hospital birth

A new mom and dad pose in a hospital room with their newborn baby

Virtual Birth Support: Podcast Episode #95

Sam & Justin recently had their baby boy, Judah, in the hospital in the midst of the COVID-19 pandemic.  They describe their experience in the hospital as well as how beneficial birth doula support was throughout pregnancy and then during labor and delivery, even though support was virtual instead of in-person.  You can listen to this complete podcast on iTunes or SoundCloud.

 

Alyssa:   Hi, welcomes to the Ask the Doulas Podcast.  I am Alyssa Veneklase, co-owner of Gold Coast, and today I’m talking to Samantha and Justin, who recently had a baby at a hospital in this midst of this Coronavirus pandemic.  We’re going to talk to you about what that was like.  Gold Coast is not attending births after Governor Whitmer’s declaration that we have to stay at home, and we don’t know when the order will be lifted.  So we kind of just wanted to get a sense of what it was like for you two to go through this whole process.  How far along were you when you hired us?

Samantha:  Pretty early when we found out.  We knew when we were trying to get pregnant that having a doula was something that was really important to us, as well as a midwife and just trying to go that more natural route.  So the minute we found out we were pregnant, it was kind of getting things in plan.  So I would say after the first trimester after we kind of told everybody.

Alyssa:  So you hired pretty early, and that was before all this crazy virus stuff happened.  And you worked with Kristin and Ashley as your birth doula team.  Even before all this stuff happened, what did support look like through the majority of your pregnancy?

Samantha:  It was wonderful.  Being a first time mom, obviously, you have a ton of questions, and I just didn’t want to be the person to be blowing up my midwife all the time, plus it’s hard to get ahold of them.  Our midwife was through Spectrum, so obviously you can’t just pick up the phone and call her.  It’s not as easy.  So being able to have a team of doulas that, any question I had from — I had artisan cheese one day and freaked out thinking I did something wrong.  So to be able to text them things like that and just have that reassurance all the time was awesome, as well as after every appointment, they wanted updates on what’s going on with baby, so it was just that extra support and knowing that they’re there no matter how stupid the question was.

Alyssa:  Well, and as a first time mom, I think we feel like all of our questions are stupid.  Oh, I hear the baby!  Hi, Judah!  So, yeah, obviously, because of this, we’re on speakerphone, and they’re at home and I’m at my home because nobody can go into work.  You guys are quarantined at home with the baby, which is probably kind of a blessing in disguise, maybe.  You can actually kind of hunker down and just focus on bonding and feeding and all these great things without visitors.  But like you said, Grandma comes over and she can’t see the baby!  That’s so hard.

Justin:  It’s been a blessing for dads, I think, especially because I would have had to go back to work today.  I am working, but it’s from home and it’s slower, and I’ve got some time to help support Sam and build my relationship with Judah, too, so it’s kind of a blessing in disguise for — I mean, it sucks, but it’s been nice.

Samantha:  And as a new mom, you’re hunkered down.  I mean, I was planning on not leaving my house for a month, anyway, so it’s kind of nice, especially during this quarantine time, because you’re quarantined anyway with a newborn, so it gives you something to do and keep occupied with.

Alyssa:  Right.  Well, and focus on the positive, right?  Like, there’s so many negatives that we can be focusing on, but you’re stuck at home with a newborn baby.  Boohoo, right?  This is what you’ve been looking forward to for nine months!

Samantha:  Exactly, exactly.

Alyssa:  So your support during pregnancy really would have been the same, Coronavirus or not, because it’s a lot of text and phone calls and emails, right?  It’s all virtual, anyway?

Samantha:  Yeah.  Yeah, that wouldn’t have changed, and like I said, they were available pretty much 24/7, so it was just nice to always have them in our back pocket when we needed them.

Alyssa:  Right.  Tell me about the labor, then.  What happened when you were at home, and how did that support, the actual virtual support after finding out that your doulas can’t support you in person, how did virtual support look then once labor began?

Samantha:  So we came up with a plan that we would utilize anything that we needed.  If we needed to do a video chat, we had my laptop ready to go to bring to the hospital.  But once labor started, we kind of — before I went into labor, we talked over, you know, what are the signs, when we should contact them, how long I wanted to labor at home; all that stuff that we would have done anyway if it was just normal circumstances.  So when I went into labor, it was the middle of the night, of course, and we texted both of them and ended up calling Kristin.  She was the one who answered, and we told her how far apart the contractions were.  She could hear, you know, how I sounded and could tell that they were ramping up.  You know, you can just — moms — everybody says moms have the telltale sign of when contractions aren’t a joke anymore.  So, yeah, she said, yep, sounds like you’re really getting in the swing of labor.  She told me to get something to eat before I went to the hospital and kind of gave us some tips before we — as Justin was packing the bag and getting our bags in the car, some tips I could do before we headed out the door.  And so we did that and then headed to the hospital, and from the moment we got there in triage, I had a couple — well, of course, birth is always unexpected, but I had a couple things come up that I wasn’t expecting to happen.  So from the moment we were in triage, we were in constant contact with Kristin and Ashley, whether it was me or — it was actually mostly Justin.

Justin:  Yeah.  I actually took — like, I would step out of the room a few times just to call her.  There was just a couple moments there when we were down in triage where she was uncomfortable, and the room is a little small.  It was hard to get into that calm state of mind that we were looking for.  So without trying to stress Sam out, I stepped out of the room and just called Kristin.  I was, like,  hey, you know, what are some things I could try to, you know, bring her back into this calm state of mind that we’ve been working on forever.  It was great.  She gave us some positions to try, some things to talk to the nurses about.  Like, she knew there was a tub down in the triage area, so she said to go ask them to use the tub.  So it was good to have them just there — just any questions we had, just to call real quick.

Samantha:  Yeah.  And we had a couple unexpected things, because I wanted to labor naturally, but we had some issues.  I had a LEEP procedure a couple months ago.  Well, not a couple months ago; about a year ago, but that caused some scar tissue that made my labor really difficult.  So we had to have the conversation of having an epidural because my labor was so erratic and my body was under a lot of stress.  So that decision we talked over with the doulas.  And then having Pitocin brought in, which was also something that was on our “absolute no” list, but it was nice to be able to call Kristin.  Spectrum was wonderful, too.  I mean, the nurses and midwives were great as far as giving us all the information we needed and then giving us time to talk it over.  But having Kristin there to be able to call and say, here’s what they’re telling us, here’s what we’re thinking — to have that reassurance from them was huge, especially because our birth plan changed so much, and it was upsetting for me, especially.

