Coping with Labor: Honoring Choices and Options

There really is no jam like a Rising Tide Women Wednesday Doula Jam.  Typically, Lindsay and Liz spend each week rotating through subjects that pertain to pregnancy, birth, breastfeeding, and the postpartum healing period.  When we got to the “birth” week, and wanted to cover “coping in labor”, we knew that it would be best to spend two Jams on the topic.  The first week we chatted about pain medication options, and the second week, non-medicated options.  Since both of these options require a childbirth prep class to fully understand the intricacies, we thoughtfully reviewed the options, giving our viewers a taste.  You should always fully discuss ALL of your options with your care providers and we do highly recommend private birth preparation with certified instructors (heads up, this is what we DO) so that you understand all of the risks and benefits before you say “yes” to anything.

One of the initial thoughts that may race through your head when you find out that you are expecting is “how am I going to deal with the pain?  My friend said that labor was just awwwwful!”  We hear you, we also want you to know that we believe in you and your abilities.  You WILL get through labor, one way or another.  You do not need to commit to a plan at any point, nothing is written in stone.  Keep your options and your mind open. 

Some pregnant people know off the bat that they want meds.  For whatever personal reason, it is their choice and its not our job to sway a person based on our beliefs.  We at Rising Tide Women do ask that you do lots of research before hand and understand what saying “yes” to medications really means.  The way Lindsay and Liz see it, “yes” is a very empowering word in birth, as long as you consent as a fully informed person.  Epidurals are usually NOT your only medication option.  Depending on the place you birth, you may be offered nitrous oxide (“laughing gas”), narcotics, or an epidural or spinal.  You may want to try one of those before an epidural.  Please do keep in mind, the facility you are laboring at may suggest (or even require) you to stay in bed if you elect one of these medications.  Limiting your mobility during birth can change the course of things.  You’ll want to understand what restrictions the hospital will impose.  It could change your decision.  Please view the Pain Meds in Labor video below.

Another way to approach birth is to do it without medications.  Just as valiant as having a medicated birth, because lets face it, birth givers are total badasses, and it takes all the courage in the world to do this work.  However, if it is your philosophy to labor and have your baby without any pharmaceuticals, we think you are awesome too!  This option takes a solid education in birth preparedness with certified instructors (see: Rising Tide Women Birth Classes) in order to learn about coping, expectations, and techniques to get you and your birth support team through the process.  Research does conclude that where a person gives birth and who is by their side (care providers, doula, support people) impacts pain relief.  Very briefly, ways to reduce the perception of pain include: surrounding yourself with people you love and trust, playing music, having comforting smells around you, movement (walking, slow dancing, lunging, swaying, rocking, stairs), position changes (squatting, leaning, hands and knees, side-lying), water emersion (tub or shower), slow and deep breathing (gives the brain something to concentrate on), hypnosis/guided meditation, touch (light touch/stroking, massage, acupressure, counterpressure), applying heat/cold to body, and verbal reassurance.  Our Non-medication Ways to Cope in Labor video below discusses this further.

Because we love you, and always want you to have immediate access to our favorite resources, here are some links to click about this subject! 

• Basics of labor support

•  The evidence on what helps during labor

Please share this with your loved ones if they are expecting!  We appreciate all of your support, kindness, and Doula Jam love! 

Lindsay and Liz

First steps once you find out you are pregnant

You are pregnant.  Either you knew it before any test, or you needed to pee 10x on a stick to make the news sink in.  What is going through your mind?  How is this news making you feel?   (PS: all emotions welcomed during this intense time, no wrong answers). Knowing what to do soon after learning about your pregnancy isn’t in the manual. In fact, I do not think my copy ever arrived when I found out I was pregnant!  We like to keep it light when we can around here, there is no manual and that’s okay!  You have Rising Tide Women: Doulas and Lactation.  

This Wednesday, our Live Facebook Doula Jam covered some important first steps to take once you know for sure that you are making a baby in there. 

