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How To Choose The Best Doctor Or Midwife For YOU

10/16/2017

3 Comments

 
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There are many factors to consider when choosing the care provider who will attend your baby's birth.  Today we're going to unpack a few of those considerations and give you some ideas for questions to ask when meeting a care provider to help you make your choice.

Things to Consider
    Consider where you want to birth your baby.  Your options for a care provider will be limited by your birthing location.  For example: Most obstetricians work only in hospitals.  Someone who is planning a home birth may not have the option of having an obstetrician at their birth.  Consider whether the place of birth is more important to you or whether having a specific care provider is more important to you if faced with such a situation.

   Trust your intuition.  It's there for a reason.  If you just seem to “click” with a certain care provider, that might mean they are a good choice for you and your family.  On the other hand, if you meet with someone and have an uneasy feeling about them, you may want to find another care provider whom you feel better about.

   Consider a care provider's philosophy on birth.  Are they pro-natural birth or are they more comfortable when birthing women are medicated?  Do they view birth as a natural, normal event that occasionally needs intervention?  Or do they view it as a potentially dangerous situation that needs swift and frequent intervention? How does their stance line up with your own?  

   Let's take a moment to clear something up.  It is never to late to change care providers. While it is true that the options may be more limited late in pregnancy, making a swap is always a viable option.  If a care provider who originally seemed like a great fit begins to seem like not-so-great a fit, you have the freedom to change your care provider at any time.  Please be confident in doing so, if necessary.  


Questions to ask
The following questions are some suggestions of things you may want to ask a potential care provider. Some questions may not apply to you or the care provider.  It may also be helpful to draw up a list of things that are most important to you for your birth and ask your care provider how they feel about that list.

*Note that there are several links in this list. 



  • Where do you attend births?
 
  • If you attend births at more than one location, where do you prefer to attend births? 
 
  • What are the advantages and disadvantages of each?
 
  • What tests are done during pregnancy? How are negative/positive results handled?
 
  • How often should I see you during pregnancy?
 
  • What are some reasons why I might want to call you between visits?
 
  • At what point in pregnancy do you do routine vaginal exams?
 
  • Are you open to limiting or eliminating routine vaginal exams in pregnancy?
 
  • Have you ever done a membrane sweep without a woman's knowledge or consent? 
 
  • What were the circumstances?
 
  • How many ultrasounds to do you recommend during pregnancy?
 
  • Do you like attending non-medicated births?  Do you prefer medicated births?  Why?
 
  • What is your current cesarean rate?
 
  • What are the most common reasons for cesarean?
 
  • What is your current induction rate?
 
  • What are the most common reasons for induction?
 
  • When should I call if I suspect my birthing has begun?
 
  • When should I go to the hospital/birth center?  OR When can I expect you to arrive at my home?
 
  • What is your stance on using a tub during my birthing?  What is you stance on water birth?
 
  • During my birth, am I free to use whatever positions I desire?
 
  • During the pushing phase am I free to use whatever positions I desire?
 
  • Will you wait to cut the umbilical cord until is stops pulsing? 
 
  • Will my partner be allowed to cut the cord?
 
  • Will my baby be given to me immediately after birth?


Do you have any considerations or questions you would add to this list?  We'd love to hear them in the comments!

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Kayla Wells Smith, Birth Doula, HCHI
My introduction to doulas came when I was 36 weeks pregnant with my first child. My midwife looked at me and said, “You need a doula.” I had no idea what a doula was, but she gave me an email address for an amazing doula who eventually attended the birth of my first.

When my first little guy was just 7 months old, I found out that I was pregnant with my second. I promptly called my doula friend who said, “You need Hypnobabies!” I signed up and took the Hypnobabies class she was teaching at the time and never looked back! My Hypnobabies birth was amazing! My husband and I could hardly believe that birth could be so comfortable and calm! After a fabulous second birth experience I decided that I wanted to be a part of helping families have the best birth for them. I started by becoming a doula. I trained with DONA International and in 2014 I decided to begin the process of becoming a Hypnobabies Instructor. I was officially certified as a Hypnobabies instructor and Hypnodoula in June of 2015. I love helping families become educated about childbirth and supporting them through pregnancy. In 2016, I officially completed the Becoming Dad Certification process and am now "Becoming Dad Certified."


