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Thanks so much for all of your support. I've moved my site! Please continue following me at Kavanah Doula there.

Love and Light,

Erika

Rosh Hashanah Baby-A Cross Post

This is a cross-post from my personal blog:

A few days before I left for Isabella Freedman for the Ride I had the most vivid dream-My 1st Doula Mama was in labor! I woke up with a start and looked over at my phone (which was on vibrate but I slept through) she’d  text messaged me contraction times. As I looked at her text, the numbers and calculated quickly in my head I saw that she was having “pains” as she said about 10 minutes apart-not yet in active labor. I called her, but it was an hour after her text so she’d fallen back asleep-definitely not in active labor yet.

While in the woods I got a message from my back up doula that my Mom was starting to lose her mucous plug. Her contractions were still sporadic with no clear patterns so I didn’t fret too much.

She had a planned induction because of age and a variety of other factors and while we hoped that she’d go early, even if it meant I would miss her birth, we thought it would be best that she give birth as naturally as possible. We knew that if they started an induction, the likelihood of her going on to have more medical interventions was greater.

This Mama was a single woman so my back up doula  and I met with her at the hospital on Tuesday afternoon…and I didn’t leave her side until early Thursday morning after she gave birth to a healthy baby boy on Wednesday evening at 10:56PM.

The birth was long and exhausting and in the end, she only pushed about 6 times before her baby boy made is entrance into the world. It was, without a doubt, the single most life-altering experience of my life. And I haven’t said that since being in the Holy Land.

On Rosh Hashanah, it is said that the world is born and on this Rosh Hashanah, the Head of the Year, the beginning of 5774 I watched a life be born. I cut him from his mother and my arms were the second arms this little one was cradled in. That little boy was the first baby I was a doula for and since him I've scheduled four other Mamas. Being by his Mom's side on Rosh Hashanah, holding her hand and comforting her while she brought life into the world was the most precious gift I could've ever received. It was the best and in the end, the only way I was supposed to spend Rosh Hashanah this year. I could've been at shul, and I heard Amichai's service was amazing, but being in that hospital exhausted and at the very end of my rope supporting a Mother in labor; emotionally, physically and mentally was truly magical. It was exactly what I needed to start the year-a reminder that life is always changing, always evolving and that life exists so that we can live it.

It was also confirmation that the choice to be a doula is the right one. The one-on-one support between a doula and a mother, especially a single mother, is so vital and I feel incredibly blessed to be walking down this path.

What Mamas Need After Baby is Born

I attended my first birth last week!

More on that later, but for now this amazing list of what a Mama needs AFTER the birth. She can, of course, call a postpartum doula as well.

Re-posted from Gloria Lemay Birth Blog

After the Birth, what a family needs

Posted on October 28, 2008 by gloria

 “Let me know if I can help you in any way when the baby is born.” … “Just let me know if you need a hand.” … “Anything I can do, just give me a call.”

Most pregnant women get these statements from friends and family but shy away from making requests when they are up to their ears in dirty laundry, unmade beds, dust bunnies and countertops crowded with dirty dishes. The myth of “I’m fine, I’m doing great, new motherhood is wonderful, I can cope and my husband is the Rock of Gibraltar” is pervasive in postpartum land. If you’re too shy to ask for help and make straight requests of people, I suggest sending the following list out to your friends and family. These are the things I have found to be missing in every house with a new baby. It’s actually easy and fun for outsiders to remedy these problems for the new parents but there seems to be a lot of confusion about what’s wanted and needed…

1. Buy us toilet paper, milk and beautiful whole grain bread.

2. Buy us a new garbage can with a swing top lid and 6 pairs of black cotton underpants (women’s size____).

3. Make us a big supper salad with feta cheese, black Kalamata olives, toasted almonds, organic green crispy things and a nice homemade dressing on the side. Drop it off and leave right away. Or, buy us frozen lasagna, garlic bread, a bag of salad, a big jug of juice, and maybe some cookies to have for dessert. Drop it off and leave right away.

