Obstetricians

Obstetricians are trained in the care of pregnancy, labour and delivery, and the post partum period. I believe they are best suited to be utilized for those women who have higher risk pregnancies and/or labour and deliveries.
The obstetric branch of medicine views the process of pregnancy and birth as a series of potential problems and because of this view towards the whole process they are ready to intervene when things aren’t within the scope of a ‘normal’ pregnancy or labour and delivery. They can potentially inadvertently cause the problem they are looking for.
Obstetricians are also not as incline to share information and include the parents in decisions regarding care of the pregnancy, labour or birth. They view you as a patient who is in their care to be treated. And if they do pass on information it is generally delivered in a way to create fear of what can happen if you don’t do something they want you to do such as prenatal testing or medical intervention during labour.
Don’t get me wrong. I feel that Obstetricians save many lives and are fantastically skilled to handle any situation that may arise, but I also feel their care should be set aside for those with a higher risk pregnancy. For those that are healthy and are looking to have a natural labour and delivery and to be involved in their care it would be advisable to seek the care of a midwife.

What is a Doula?

While studying to become a doula. People would get a puzzled look on their face when I told them what I was completing my certification for.  I would then have to explain to them the role of the doula and they would nod and say “ohhhh…like a midwife!!” To which I would then explain, again, the scope of practice for a doula.

I highly recommend doulas for expecting parents, especially if it’s a first child.  They not only support the labouring mom but are encouraging and helpful for the birth partner.  They have extensive knowledge, not only about labour and birth, but are usually familiar with your local hospital policies and procedures.

The word ‘doula’ is a Greek word meaning ‘woman’s servant’ or a ‘woman who serves’.  Doulas are certified through individual organizations.  Some of the best are DONA, BirthWorks,   CAPPA and C.A.R.E. Some certifications are intense and ensure the certifying doula has the knowledge and experience to confidently and successfully be an asset to expecting parents. There is a fee for the doulas service.  This fee varies from doula to doula, some doulas base their fee on the parent’s income, and some have a set fee.  

Its best to start searching and interviewing doulas in your second trimester as it may take some time to find one you are comfortable with and want at your birth.  It’s important to feel comfortable and secure with whomever you choose.  Once you have picked your doula you will meet with her to get to know each other better, to go over your birth plan and express fears or concerns.  In labour, your doula will be with you once you feel you need her support and will stay with you up until a few hours after birth, once the your family is comfortable and resting.  She will then come and visit a few days post-partum. Together you can retell your birth story and answer any questions you have about the birth.

Doulas are not medical professionals.  They are a labour councillor, or labour coach.  They do not provide any medical procedures or tests.  They do not give medical advice and are not able to prescribe medicine.   They are not allowed to speak on your behalf to the medical attendants. 

They are, however, very knowledgeable about the medical procedures and tests that may take place during your pregnancy and labour and will answer any questions you have about them.  Which is nice, especially if you are delivering in a hospital, as minimal information is usually passed on and nurses and doctors may be working with numerous patients.  Doulas help the mom to relax by talking calmly, massaging, rocking, walking, and breathing. They help make suggestions while keeping in mind the birth plan in terms of pain management, and position changes.  They are also encouraging, not only for mom, but for her birth partner too.

It is proven over again that doula care significantly lowers risk of having a caesarean, epidural, forceps, episiotomy, and have significantly shorter labours. They also show to lower the risk of mood disorders after birth and families report an easier transition to the new family.

Those that have had a doula for their birth usually are extremely happy that they had one and couldn’t imagine birthing without one.  I know personally, I really wish I would have had one for both of my births.  The first one would have been nice being so young.  I was going to have my mom and sister with me, but they just sat there, eating and drinking their coffee, waiting for the show.  I actually had to ask the midwife to ask them to leave as they were actually making me very uncomfortable.  My second birth would have been nice because my labour was so fast and intense, I gave birth after a little over an hour after arriving at the hospital. My midwife was so busy with the paperwork and the assistant didn’t get there until I was pushing. My partner was very unsure and I had to labour without much support.