E-mail: kayla@nashvillebirthandbabies.com

3 Comments

How To Choose Where Baby Will Be Born

10/16/2017

2 Comments

 
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Where do you see yourself birthing your baby?  Generally, there are three options: hosptial, birth center, and home.  Each has it's own unique set of benefits and drawbacks.  Let's dive in and see if you can discover which one is right for you.  Remember:  This is YOUR baby's birth.  It does not matter what your mother, sister, best friend, or doula thinks about these options.  It matters what YOU think!


Hospital:
    While hospitals have become the most common place to have a baby, that was not always the case.  Through most of history babies were  born at home, attended by the various women in the birthing woman's life and/or a midwife.  In fact, by the 1930's only about half of all births happened in hospitals.  About 40 years later in the 1970's almost all babies were born in a hospital.  There are some definite benefits to birthing in a hospital, and a few drawbacks as well.


Benefits of Hospital Birth:
  • The safest option for high-risk situations
  • Often gives parents peace of mind to know that any unexpected situation can be dealt with swiftly
  • Hospitals offer several medical options for managing discomfort
  • The only option for cesarean births


Some hospitals:
  • Offer tubs for hydrotherapy during birthing
  • Are comfortable and experienced with those who choose a non-medicated birth
  • Allow birthing women to eat a drink during birth


Drawbacks to hospital birth:
  • Timing arrival at the hospital can sometimes be tricky.  Too early may mean repeated trips are needed.  Waiting too long may mean a birthing woman doesn't have time to arrive.
  • Greater access to medical equipment sometimes leads to a greater reliance on them.
  • Can be chaotic.
  • It can be difficult to rest in a hospital setting.


Home:
    Many expectant women who are designated low-risk have the option of birthing their baby at home under the care of a midwife or supportive doctor.


Benefits of home birth:
  • Home is a comfortable, familiar environment
  • Home births eliminate the need to decide when to leave for the birthplace
  • Home births ease the postpartum time by allowing a woman to stay home after birth rather than transferring home after her birth.  
  • Home tends to be a much calmer birthing environment

Some home births:
  • Are less expensive than hospital births
  • Are attended by obstetricians

Drawbacks of home birth:
  • Not suitable for high-risk births
  • In the unlikely event of a complication requiring significant intervention, a transfer to the hosptial may be needed.  This transfer can sometimes be traumatic.
  • Some parents are less comfortable at home because there is less medical equipment available.
  • There are no medical options for managing discomfort 


Birth Centers:
    Birth centers are not available everywhere, but in places where they are available they can be a good alternative to both hospital and home births.  They are a kind of  an “in between” option for those who like some of the benefits of both.


Benefits of birth centers:
  • More calm, comfortable and home-like than a hospital
  • Often have beautiful, resort-like accommodations
  • Short 6-12 hour stays after birth 


Some birth centers:
  • Are in a wing of a hospital, allowing for easy transfer in the unlikely event that it is needed
  • Others are nearer the hospital than some homes.  This gives some parents peace of mind to know that a transfer could be done much more quickly from the birth center than from home.
  • Have obstetricians attending births


Drawbacks of birth centers:
  • Very low risk tolerance sometimes leads to panic
  • Resting for a few days before going home is not an option
  • Just as for hospital births, timing arrival can be an issue.


Are you someone who has already had a baby in one of these places?  What would you add to this list for those considering birthing there?

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Kayla Wells Smith, Birth Doula, HCHI
My introduction to doulas came when I was 36 weeks pregnant with my first child. My midwife looked at me and said, “You need a doula.” I had no idea what a doula was, but she gave me an email address for an amazing doula who eventually attended the birth of my first.