4. Come over about 2 in the afternoon, hold the baby while I have a hot shower, put me to bed with the baby and then fold all the piles of laundry that have been dumped on the couch, beds or in the room corners. If there’s no laundry to fold yet, do some.

5. Come over at l0 a.m., make me eggs, toast and a 1/2 grapefruit. Clean my fridge and throw out everything you are in doubt about. Don’t ask me about anything; just use your best judgment.

6. Put a sign on my door saying “Dear Friends and Family, Mom and baby need extra rest right now. Please come back in 7 days but phone first. All donations of casserole dinners would be most welcome. Thank you for caring about this family.”

7. Come over in your work clothes and vacuum and dust my house and then leave quietly. It’s tiring for me to chat and have tea with visitors but it will renew my soul to get some rest knowing I will wake up to clean, organized space.

8. Take my older kids for a really fun-filled afternoon to a park, zoo or Science World and feed them healthy food.

9. Come over and give my husband a two hour break so he can go to a coffee shop, pub, hockey rink or some other r & r that will delight him. Fold more laundry.

10. Make me a giant pot of vegetable soup and clean the kitchen completely afterwards. Take a big garbage bag and empty every trash basket in the house and reline with fresh bags.

These are the kindnesses that new families remember and appreciate forever. It’s easy to spend money on gifts but the things that really make a difference are the services for the body and soul described above. Most of your friends and family members don’t know what they can do that won’t be an intrusion. They also can’t devote 40 hours to supporting you but they would be thrilled to devote 4 hours. If you let 10 people help you out for 4 hours, you will have the 40 hours of rested, adult support you really need with a newborn in the house. There’s magic in the little prayer “I need help.”

First posted online August 2001

Swollen Feet

This morning one of my Mamas wrote a FB airing her 8 months of pregnancy grievances. Hot NYC weather, inability to roll over in bed or touch her toes which have swollen into little vienna sausages. Inspired by her, I've put together the following informational sheet about swollen feet and natural remedies. I've also been inspired to create either a foot soak or a foot massage oil for my Etsy shop. Stay tuned!

Kavanah Doula-Tips for Managing Swollen Feet

What causes swelling in pregnancy?
Swelling (oedema) is triggered by increased pressure in the veins of your legs, and by pressure from your growing baby on the big veins in your groin. Water retention adds to the problem.

Swelling is common. About half of all pregnant women experience swelling around their ankles, particularly in the last few months of pregnancy. You may find your fingers, face and lower back become swollen too.

The swelling in your legs usually gets worse as the day progresses, especially if you are on your feet a lot. Gravity makes the fluid build at the lowest point. Hot weather and being tired can also make swelling worse. You'll probably have oedema in your feet and ankles, and in both legs.

Call your doctor or midwife if the swelling:
• Moves up your calf and leaves an indentation when pressed, or is sudden or severe in your face, hands or feet. If this happens in your third trimester, it could mean that you have pre-eclampsia.
• Occurs only in one leg, particularly if your calf is red, tender and lumpy. These can be symptoms of a blood clot in your vein (thrombosis).

If your wrists and hand are swollen, you may have carpal tunnel syndrome, which is when the swelling compresses the channel of nerves running up your arm.

Your swelling is likely to become temporarily worse in the first three or four days after your baby's birth.

As your body recovers after birth, all the extra tissue, blood vessels and fluid needed during pregnancy now need to be dissolved and expelled. This makes you pee a lot more, though your kidneys won't yet be able to cope with the extra fluid. Some of the fluid will build up in the tissues around your body until it can be passed out of your body.

How can I prevent swelling?
It may not be possible to prevent some swelling from developing. But you can prevent it from becoming severe. Severe swelling can make your legs painful and your skin tender.

Try to eat a balanced diet so that you put on a healthy amount of weight during pregnancy. Your diet should include a small amount of lean protein such as meat, poultry, eggs, beans and pulses, with each meal.

Eat at least five portions of fruit and vegetables every day. Aim to reduce how much salt, sugar and fat you have and drink plenty of water to help your kidneys to filter the excess fluid.

Some foods may help to maintain good kidney function and make you pee more (natural diuretics). These include celery, watercress, parsley (in small amounts), apples and citrus fruits. Onions and garlic may help to improve your circulation.

