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Ramblings & Musings

What does a doula do?

8/27/2019

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We're often asked what it means to be a doula. It's such a wildly varying experience every day, it's hard to put into words. But, we've tried to express what life is like for us over here at AthensBorn.

We hold hands and rub shoulders.
We whisper in ears and cheer loudly for milestones.
We teach and we learn.
We give back to our community.
We’re activists, we listen, we support, we protest, we vote.
We’re small business owners. We work from home, from coffee shops, in waiting rooms, our cars, wherever we find the minutes.  
We miss special occasions.
We leave our homes in the quiet of night.
We witness birth in awe. Every time.
We marvel at the strength of people.
We celebrate with our clients.
We grieve with them, too.
We make mistakes. We hate that. But, we’re learning to forgive ourselves.
We’re nerds. We love science and research and learning new things.
We talk loudly about placentas in public places. Oops.
We laugh together. Really hard. Like shushed in the library kind of hard.
We still get excited every time we're hired.
We meet the very best people and feel so grateful for it.


We know how lucky we are to be living this doula life. Thank you to our AthensBorn Families for making it possible!
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What to ask your potential doula...

6/26/2017

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We've heard it so many times when sitting down to chat with potential clients. 

"Umm...we're not really sure what to ask." 

Many people first hear about doulas from their midwives or from friends who've had a great experience with a doula during a previous birth. But, they don't always understand what a doula does or what they should ask during an interview to help them figure out which doula is the best fit. In fact, we've heard this same sentiment from so many people that we actually made a list to help them out.

Here are our most frequently asked questions and some suggestions of our own. Of course, these aren't the only questions you can ask and you should always ask anything you like. More personalized questions based on your individual needs, wishes, and personalities are great! Take a look at our list to get started and let us know if you have any additions!

Do you have availability for my due date?

Where do you work/what area do you cover?

What's your guiding philosophy for supporting women in labor and birth?

What training or experience do you have?

Why did you become a doula?

Can you provide references from past clients?

What is your birth fee and what does that cover?

How many clients do you take per month?

How do you feel about the use of pain medication during labor?

How do you work with and involve partners?

Do you offer other birth-related services? (breastfeeding support, postpartum care, placenta encapsulation, etc)

Remember, these are just a starting point. Always feel free to ask anything that's on your mind!

Take care,
​Kate & Becca
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Prodromal WHAT?!

2/11/2017

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Prodromal labor.

If you’ve ever experienced it, it’s like I just said a really nasty cuss word. If you’ve never experienced it, please… allow me to enlighten you.
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Don't you love the look on her face? That's the look of days of prodromal labor.
What is it?

Prodromal labor is a pattern of contractions that can begin anytime in the last few weeks of your pregnancy. It can hurt. It can feel like active labor. It can keep you up at night, it can last for days, it can totally exhaust you and your partner. Prodromal labor contractions may be far apart, close together, short, long, painful, or mild.

But here’s the kicker - these contractions are more annoying than they are productive. Prodromal labor contractions can start and stop at any time. It can be absolutely miserable, especially when you’re trying to plan your life around this labor that never seems to truly start, and worse… never seems to end. Active labor results in cervical change. That means your cervix (the opening of the uterus) gets soft (effacement) or open (dilation). Prodromal labor doesn’t cause any cervical change, though it can transition into active labor at any time - and only a cervical check can provide that particular information.

You may have heard the term “false labor,” which is a very bad, no-good term that we don’t use. I’m using it here so that you won’t have to. Just because prodromal labor contractions don’t immediately result in a baby doesn’t mean they’re false. Ask anyone who has experienced mind-numbing exhaustion from 3 solid days and nights of difficult contractions - that was not “false labor.” It’s very real and to call it “false” seems to imply that it wasn’t important or necessary. Prodromal labor does help with toning the muscles of the uterus and can lead to other physical preparation that your body goes through to have a baby. There is a meaning to all the madness.

Some other notable qualities of prodromal labor are that it can’t always be stopped, it is often painful, and sometimes occur at a particular time of day, like when you lay down to go to sleep at night. Prodromal labor contractions can seem like they’re occurring very quickly and for long periods of time, which is one reason it can feel like active labor is imminent.

So, how do I survive it?

We wrote a blog post a while back on ignoring early labor, and one of the big reasons we constantly urge our clients to ignore, distract, and rest during early labor is because of this… it may be prodromal. Seriously, people. If you think you’re in labor, that’s great! Contact your healthcare provider, contact your doula. But then… pull an Elsa and let it go. If you need to sit on your birth ball or relax in the bath, that’s ok - do what you need to do. But don’t jump in the car and head to the hospital just yet. You want to look for the sign that your contractions are getting longer, stronger, and closer together.

