Center

I had a private class with Amy for my pregnancy. She came to our house and helped my husband and I realize that although we were health professionals and though we knew a lot about labor and delivery we still did not have to succumb to the medical model of the process. Without Amy I would never have had the confidence to truly believe that a natural birth is something I could have achieved. She also provided great resource videos and handouts and encouraged us to get a doula, which was the best decision we could have made. I would recommend Amy's class to any family interested in natural birth.

An Informed Childbirth has made some changes!

An Informed Childbirth is now being offered through private classes!

Private instruction affords you the opportunity to customize instruction, get to know your instructor, explore fears, and dive deeper into topics that are pertinent to your unique situation.

I can work with your tricky work schedule, meet you at your home and customize a class that meets your needs exactly! See the Tuition Rates and Registration page for more information.

I am looking forward to serving you and meeting your needs!!

Welcome Baby Theo!

We welcomed our new little one to the world on Thursday, June 25th at 4:52pm! He was 8 pounds 10 ounces and 20 inches long.

Keep checking back... Eden's Garden has some new things in the works!

Eden's Garden is on Maternity Leave!

I knew the day would come, but it's official!  Growing this new baby has become my life's work!  For the last trimester, I will be taking a break from teaching.  I expect to return in mid-August.  

Check back for baby updates and for the new class schedule.  I hope to have the class schedule for the late summer and fall up in the next week or so.

Blessings,

Amy

Evidence-Based Healthcare

Many people want to be informed consumers of healthcare.  We all want to make the best decisions about our care and our family's care.  How do you find the best information?  How do I know that what my doctor is telling me is the most up-to-date information?  

Cochrane.org is the website of The Cochrane Collaboration.  They are an organization that is dedicated to improving healthcare decision-making globally, through systematic reviews of the effects of healthcare interventions.  They do not accept "conflicted funding" and are funded through grants and donations.

What does this mean for you as a pregnant woman?  It means that you have a place to go and find the studies to back up your choices!  You can find out if your doctor's advice is based on the evidence!  You can make your own best choices.  The site is free.  Check it out!

Practical Ways to Avoid Back Labor

I have been discussing optimal fetal positioning with a client and thought it was something that I should write about!  

One of the positions that you hear about a lot among mamas is the occiput posterior position (OP).  OP is the position that is responsible for the often painful "back labor" that is the subject of so many labor horror stories.  You probably know someone who has had back labor.  Here are some practical ways to avoid it yourself!

Your baby's back is the heaviest side of its body. This means his back will naturally gravitate towards the lowest side of your belly. So, if your belly is hanging lower than your back (you are sitting on a chair leaning forward) then the baby's back will tend to swing towards your belly. If your back is lower than your belly (you are lying on your back or leaning back in a recliner) then the baby's back may swing towards your back.

Avoid positions which encourage your baby to face your belly. The main culprits are said to be reclining chairs, sitting in car seats where you are leaning back, or any position where your knees are higher than your pelvis.

The best way to avoid the wrong positions is to spend lots of time kneeling upright, or sitting upright, or on hands and knees. When you sit on a chair, make sure your knees are lower than your pelvis, and your trunk should be tilted slightly forwards.

• Watch TV while kneeling on the floor, over a beanbag or cushions, or sit on a dining chair. Try sitting on a dining chair facing (leaning on) the back as well.
  
  
• Use yoga positions while resting, reading or watching TV - for example, tailor pose or lotus pose (sitting with your back upright and soles of the feet together, knees out to the sides)
  
  
• Sit on a wedge cushion in the car, so that your pelvis is tilted forwards. Keep the seat back upright.
  
  
• Don't cross your legs! (not that you can anymore anyway) Crossing your legs reduces the space at the front of the pelvis, and opens it up at the back. For good positioning, the baby needs to have lots of space at the front.
  
  
• Don't put your feet up! Lying back with your feet up encourages posterior presentation.

• Sleep on your side, not on your back.  Switch sides whenever you wake up (and I know you wake up a lot!!)
  