When my first little guy was just 7 months old, I found out that I was pregnant with my second. I promptly called my doula friend who said, “You need Hypnobabies!” I signed up and took the Hypnobabies class she was teaching at the time and never looked back! My Hypnobabies birth was amazing! My husband and I could hardly believe that birth could be so comfortable and calm! After a fabulous second birth experience I decided that I wanted to be a part of helping families have the best birth for them. I started by becoming a doula. I trained with DONA International and in 2014 I decided to begin the process of becoming a Hypnobabies Instructor. I was officially certified as a Hypnobabies instructor and Hypnodoula in June of 2015. I love helping families become educated about childbirth and supporting them through pregnancy. In 2016, I officially completed the Becoming Dad Certification process and am now "Becoming Dad Certified."


E-mail: kayla@nashvillebirthandbabies.com

2 Comments

What Do You Want For Your Birth?

10/16/2017

2 Comments

 
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    When it comes to pregnancy and birth, there really isn't a “one-size-fits-all” strategy.  Different things are important to different people.  An unmedicated birth may be of the utmost importance to one mother, while an epidural may be of the utmost importance to another.  Neither is necessarily better or worse than the other, they are merely unique choices made by unique individuals.  Each choice that we make carries it's own set of risks and benefits.  It's often best to educate yourself on these risks and benefits before birthing begins.  Knowing these risks and benefits ahead of time makes the process of decision making “in the moment” much easier.  

    When thinking about the options that are available to you, it is often helpful to take some time to visualize your ideal birth:

What kind of experience do YOU want?  What does your ideal birth look like?  Sound like? Smell like?  Feel like?  What kinds of support do you have?  Who is there with you?



Consider the following:
What words would you use to describe your overall birth experience? There are many words you could use.  What words come to mind?
  • Calm
  • Quiet
  • Peaceful
  • Fun
  • Quick
  • Safe
  • Medicated
  • Unmedicated 

Think about the early part of birth. 
The time when you may still be wondering, “Is this it?”  Where do you imagine this happening?  What do you want this experience to be like?  What will you be doing?  Who will be with you?  Who will you tell? Who will you NOT tell?


Think about where you want to birth your baby. 
Is it at home?  The spa-like atmosphere of a birth center?  In a hospital?  Which option feels right for you?  If it is somewhere other than home, when will you go?  How do you imagine getting there?  What will you do on the way? What will happen once you arrive?  What do you want your care provider(s) to do for you?  Or not do for you? What kinds of things will give you peace of mind about the process? 
What options do you want when you are pushing?  What positions do you want to try? Where do you want to push?

After your baby is born, what do you want the immediate postpartum period to be like? 
Will baby be placed on your abdomen?  Do you want baby taken to be checked out first?  Who will cut the cord?  Do you want to breastfeed immediately?  Do you plan to bottle feed?  



    Visualizing your ideal birth in this way can be helpful to you in creating an excellent birth for yourself and your baby.  It is helpful when making important during pregnancy and also during birthing.  As you educate yourself on what choices you have, your answers may change, and that's ok!  The important thing is to be proactive in seeking the best birth for you and your family, and making the decisions that are right for you. 
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Kayla Wells Smith, Birth Doula, HCHI
My introduction to doulas came when I was 36 weeks pregnant with my first child. My midwife looked at me and said, “You need a doula.” I had no idea what a doula was, but she gave me an email address for an amazing doula who eventually attended the birth of my first.

When my first little guy was just 7 months old, I found out that I was pregnant with my second. I promptly called my doula friend who said, “You need Hypnobabies!” I signed up and took the Hypnobabies class she was teaching at the time and never looked back! My Hypnobabies birth was amazing! My husband and I could hardly believe that birth could be so comfortable and calm! After a fabulous second birth experience I decided that I wanted to be a part of helping families have the best birth for them. I started by becoming a doula. I trained with DONA International and in 2014 I decided to begin the process of becoming a Hypnobabies Instructor. I was officially certified as a Hypnobabies instructor and Hypnodoula in June of 2015. I love helping families become educated about childbirth and supporting them through pregnancy. In 2016, I officially completed the Becoming Dad Certification process and am now "Becoming Dad Certified."