Alyssa:  Right.  That’s hard when we get into this mindset of, like, here’s my plan and I’m going to stick to it, and baby or your body says otherwise.  To have an expert to ask those questions and give feedback that’s not — and I think that’s one thing a lot of people thing, that doulas are there to tell you what to do.  It’s more about asking you the right questions so you can figure out what’s right for you.

Justin:  Just having that — just having that information so that we can make our own decision.  Just having them giving us all the proper information we knew everything that was at stake and we could make a better, informed decision.  It was a huge help.

Alyssa:  Right.  Knowledge is power in this instance, for sure.

Samantha:  Yeah, and even the positions.  Once I did get the epidural and Pitocin, we still wanted to do a really low dose of Pitocin to try to have my body naturally ramp up contractions, so Ashley and Kristin sent us a bunch of pictures of positions we could try.  They were always available for Facetiming and virtual, as well, but we never needed to.  But to have that in the back pocket was comforting, as well, that if we needed to virtually see them face to face, knowing that we could do that was very comforting for me, especially.

Alyssa:  So once you actually moved from triage to the labor and delivery room, you said you didn’t actually have to use Facetime or anything.  Was it more of you, Justin, were in contact with them because Sam was in active labor?

Justin:  Yeah.  It was a lot of text messages and a few phone calls.  If it was something we wanted to all talk out together, we’d call, or if it was just a quick question, I’d just shoot them a message real quick.

Samantha:  And I definitely think if I didn’t need — if I wouldn’t have had the epidural, we definitely would have utilized Ashley and utilized some of our HypnoBirthing techniques to help me get through labor and probably would have used virtual face to face more, but just because things moved so fast as far as me needing some intervention, it again changed our plan as far as utilizing the doulas a little bit differently.  But, yeah, it was constant contact throughout the whole labor process, and it was actually nice after I did get the epidural.  I was able to then talk to them and tell them what’s going on and what kind of positions I can try and different things like that.  So the plan changed a little bit, but staying in constant contact with them didn’t.  It was pretty consistent throughout the whole labor process.

Alyssa:  And what about when you got to the point where you were ready to push?  Was there anything they could do to support you during that time?

Samantha:  Well, we planned on having them Facetime for that, but my pushing went very quickly.  I only pushed for about 30 minutes, and we didn’t even — when we started, it was — we texted them saying, oh, they want us to do some practice pushes, and 30 minutes later, we were messaging them saying, well, baby’s here!  So, yeah, we had the whole plan set up for them to help — especially because I had an epidural, they were really going to help me try to breathe baby down, which is what we ended up doing, but to have them face to face so they could see what was going on.  But it just ended up happening so fast that we weren’t able to do that.  But after baby came, we were in contact with them, telling them his birth weight and all that stuff, and once we got up to the room, letting them know how latching was going as far as breastfeeding.  So it was just the best experience possible, especially because I was so devastated, you know, being nine months pregnant and all this emotional — that’s emotional in itself, and then to find out your birth plan is completely blown to smithereens…

Justin:  Two weeks before we even go to the hospital.

Samantha:  Yeah, two weeks before the hospital.  It was just terrifying, but to have them there in that virtual sense was everything because it would have been a very different experience if we weren’t able to have them at all, that’s for sure.

Alyssa:  So let’s say a couple just found out they’re pregnant, and they knew they wanted a doula, like you, but then they have this worry.  They’re going to do the hospital birth; they want a doula, but the doula may or may not be able to be there.  What would you say to a family who’s kind of on the fence about hiring a doula because of the current situation?

Samantha:  I would say, hire.  Hire a doula because, yeah, the situation has changed, but I think even more in this time, you need that extra support more than ever, especially because, in my circumstance, my midwife wasn’t even able to be there.  I had a totally different team because of the way they split up her team, so not only is your birth plan changed, but then my midwife who I’ve been seeing for the last nine months wasn’t able to be there.  So just to have that team, that constant contact, still stay the same even though they’re not there in person, was just a huge comfort and relief for me.  And especially for Justin.

Justin:  I was going to say, for the fathers-to-be out there, I think it’s even more important for them.  We went through a lot of the classes and stuff, and we had good knowledge going in, but you get in the heat of the situation, and you know, her surges and contractions were starting to really hurt her, and I didn’t know what to do in that situation.  So we had this whole plan, and I was doing my best to stick to this plan, and when you get thrown that curve ball, having someone to turn to and just get that reassurance.  I might have made the right decision in that situation, but just to have them say, “Yeah, you did,” or, you know, this is — “Yeah, you did do a good job there.  This is what’s going to happen.  Here’s the outcome.”  Just having that extra sense of security in this very unsecure time is a huge benefit.  Even though they’re not there, it was almost like they were, and it was very helpful, especially for the dads that sometimes might feel a little lost.

Alyssa:  Right, which usually, most of them, I feel like, they do probably feel a little bit lost.

Justin:  Especially the first time.

Samantha:  Yeah, and it takes the pressure off, too, you know, just because I’m telling him one thing, and he’s trying to say, you know, it’s going to be okay, but for him to then reach out to the doulas and say, you know, here’s what’s going on, and for them to not only give me reassurance but him was a game changer, for sure.

Alyssa:  And like you said, you’ve built a rapport with them throughout your pregnancy.  I didn’t know that your midwife couldn’t be there either!  So without your doulas, you would have not had your midwife either, and you would have literally been in a hospital with a bunch of nurses who you’ve never met, and that was it.

Justin:  Right.  Exactly.

Samantha:  And thankfully, we had an amazing team.  Our nurses and midwives that we ended up getting were amazing.  But also, you’re going — it’s your first time.  You’re laboring.  It’s new.  And then you have a whole bunch of strangers, so you’re throwing that mix in it.  So having the doulas there that we’ve had throughout the whole pregnancy, virtually, even though they couldn’t be there, was such a comfort because it just — you had somebody to turn to that you know.

Justin:  One more thing, too, is the hospital — I don’t know about other hospitals in the area, but Spectrum — it was like a fortress.  It was so clean and locked down in there.  We kind of forgot this whole thing we even going on until we left.  I mean, I went down in the cafeteria a few times, and every time I went down there, a whole different section was being completely pulled out and cleaned.  There was no visitors walking around.  There was no one walking around.  I mean, it really did feel like a fortress.  Even getting into the building, we had to go through a couple security checkpoints, so if anyone was worried about the hospital part of it, I think that especially Spectrum, that I know of, I think they’re doing a very good job of keeping everything separated, and the sections of the hospital that need to be cleaned and all that.