  
• Avoid deep squatting, which opens up the pelvis and encourages the baby to move down, until you know he/she is the right way round.  Sitting on a birth ball or a low stool with your legs in a deep spread is a good way to open your pelvis. 
  
  
• Swimming with your belly downwards is said to be very good for positioning babies- not backstroke, but lots of breaststroke and front crawl. Breaststroke in particular is thought to help with good positioning, because all those leg movements help open your pelvis and settle the baby downwards. A mask and snorkel may be helpful.
  
  
• A Birth Ball can encourage good positioning, both before and during labour. Doing "hula" movements is particularly helpful.
  
  
• Various exercises done on all fours can help. Wiggling your hips from side to side, or cat/ cow (arching your back like a cat, followed by dropping the spine down). 

Helping your baby into the proper position before labor begins is the best way, but if you find yourself in a tremendous amount of back pain during labor, try these techniques again!  They may keep you from having one of those horror stories!

10 Natural Childbirth Myths

This is one of my favorite Monty Python skits!  While farcical, it hits pretty close to reality in many hospitals!  

Did your first birth experience go more like this than you had hoped?

Are you wondering where the bliss of the best moment of your life went?

Were you disempowered by your experience?

Are you trying to avoid this scenario with your first birth?

Are you fearful of the "natural" birth alternative?

Here is an interesting article from birthingnaturally.net:

10 Natural Childbirth Myths

When weighing your options for childbirth, it helps if you have accurate information about the options available to you. Unfortunately childbirth is an area where myth often pervades fact. What you hear may have started as truth, but has become such a distorted version, there isn’t much truth left. Here are ten of the most common misunderstandings about natural childbirth and the truth behind them.

1. You have to have a super-high pain tolerance.

Almost nobody likes pain, and it is easy to assume giving birth causes large amounts of pain so only the most pain tolerant women can do it. What is less well known is how a woman’s body increases endorphin levels during labor. This means as the intensity of the contractions build, so does her ability to handle them. Also, contractions peak at about 30 seconds. This means once your contractions become about a minute long they may increase in duration (get longer), but they do not tend to continue building in intensity.

2. You have to do HEE HEE HOO HOO panting the whole time.

While Dr. Lamaze did include patterned breathing for distraction in his natural childbirth training, it was one of several tools and his was the only program that recommended it. Dr. Dick Read, Dr. Bradley and others recommended natural deep breathing relying instead on positioning and relaxation. Patterned breathing remains one of many tools a woman can use in labor if she finds it helps her manage contractions, but most women use normal breathing.

3. It feels like pulling your lower lip over your head.

I enjoy a good comedy routine, but we shouldn’t base our understanding of childbirth on stand up comedy. After having given birth without medication twice, I can most assuredly promise you it feels nothing like pulling on your lips. The parts of the body needed for childbirth are designed to stretch and make room for baby – your lower lip is not designed to be pulled over your head.

4. You have to be at home to do it.

Homebirth is an option, but it is only one option. Women interested in natural childbirth can also give birth in birth centers or hospitals. It is not the location that matters, but the support you have to help you through contractions. While hospitals have access to medications and emergency equipment, many also have birth tubs, balls and flexible staff who will work with a family to achieve the birth they desire. Hiring a doula gives you even more support and increases your chances of giving birth naturally.

5. Women become screaming lunatics, yelling at their husbands.

Childbirth is not a psychosis where a woman suddenly takes on a new personality. Although in the earlier half of the 20th century women were given labor drugs that made them act very strange indeed, becoming crazy isn’t a part of the natural childbirth process. What does happen is a woman uses all her energy to focus on the work she is doing and distraction makes this harder. Women in hard labor will use the least amount of energy to communicate – this may mean body language, grunts or one word commands. Without the understanding this behavior is normal, a support person can feel as if they have somehow upset the laboring mother.