Try to avoid eating pre-packaged, highly processed foods that contain both salt and other additives, as these can make fluid retention worse. Opt for foods which are naturally rich in vitamins C and E.

Good sources of vitamin C include:
• Citrus fruits
• Melons
• Potatoes
• Tomatoes
• Dark leafy greens (Kale, Collards, Spinach)
• Broccoli, Cauliflower, Brussel Sprouts
• Kiwi fruit
• Papayas
• Strawberries
• Bell Peppers
• Papaya

Foods rich in vitamin E include:
• Sunflower seeds
• Wheatgerm
• Sweetcorn
• Cashews and almonds
• Leafy Greens-kale, spinach, mustard greens
• Swiss Chard
• Broccoli
• Olive Oil
• Papaya
• Kiwi
• Bell Peppers
• Asparagus

Smoking may contribute to your swelling, which is another good reason to quit during pregnancy.

What tips can I try to ease swelling?

Rest as much as possible, putting your feet up above your hips by resting them on a stool. Try not to cross your legs, as this restricts your blood flow. Sit down when you can, and if your work involves standing for long periods of time, move about from one foot to the other to increase blood flow.

Ask your partner to massage your feet and legs gently, using both hands and working upwards from feet to knees, using a base oil such as grapeseed. However, if your legs are excessively swollen and the skin is very tight, this may be too painful for you.

Dandelion tea, an herbal remedy, may help to prevent fluid retention, but don't take this if you have a gall bladder condition. Always drink herbal teas in moderation during pregnancy.

Which complementary therapies could help?
Acupuncture may help. The theory is that it rebalances your internal energies and aids your circulation and kidney function. Osteopathy and chiropractic treat misalignments in your skeleton, which may be placing stress and tension on specific areas of your body, restricting your blood flow.

Foot massage may help to relieve your swollen ankles, and reflexology may ease swelling and the discomfort it causes. Choose a registered reflexologist who is qualified and insured to treat pregnant women.

http://www.babycentre.co.uk/a549316/swelling-natural-remedies#ixzz2dCHN3ioN

Soothing tired, sore, achy feet can easily be relieved by using carefully selected aromatherapy oils in a footbath or as massage oil.

Best of all, these oils will provide you with an instant pick-me-up leaving you feeling invigorated and refreshed. Pure essential oils such as Litsea cubeba and Grapefruit (Citrus paradise) have excellent anti-inflammatory and calming properties and also treat swelling water retention, fatigue and insomnia. In addition, Ginger essential oil acts as a pain, eases aches and cramps also improves circulation. Cypress oil is particularly good for circulation and varicose veins. Lavender and chamomile oil may ease your discomfort and make you feel more relaxed.

Tips to Help Soothe Swollen Feet
There are a number of things that you can do to ease swollen feet during pregnancy and prevent further foot problems and these include:

• Take short breaks during the day and elevate your feet to relieve the pressure
• Stretch and flex your feet when you are sitting down
• Wear shoes that fit properly and avoid wearing high-heeled or tight shoes while you are pregnancy as they will constrict circulation
• Exercise regularly to ensure optimum health – practice walking every day
• Shop for shoes towards the end of the day as feet tend to swell as the day progresses
• Measure your feet often throughout your pregnancy as they will change in size
• If you suffer from over-pronation, use custom-made inserts in your shoes
• Wear compression hosiery to keep the pressure from fluids down
• Wear seamless socks that do not constrict circulation
• Eat healthy, well balanced meals and avoid foods high in salt that can cause water retention
• Drink plenty of water to keep the body hydrated, reduce swelling and improve circulation
• Have a relaxing foot massage to soothe swollen feet and stimulate circulation
• Soaking your feet in tonic water can help relieve swelling

Water Retention Massage Oil- safe throughout pregnancy to help reduce swelling
2½ tablespoons almond or coconut oil
½ tablespoon jojoba oil
1 Evening Primrose oil capsule (approx. 10 drops)
2 drops tangerine oil
1 drop lemon oil
4 drops cypress oil
4 drops lavender oil
3 drops geranium oil
This can be used throughout the pregnancy.  Just relax on the sofa, with your legs raised on pillows.  Apply this aromatic massage oil to your feet, ankles and legs, massaging toward your heart to help circulation.  (The help of your partner would certainly be appreciated.)