Alyssa:  That’s a good point.  For those who maybe have that as a main point of fear for them, delivering in the hospital, they’re doing everything right.  I mean, they obviously want to keep their patients safe and healthy.  It’s got to be weird to walk through that hospital and hardly see anybody because there’s no visitors.

Samantha:  It was weird pulling up because they have the whole security detail, and it was, like, “Why are you here?  What’s going on?”  It was very weird, but like Justin said, it ended up — I almost was sad to leave, just because you’re in this clean, sterile bubble, and like I said, we almost forgot about this whole Corona thing because you’re in — you are — you end up being in the bliss of having your baby, even though it’s such a scary time.  But having — you know, right after he was born, we talked with Ashley and Kristin, and then it was just kind of that blissful — we went up to the room, and they’re doing a very good job.  Obviously, things change, but I think they have it pretty locked down.

Alyssa:  That’s great.

Justin:  They’re definitely out in front of it.

Alyssa:  So then you guys go home, and usually, they do a postpartum visit, but I’m assuming they did that virtually, as well.

Samantha:  Yes.

Alyssa:  Did you have that already?

Samantha:  We did.  From the moment we got home, too, we were in constant contact with them, from them asking how he was sleeping.  I had a couple questions just as far as my recovery and what I could do for comfort as far as that goes, just because as a new mom, you just don’t really expect the discomfort.  I kept thinking, you know, I didn’t have stitches or anything like that, so I thought, oh, I’m going to be good, but you don’t realize what you’ve put your body through.  So it was just nice to have them there so I could say, I’m feeling — you know, what can I do about this pressure that I’m feeling?  I’m having some pain and discomfort here.  To have that support on the postpartum aspect, because, you know, this whole time leading up to the birth, you’re thinking pregnancy and delivery and labor and all that, but postpartum support is also huge, and they really, really helped with that, giving me ideas and tips of helping my milk supply come in.  It was just — they’ve been wonderful.  And we just had our virtual visit with them face to face, and that was great to be able to see them.  They could see the baby.  And then to tell them the birth story, since they weren’t there — I mean, they were there, but they weren’t.

Alyssa:  They got bits and pieces but finally got to hear the whole thing.  That’s great.  Well, is there anything else that you wanted to add or that you think other parents should know?

Samantha:  I just think if you’re on the fence, I mean, nothing — I had this whole — I thought I planned for even the most unexpected in pregnancy, and I definitely didn’t because pregnancy can change in an instant.  But I think that’s why even more now in these times to have that extra support and to have a doula because we plan on having another child, and I’ve already said to them — I said, well, hopefully you guys will be there in person for our next baby!  But I couldn’t imagine going through labor and birth and even through pregnancy and postpartum without having a doula and support, and I think Justin feels the same way.

Justin:  Absolutely.

Samantha:  It’s like having your best friends to be able to talk to, and it’s such a comfort, especially —

Justin:  But a best friend who’s also very knowledgeable!

Alyssa:  Your best friend who’s knowledgeable and judgment-free and can give you all the best support.

Samantha:  Yeah.  And especially because my birth plan changed so much in the sense of having to have interventions, which I didn’t think I was going to, so that was even more unexpected, and to be able to — you know, you’re in the rush of the moment, and I was really upset, and, you know, you get down on yourself as a new mom thinking you’re failing in some aspect.  To be able to have them — obviously, Justin can sit there and tell me all day that I’m doing the right thing, but to have somebody else who’s not only gone through that experience but seen other women and giving me advice and telling me what I’m doing and the decisions I’m making are right for me and my baby was such a relief and such a comfort because it’s such an emotional time, and when things aren’t going already as planned, and then you throw in more wrenches into the mix, it can overwhelming.  So to have them as support was just everything to me.

Alyssa:  Thank you so much for sharing!  I wish that I could see little Judah, too.

Samantha:  I know!  I know.

Alyssa:  It’s really hard!  But, yeah, focus on bonding with that little guy.  How’s breastfeeding and everything going?

Samantha:  Breastfeeding is going good.  We’ve had to supplement a little just because he’s such a peanut, but, again, they’ve helped with that, as well, just because that can be hard as a mom.  You know, you think, oh, breastfeeding is going to be this simple thing, and it’s hard.  Being able to talk it over with people — they’ve given me some great articles, and I had a virtual meetup with some new moms that Kristin suggested, a team that I should join in on, and that was really helpful.  I got some great tips from that, and to not only see new moms who delivered around the same time as I had, and that was all virtual and really cool to be able to hear from them.  You know, they might not be going through the same issues as I am, but to hear they’re also having questions and not knowing what to do was really reassuring because you can get stuck in this loop of, why is this not working for me?  What am I doing wrong?  Why is it so easy for everybody else?  And you don’t realize other moms have, you know, if not the same issues, then different issues.  It’s all different for each person.

Alyssa:  Yeah.  It’s not easy for everybody else.  It just seems like it is.

Samantha:  It does, and it’s easy to get down on yourself and think, oh, you know, woe is me, why is it not working for me?  But to be able to have not only doulas but then give me other resources to be able to reach out to was also great, as well.

Alyssa:  That’s awesome.  Thank you for taking the time to share your story!

Samantha:  Of course!  Thank you

 

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Coronavirus (COVID-19)

COVID-19 Reduce Your Risk!

 

Reduce Your Risk by Megan Mouser, NP.
March 31, 2020

STATISTICS COVID-19
With statistics regarding the novel coronavirus changing daily (and even hourly), the most up-to-date information can come from Michigan Department of Health and Human Services as well as the Centers for Disease Control. To date, at the time of this publication, there have been over 163,000 cases in the U.S. alone with over 2,860 deaths. Michigan appears to be an emerging epicenter for COVID-19, making our efforts to reduce the spread of this virus even more emergent.

WHAT ARE WE SEEING? WHY SHOULD WE BE CONCERNED?
Locally we are beginning to see an increase in cases. Today there are 108 presumed positive tests with 119 tests pending. You can find local updates for Kent County on the Access Kent website.