6. Childbirth is the worst pain you will ever feel.

A childbirth educator’s husband figured out from her normal 12 hour labor that the time she spent in pain in contractions totaled to about 3 and a half hours. You can be in pain longer than that for a migraine. And unlike other types of pain, contractions build to a peak, release from the peak and then give you a break. Even in a longer than average labor, there are breaks between contractions. In a 12 hour labor, you might not even need to work through contractions until the last 2 or 3 hours before pushing because most of the time you spend in labor is early labor.

7. If they know you want a natural childbirth, the nurses won’t give you anything for the pain.

Wanting a natural childbirth and achieving a natural childbirth are two different things. While most doulas, nurses and midwives will work with you to achieve your goal of a natural childbirth, they never force you to give birth without medication. Whether or not to use medical pain relief remains your choice regardless of what type of labor you prepared for.

8. There is no reason to go through labor pain anymore.

There have been ointments and herbs to treat labor pain as far back as the Roman Empire, and probably further back than that. There are also positions and non-medical techniques that work extremely well for keeping mothers comfortable and helping labor progress. It isn’t so much the use of a treatment to manage pain that bothers modern women as much as it is the possible side effects and risks of using the treatments. There is a big difference between the risks of having a massage in labor and having an epidural. Although the massage may not eliminate all the pain, if it allows the woman to labor without having to add the risks of an epidural then why not use it? Studies show just the change of using a doula for additional support decreases requests for pain medication while also decreasing needs for additional medical interventions. It should more rightly be said that with all we know today, there is no reason to add the risks of medical pain relief to manage labor pain anymore.

9. Women used to die giving birth.

Yes, and women still die giving birth. It has nothing to do with the natural childbirth process. Instead factors such as poor nutrition, infection and inadequate sanitation are the causes of high mortality rates. In fact, the highest childbirth mortality rate happened because birth was moved to the hospital and infection spread quickly among laboring women when doctors didn’t wash their hands. Pain medications increase the risks of having a problem in labor, not reduce them. Cesarean birth adds the increased risks of surgery to childbirth, which means for a normal, healthy pregnancy your risk of dying from childbirth goes up.

10. I don’t need to prepare to give birth, it’s a natural process.

While your body is doing the work with or without you, how you respond to labor will have a large impact on how well labor progresses and the amount of pain or discomfort you feel. Knowing positions, tricks and techniques for labor greatly improves your chances of being successful at giving birth naturally, and greatly improves your chances of staying comfortable during labor. It takes physical and mental energy to labor; if you haven’t practiced natural childbirth techniques enough to use them without thinking you won’t be able to use them during labor. Preparing for a natural childbirth doesn’t necessarily guarantee you will give birth without medications, but not preparing almost always guarantees you will use medications.

Jennifer Vanderlaan is a childbirth educator and doula who helps families learn tools, tips and techniques for natural childbirth at http://www.birthingnaturally.net Article Source: http://EzineArticles.com/?expert=Jennifer_Vanderlaan

Birth Talk

The next Birth Talk will be on Monday,November 4th at 7 pm! Hope you can make it!

Birth Talk Mission: To form an inclusive circle of trust and support for pregnant and postpartum women by:
SHARING stories of pregnancy and birth, as well as options for local providers, birth locations and birth educators;
INSPIRING power and confidence throughout the experience of pregnancy, birth and parenthood;
DISCOVERING how to become your own birth advocate in order to experience the birth you desire;
and CELEBRATING the life-changing experiences of pregnancy, birth and parenting.

Birth Talk will meet the first Monday of each month at 7 pm at Franklin Goose in Carytown. Come at 6:30 for special speakers.

Contact Jennifer Kyzer at 440-2498 or e-mail safe-n-happy@iglide.net.

The Business of Being Born comes to The Byrd!

This is a powerful film. It is coming to back to

Richmond after 2 sold out shows in November.

It will be showing at Richmond's Byrd Theatre on

February 3rd at 12:30pm. There will be a question

and answer time following. Tickets are only $2 (free

with a student ID)!

Buy your tickets here.