Recipe from Young Living Oil website

Why A Doula?

The following post is from Jodi the Doula, a wise wealth of knowledge.

Many women, I'm finding, fall into three camps: Those who know for sure they want a doula, those who think they want a doula, but are unsure of her role, and those who don't know what a doula is. Because I am a doula, I think that every woman should have a doula at her birth, but also realize that for a variety of reasons this is impossible. So, I seek information about the roles of doulas in births today as well as the role of doulas in birth in the past to help guide my practice and my on-going education as a doula.

I'm happy to report that I've met with my first Mom through ASDS's volunteer program and have a meeting with my second mom later in the month! I've also sold quite a few products over on Etsy for Moms, Moms-to-Be and women interested in natural skin care. 

What ever you chose for your birth, be it a hospital birth, home birth or birth center birth, make sure that you educate yourself about your options so that you can have the best birth possible!

Image from DaisyBones

Doula FAQ

What’s a doula?
What does a doula do?
At what point in my pregnancy should I contact a doula?
I have a great doctor or midwife, and will have a nurse. Do I really need a doula, too?
I am already taking childbirth classes. Why would I need a doula?
I’ve already taken another class. Would you still be my Doula?
Do I need a doula if I already plan to have someone (my mom, my partner, my friend) to be with me during my labor and birth?
I’m not sure that I want a “stranger” in the delivery room with me. Isn’t birth supposed to be private?
I’m not sure yet what choices I’ll make in labor. Do I need a doula if I might have an epidural? What if I have to have a Cesarean birth?
How much does it cost to have a Doula?
Are the costs of your services covered by insurance?

What’s a doula?
The term Doula, originally from the Greek word meaning “Woman’s servant”, is used today to describe a professional who provides women with emotional and physical support during pregnancy, labor, birth and the postpartum period. Doulas are known by many names, including: Childbirth Assistant, Labor Support Professional, Birth Assistant, Birth Companion, etc.

What does a doula do?
A birth doula provides a listening ear for the emotional process of pregnancy, physical comfort suggestions during pregnancy and labor and informational support for both the laboring mom and her partner. The doula is knowledgeable about the entire birth process, possesses skills to help a laboring mom cope with the physical experience and emotions of labor and understands the importance of this event in the life of the couple. The doula will provide support for mom and baby by helping mom formulate questions, gather information, and discuss the options available with the medical staff. The doula will not perform clinical tasks, and will never make decisions on behalf of a woman. A Doula will always respect that it is up to the mother to make the informed choice that is best for her. Most importantly, the doula uses her skills to complement those of the woman’s partner and medical providers, helping to ensure a satisfying birth memory.

At what point in my pregnancy should I contact a doula?
The earlier the better! Although the benefits of having a doula for your birth will be the same whether you contact her at 12 weeks or at 35 weeks, the difference in finding your doula early in pregnancy is that you’ll have someone you know that you can call on with those “Is this normal?” or “What does this mean?” sort of phone calls throughout your pregnancy. As well, the longer you have known your doula, the more of a relationship you will build. Furthermore, I tend to book up very quickly, so it is a good idea to contact us soon, so that I can be sure to be available for you. With that said, there is no such thing as “too late” to find a Doula. You will benefit from Doula support, whether you have known your Doula for months, or merely days.

I have a great doctor or midwife, and will have a nurse. Do I really need a Doula, too?
Doulas, doctors, midwives, and nurses all take on separate and unique roles in supporting birth. Each one is important part of the birth team, and all work together to help the laboring woman have a healthy and positive experience. The nurse is responsible for charting, monitoring, and reporting to the doctor or midwife, sometimes for several patients at once. Physicians and midwives are highly trained as medical experts, and are responsible for monitoring the safety of the mother and baby during labor and delivery. A Doula remains a constant presence throughout labor, focusing entirely on providing comfort for the laboring mom and her partner. A Doula’s job is not to replace any part of the medical team, but to complement their roles by providing constant support and information to the mom and her partner.