With coronavirus being a new (novel) virus, very little is known about best practices. This is why you are seeing information and decisions varying day to day. The clinical picture for those suffering from this virus can range dramatically from very mild symptoms (including some with no reported symptoms) to severe illness resulting in death. Current treatment options are fairly limited, however new therapies and studies are emerging. Even with recovery from the illness, long-term consequences are possible. Coronavirus is also very easily transmitted, even without an individual ever presenting with symptoms. This is why socially distancing and practicing preventative measures is so important! In regards to healthcare resources here in West Michigan, we are preparing for a large influx of possible patients from this virus which will put a strain on our healthcare resources if we do not slow the spread. We are already beginning to see this in the metro Detroit area.

GENERAL RECOMMENDATIONS
We cannot stress enough the importance of washing your hands often with soap and water for at least 20 seconds (if not available, use hand sanitizer with at least a 60% ethanol or 70% isopropanol alcohol content), covering your mouth and nose with your elbow when coughing or sneezing, avoid touching your face, cleaning “high touch” surfaces daily, limiting your contact to only people in your household, and practicing social distancing by remaining at least 6 feet apart from anyone else if you absolutely must go out.

I also think it is important to recognize that this is a very stressful time for many of us and it is important for our overall health to make sure that we are taking care of ourselves including getting adequate sleep, regular exercise, eating a nutritious and healthy diet, getting out for some fresh air (while maintaining social distance), reaching out to our support systems, and allowing yourself some “slack” regarding loss of control and frustrations.

In regards to specific populations, this virus does pose a higher risk to people who are older or have other serious chronic medical conditions such as heart disease, diabetes, or lung disease. Women who are pregnant are also considered at increased risk, however to date limited data is available regarding this illness during pregnancy. Coronavirus has not been shown to cross into amniotic fluid or into breastmilk at this time. However, if a pregnant woman became ill with the virus, additional precautions would certainly need to be taken at the guidance of your healthcare team. While on the topic of pregnancy, we can rest assured that healthcare providers and hospital staff are working diligently to reduce the risk and spread of COVID-19. While locally there has been visitor restrictions in place at the hospitals, your support person (as long as healthy) will be able to support you through delivery and hospitalization at this time.

Infants are also considered to be more at risk for not only COVID-19, but illness in general due to underdeveloped immune systems at birth. I would encourage all new parents to continue to practice not only standard precautions (including hand washing, cleaning surfaces, avoiding sick contacts, etc.) but also to continue to restrict visitors to the home after delivery to only members of the household. While this is certainly a time to celebrate your new addition, our primary goal is a healthy baby and family!

As for older children and teenagers, we know that this is very challenging time with the cancellation of schools or daycares and changes to routines and schedules. The risks for these age groups from coronavirus continues to be present, therefore as difficult as it can be to enforce and practice social distancing, it is imperative for parents to not only model this behavior but to also help our children understand why this is necessary. In a time of uncertainty, parents can continue to lessen anxiety in children by discussing together as a family, remaining calm, and continuing to offer love and support.

As a community we all share responsibility to continue efforts to reduce the significant risk from COVID-19!

Reputable Resources:
Centers for Disease Control and Prevention
Michigan Department of Health and Human Services 
World Health Organization

Megan Mouser is a board certified Family Nurse Practitioner serving the Grand Rapids area since 2014.  Born and raised in the Upper Peninsula of Michigan, she completed her Bachelor’s of Science in Nursing through Northern Michigan University and went on to obtain her Masters of Science in Nursing through Michigan State University.  She has over a decade of experience working with infants and children in the Neonatal Intensive Care Unit, and most recently seeing both adults and children in her outpatient family practice office. She also volunteers her time teaching graduate students as an adjunct clinical faculty member with Michigan State University School of Nursing’s graduate program.  Megan is passionate about preventative medicine and creating strong relationships with her patients and families in order to provide personalized, high-quality healthcare. Megan resides in Grand Rapids with her husband Matt and two golden doodle rescues “Max” and “Marty”. In her free time she enjoys spending time with her family and friends, traveling, being in nature, cooking, and gardening.

 

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Birth story

When Your Baby Doesn’t Follow Your Birth Plan

Have you ever set out to accomplish something life-changing? How did you prepare for it? Did you research it online? Did you read a how-to book? Did you seek advice from those you trust? Would you ever show up for the big day without preparing ahead of time?

Back in November of 2017, I finally saw those two blue lines on a pregnancy test.  I was unbelievably excited, but yet filled with fear and anxiety. After over a year of trying to conceive and a devastating miscarriage, my husband and I were blessed with the opportunity to try it again.  For anyone that has experienced a miscarriage you know that each cramp, test, and Dr. appointment is filled with intense emotion and fear.

The fear and anxiety wasn’t completely gone after our 12 week ultrasound, but it definitely became a background noise that I could drown out with our baby registry, nursery decorations, and my efforts to create the perfect environment for my baby for the remainder of the pregnancy.

During my first trimester, I was gifted The Mama Natural Week-by-Week Guide to Pregnancy and Childbirth by Genevieve Howland (highly recommended by the way, even if you’re not a super crunchy mama) by my sister who unknowingly would become the trail blazer that would go before me by about 12 weeks and share all her child rearing wisdom with me.  This was new for me as an OLDER sister, but her recommendations and personal experience were pivotal in creating an empowering childbirth experience for me.

Fast forward to the third trimester where it really started to sink in that I was going to birth this tiny human inside me.  This is the part of the story where I realized I was going to experience something life-changing that I knew very little about.  After reading the best books, talking with seasoned mamas and investing in a bomb childbirth course (Mama Natural’s once again!), I decided that my ideal birth plan was to have a vaginal delivery with as few medical interventions as possible.  I did the research to get the facts and my husband was very supportive (but also a rookie) so I wanted some reinforcement to help me achieve my dream birth story. This is the part where my very wise sister recommended talking with Gold Coast Doulas about how they could help me reach my goals.  She had just accomplished a successful, low intervention vaginal delivery so it didn’t take much convincing for me to call and get matched up with doulas that were a good fit for my birth goals.

At 41 weeks and 3 days, it became apparent that my son had not read my birth plan and despite my best efforts was coming out on his own terms.  In the midst of my research, I learned that induction could be intense, unpleasant, and ruin my plans for an unmedicated birth; unfortunately, my OBGYN had decided this was the best option for me. My husband and I walked into the hospital like a couple headed to Baby-Mart to pick-up our baby.  I had not experienced one real contraction to this point, was dilated to 1cm (I still think this was a pity centimeter) and I had shed many tears as I realized how little control I actually had over this birth experience.  I prayed God would help me surrender to His will for this birth.