The Birth Talk meeting for the month of February

is scheduled for the 4th. Come to the show and then

to the Talk!

from The Coalition for Improving Maternity Services

Having a Baby? Ten Questions to Ask

Have you decided how to have your baby?

The choice is yours!

First, you should learn as much as you can about all your choices. There are many different ways of caring for a mother and her baby during labor and birth.

Birthing care that is better and healthier for mothers and babies is called "mother-friendly." Some birth places or settings are more mother-friendly than others.

A group of experts in birthing care came up with this list of 10 things to look for and ask about. Medical research supports all of these things. These are also the best ways to be mother-friendly.

When you are deciding where to have your baby, you'll probably be choosing from different places such as:

• birth center,

• hospital, or

• home birth service.

Here's what you should expect, and ask for, in your birth experience. Be sure to find out how the people you talk with handle these ten issues about caring for you and your baby. You may want to ask the questions below to help you learn more.

1. Ask, "Who can be with me during labor and birth?"

Mother-friendly birth centers, hospitals, and home birth services will let a birthing mother decide whom she wants to have with her during the birth. This includes fathers, partners, children, other family members, or friends.

They will also let a birthing mother have with her a person who has special training in helping women cope with labor and birth. This person is called a doula or labor support person. She never leaves the birthing mother alone. She encourages her, comforts her, and helps her understand what's happening to her.

They will have midwives as part of their staff so that a birthing mother can have a midwife with her if she wants to.

2. Ask, "What happens during a normal labor and birth in your setting?"

If they give mother-friendly care, they will tell you how they handle every part of the birthing process. For example, how often do they give the mother a drug to speed up the birth? Or do they let labor and birth usually happen on its own timing?

They will also tell you how often they do certain procedures. For example, they will have a record of the percentage of C-sections (Cesarean births) they do every year. If the number is too high, you'll want to consider having your baby in another place or with another doctor or midwife.

Here are some numbers we recommend you ask about.

• They should not try to start labor for more than 1 in 10 women (10%).
• They should not do an episiotomy (ee-pee-zee-AH-tummy) on more than 1 in 5 women (20%). They should be trying to bring that number down. (An episiotomy is a cut in the opening to the vagina to make it larger for birth. It is not necessary most of the time.)
• They should not do C-sections on more than 1 in 10 women (10%) if it's a community hospital. The rate should be 15% or less in hospitals which care for many high-risk mothers and babies.

A C-section is a major operation in which a doctor cuts through the mother's stomach into her womb and removes the baby through the opening. Mothers who have had a C-section can often have future babies normally. Look for a birth place in which 6 out of 10 women (60%) or more of the mothers who have had C-sections go on to have their other babies through the birth canal.

3. Ask, "How do you allow for differences in culture and beliefs?"

Mother-friendly birth centers, hospitals, and home birth services are sensitive to the mother's culture. They know that mothers and families have differing beliefs, values, and customs.

For example, you may have a custom that only women may be with you during labor and birth. Or perhaps your beliefs include a religious ritual to be done after birth. There are many other examples that may be very important to you. If the place and the people are mother-friendly, they will support you in doing what you want to do. Before labor starts tell your doctor or midwife special things you want.

4. Ask, "Can I walk and move around during labor? What position do you suggest for birth?"

In mother-friendly settings, you can walk around and move about as you choose during labor. You can choose the positions that are most comfortable and work best for you during labor and birth. (There may be a medical reason for you to be in a certain position.) Mother-friendly settings almost never put a woman flat on her back with her legs up in stirrups for the birth.

5. Ask, "How do you make sure everything goes smoothly when my nurse, doctor, midwife, or agency need to work with each other?"

Ask, "Can my doctor or midwife come with me if I have to be moved to another place during labor? Can you help me find people or agencies in my community who can help me before and after the baby is born?"

Mother-friendly places and people will have a specific plan for keeping in touch with the other people who are caring for you. They will talk to others who give you birth care. They will help you find people or agencies in your community to help you. For example, they may put you in touch with someone who can help you with breastfeeding.