1.  Exhale.  Whether this news has been long awaited, or still a shock, take a few deep breaths and ground yourself.   

2.  Inform family and friends when you feel ready to share.  No rush.

3.  Begin the thinking process about care providers.  Keep in mind, you can ALWAYS switch providers, models of care (i.e. OB to midwife, or vice versa, or hospital to homebirth), places to birth, and so on.  If you want to start with your current care provider, go for it.  See how you are treated as a pregnant person and if the practice feels right for your needs.  Here is helpful information that can assist you with these important decisions.  

4.  Learn about doula support here.  Research supports utilizing a professional doula for better birth outcomes.  If the thought of hiring a doula doesn’t really feel like “your thing”, reconsider.  And research.  There is a doula for everyone.  They all have different personalities, backgrounds, and styles.  Doulamatch.com is a wonderful way to search area doulas.  Find a doula who you feel safe and comfortable with.  Book early on in your pregnancy to get the most out of it.  Ask about payment plans or set up your baby registry (Baby List for example) to include helping you cover doula support.  We know that you’ve had your eye on the latest and greatest gear out there, but put some thought into labor support.  It’ll last a lifetime.  Doula support with Lindsay and Liz of Rising Tide Women: Doulas and Lactation means you get two doulas for the price of one.  You get pregnancy and labor support AND lactation/feeding support, including a private lactation consult with Liz Libby, IBCLC once you are settled at home.  Learn more here.

Have an enjoyable look at our Live Facebook Doula Jam from October 17 that delves deeper into these thoughts.  We hope it gets you thinking and on your way to an informed and incredible birth experience.

Post-birth recovery after a cesarean birth

If you know us, you know we love to talk about postpartum recovery and postpartum care. And I always like to clarify that when we talk about postpartum, we are just talking about a period of time: post, after, and partum, birth. All we mean when we say postpartum is the period of time after you give birth. And how long that time lasts can vary, depending on who you ask; some say it’s the first 6 weeks, for some it’s the first 3 or 6 months, but we like to talk about it as the first year after giving birth. Heck, I’m 6 years out from my youngest and I still feel like I’m in the postpartum phase sometimes.

So when we talk about recovery, we are really talking about healing from the pregnancy and birth processes (spoiler alert: it takes more than six weeks), because even though they are natural things that your body does, they are still a big deal and need some recovery time, particularly if you’ve given birth surgically. Not to mention, you have a brand-new baby to care for as you are recovering, and you are making the huge adjustment to what it means to be a new parent (or a new parent of two, or three, or… you get it).

This week, we talked in our Doula Jam (did you know we do them on our facebook page every Wednesday morning at 9amEST?) about tips for recovering after a cesarean birth. And honestly, our biggest recommendation is to get some help. Whether it’s family, friends, a religious community, other moms, your partner, anyone (supportive) you can line up is great. AND! Did you know that postpartum doulas are a thing that exists? I’m honestly asking, because I didn’t know about postpartum doulas when my first guys were born, and boy do I wish I had. Here at Rising Tide Women, we offer exceptional postpartum doula support through all of Cape Cod and the South Shore, including overnight care.

PSA: You don't have to love breastfeeding

The other day, I was doing a home lactation visit with a family in Sandwich, and one of the things we talked about was how the nursing mom was not enjoying breastfeeding. And (after doing what I could to make it more pleasant for this mama) it made me really want to write about that experience, because so often we are given only two stories about breastfeeding:

1. The soft-focus version: That it's blissful and easy and free. It's natural, after all, so it should all just come easy. You'll be sitting on your white couch, with your happy baby, feeding with no trouble, and nobody will cry, ever.

2. The Horror Show version: That it's painful and terrible and doesn't work. That you won't make enough milk or it will not make your baby happy or they won't like it. You'll be stuck at home tied to your baby or your pump forever, and you'll never be happy again.

And the reality..... well, it's mostly somewhere in between those two versions. The truth is that there are some folks who experience one of these two stories, but for the vast, vast majority of nursing parents, the soft-focus version of breastfeeding is completely unrealistic (although you'll have glimpses of it here and there), And, blessedly, for the vast majority of nursing parents, the Horror Show version of breastfeeding is also unrealistic (although let's be honest: you may get glimpses of it here and there). 