As if this was the moment my son had been waiting for all along, I felt my first real contraction minutes after being hooked up to the fetal heart monitor before beginning the induction process.  I finally stopped feeling sorry for myself about my “ruined” birth plan and regained my confidence knowing this was MY birth plan and no matter how it ended, it was the perfect plan for me!

Contractions continued to come, and they recommended that I receive a dose of Cytotec to soften my cervix. Thankfully labor continued to progress on its own without any further doses of cytotec or pitocin.  Several hours after contractions started, I peed the bed… or so I thought. After 2 trips to the bathroom and continued “leaking” I realized my water had broken. My cervix continued to dilate and my husband was now recruited to help me through my increasingly more intense contractions.  My nurse was amazing and encouraged me to change positions by kneeling and leaning forward on the bed and rolling from side to side with a peanut ball between my legs to encourage continued progression of my labor. It’s funny because I knew this movement was important, but in that moment, all I could think about was how it made my contractions hurt worse and that I didn’t want to move at all. Turns out that’s the point! You want to intensify contractions, progress labor, and get that baby in your arms!

As the hours progressed my husband continued to ask if we should ask Mary, our doula, to join us (she’d been checking in with him periodically) and I continued to say no. I guess I had heard too many stories about long labors because I was convinced we still had a long way to go.  When my attentive husband noticed the signs of transition he quietly vetoed my decision and let Mary, along with family, know that we were getting close and it was time to come to the hospital. When Mary arrived they were wheeling in delivery equipment and it was go-time. She reminded me of the breathing techniques I had practiced and was available to help with whatever comfort measures we needed even when it was silence.

There was no mistaking when it was time to push as my fetal ejection reflex kicked in.  I was thankful that my provider let me stay in a side-lying position to push while my husband and Mary held legs and hands (focusing on my needs) allowing the doctors to focus on our son. My husband excitedly updated me that they could see his head, but he just didn’t seem to want to move past that point. Despite my best pushing efforts for about 40 minutes, our baby’s heart rate was dropping, and I was now needing oxygen. At this point, my OBGYN highly recommended an episiotomy to deliver my son quickly. This was not part of my birth plan, but I agreed knowing everyone’s goal was to deliver a healthy baby. As his head emerged and the OBGYN quickly freed him from the umbilical cord around his neck, he launched himself earth-side and to this day has not stopped moving and wiggling.

It’s crazy to think that at 8 pm on Sunday night we walked into the hospital with a space in our hearts we had no idea even existed and by 8:30 am on Monday morning our hearts were overflowing with love and connection with someone we had only just met.  Childbirth was unknown, exciting, and challenging.  The experience was so very empowering and the outcome was undeniably life-changing. My piece of advice for expecting moms is to go into labor and delivery prepared, supported and believing in yourself knowing that your body was made to do this!

Written by Dr. Nicole Bringer, DPT
Owner of Mamas & Misses Physical Therapy
www.mamasandmisses.com 

 

When Your Baby Doesn’t Follow Your Birth Plan Read More »

Spectrum Health Midwives

Baby-Friendly Hospital Initiative: Podcast Episode #89

Today we speak with Katie and Becky from Spectrum Health in Grand Rapids about what it means to be a designated Baby-Friendly hospital. You can listen to this complete podcast episode on iTunes or SoundCloud.

Kristin: Welcome to Ask the Doulas with Gold Coast Doulas. I’m Kristin, co-owner, and I’ve got Alyssa here. And we’ve got special guests joining us today from Spectrum talking about the Baby-Friendly initiative. So welcome, ladies! Introduce yourselves and tell us about your background!

Becky: My name is Becky Crawford, and I’m a nurse manager at Spectrum. My background is in postpartum and labor and delivery nursing.

Katie: And I’m Katie. I’m the project specialist for women and infants at Spectrum Health. My background: I am an RN, and my background is high risk OB and postpartum nursing.

Alyssa: Awesome!

Kristin: Fantastic! Thanks for joining us! Tell us about what baby friendly means and why it’s such an intense process to go through certification. Fill us in!

Katie: The Baby-Friendly hospital initiative was actually created back in the early 90s, and it’s an international organization to promote, protect, and support breastfeeding practices. Spectrum Health Butterworth was designated Baby-Friendly initially in October of 2014, and we just went through the redesignation process and were redesignated at the end of May of this year. There are ten steps for Baby-Friendly that each support breastfeeding practices, and we can talk through some of those steps, as well. You have to be proficient in all of those ten steps to receive the designation, so you really have to show breastfeeding excellence, and it’s a really strict and rigorous process to go through.

Becky: I think overall, the way I describe it to patients is that we’ve created a culture that’s supportive of breastfeeding and of moms that want to breastfeed. So it’s not that we force anyone to breastfeed. Our goal is just to educate moms, support them, and help them be successful if that’s the option they choose.

Katie: Absolutely. As nursing professionals, part of our responsibility it to make sure that best practice and current research reaches our patients and that they’re educated on all of those best practices. Breastfeeding is best practice, but it’s also about informed choice and supporting our patients with whatever choice they make. While Baby-Friendly is primarily about breastfeeding and supporting breastfeeding, there is a formula feeding option there, and we support patients in that option, as well. It should never be about pressure. It should just be about education and informed choice.

Kristin: That is a question that I get from doula clients. If they choose, whether for medical necessity or personal choice, to formula-feed, how they can navigate the system with Baby-Friendly hospitals.

Alyssa: That’s what I was going to ask, too. Do you think that designation scares a mom who knows she doesn’t want to breastfeed? Does she think shes going to come into this hospital and you’re going to try to force it? What does that look like for a mom who doesn’t want to?

Becky: We do hear that feedback from moms that haven’t delivered with us, that they’re just nervous. Having to talk about breastfeeding, even, can be an uncomfortable conversation if they know that’s not the choice they want to make. So our approach with our staff is to educate the patient on all the options, let them choose, and then support. So it should be a one-time conversation. We’re going to talk through all your feeding options. These are the great benefits of breastfeeding. If you choose not to do it, okay. Then let’s talk about formula feeding, and we’ll focus our education there. So making sure they know their options, they understand the benefits, and then support.