I am already taking childbirth classes. Why would I need a doula?
Doulas are intended to enhance – not replace – the services of your childbirth instructor. Your doula will be with you to remind you at appropriate times during labor of the things you have already learned in childbirth class.

I’ve already taken another class. Would you still be my Doula?Gladly! I have a strong understanding of many different childbirth class philosophies, and can work comfortably with any laboring woman.

Do I need a Doula if I already have someone (my mom, my partner, my friend) to be with me during my labor and birth?
It is certainly wonderful for a laboring woman to have the presence of others who love her. A doula will enhance the support that others will provide, without being intrusive. Often, your doula has a level of knowledge and experience that your partner may not. Additionally, mothers, fathers, grandmothers, and dear friends each have their own emotional response to seeing the woman they love experience labor, and to welcoming this new child into their lives. A Doula will respect that this is a special moment for each person, and will gently provide encouragement, information and reassurance that will help a woman’s loved ones offer their support in a way that also respects the laboring woman’s needs.

I’m not sure that I want a “stranger” in the delivery room with me. Isn’t birth supposed to be private?
Birth is an intimate experience, and the doula is a professional who will respect your wishes regarding privacy and modesty. Many women and their partners report feeling more secure due to the presence of a doula.

I’m not sure yet what choices I’ll make in labor. Do I need a doula if I might have an epidural? What if I have to have a Cesarean birth? 
A doula’s goal is to help you have the best birth experience possible, however you define it. If using pain medication is an option you are considering during labor, your doula will help you make an informed choice about what’s best for you and your baby in the moment. Your Doula will support you and your partner in the early stages of labor before an epidural can be considered, continue to provide support in whatever way is needed throughout labor, and help you avoid further intervention.If your caregiver suggests a cesarean, your doula will help you be as informed as possible about the surgery and the post-partum recovery. your doula will guide you in asking questions that will help you gather necessary information about the reasons your caregiver recommends a cesarean, the risks and benefits relative to your particular situation, and any alternatives you may have. In this case, you will likely make an informed decision and will therefore be more satisfied with a surgical outcome.She will also help to reinforce that even though a cesarean may not have been your goal, you are still giving birth. She will celebrate with you, and facilitate closeness between the new family.

How much does it cost to have a Doula?
This varies somewhat, based upon the services you desire and the going rate in your location. An average birth Doula services package begins at $800 to $1,000. However, I believe in “A Doula for every woman who wants one”, and when possible I am willing to set up a sliding scale or payment plans for those with whom affordability is a concern, or will help you in finding another professional who can serve your birth. Finances should never be the deciding factor in the choice to hire a Doula.

Are the costs of your services covered by insurance?

As more woman are choosing doulas as part of the birth team, and more research is being done proving the benefits of Doula care, more insurance companies are covering the cost of Doula service. Many insurance providers also cover the cost of childbirth classes, whether those classes are private or in-hospital. All receipts and information you need for filing for insurance reimbursement will gladly be provided.

Three New Articles on Adverse Effects of Pitocin

The past few days there have been a total of three articles about the dangers of a common occurrence in American births-augmentation.

Augmentation can happy for a variety of reasons, both medically "warranted" and for the sake of convenience for either a busy doctor or mother. Augmentation is usually done by administering pitocin, a synthetic form of naturally occurring oxytocin, through an IV. While pitocin usually has the same effects of oxytocin (uterine contractions) there are certain other risks. The pitocin can sometimes cause fetal distress because the contractions come on stronger, more closely together and for longer periods of time than naturally produced oxytocin. And, as some of the studies have seemed to find, pitocin may be linked to Autism.

One of the most lasting impressions of The Business of Being Born was when one of the doctors said just this. Pitocin is a rather new drug with, until now, not much research into the long-term effects of its use. Am I against inductions? Do I think that mothers are "bad" for having their labors induced? Do I think that mothers who have inductions are some how putting their children in harm's way? No. What I am saying is that we as women have to remember our voices.