First, try drinking a big glass of water, changing your position (get up if you’ve been laying down, or vice versa), taking a nap, or laying in a relaxing bath. Sometimes, these minor changes can alter the trajectory of prodromal labor.

If you’re a do-er, find something to DO. Make food. Clean your house. Go shopping, go to a movie. Distract yourself. Don't time your contractions!

If you’re a worker, and you need to feel like you’re doing something to help yourself and your baby, check out The Miles Circuit. There has been some speculation in the birth world that prodromal labor may be related to a less-than-optimally positioned baby, and the Miles Circuit is a healthy, physical set of moves that gives you a job to do.

Otherwise...hang in there! Prodromal labor is tough, but it has a silver lining or two (I’m all about the silver lining!). It’s great practice for labor - you can test-drive positions that feel good, find comfortable places in your home to do contractions, work with your partner to find some massage techniques that feel good. It does bring baby closer through uterine muscle toning. And… it’s a time to truly find your strength and use the power within your body to do the work that needs to be done. And trust us… that’s also great training for parenthood <3

Love,
Becca

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The unBossy Doulas

11/16/2016

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Hi, loyal readers! Here’s a topic that all three of you can get on board with - we will NOT tell you what to do in pregnancy or in birth. Of all the things Kate and I are (Funny? Smart? Maybe. A little weird, definitely), we’re certainly not bossy (though our spouses and kids may beg to differ. Good thing they don’t read our blog!) Particularly to our clients.
No one likes being bossed around, especially in a vulnerable situation such as pregnancy and birth. So I wanted to tell you a little about the AthensBorn ‘birth philosophy’ … get ready, this is big.
We will NOT boss you around. We will NOT tell you what to do. We don’t make decisions for our clients, we don’t tell them what’s best for them, we don’t even give out our personal opinions if we can avoid it. We want each client to own their decisions, from which pediatrician to choose to where they give birth to what they wear while in labor. We offer helpful tips, we share our experience and what we’ve learned, and we try to stay on top of evidence-based information so we can share that too. But, we will not decide what each client should do!
“Why???” you ask. WHY?
Because it’s not OUR birth! It’s not our baby, it’s not our body, and we don’t get to make the decisions that affect those things. We support parents in the way they need, in the way that’s right for them. We don’t draw a lot of lines in the sand, because it’s not our job to police your choices.
Another thing I want to point out - other doulas may practice differently, and it’s not our job to police them, either! There’s a doula out there for every couple who wants one, and each couple deserves to find one who fits in with their own philosophy and needs. We just wanted you to know how we practice.
And, you know what? You don’t even have to believe me just because I wrote this. You’re welcome to contact us and see what we’re all about. Or not. It’s your choice <3

Love,
Becca
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Howdy, Partner.

11/5/2016

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AthensBorn Birth Services - Partners
Our words matter. They communicate our needs, express our feelings, and set expectations for things to come. As doulas, we often find ourselves choosing words carefully because of the power they hold in emotional situations. There’s one certain word that we often hear in birth communities that has always rubbed me the wrong way. I’ve never really cared for the word “coach” when talking about a partner’s role during labor and birth. I’m not sure how the term came about, but I suspect it was an attempt to give fathers a “gender-appropriate” role as society allowed them to start coming into the delivery room to witness the births of their children. What can I say? The history of childbirth is fraught with both strange and sexist ideas. Regardless of its origins, Becca and I don’t find ourselves using it when talking to clients.

The term “coach” is most often used to describe a person who has experience and expertise in a certain area and uses their skills to improve another person’s technique. Does this sound like a fair and reasonable label for a newly expecting parent? I think not.

There certainly are times when a significant other has seen labor before and may have even given birth, themselves...but, even these individuals are unlikely to claim expertise. And, what about those who have zero experience? “Hey, I know you’ve never been to a game before, but it’s time to get in there and tell her how to do this thing right!” Yikes. Talk about pressure to perform. Words are important, so let’s choose a word that doesn’t totally freak people out by asking them to coach a high-stakes game in a sport they’ve never played before.

At AthensBorn, we prefer to use the term “partner”...and not just because we’re in the south and it sounds great with the accent. (It does.) But, because two people moving through a labor and birth are, in fact, partners. And, there is no one right way to be a partner. Some partners want to be right in the midst of labor, holding their loved one up, massaging her back, reminding her to breathe. Some partners are a little nervous...they are present and loving but also need support, guidance, and reassurance themselves from time to time. Some partners are deeply anxious and fearful in these types of situations and are not able to provide hands-on, physical support during labor but they still want to be present for that miracle moment of their child entering the world. A doula can help facilitate any one of these situations...and she’ll do it judgment-free.