E-mail: kayla@nashvillebirthandbabies.com

2 Comments

6 Reasons Why Birth Partners Need Doulas

10/7/2017

2 Comments

 
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Sometimes when an expectant mom decides that she wants a doula, she is met with a bit of resistance from her birth partner.  The birth partner may feel that the doula will take their place and that they will not be able to be as much of a part of birth as they want to be if a doula is there.  Many of them feel that they have sufficient skills to support the birthing woman, especially if they have taken a good childbirth education course. The birth partner may also feel that a doula is an unnecessary expense.  Today I'm going to give birth partners 6 reasons why having a doula is a benefit to you!


​​1. Doulas Make Sure Partners Are Taken Care Of! 
While the focus of birth is on the mom and baby, birth partners and dads also have needs during birth.  You may need to eat a meal, brush your teeth, take a nap, take a walk, get a shower, change clothes, etc.  Having a doula gives you an opportunity to do these things without leaving mom all alone.  Not only that, a doula may be able to help you know when a its a good time to do these things.

2. Doulas help birth partners be involved.
Even birth partners who are well-prepared for birth may find a moment or two when they are unsure what to do or how to help.  A doula will look for opportunities for a you to be as involved as you want to be.  It may be as simple as inviting you to a particular place where you can be close to mom when space is limited.  It may be that the doula reminds you of things that you learned about in your childbirth education class, or in meeting with your doula, that may be helpful.  It may be that a doula shows you just exactly what kind of massage or what kind of support may be helpful in a particular moment.


3. Doulas help birth partners relax.
In addition to giving you a chance to take a nap, a doula helps you relax about the process of birth and about things that may be happening in the room. If at any point there is confusion or concern about what is happening, a doula can help explain things to you which often gives birth partners peace of mind.


4. Doulas give birth partners freedom.
In two different births that I have attended, a birth partner who had been planning to be present during the entire birth was, for their own reasons, overwhelmed and needed to leave the room for a while.  They had the freedom to do so because they had hired a doula to stay with the birthing woman while they left.  Birth is an emotionally rich time and birth partners are sometimes surprised by just how and when those emotions hit.  A doula gives you the freedom to feel those feelings while the birthing woman is still supported.


5. Doulas give birth partners a team mate.
It is fairly common for a birthing woman to need physical support, massage, help with positioning and other things that may be physically demanding for her birth support team.  When a birth partner is taking this responsibility on themselves it can be exhausting.  Sometimes they become too tired to effectively support the birthing parent in those ways anymore.  When you have a doula present you can each take turns supporting a mom and keep yourselves from wearing out.  In addition, when you both are present you can do things together that one of you alone could not do.  For example, the birthing woman can lean on one of you while the other provides massage or counter pressure.  
​

6. Doulas Love Birth Partners!
We do what we do because of our love for the birthing family.  We recognize how much your presence at birth means to the birthing woman.  If you and the birthing woman are in a committed relationship, then there is no possible way that a doula could replace YOU in the birth space.  As a doula looks for ways for you to be involved in the birth process she will also seek to recognize when it is YOUR presence that will be most helpful and when she needs to take a step back.  She will give you privacy when it is needed and hopes to help you BOTH have a positive birth experience.
    

    It is sometimes said that “Doulas make Dads look good!”  This is true for all birth partners.  When you have someone there to cheer you on and help you out, you get the credit for being an amazing support for the birthing woman!

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Kayla Wells Smith, Birth Doula, HCHI
I am a homeschooling mom of two little boys and wife to a musician who also works as a freelance
videographer. We have three beautiful cats (which is admittedly too many), two fish, and a gazillion “rolypoly's" outside that the kids claim as pets. I enjoy gardening and researching everything.

My introduction to doulas came when I was 36 weeks pregnant with my first child. My midwife looked at me and said, “You need a doula.” I had no idea what a doula was, but she gave me an email address for an amazing doula who eventually attended the birth of my first.

When my first little guy was just 7 months old, I found out that I was pregnant with my second. I promptly called my doula friend who said, “You need Hypnobabies!” I signed up and took the Hypnobabies class she was teaching at the time and never looked back! My Hypnobabies birth was amazing! My husband and I could hardly believe that birth could be so comfortable and calm! After a fabulous second birth experience I decided that I wanted to be a part of helping families have the best birth for them. I started by becoming a doula. I trained with DONA International. In 2014 I decided to begin the process of becoming a Hypnobabies Instructor. I was officially certified as a Hypnobabies instructor and Hypnodoula in June of 2015. I love helping families become educated about childbirth and supporting them through pregnancy. In 2016, I officially completed the Becoming Dad Certification process and am now "Becoming Dad Certified."