Throughout history our voice has tried to be stifled and throughout history we make it heard. Educate yourself on the procedures that are often suggested or offered as normal and regular and ask questions.
Why do we need to do this procedure?
    What will happen if we don't?
        Is that bad?
            Why is it bad?
                What are the alternatives to this procedure?

In terms of speeding along labor or inducing labor there are natural alternatives. Raspberry leaf tea and Thyme tea will both bring on contractions. Clary Sage, an active ingredient in my Birthing Sprays, is also thought to bring on contractions. Walking or other types of exercise can bring on contractions as well as boy-girl sex (chemical reaction of the sperm) as well as any sexual activity that brings orgasm. Nipple stimulation can also help bring on contractions.

I'm linking the articles below not to shake a finger, but so that we read, learn and research our options and alternatives.

From the American Congress of OBGs: New Study Finds Adverse Effects of Pitocin in Newborns
From the BBC News Induced Labor Linked to Autism
From MedPage Today Induced Labor Linked to Higher Autism Rate

The Breastfeeding Chronicles: I Used Donor Milk To Help Feed My Twins (CP)

One of the beautiful things about being a doula is supporting women and their choices for there pregnancy, birth and postpartum time. We also educate, but we don't pressure or try to sway a woman in either direction or another, rather we can present multiple options and allow the mother to decide.

There is a spirited debate about bottle feeding vs. breastfeeding and I have my own opinions, to be sure. I've spoken to several friends who expressed their desire to nurse there children, but for a variety of reasons were unable to. I've spoken to other friends who didn't think they'd enjoy breastfeeding, but now love it and hope to do it for as long as possible.

The concept of a wetnurse isn't new and it's not something that only the wealthy or aristocratic people do, it's actually more common that we'd like to think. I, for one, think if you've got it, why not give it?

Below is a story of a mother who wanted to nurse hear children and her journey to getting them yummy and nutritionally-dense good, old-fashioned mama milk.

Breastfeeding her twins -- a boy and a girl, born two weeks early -- mattered very much to Melissa, 38, a special education teacher from North Carolina. But when they quickly started losing weight, she and her husband were forced to turn to options like donor milk and a supplemental nursing system to make it happen. As part of our series on what it's really like for new moms to breastfeed, Melissa talks about how it feels to rely on donor milk, and how dramatically nursing can vary from child to child.The BirthThe twins came two weeks early, so they actually made it a long time for twins. I didn't want a cesarean section, but at 38 weeks, my doctor was really insistent that I needed one. It was the end of June, and I was so swollen. I had so much water retention, I ended up needing carpal tunnel surgery to reduce the pressure in my hands, and my doctors were worried about permanent nerve damage. They thought that maybe I could deliver my daughter vaginally, but I'd need a C-section for my boy. I didn't want to do both, so we went with the C-section.
The nurses at the hospital were fabulous. As soon as the babies were born and cleaned up, we tried nursing. I knew I wanted to breastfeed, but I didn't know what to expect. I knew there was a learning curve, but it hurt, and there I was in the hospital, watching their weight drop. The doctor said that we had to start supplementing, because their weights were getting really low. He said we could do formula or donor milk. We were really fortunate that there was a milk bank right there in the hospital.
Going DonorI had heard about donor milk before, but I had a lot of questions about how it works and where the milk comes from. Ultimately though, breastfeeding was so important to me. Selfishly, there were health reasons -- there's breast cancer in my family, and I know breastfeeding can help reduce the risk. Plus, I wanted the twins to have the health benefits of breast milk, so at the end of the day, that's what we went with.
It's amazingly expensive, probably $4 to $5 an ounce. It was a lot of money, but we knew it wasn't going to go on forever, and knew that we really wanted to provide our babies with breast milk. We probably used donor milk for almost two months. I haven't calculated what it was total ... but it was a lot.
The fact that it came from other women was a total non-issue for me. If anything, it seemed like such an amazing gift for these women to be able to provide milk to babies who need it. And we knew it had been screened and tested.

Read the rest of this article on Huffington Post