Katie: And, you know, nurses educate on a lot of topics, right? It’s not just about breastfeeding. But the other topics we educate on, it’s the same sort of informed choice, right? Breastfeeding is such a personal decision. It’s such an emotionally charged topic. I think that while we need to educate our patients on breastfeeding and why it’s great, we also need to acknowledge the fact that it is a really personal choice, and it’s okay if you choose not to, as long as we’ve given you all of the information.

Kristin: And so your labor and delivery nurses, your postpartum nurses — everyone is specially trained to support the initial latch and continued breastfeeding through their stay?

Katie: Yes.

Kristin: And that’s something that we always stress as doulas is that you have support from your nurses as well as the board-certified lactation consultants who do rounds in the postpartum time.

Katie: Actually, one of the ten steps is staff education. All of our nurses receive 20 hours of dedicated breastfeeding education. Of that, 15 hours are classroom education and then 5 of those is clinical, practical breastfeeding education hours. Every one of our nurses; it’s built into orientation for any women’s nurse, so everyone from labor and delivery to postpartum gets this education. There’s also a requirement for providers, so nurse midwives as well as physicians, to receive additional breastfeeding education, as well. Per Baby-Friendly, they’re required to receive three hours of breastfeeding education.

Becky: We also have a team of lactation consultants that offer further help for any mom that’s struggling, but I’m also bringing in more peer counselors, too, just to round on every patient and offer every mom some support, ever with those first few times they’re latching, just so they can hear that they’re doing a great job. It’s really just to address the breastfeeding concerns of all moms, not just the moms that are struggling, just to really walk them through it.

Katie: And we do have quite a few nurses that are certified breastfeeding counselors, so they have received additional education as well as the education that they received for Baby-Friendly.

Kristin: How are you able to support moms with babies that go to the NICU initially with their breastfeeding goals?

Becky: Well, actually, we get them pumping right away. If your goal is to breastfeed, we like to have them pump within two hours of delivery to start establishing that supply. Our nurses will come in and do education, and the lactation consultants will see them, also, and just talk about the importance of pumping to build up that supply. They’re also going to skin to skin. There are some lactation consultants that are dedicated just to the NICU and these moms, so there’s a lot of support there, too.

Katie: The providers in the NICU are very, very supportive of breastfeeding, and they encourage and educate moms on the importance of breastfeeding, as well, so there’s good collaboration between our OB teams and our NICU teams regarding supporting those moms in breastfeeding and being successful.

Kristin: That’s what my clients tell me, that they get a lot of support, even over at Helen DeVoss, as well as in their rooms with lactation. As far as other elements of the Baby-Friendly designation, what else encompasses those ten standards?

Becky: There’s a lot. We start right at delivery, with the golden hour after delivery. We place baby skin to skin immediately after delivery, and we avoid all unnecessary care for that first hour. Any exams or assessments would all be done while the baby is skin to skin on mom. We try to give them that time to bond and establish that first feeding.

Kristin: And if the mom can’t do skin to skin, I have dads ask me all the time about the benefits of them doing skin to skin with baby. So that’s something that’s encouraged, as well?

Becky: Absolutely. We’ve had lots of dads do skin to skin. We like to bring them in on the process whenever possible.

Kristin: That’s fantastic. And then delayed cord clamping is now a standard policy?

Becky: Yes. And we also room-in, so babies stay with their moms 24 hours a day unless mom requests otherwise. But that’s what we try to encourage and do all procedures at the bedside to keep the family together 24 hours a day.

Katie: I think that rooming in is another hot topic when you’re talking about Baby-Friendly and breastfeeding, and the literature does tell us that rooming in does help moms to be more successful breastfeeding. I think that it’s important that patients understand that we’re going to allow you to keep your baby with you. We’re going to be able to take care of mom and baby together. You’re going to learn your baby’s feeding cues. You’re going to learn all those little nuances. We’re going to help you learn that in the couple of days that you have with us. There is space where if you wanted your baby to go to a nursery, we could do that. We’re supportive of that, as well, but again, we are going to educate, and then we’re going to honor choice.

Becky: Exactly.

Kristin: And then there’s delayed bathing and other procedures beyond that?

Katie: Yes.

Alyssa: What’s the thought behind all the delayed cord clamping, delayed bathing? Why? What are the benefits?

Katie: The delayed bath is sort of about the transition from being inside mom and then outside and regulating temperature. So we wait at least twelve hours. We like to wait closer to 24 hours to do that first bath. We’re, of course, not going to hand you an ooey gooey baby. We do a little wiping off, but it really does help that baby transition to life outside of mom and regulate. It also allows you to go immediately into skin to skin so the baby can help regulate not just the temperature, but the heart rate and the breathing. And, again, that’s evidence based. In fact, there’s a pediatrician out in Massachusetts who really pioneered the Baby-Friendly initiative in the hospitals out in Massachusetts, and she did a study on delaying the baby bath, as well. That’s the literature we have for it; it’s all about maintaining stability for the baby.

Kristin: That’s awesome, Katie.

Becky: For the delayed cord clamping, that just gives the newborn a little more blood volume, and, actually, it’s better for baby. There’s no reason to cut the cord any sooner, unless the baby is having a respiratory issue and would need resuscitation, so that would be out of the norm. But otherwise, we do wait and delay so the baby can have more blood volume from the placenta.

Alyssa: How long?

Becky: Our standard is a minimum of one minute. I know a lot of moms request —

Alyssa: So this isn’t like it’s for an hour —

Becky: We’re not saying 10 minutes or 20 minutes. Generally, the cord stops pumping within five minutes. So some moms request to please wait until it stops pulsating, and we can do that, too. Generally, we wait about a minute, and that’s probably close to when it stops pulsating. But we’re not talking about an hour or anything like that.

Kristin: Yeah, some of my clients want to see it actually turn gray and stop pulsating before it’s cut.

Alyssa: And I didn’t want to see mine at all.

Becky: I didn’t either, personally!

Alyssa: My husband did accidentally and was like, oh, my God, an organ just fell out of you!

Katie: I love all of that stuff. It’s so fascinating!

Kristin: As far as additional steps that you take to get recertified, tell us about that process and why it’s important.

Katie: You will see in our women’s and infant services department that OB triage is on A level, and then all the way up to the 8th floor in that tower, you’ll see the 10 Steps for Baby-Friendly posted. It’s just showing our support of those ten steps. We have to show that patients receive prenatal education in our clinics regarding breastfeeding. We have to show that all of our staff receive the education. The people that come out to do our survey — the interview staff.