But the reality is that you won’t enjoy every minute of breastfeeding, because literally nobody does. It’s so, so normal if you:

• Feel touched out sometimes.

• Miss being able to do what you want, when you want sometimes.

• Sometimes feel frustrated that your baby wants to nurse AGAIN.

• Love breastfeeding your baby.

• Don’t love breastfeeding your baby.

• Love breastfeeding sometimes.

• Are exhausted.

Some nursing parents even experience unpleasant emotions while breastfeeding, and it’s a physiological response, not a measure of your parenting abilities.

I guess what we’re trying to say here is: it’s not all rainbows and unicorns, and that doesn’t mean you are doing anything wrong. It just means you’re a normal human with limits, and you have a normal baby. And it’s okay to pass that baby off so you can catch a break, if that’s an option for you.

Basically, we want you to know: you are enough. You are a good parent. Your baby loves you. And you have permission to take care of yourself. (Please note: I’m not giving you permission because you sure as sugar don’t need it from me; I’m just telling you that you already have it)

Whats love got to do with it? A doula reflects on birth

Thinking about birth doesn’t conjure up feelings of love for the majority of us.  I know that long ago (well, 11 years ago) when I was pregnant for the first time, I did not associate giving birth with feelings of love.  I mean, I envisioned my partner and I sharing a kiss after our baby arrived, but my brain was conditioned to see birth as this harried screamfest with me yelling “you did this to me!”  When it came time to hunker down at the hospital in Plymouth, MA to give birth to our child, “love” was not exactly what I was thinking about, but our nurses and my husband showed me differently.  But first, a short backstory...

I did nothing to sufficiently educate myself on birth.  At the time, I was working full time as an operating room nurse in Cambridge, MA (it was an hour and half commute each way, 5 days a week) and felt that I had zero time to study birth.  I was a bit overconfident to be honest.  I felt that my being a nurse who absolutely loved and thrived in her maternity rotation, I had seen all I needed and felt quite comfortable having our baby in a local community hospital on the south shore.  I knew that I’d labor at home and would show up to the hospital when my contractions were about 5 minutes apart , and the nurses would do their thing, and the doctor would her thing, and boom, it would be over and I’d be a mom.  Where’s the love in that?  Clearly, I didn’t know the key piece to giving birth.  

Some of you may be at a point in reading this where you think its a good time to exit out of this piece because associating birth and love is only for the natural hippie birthers, which you do not identify with.  Please let me reassure you, that’s not my angle.  When I write, its for everyone. This is the information that I now understand and realize that it would’ve helped me connect better with my body and my experience.

See, there’s this hormone that we talk about endlessly in the birth world called oxytocin. In case you haven’t heard of it, it’s the hormone that causes strong, regular contractions  during labor. But it also has a whole bunch of other jobs, too: for one, it’s the hormone at play when you are feeling love and affection. Whenever you get the warm fuzzies for your partner, or your baby, or even a really cute puppy, that’s oxytocin doing its work. (It has other jobs, too, but we’ll get to those later.)

Oxytocin is partially responsible for bonding, orgasms, childbirth, and breastfeeding. It even helps the uterus to clamp down after the placenta has been birthed!  Clearly, its a big deal, yet many of us go through life, never mind childbirth and parenthood not even knowing its name.  Once people are clued into this fabulous and multitasking hormone, they want to know how to access it during labor.  The secret is to say its name three times in the mirror (kidding, kidding!) As easy as it should be to just call upon “more oxytocin” during childbirth, we have generations of scary birth stories to unravel, stories that are part of our cellular makeup, stories that make us feel unsafe during birth.  What have we done?  Well, instead of encouraging and listening to birth givers, we have told them all the horrific things that can go wrong with birth, and we have actually caused their bodies to go into a fight, flight, or freeze mode.  We (as a culture) have plugged up the natural flow of oxytocin and we are putting people into a high adrenaline state. Adrenaline halts the rush of oxytocin.  Labor slows or even stalls, and in most hospital settings, interventions are brought up by care providers to “get labor going again”.  Usually, oxytocin’s synthetic form, Pitocin, is introduced.