E-mail: kayla@nashvillebirthandbabies.com

2 Comments

How Doulas Get Along with Doctors and Midwives

10/7/2017

2 Comments

 
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When I meet with expectant couples for a consultation, they often want to know how I, as a doula interact with hospital staff and/or their midwife and assistant(s).  It is an excellent question!  Today I'd like to clear up any confusion about how a doula fits into the birth team.

The doula and hospital staff
    A good doula aims to be a team player.  The doula's focus is on the birthing woman and her partner. Often the way in which she helps the birthing couple is helpful for the hospital staff as well.  A doula facilitates communication between the birthing couple and the hospital staff.  This is helpful for the birthing couple AND the hospital staff.  
    Also, a doula takes care of many of the emotional and physical needs of a birthing couple.  This may mean that the couple is less reliant on nurses and care providers for those needs.  The nurses and doctors still offer some level of support and encouragement, and they are able to keep their attention where it is most needed.

Will the doula get in the way or interfere?
    No!  A doula strives to be out of the way and to not interfere with any medical procedures that are being done.  Occasionally a doula may find herself in a less-than-ideal position and she will do her best to move out of the way so that hospital staff can do what they need to do and do so in such a way that the birthing woman continues to feel supported.

Will the doula tell the staff what to do?
No!  That is not a doula's place!  A good doula empowers the birthing couple to make their wishes known.  A doula will never tell hospital staff what a birthing woman wants, needs or should do.  And she will never tell the staff what THEY need to do.  The doula may ask questions if she feels that the answers will be helpful to the birthing couple.  She may remind the birthing couple that they had wanted to do (or not do) something.  She may even alert the couple to things that are happening that the couple may otherwise be unaware of.  But she does not tell the staff how to do their job!  

What about homebirth?
    At a home birth a doula's job is much the same as at a hospital birth.  A midwife is usually focused on the whole woman – physically, emotionally, and medically.  This means that the addition of a doula is very helpful, especially for moments when the midwife and/or her assistants need to be focused on the medical elements.  Having multiple people present who are focused on the birthing woman and her growing family is often helpful.  A doula will not tell a home birth midwife or her assistants what needs to be done, but will help ensure that the birthing couple is empowered to speak for themselves.  

​
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Kayla Wells Smith, Birth Doula, HCHI
I am a homeschooling mom of two little boys and wife to a musician who also works as a freelance
videographer. We have three beautiful cats (which is admittedly too many), two fish, and a gazillion “rolypoly's" outside that the kids claim as pets. I enjoy gardening and researching everything.

My introduction to doulas came when I was 36 weeks pregnant with my first child. My midwife looked at me and said, “You need a doula.” I had no idea what a doula was, but she gave me an email address for an amazing doula who eventually attended the birth of my first.

When my first little guy was just 7 months old, I found out that I was pregnant with my second. I promptly called my doula friend who said, “You need Hypnobabies!” I signed up and took the Hypnobabies class she was teaching at the time and never looked back! My Hypnobabies birth was amazing! My husband and I could hardly believe that birth could be so comfortable and calm! After a fabulous second birth experience I decided that I wanted to be a part of helping families have the best birth for them. I started by becoming a doula. I trained with DONA International. In 2014 I decided to begin the process of becoming a Hypnobabies Instructor. I was officially certified as a Hypnobabies instructor and Hypnodoula in June of 2015. I love helping families become educated about childbirth and supporting them through pregnancy. In 2016, I officially completed the Becoming Dad Certification process and am now "Becoming Dad Certified."


E-mail: kayla@nashvillebirthandbabies.com

2 Comments

What is a Doula?

10/7/2017

0 Comments

 

What is a Doula?

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    The first time I learned what a doula was, I was 36 weeks pregnancy with my first child.  My midwife told me that I needed a doula.  I had no idea what a doula was.  She briefly explained to me what a doula was and gave me an email address for a fabulous doula.  
    If you are in a similar boat, pregnant and with no idea what a doula is; this post should clear things up and help you decide if having the support of a doula is right for you!