So look into it if you are expecting, perhaps meet with a few doulas in your area and make a decision that suits you.  

 

Information Sources

“Having a Doula:  Is a Doula for Me?” , (2013, January), (American Pregnancy Association), Available: http//www.americalpregnancy.org (Accessed: 2013, April, 18).

 Kennell, John, H., Klaus, Marshall, H., Phyllis, H., (2002), The Doula Book: How A Trained Labor Companion Can Help You Have A Shorter, Easier, and Healthier Birth, 2nd edition, Da Capo Press, Boston, MA.

 “What is a Doula?”, (DONA International), Available: http//www.dona.org/mothers (Accessed: 2013, April, 18).

Book Review : The Womanly Art of Breastfeeding 7th edition, By La Lache League

I wish I would have read this book when I was breastfeeding my two children. It is packed full of such useful and encouraging information.  It actually made me want to breastfeed all over again!

I think I was most inspired by the offering of support La Leche League offers new and experienced mothers.  I know being such a young mother I would have benefited from attending meetings.   In chapter 3 the book explains the support La Leche League meeting offers. 

I learned so much from this book. The most applicable to my experience would be the section on ‘a nursing strike’ (pg.142).  I think both my children did this before 6 months and I mistook it for their desire to wean off of the breast.  It was also encouraging to learn that most mothers can make enough milk for their babies. (pg.132) I have heard so many times woman stop breastfeeding because they are told they couldn’t make enough milk. There are numerous suggestions (pg.135, 137,138) to help increase mothers milk supply.

I disagree with the information presented in ‘getting enough hindmilk’ (pg.316). I just did a lot of research on foremilk and hindmilk and the issue I have with what they are saying in this section is that if a baby is switched to early from one breast to another they may not be getting enough milk with a higher fat content. One of the benefits of breastfeeding is for your baby to be able to establish self-regulation at feeding time. If the baby comes off the breast and is done with that side, but mom is worried baby isn’t getting enough hindmilk, she may needlessly try to force the baby back on the same side.   As long as baby is gaining and growing there is no reason to force a baby to stay on one side for a certain length of time.

I definitely agree with most of the information provided in this book and will be recommending it to new and expectant parents.  I am a strong supporter of breastfeeding and am always in amazement of all the benefits both to mother and baby. 

Colostrum, Foremilk and Hindmilk…What’s the difference?

I attended a breastfeeding class the other day and I was a little shocked to hear the instructor give out wrong information. This prompted me to do some research, again, just to confirm the true facts. I thought I would pass on the information, as I’m sure this is a topic many question.

Breast milk changes throughout the breastfeeding period. The milk that comes in at the beginning of a feeding is composed differently than the milk that comes in later on. So….which is which and what’s the difference?

Let’s start from the beginning. During your last weeks of pregnancy your body is preparing for the birth of your beautiful baby. Including your breasts. You may notice you may be leaking or are able to express a few drops of colostrum. This is the first milk you make for your baby.

Colostrum is a thick yellowish colour that comes in 1-3 days after birth if its not already present. The colour is due to a high level of Bata-carotene. It is low in fat (fat is harder for a newborns system to digest) and high in protein which is a building block of all cells. Its also packed full of essential vitamins and nutrients all which is perfectly suited for a new baby. Colostrum is also packed full of antibodies and live cells which are essential in protecting this new being from the outside world, because up until this point baby has been in a totally sterile environment. There is actually an antibody passed from mother to baby that lines the mucus membranes in your babies stomach, intestines, respiratory tract and lungs. These membranes are not matured yet and with out this antibody germs and other invaders can pass through the membrane and into the babies body. Another amazing fact about colostrum is it has a mild laxative effect which helps to pass the meconium from babies digestive system, it is a very thick black, almost tar-like substance which is in your babies bowels at the time of birth.