Whatever kind of partner you see yourself being, your thoughts, hopes, and wishes for the birth matter. As doulas, we want to get to know you during the pregnancy, too. We want to know what you’re looking forward to, what you’re worried about, and understand how we can best support you. You don’t need an in-depth understanding of the intricacies of birth to be a great partner (hey, that’s why you hired a doula, right?). You don’t need coaching skills, you simply need love and compassion. No one knows your partner better than you and that's irreplaceable during labor. We’ve been to many births with many devoted partners who each found a way to support their loved ones during birth.

Trust us...you’ll find your own best way, too.

Take care,
Kate
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Counter Pressure: Why does it rock so hard?

10/11/2016

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People who have given birth: If you’ve experienced contractions, you may have been one of the blessed ones who also received this magical thing we call counter pressure. That basically means that you have someone in your life who loves you enough to push on your lower back during each contraction. You may not remember (or care) who was doing it or exactly how, but you know it was one of the things that helped you survive that moment and conquer each contraction as it came.

The rest of this blog post is for everyone else: partners, doulas, friends, anyone who might be assisting someone as they give birth. If you have provided counter pressure to a laboring person, you are a saint. You will forever be remembered as part of their labor survival kit and they will refuse to do labor in the future without it.

There are a few things to note about it, though, especially for anyone who has never used counter pressure as a tool. So let’s go over some basics:

​How does it work? See this picture below? Look in the middle of that person’s back - that’s their sacrum. Sometimes laboring women feel pain in that place as their baby’s head passes by it on the way down - and yes, it’s generally more uncomfortable when the baby’s head is in the posterior position, meaning the bony back of the baby’s head is pushing against the sacrum. However, even anterior-positioned babies can cause discomfort - so counter pressure helps by pressing back against the baby’s head and lessening the sensation of pain. It doesn’t necessarily fix the problem, but it can be a great coping strategy for the laboring woman in that moment. If it works, do it!
AthensBorn Birth Services - Counter Pressure Anatomy

Communicate. You have to communicate with the owner of the back you’re providing counter pressure to. If you don’t know exactly how to do that, here’s a little labor role play you can practice:

Partner: Can I try some counter pressure on your lower back during the next contraction?
Pregnant person: Uuuuuuggggghhhhhh. [Assume that’s a yes.]
<Attempt counter pressure throughout entire contraction.>

Partner: How did that feel?
Pregnant person: OMG, do that forever.

If they LOVED it, do it again! If they hated it or want you to try again, but in a different spot, try again but in a different spot. If they hated it and never want you to touch their lower back again, that’s ok! Try not to let your feelings get hurt. She’s not trying to make you feel bad, she’s just in an intense place in her life. Laboring women don’t always know what they want, so it’s important for her birth team to be flexible and not take thing personally.

Keep communicating. Sometimes as the baby’s head moves down, the perfect spot for counter pressure moves down, so keep communicating with your laboring person! What works in early labor might not work later, and that’s ok. Counter pressure might work against the lower part of the person’s spine, or further down towards their tailbone - you just have to try it and find out.
AthensBorn Birth Services - Counter Pressure Demo
The Method. As this person in the picture is doing, use the palm of your hand - it provides an even, steady pressure. You can even use both hands, one on top of the other, to provide MORE pressure and to lessen the physical impact to your arms. Aim for the center of her back, right on her sacrum.

Some laboring women like the pressure to be steady and unmoving. Some women find that they like to feel some movement, so you can try a firm circular or stroking pattern and see what she likes better. (Remember to communicate!)

Positions, anyone? The laboring woman can be in lots of different positions to receive counter pressure: on her hands and knees on the floor or bed or couch, sitting on a birth ball, laying on the birth ball, sitting on the toilet, leaning over a kitchen counter, laying on her side, standing up, in the tub, in the shower. Anywhere she is comfortable where you have access to her back is a good place.

Test drive during pregnancy. There’s no need to wait until the contractions get intense before you try counter pressure. It can provide relief throughout pregnancy, especially in the third trimester, and give pregnant women and their partners something to do while they wait for the big day. This kind of labor preparation also provides couples a sense of partnership and togetherness, which is always a positive thing as parenthood approaches.

So, what do you think? If you’ve had a baby, did you enjoy counter pressure? What made it work or not work for you? If you’ve assisted as someone had a baby, do you have any tips to give to other birth partners? Feel free to share your experience with us! We love your stories!