6. Ask, "What things do you normally do to a woman in labor?"

Experts say some methods of care during labor and birth are better and healthier for mothers and babies. Medical research shows us which methods of care are better and healthier. Mother-friendly settings only use methods that have been proven to be best by scientific evidence.

Sometimes birth centers, hospitals, and home birth services use methods that are not proven to be best for the mother or the baby. For example, research has shown it's usually not helpful to break the bag of waters.

Here is a list of things we recommend you ask about. They do not help and may hurt healthy mothers and babies. They are not proven to be best for the mother or baby and are not mother-friendly.

• They should not keep track of the baby's heart rate all the time with a machine (called an electronic fetal monitor). Instead it is best to have your nurse or midwife listen to the baby's heart from time to time.
• They should not break your bag of waters early in labor.
• They should not use an IV (a needle put into your vein to give you fluids).
• They should not tell you that you can't eat or drink during labor.
• They should not shave you.
• They should not give you an enema.

A birth center, hospital, or home birth service that does these things for most of the mothers is not mother-friendly. Remember, these should not be used without a special medical reason.

7. Ask, "How do you help mothers stay as comfortable as they can be? Besides drugs, how do you help mothers relieve the pain of labor?"

The people who care for you should know how to help you cope with labor. They should know about ways of dealing with your pain that don't use drugs. They should suggest such things as changing your position, relaxing in a warm bath, having a massage, and using music. These are called comfort measures.

Comfort measures help you handle your labor more easily and help you feel more in control. The people who care for you will not try to persuade you to use a drug for pain unless you need it to take care of a special medical problem. All drugs affect the baby.

8. Ask, "What if my baby is born early or has special problems?"

Mother-friendly places and people will encourage mothers and families to touch, hold, breastfeed, and care for their babies as much as they can. They will encourage this even if your baby is born early or has a medical problem at birth. (However, there may be a special medical reason you shouldn't hold and care for your baby.)

9. Ask, "Do you circumcise baby boys?"

Medical research does not show a need to circumcise baby boys. It is painful and risky. Mother-friendly birth places discourage circumcision unless it is for religious reasons.

10. Ask, "How do you help mothers who want to breastfeed?"

The World Health Organization made this list of ways birth services support breastfeeding.

• They tell all pregnant mothers why and how to breastfeed.
• They help you start breastfeeding within 1 hour after your baby is born.
• They show you how to breastfeed. And they show you how to keep your milk coming in even if you have to be away from your baby for work or other reasons.
• Newborns should have only breast milk. (However, there may be a medical reason they cannot have it right away.)
• They encourage you and the baby to stay together all day and all night. This is called "rooming-in."
• They encourage you to feed your baby whenever he or she wants to nurse, rather than at certain times.
• They should not give pacifiers ("dummies" or "soothers") to breastfed babies.
• They encourage you to join a group of mothers who breastfeed. They tell you how to contact a group near you.
• They have a written policy on breastfeeding. All the employees know about and use the ideas in the policy.
• They teach employees the skills they need to carry out these steps.

© 2000 by The Coalition for Improving Maternity Services (CIMS).

Permission granted to freely reproduce in whole or in part along with complete attribution

Beautiful Birth Video!

This video is a picture of what birth can be if left to happen 

without unnecessary medical intervention.

It contains photos of actual births.

Circle of Life Midwifery

Birth Is Not an Illness- 16 Recommendations From the WHO

Birth is Not an Illness!
16 Recommendations from the World Health Organization

These 16 recommendations are based on the principle that each woman has a fundamental right to receive proper prenatal care: that the woman has a central role in all aspects of this care, including participation in the planning, carrying out and evaluation of the care: and that social, emotional and psychological factors are decisive in the understanding and implementation of proper prenatal care.

1. The whole community should be informed about the various procedures in birth care, to enable each woman to choose the type of birth care she prefers.

2. The training of professional midwives or birth attendants should be promoted. Care during normal pregnancy and birth and following birth should be the duty of this profession.