So after you breastfeed for a few days your milk will begin to mature and change. It will become watery and take on a white, almost bluish colour at times. Mature milk has more calories than colostrum. Colostrum has about 58 calories per 100ml, while mature breast milk has about 70 calories per 100ml.(The number will change slightly with variations in diet, these numbers are based on a study on British women.) Mature milk contains less protein than colostrum but has more fat and carbohydrate composition. It is shown that the fat and caloric content in mature milk increases in mothers that feed past six months.

During individual feedings,the longer baby feeds at the breast the fattier the milk composition. Which bring us to the foremilk and hind milk. These terms seem to imply that there are two different types of milk your breasts make during a feeding. But this is not the case. When your milk is stored in your ducts between feedings. The fat in the milk separates from the watery portion and clings to the walls of the cells. The thinner portion of the milk passes down to the nipple quickly once the baby latches on and starts sucking and the longer the baby sucks the more fat will pass down the ducts to baby.

There is no need to worry about how much hind milk your baby is getting, as long as he or she is gaining weight, growing and wetting enough diapers.

I hope this helps to clear up any questions you may have had and helps you to better understand breast milk.

I always welcome feedback and questions. :)

REFERENCES

“Are the Terms ‘Foremilk’ and ‘Hindmilk’ Still used?”, (Unicef), Available: http://www.unicef.org.uk(Accessed:2013,April 14).

“Basic Biology-Molecules of Life-Proteins”, (EMBL-EBI), Available: http://www.ebi.ac.uk(Accessed: 2013, April 14).

Bonyata,K., (2011,August 29), “I’m Confused About Foremilk and Hindmilk-How Does This Work?”, (Kellymom), Available: http://www.kellymom.com(Accessed:2013, April 14).

Dewar,G., (2008), “Nutrients and Calories in Breast Milk: A Guide for the Science-Minded”, (Parenting Science), Available: http://www.parenting science.com(Accessed: 2013, April 14).

La Leche League, (2004), The Womanly Art of Breastfeeding, 7th edition, the Penguin Group, New York.

Marasco,L., West,D., “What is the Difference Between Foremilk and Hindmilk? Is my Baby’s Fussiness caused by the Lactose in my Milk?”, (Low Milk Supply), Available: http://www.lowmilksupply.org(Accessed: 2013, April 14).

Mohrbacher,N., (2010, June 27), “Worries about Foremilk and Hindmilk”, (Nancy Mohrbacher Breastfeeding Reporter), Available: http://www.nancymohrbacher.com(Accessed: 2013, April 14).

All About Me and My Blog :)

Hi,

First I want to thank you for taking the time to read my bio. I am currently completing my certification to be a BirthWorks educator. (for more info on BirthWorks go to www.birthworks.org ) I have been actively learning about childbirth for 11 years. I was studying to work as a Doula, but realized it wouldn’t work with my family life right now. I have been thinking about BirthWorks for a few years, and waited for the right time to start the course. Im finally completing my certification and I am loving every minute of it!

For those that don’t know…BirthWorks offers expecting parents a class in which woman are empowered with the right attitude and taught the best coping methods and optimal pelvic positioning for birth. It also encourages the mothers birthing partner and educates them on their role in the birth. Birth is ancient, during birth you have to trust your body to do what it is meant to do.  Birth should be, and is a very powerful, beautiful, life changing experience. It should be something to look back upon and be awe over.

I am going to be 30 in a couple weeks and I have two children. My daughter is 11 and my son is 6. My births were very short. My daughter was delivered after 5 hours from the start of regular contractions, and my son was born after only 3 hours.  I listened to my body, I kept my body relaxed so my body could do what it needed to do, and I used imagery, vocalization and other coping methods to handle the pain in a natural and positive way. 

My reason to start this blog is a combination of a few things. First its for myself. The more I can share this information the better I will know the facts.  Since there is so many studies with new information this will keep me up to date on the latest info.  The second is to have a nice tool for , not only my clients, but for all expecting parents to look to as a resource for information. 

I am always available to answer question and would love your feedback  :)

I look forward to this journey together and hope you find the information helpful and encouraging.

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