Becky: And patients.

Katie: And patients and providers, so they will go in patient rooms to see that they receive the education about breastfeeding and that they’re being appropriately supported for breastfeeding. So they look at our exclusive breastfeeding rate.

Kristin: And then you have support groups, as well, when mothers go home and need additional support. They can go to free support groups and seek help through their OB or midwives or pediatricians?

Katie: Absolutely. I think a lot of our pediatricians have at least one pediatrician who is an IBCLC, so a lactation consultant, as well. I know that our DeVoss clinic has two pediatricians that are lactation consultants.

Becky: And our pediatrician who is an IBCLC actually oversees the residents, and so she’s the one working with them and training them. It’s kind of keeping that mindset forefront for all of them, too, and helping them learn the Baby-Friendly system.

Katie: So while nursing took this on and rolled it out, there is a lot of support from providers, as well. Of course, our nurse midwives receive, as part of their education, breastfeeding, but our pediatric providers are all very supportive of breastfeeding, as well.

Alyssa: Is there anything that you think is a misconception for this Baby-Friendly Initiative? Is there anything that it isn’t? You told it what it is, but what isn’t it?

Becky: Yes. I think the thing we hear most is that, I’m going to be pressured to breastfeed if I deliver there. And there is nothing further from the truth. Our goal is a culture supportive of breastfeeding, not a culture of pressure. So our goal is to educate, let moms make decisions, and support them. So there’s no pressure. I think the other big misconception is about rooming in. Sometimes you have a mom who, let’s say, has had a C-section and she’s exhausted, and she just needs support for a couple of hours. We will accommodate that. We’re all about supporting moms. So although we do encourage rooming in, and there are a lot of benefits to it, in certain circumstances when it’s not best for the family, we support what is.

Katie: I think that it’s the 80/20 rule. There’s going to be exceptions to every rule, and it’s just important that we support our patients through that. I think that Becky and I have probably both taken care of those moms that have had long labors or C-sections, and they come up to the floor, and they just need rest. You have to take care of yourself.

Becky: They’re crying. The baby’s crying. Everyone’s hit a wall. And it’s like, why don’t I just cuddle your baby for an hour. You take a nap, and then let’s try again. Sometimes just 45 minutes of sleep can change the entire situation.

Katie: I remember after my second one, I got two hours of sleep. Like, two consecutive hours. And it was the best two hours ever!

Alyssa: I’m thinking about my situation. It was fairly quick. Yeah, sure, I was tired, but I did choose one time in the middle of the night to have them take my daughter to the nursery so I could get — it was about two hours. But I felt so amazing. But I wasn’t in this dire circumstance. So today with — this was before the Baby-Friendly. So today, would I have to prove to you that I need the sleep?

Becky: No.

Katie: No!

Alyssa: It’s just, would you take her for a couple of hours? You’re not going to say, well, you don’t check these boxes, so she won’t go.

Becky: No. I think the goal is when moms come up to the postpartum unit to talk to them about, well, babies room in 24-7, and we keep you together and care for you together. However, if you have a need to send your baby to the nursery, we’ll accommodate that. So our goal is to not educate the mom at 2:00 a.m. who’s exhausted and crying about how she should room in with her baby. That’s not really the time to have that conversation, and it probably wouldn’t be well-received. So we want to educate them when they first come up so that at that point, at 2:00 a.m., if you decide to make that decision, it will be more like, okay. I’ll bring her back for her next feeling.

Alyssa: I didn’t think I wanted to, but now I do.

Becky: And that is common. Okay, I just need a little bit of a nap, and then I can keep going.

Kristin: Yeah, we’ve had clients hire us to help out in their postpartum room when their partner had to go home to tend to another child or had a job to get back to. We’ve loved that role of being in the hospital, as well as later on in the home, to support them and help them get sleep and also learn baby cues and feedings and help support breastfeeding.

Alyssa: Basically, be their postpartum doula in the hospital as well as at home.

Becky: We would welcome that support, definitely! I’m sure our nurses would love to partner with you on that!

Alyssa: For those moms who don’t want to send — maybe they desperately want the sleep, but they don’t feel comfortable sending their baby to the nursery. Your doula sits in the rocking chair and holds your baby.

Becky: What a great option!

Alyssa: Yeah, it’s been really kind of life-altering for a few of our clients who are a little bit more on the — you know, a lot of moms just have anxiety, especially first-time moms.

Katie: I think that so much of the focus goes to the baby, but we’re taking care of mom, too, and that needs to be in the forefront, as well. There’s two patients there.

Becky: And be aware of her self-care and her needs in the moment, too, because what I always try to tell my patients is, you need to take care of yourself so you can take care of this baby. And if that means a short nap, then I think we need to do that because it’s going to make you a better mom in the morning when you’ve had a little bit of sleep.

Kristin: Exactly. What other hospitals in the area within the Spectrum brand are Baby-Friendly? We have clients in a 50-mile radius of Grand Rapids, so we work with a lot of your smaller hospitals, as well.

Katie: So Spectrum Health Butterworth just received redesignation, like we talked about. Spectrum Health Zeeland.

Becky: They’re newly designation last September.

Katie: And then Spectrum Health United Memorial up in Greenville. They were designated five years ago, and they’re going through the redesignation process right now.

Alyssa: So is it every five years?

Katie: Yes. And then Spectrum Health Big Rapids is going after designation, as well. We have, as a system, Baby-Friendly requires us to have an infant feeding policy, and we have standardized that infant feeding policy across the system for all of our regional hospitals, as well. So you’re going to see a piece of Baby-Friendly in all Spectrum hospitals. And the reason for that is that it’s evidence based and it’s best practice, so even if they’re not designated Baby-Friendly, these are practices that we should all be doing.

Becky: Right. They’re probably practicing very similar to Baby-Friendly, even if they don’t officially have that designation.

Alyssa: That’s great. Anything else you want to share before we sign off?

Kristin: What resources, if any of our listeners want to learn more about Baby-Friendly or some of the work Spectrum has done — where can they go online to get more information?

Becky: I think just going to the Baby-Friendly website will give you a lot of information about the 10 Steps and about what we’re focused on as a Baby-Friendly hospital. So you can really start just researching Baby-Friendly, and we are following that to a T, so that will tell you how we’re practicing.

Katie: Our provider offices also have education and information about Baby-Friendly, and then —

Becky: Our childbirth education classes.

Katie: Yes, at Spectrum Health Healthier Communities. They have information, as well.