Take care,
Becca

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Blessing the Mother Through Ritual...

7/13/2016

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Mother Blessing - Pregnant Belly with Flowers
Mother Blessing
Honor the Mother-to-Be with a Mother Blessing Ceremony  
In today’s Western societies, much of the time leading up to a baby’s arrival is spent focused on...well...the baby. And, we are *all* for focusing on sweet, little babies! But, in the midst of baby showers, baby books, baby clothes, painting nursery walls, and focusing on all the items and tasks that seem to come along with these adorable, tiny individuals, it’s all too easy to lose sight of the truest preparations needed for the new parent’s journey: readying the heart in love, strength, connection, and openness. At AthensBorn, we believe the most important “stuff” that’s needed to parent a new baby is not actually material “stuff” at all. One lovely way to refocus attention to this readying of the heart is to honor the mother-to-be with a Mother Blessing Ceremony.

What is a Mother Blessing Ceremony?
A Mother Blessing serves to help prepare the expectant woman for the emotional and spiritual work of labor, birth or adoption, and motherhood. Words of wisdom and encouragement are shared, beautiful memories exchanged, and space is held for the woman of honor as she grounds herself and prepares for the life transition to come.

The guest list for a Mother Blessing tends to be much smaller than the guest list for a baby shower because only the most trusted women from the innermost circle of the woman’s life gather together, as this is an emotionally tender and especially meaningful event for her.

Activities at a Mother Blessing Ceremony are crafted to the unique desires of the woman of honor,  and usually include two elements: the creation of something the mother can carry with her into her birthing or adopting time to remind her of the web of women holding her up across time and distance; and, something to signify the connection between the women until the baby has safely arrived into her mother’s arms.

Food, laughter, tears, love, discussion, song, and a deep sense of togetherness are an incredible gift to mark this significant time in a woman’s life.

It’s a powerful, beautiful tradition that we absolutely love facilitating for women!

If you would like more information about our Mother Blessing Ceremony, please let us know.  We’d be happy to answer your questions.


Take care,
Kate
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Early Labor: Don't Do It!

6/20/2016

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TARDIS BellyExploding Time And Relative Dimension In Space.... On Belly


















​Hello friends!
​
If you’ve ever sat through one of our final prenatal appointments, you may remember one thing we tend to stress: When in early labor, thou shalt not freak out and get all excited. Instead, ignore/distract/rest! (And yes, we mean it.)


So, let’s address a few things here. What’s early labor? That basically means that you are showing signs of labor (regular contractions, back pain, bleeding, diarrhea, restlessness, or any combinations of those things). However, you can be distracted, you can talk, walk normally, and basically still do everything you normally would - you just sort of have this labor thing happening in the background. It’s not uncomfortable yet, but it’s starting to get your attention and it’s not going away.

Second, why shouldn’t you freak out? Why not be excited? I mean, you’re about to have a baby! There aren’t many more freak-out-worthy and exciting events in life, especially if it’s a first baby. However, this is a good time to remember that you’re in it for the long haul. It may take several more hours (or, sorry mama, days) for your labor to really get going, then who knows how long after that until your baby is born. Those are the hours you need to save your energy and attention for.

So what we want our clients to do in early labor are these things:
  1. Call your healthcare provider! They may have particular recommendations for you based on their knowledge of your medical history, so please let them know what’s going on!
  2. Ignore your labor - keep “doing life” as normal. Go grocery shopping if you need to. Pick up your older kids from school. Eat supper. Shower. Don’t focus on labor yet, because the time to focus will come. Just do life.
  3. Distract yourself - go to the movies (it may be your last chance for a long time!). Go on a date with your partner* to your favorite restaurant. Put together nursery furniture. Prep some meals for your postpartum period. Let someone decorate your belly (hello, who wouldn’t want an exploding TARDIS to enjoy during labor?). Just try anything that will keep you from watching the clock.
  4. REST. Please, please rest. If you can sleep, do it. If you can lay on the couch and watch a movie, do it. Don’t put a lot of work into your early labor! No curb walking, no fancy breathing, no stomping. You need to save your energy.

*Speaking of partners: It might be important for YOU to remember to remind her to ignore/distract/rest. If she acts like she’s jumping headfirst into Labor Land, gently call her back so she can get out of her head.