So, what can we do to encourage our own  natural use of oxytocin?  We can start by helping pregnant people feel safe, educated, heard, and lifted by positive birth stories.  For those of you who did experience trauma during birth, we want you to know that there is space in our hearts for you and your story.  We just need to be mindful how we share.  Giving birth requires that feeling of safety.  In order for our bodies to relax and release necessary hormones, we need to feel protected.  Where do you feel most at ease?  Where do you feel comfort?  I bet most of you would say home.  You are sheltered, you know your way around, you are familiar with the smells and furnishings, you can eat and drink all you want, and your bed is your haven.  That’s why we doulas and most care providers say to “stay home as long as possible” when you are in early labor.  We want you and your body to be able to do its thing on its own without unnecessary interference.  This is why some people choose a homebirth with skilled and experienced midwives and doulas.  Home is usually where the oxytocin is at!

What else can we do?  What can we do once we are  at the hospital or birth center?  We tend to feel that once we are outside the home, we are frightened, not in control of things, and disoriented.  We at Rising Tide Women always suggest to our doula and birth prep clients to visit the place of birth long before labor.  Bring all of your questions to the tour and do not hold back asking.  The other people on the tour will be grateful for your inquisitiveness!  Another thing you can do before labor is to make sure that your care provider is supportive of your choices and the vision you have for your birth.  This can be accomplished by writing down your wishes and giving copies to your OB or midwife.  Go over these wishes together during your prenatal visits.  Make sure your doula is in the loop as well, they are the ones who work tirelessly to help make these things happen!

Once labor has begun, whether you are planning to birth at home or hospital, have your support people make your surroundings as comforting as possible.  Draw the curtains, keep privacy a priority, keep light snacks and beverages fresh and handy, dim the lights, turn on battery operated candles, and keep all floors clear of clutter, because walking and walking and walking is another way to get a baby born!  These ideas all seem like a romantic setting, right?  Well, yes!  Romance is oxytocin, and oxytocin is birth, therefore birth is romantic!

In fact, smooching and cuddling with your partner (and even getting intimate if you feel like it) can really help get that oxytocin flowing and keep labor rolling along. One of the sayings you may hear in the birth world is “what got the baby in, gets the baby out!” Some laboring parents even use nipple stimulation to get labor started or keep it moving; please run that by your care provider before you dive in, though. 

One of the things we encourage our birth clients to do is think about the answers to these questions and talk them over with their partners. How can you incorporate these answers into your birth planning?

• What kinds of things make you feel safe and loved?

• When you are feeling stressed or uncomfortable, how does touch and physical affection work for you?

• What makes you feel better after a long, stressful day? 

Did you use oxytocin in your birth experience? What helped you feel good? Share in the comments!

5 stellar reasons to take a Rising Tide Women’s birth prep class

Birth prep.  Ugh.  One more thing to add to your ever multiplying list of things you must do before baby arrives.  Don’t parents and babies already know how to do the whole birth thing?  Isn’t it natural and haven’t we been birthing since like, forever?   Don’t we just give birth the way Hollywood has so accurately portrayed it?  And what about all the stories that have been passed down from family and friends?  Isn’t that just the way it will all go down, down there?

If your mind has been made up already that you are going to skip the birth prep, and wing it, we would love it if you kept reading.  Heck, it’ll save you a few minutes from tackling the next item on your to do list!  If you are considering birth prep with Rising Tide Women, but need more convincing, stay with this and keep reading. 

I’ll do the 5 reasons countdown backwards Just to build some fun suspense.  Lindsay and Liz your Rising Tide Women certified birth educators LOVE to have fun! 

5.  Location. Location. Location.

Newborn photography by Irish Eyes Photography

Where you learn about birth is very important to how much you retain and utilize when it comes to baby time.  You need to feel ultra welcomed, fed, hydrated, comfortable, and listened to.  Our classes are currently held in the comfort and privacy of your home, or at the South Shore Perinatal Wellness Center in Norwell, MA.  Where better than learning in your own living room or in a super cozy center where your learning needs will not only be met, but your expectations will be exceeded?  Classes held in home are typically private or semi-private, where you are most at ease to ask all the questions about your body and baby.  Classes at the center are small, usually up to 6 people and the laid back environment is maintained so that you feel free to laugh, wonder, and learn about birth and the immediate postpartum.