 What does a doula do? 

     In previous decades a doula might have been referred to as a “labor coach.”  A doula provides emotional, informational and physical support to a birthing person or couple.  Let's break that down a little bit.  What do those types of support look like at a birth?

    Emotional support: A doula supports a birthing woman emotionally by providing a safe space for her to feel what she feels. Your partner is undoubtedly having their own emotions and having a doula there allows them the space to feel those things as well.  A good doula will also look for opportunities for the birth partner and/or dad to be as involved as they wants to be!  You both may also feel more calm knowing that someone knowledgeable about birth is present.  A doula cannot answer medical questions, but she may be able to help you better understand what is going on, which leads us to...

    Informational support: While a doula cannot provide medical advice or opinions, she can help you get the information that you need.  A doula can help facilitate discussion and help you to understand the information that your care provider is giving you.  Informational support really extends into the “before birthing” time as well.  Ideally, you will know most of their birthing options before birthing begins, and while a childbirth class is the ideal way to get this knowledge, a doula can help to fill in the gaps, help you better understand the information you've learned, or maybe even help you to understand what kinds of information you need to know ahead of time.

    Physical support: Physical support is perhaps the broadest category of support that a doula provides.  This can be everything from massage, to supporting a leg, to supporting a birthing woman while her partner gets a meal.  Physical support is often a physically demanding part of the process of birth and birth partners often find it helpful to have someone else to tag team with for this part.


What a Doula doesn't do.

There is sometimes some confusion about the difference between a midwife and a doula.  Many people are under the impression that a doula is “kind of like a midwife.”  But there are some significant differences in our roles.  The primary difference is that a doula is NOT a medical professional.  Ok, that may be overstating it a bit as there are some doulas who are also medical professionals, but they are medical professionals IN ADDITION to being a doula and not because they are a doula.  


Because doula work is not medical, a doula (who is acting as a doula) DOES NOT:
  • Give medical advice
  • Perform medical tests
  • Check fetal heart tones
  • Perform vaginal exams
  • Catch babies

I had a mentor who used to say, “If it requires gloves, we don't do it.”  There are some exceptions to this.  I have worn gloves in order to massage an amniotic-fluid-covered back, for example, but wearing gloves is certainly an exception and not the rule.​

Nurses, midwives, and doctors are great at performing all of the medical tasks.  And most of them genuinely care about the women, babies, birth partners and families that they serve.  As such, many of them also care about the emotional health of everyone involved.  Having a doula at your birth means that you have someone with you who is dedicated solely to your physical comfort, emotional well-being, and who is helping to empower you to make the choices that are right for you and your growing family.


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Kayla Wells Smith, Birth Doula, HCHI
I am a homeschooling mom of two little boys and wife to a musician who also works as a freelance videographer. We have three beautiful cats (which is admittedly too many), two fish, and a gazillion “rolypoly's" outside that the kids claim as pets. I enjoy gardening and researching everything.

My introduction to doulas came when I was 36 weeks pregnant with my first child. My midwife looked at me and said, “You need a doula.” I had no idea what a doula was, but she gave me an email address for an amazing doula who eventually attended the birth of my first.

When my first little guy was just 7 months old, I found out that I was pregnant with my second. I promptly called my doula friend who said, “You need Hypnobabies!” I signed up and took the Hypnobabies class she was teaching at the time and never looked back! My Hypnobabies birth was amazing! My husband and I could hardly believe that birth could be so comfortable and calm! After a fabulous second birth experience I decided that I wanted to be a part of helping families have the best birth for them. I started by becoming a doula. I trained with DONA International. In 2014 I decided to begin the process of becoming a Hypnobabies Instructor. I was officially certified as a Hypnobabies instructor and Hypnodoula in June of 2015. I love helping families become educated about childbirth and supporting them through pregnancy. In 2016, I officially completed the Becoming Dad Certification process and am now "Becoming Dad Certified."


E-mail: kayla@nashvillebirthandbabies.com

0 Comments

    Nashville
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