We hope this info is helpful to any of you who might be approaching the final weeks of your pregnancy. If you’ve been there before, what were some of your favorite ways to ignore labor and distract yourself? What are some things you’ll definitely do next time? For me, it’ll be watching Empire Records, letting my toddlers Sharpie my tummy, and taking a nap. <3

Lots of love,
Becca

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How to communicate effectively with your care provider: (AKA, Becca fangirling over local midwife)

4/6/2016

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AthensBorn - Medical Staff
We know a lot of parents wonder about how to talk with their care providers about their biggest birth/baby issues, such as interventions, policies,and procedures. The list of questions parents ask of their care providers is truly endless - and for good reason! This is your baby, your body, and your birth we’re talking about here. You deserve honest, full discussions of all the issues. But, let’s consider for a minute the perspective of your midwife or obstetrician: she or he is tasked with keeping your health and the health of your baby at the front of their minds, while also navigating each patient’s particular wishes for their baby’s birth (which can vary WILDLY from parent to parent). This can be tough for care providers, to say the least.

So, we went straight to the source. The marvelous Alexa Clay agreed to be our expert witness. She’s a Certified Nurse-Midwife at Women’s Healthcare Associates and was a doula for over a decade before deciding to go into midwifery, so to many of the doulas in town (yours truly included) she’s kind of a rock star. She’s also a busy mother of two, so we’re incredibly thankful that she took the time to work on this blog post with us.
Here’s what Alexa had to say to my probing questions:


How can patients best let their Healthcare Provider know their wishes for their birth? For example, do midwives and OBs prefer for a client to tell them their wishes during office visits, or is a printed-out birth plan better?

Alexa: I feel like the most effective way of learning about a patient's expectations is for the patient to write out what their biggest wishes/expectations are for their birth and to bring them into their prenatal visit sometime during the last month or two. I like to read over and discuss the plan with them. It's a great opportunity to talk in more depth about practice philosophy and which expectations are easily attainable or even standard, and which ones may need more discussion. In our practice we put notes in people's charts about things that we may need to be reminded of when they come in for labor.


What happens if a patient disagrees with the health care provider’s recommendation or point of view? What's the best way that a patient can handle a situation like that? Should the patient worry that the doctor or midwife will be offended?

Alexa: Do your research and learn what the latest evidence says. Ask about risks and benefits of specific procedures. Just as importantly- ask about what the risks and benefits are if you do not do a procedure. Your provider is your partner in health and decisions should feel like joint decisions, especially during a normal, healthy pregnancy and birth.


Is it possible for a patient to ask too many questions?

Alexa: Have your questions written down or type them into your phone. Asking questions is important and should be expected by providers. Do be mindful of your midwife or doctor's time. Some questions can wait until future appointments.


What can a patient/partner do to make their health care provider’s job easier?

Alexa: Be curious, read books, go to childbirth education classes, hire a doula! See your doctor or midwife as an advocate- a part of your team.


Does having a knowledge of medical terminology help patients understand what their doctors and midwives are saying in appointments?


Alexa: If you don't understand what your midwife or doctor is talking about, ask them. We should be able to explain everything in terms that you understand.

​
There you have it, friends! My very own, up-close-and-personal (via email, anyway) interview with Alexa Clay, CNM and all-around awesome person. Thanks for your time, Alexa!

So, dear readers, we pose these questions to YOU:

1. What were some effective ways you found of talking with your care provider and getting the answers you wanted and needed?
2. What would you do differently if you got to do it over again?
3. What advice would you give new parents?

Can’t wait to hear your responses!

Take care!
Becca

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Do I need a doula and a midwife?

3/29/2016

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This is a question that comes up a lot for women who are experiencing their first pregnancy or for women who've previously given birth without a doula. Many women wonder if they really need a doula when they're already under the care of a midwife. Sometimes parents aren't sure of the distinction between the two roles, or they mistakenly think that one can be a substitute for the other. 

Basically, it comes down to this...midwives and doulas make a great team. Can you have a great birth without a doula present? Of course you can. And, many women do. But, that doesn't mean there aren't many benefits to adding another skilled, educated, compassionate member to your birth team. Remember, your doula provides non-stop, emotional and physical support for *only* you and your partner during your birth.

This article offers some great points on why having both a midwife and a doula as members of your team can help your birth be an empowering, beautiful experience.

http://www.sheknows.com/parenting/articles/1039849/do-i-need-a-doula-and-a-midwife

If you're still not sure, try the following....

#1- Ask your midwife if she thinks a doula is beneficial to a woman in labor. Most midwives are happy to have a supportive, skilled doula in the room. The more support for their clients, the better!

#2- Ask someone who had both a doula and a midwife at their birth how they felt about their experience. We promise you'll be hard-pressed to find a woman who had a doula and felt like she didn't benefit from her skills and presence. 

Take care,
​Kate
​
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