Kristin: So the educators can fill their students in with any questions they have?

Katie: Correct, yes.

Kristin: And then is there anything special with the hospital tours that our clients go on before delivery? Do you incorporate Baby-Friendly or answer questions based on that? I haven’t been on a tour in a while.

Katie: I don’t think that they specifically talk about Baby-Friendly, except that —

Becky: The practices, probably.

Katie: Yeah. They likely don’t highlight the nursery like they used to. Our nursery — we don’t have babies lined up in the nursery like we used to. They’re with their moms, so you can’t go to the maternity floor and look through the window of the nursery. There’s no babies there.

Becky: I do think they talk about some of our practices, about how you room in and we keep babies together. And I think the other thing is maybe some of the practices, like the skin to skin after delivery. Things that might be different than other hospitals, just so they know what to expect; that we would never supplement a baby unless it was medically necessary, and we’re not handing out pacifiers unless somebody requests it. So it might be slightly different than other hospitals that are doing deliveries in the area.

Katie: Our childbirth educators are pretty passionate about breastfeeding and supporting breastfeeding practices, as well as supporting natural birth. They give the whole gamut of the birth experience.

Kristin: Well, thank you for joining us and sharing so much!

 

For tips on how to make your hospital room feel cozy for birth read Creating A Cozy Hospital Birth Space in First Time Parent Magazine by Kirstin Revere.

 

Baby-Friendly Hospital Initiative: Podcast Episode #89 Read More »

Spectrum Health Natural Birthing Suite

Make Your Hospital Room Feel Like Home

Today’s blog comes from one of our past birth doulas, Courtney Garvelink. Her experience with birth clients, as well as being a licensed massage therapist and previous HypnoBirthing instructor, makes her an expert on comfort measures in the delivery room. See what she has to say about making your hospital birth feel more like home.

If you are preparing for a birth, you are getting your body and your mind ready for what may be the most important and wonderful experience of your life to this point. There are so many options and decisions to make leading up to the birth itself, one of which is where you will deliver; home, birth center, or hospital? Maybe, for you, it’s not a choice. Your finances or insurance may limit you to one option, usually a hospital. And some families just feel more at ease in a hospital. If you are among the many who will be welcoming your new babe in a hospital setting, there are still ways create a warm and comfortable atmosphere that reminds you of home during your stay.

I believe the environment you are birthing in can greatly impact your laboring time. Before we look at what you can do to make your hospital stay feel homier, let’s understand why that would matter. Your surroundings and birth environment can have a real impact on how you cope and progress during labor.  The way we feel and our perception of comfort during labor directly effects our hormones during birth. We are not much different than animals, in that when they give birth they find a dark, secluded space where they feel safe. This allows the hormones needed for birth to kick in and flow well, shutting down the fight or flight response that happens when we feel unsafe or uncomfortable. During labor, we want our body to produce all the oxytocin it can, keeping adrenaline at bay. Hospital rooms are often bright and cold, with visible equipment you may or may not need. They can lack the welcoming feeling you get when you arrive home, ready to relax. Here are several ways you can make your hospital labor room feel more home-like.

Dim the Lights
Giving birth is about as primal as you can get, so take a note from our animal friends. Hospital room lighting is adjustable, and it’s your room, so adjust away. You can ask the nurses to keep the lights dimmed down, they usually have no issue with it. If they need to brighten the room so they can see what they are doing, they will usually turn them back down for you when they leave.

Room Temp
There will almost always be a thermostat in each room. When you get there, adjust the temperature to what you would normally have it set to at home or maybe just a touch cooler. It’s normal for women to run a little warmer during labor. You are probably working harder than you ever will during your birthing time.

Turn on Some Candles
LED candles are great for setting up a relaxing atmosphere. Please don’t bring wax candles to burn, this is a fire hazard. If you like to burn candles at home for the aroma, my next tip can help with that.

Essential Oils
There are several essential oils that are safe during pregnancy and labor that can be beneficial for boosting your energy, easing discomfort and muscle fatigue, and creating a calm aroma in the room. You can mix some water with your favorite essential oil and mist the room or linens you’ll be using. Check before using a diffuser in the room, as some staff may have sensitivity to certain aromas or the hospital may not allow them. You can also dilute the oil and apply to the skin directly. Be sure to get good quality oils or find an aromatherapist who can help you decide which oils are best.

Bring Your Own Pillow/Favorite Throw Blanket
When you are ready for relaxation or sleep at home and you lay your head on your pillow, you are conditioned to relax and sleep. This will be comforting at the hospital when you’re laboring. Use your pillow as a cue to relax as you move through different positions.

Play Some Tunes
Create a playlist of your favorite music, whether it’s calm or upbeat. Music can help reduce stress and the perception of pain during labor. Start working on that playlist while you are in birth preparations by finding what genres or artists are soothing/relaxing to you. Listen to those tracks or stations throughout your pregnancy; it’ll be familiar during labor and help promote relaxation.

Bring Your Own Gown
Lets be real, no one likes wearing the standard hospital gown. They are dull and unflattering. They remind you every time you look down that you are in a hospital. Bring your own button-down gown or an oversized button-down shirt. The buttons will help give easier access for breastfeeding and skin-to-skin. You can also find cute birthing gowns online.

Pictures From Home
Do you have a favorite picture from home that makes you happy or brings with it a feeling of calm? Bring it to the hospital! Maybe not your large canvas print, but something you can pack in your hospital bag. Having a piece of home can be comforting and calming during your stay in the hospital room.

The Best of Both Worlds
Did you know Spectrum Health now has two natural birthing suites at Butterworth (pictured above)? If you are low-risk, it’s a wonderful option. The rooms have a queen sized bed, lamps for softer lighting, birthing balls, and a Jacuzzi tub. And they didn’t forget about Dad; the rooms also have a recliner, flat-screen television, free Wi-Fi, and a pullout sofa. You cannot bring oil diffusers or wax candles, but overall they feel much more home-like than most hospital rooms.

Hire a Doula
Okay this sounds great, but how will you remember all this when the time actually comes? A birth doula can be your best resource. Let them meet you at the hospital and get the room ready for you. Let your birth doula take care of creating a home-like environment as well as pain management techniques and encouragement along the way.

To learn more about Courtney and ask her questions about birth doula support, you can fill out a contact form on our website or join her at an upcoming “What is a Doula?” event at EcoBuns in Holland. 

 

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