3. Information about birth practices in hospitals (rates of cesarean sections, etc.) should be given to the public served by the hospitals.

4. There is no justification in any specific geographic region to have more than 10-15% cesarean section births (the current US c-section rate is estimated to be about 30.2% in 2005- Virginia's 2005 rate was 31.4%).

5. There is no evidence that a cesarean section is required after a previous transverse low segment cesarean section birth. Vaginal deliveries after a cesarean should normally be encouraged wherever emergency surgical capacity is available.

6. There is no evidence that routine electronic fetal monitoring during labor has a positive effect on the outcome of pregnancy.

7. There is no indication for pubic shaving or a pre-delivery enema.

8. Pregnant women should not be put in a lithotomy (flat on the back)position during labor or delivery. They should be encouraged to walk during labor and each woman must freely decide which position to adopt during delivery.

9. The systematic use of episiotomy (incision to enlarge the vaginal opening) is not justified.

10. Birth should not be induced(started artificially) for convenience and the induction of labor should be reserved for specific medical indications. No geographic region should have rates of induced labor over 10%.

11. During delivery, the routine administration of analgesic or anesthetic drugs, that are not specifically required to correct or prevent a complication in delivery, should be avoided.

12. Artificial early rupture of the membranes, as a routine process, is not scientifically justified.

13. The healthy newborn must remain with the mother whenever both their conditions permit it. No process of observation of the healthy newborn justifies a separation from the mother.

14. The immediate beginning of breastfeeding should be promoted, even before the mother leaves the delivery room.

15. Obstetric care services that have critical attitudes towards technology and that have adopted an attitude of respect for the emotional, psychological and social aspects of birth should be identified. Such services should be encouraged and the processes that have led them to their position must be studied so that they can be used as models to foster similar attitudes in other centers and to influence obstetrical views nationwide.

16. Governments should consider developing regulations to permit the use of new birth technology only after adequate evaluation.

Compiled from Care in Normal Birth: report of a technical working group
1997 - WHO/FRH/MSM/96.24

Lending Library

As a birth education or doula client you will have access to the Eden's Garden Lending Library.

Up to 3 books may be checked out for 2 weeks at a time per client.
Please bring back books on time as other students may be waiting for the same book!
Late fees will be charged as follows:
$1/week for the first 4 weeks.
Full replacement cost of the book if 5 weeks late (and the book must be returned).

Library catalog:

A Child is Born by Lennart Nilsson

The Baby Book by William Sears, MD

Birthing From Within by Pam England

The Complete Book of Pregnancy and Childbirth by Sheila Kitzinger

The Discipline Book by William Sears, MD and Martha Sears

How to Raise a Healthy Child... In Site of Your Doctor by Robert Mendelsohn, MD

How Weaning Happens by Diane Bengson

Ina May's Guide to Childbirth by Ina May Gaskin

Natural Family Living by Peggy O'Mara

The Nursing Mother's Companion by Kathleen Huggins

Nursing Mother, Working Mother by Gale Pryor

Nutrition for a Healthy Pregnancy by Elizabeth Somer

Spiritual Midwifery by Ina May Gaskin

Taking Charge of Your Fertility by Toni Weschler

Vaccinations: A Thoughtful Parent's Guide by Aviva Jill Romm 

Wise Woman Herbal for the Childbearing Year by Susun Weed

The Woman's Book of Yoga and Health by Linda Sparrowe

You are Your Child's First Teacher by Rahima Baldwin

Your Pregnancy Week by Week by Glade Curtis, MD

Contact Information

Eden's Garden Birth Education and Labor Support
Amy Blake Rollogas
5255 Old Columbia Rd
Goochland, VA 23063

804-869-1225

Required Reading

The book that we will be using as our main text for the An Informed Childbirth class is The Complete Book of Pregnancy and Childbirth by Sheila Kitzinger You will have weekly reading assignments from this book. Coming to class prepared will allow you to join in during our discussions.

The Kitzinger book is available locally at Barnes and Noble and can also be acquired from favorite online bookseller.