4.  Realistic Expectations. 

We want everyone who takes our class to come away from it with a solid foundation and comprehension about the end of pregnancy, labor/birth, and the immediate postpartum, including breastfeeding during the early days.  We have created a curriculum that is engaging, eye appealing, hands on, humorous, and full of all the pee breaks pregnant people need.  We give you information that you can put to use during labor, whether its in a hospital or at home, based in science, research, and evidence.  We are going to give you the cool nerdy facts and help you breathe a sigh of relief knowing that birth doesn’t look the way its depicted on tv or the big screen.  When we show you birth videos, we show you the good stuff. 

3.  Bigger groups mean lower cost for you! 

Most of us groan at the idea of being in some stale room with a bunch of strangers talking about vaginas, cervixes, placentas, and breasts.  Your Rising Tide Women doulas and birth educators beg to differ, but we aren’t your average type when it comes to our favorite topics!  If you can gather up a bunch of your pregnant pals and their partner if they have one, you get to have birth prep with your friends AND at a special group rate!  Win!   Now are you excited to talk about the uterus, vernix, colostrum, and hormones?  Giddy up.

2. Community starts here

For many of us new to parenting, we flounder a bit especially in the beginning.  We are learning a whole new way of life, and that’s to be expected.  Why not build your community during pregnancy so that come baby time, you have built relationships that you can trust in and have friends with babies around the same age.  Our classes help build that team parenting approach, by getting you and your classmates bonded as quickly as possible.  We hope that you are already exchanging cell numbers and friending each other on social media by the first snack break.  You’ll have a solid new group of friends to lean on and learn from as parenthood begins, there’s no better way to start out on this adventure. 

and the NUMBER ONE reason to sign up for a Rising Tide Women birth prep class is... 

Time with Liz Libby, IBCLC and Lindsay Miller, RN BSN!  You’ll get our direct contact information before class even begins, so that you can ask questions as they come up.  We love being available to the families that put their trust in us.  As we say, we want to be the resource that we needed long ago when we were expecting our babies.  Even after class wraps up, we are still available to our students for questions/concerns/coffee dates.  Plus, we love providing a safe space to share your birth story with us privately or as a group, and we are always more than happy to cuddle your baby so that you can sip your coffee/tea while it’s still at the perfect temp.

You’ll also get access to our client only password protected website we named The Harbor.  The Harbor is a special place where we have organized your resources so that they are easy to search according to the stage of parenthood you are in.  We have you covered from pregnancy to toddlerhood, birth to breastfeeding.

What’s that?  You are interested in birth prep classes now?  Fantastic!  We love to hear that and we appreciate the time you gave us to help spread the word.  If you are not interested for whatever reason, but you liked what you read, share the info with your friends!  We teach on the South Shore and Cape Cod and are happy to work with your busy schedules. 

Breastfeeding FAQs

I love being an IBCLC (International Board Certified Lactation Consultant). I'm so proud of the work that I do, and I really believe it makes a difference in the lives of the parents that I work with. One of my favorite things about this work is that I get so many good questions from our clients, and also from just random people who are curious about what I do. Seriously, if I'm at the grocery store in Harwich wearing my Rising Tide Women T-shirt, I get stopped and asked questions. If you know me, you know I'm a talker, so I'm always happy to chat about babies and breasts and birth and postpartum support. 

Some of the breastfeeding questions I get asked the most are:

• How do I know if my baby is drinking enough milk?
• Should I still breastfeed if I'm sick?
• How can I increase my milk supply?
• My baby is cluster feeding! Is that normal?!
• What do I need to do to prepare for breastfeeding when my baby is born?

So if you check out the video below, I'll answer all those questions for you!

Have more questions? Put them in the comments and we'll talk about them in a future blog post or video!

Liz Libby is an International Board Certified Lactation Consultant, a Certified Lactation Counselor, and a CAPPA-certified childbirth educator.  She lives in Brewster, MA with her three wild boys, canine sidekick, and her partner.  Find her at info@risingtidewomen.com.