Family Planning Forum, 2016

Advocates for women’s health hold a vigil in Nov. of 2015 in Muskegon

“It’s so great to be around friends. The work we do is so hard.”

                                — Participant, 2016 Society of Family Planning’s North American Forum

In November of 2016, I had the honor of attending to the Society of Family Planning’s North American Forum, a life-changing experience, not so much because of what I learned, but because of what it made me feel. I knew this conference was going to be different from any other I had attended when I went to register and realized that I needed two personal references to even complete the online form.

This was heavy. It’s heavy because healthcare providers are risking their lives every day to provide comprehensive reproductive healthcare services to women. It’s heavy because by being in the presence of so many abortion doctors at one time, I was myself at risk for being murdered. Every conference attendee received a name badge, with a photograph that had to be scanned every time we entered the conference area. We were to turn off the location-finders on our electronic devices. We were to take off our name badges if we left the conference area. We were not to take photographs with other attendees and share them.

I’ve been to a lot of conferences before, but nothing with this level of security. One might think that I would be afraid for my own safety, but the measures taken were reassuring. A lot of people don’t understand the sacrifice people make to perform abortions. Often, it is the only work a doctor can do, due to stigma. This can result in social isolation. Going into the work is not taken lightly and is often the consequence of life-changing experiences, some of which were shared with tears and great conviction at the microphone. Sharing space with such brave people opened my heart to a small taste of what they experience daily. I can read about statistics and danger, but this experience brought me closer to a more personal understanding.

Doctors weren’t the only ones in attendance, though. There were also attorneys, researchers, academics, students, and advocates, but I think I was the only doula and childbirth educator present. I’ve shared a lot of the resources I gathered, but I haven’t written about some of the things that I learned that may be useful in my work. Here are some highlights:

  • Catholic Healthcare:
    • Although there are over 600 Catholic hospitals in the US, over 1/3 of women surveyed did not correctly identify the hospital where they sought care in terms of religious affiliation.
    • Most women believe that hospitals should never be able to restrict care.
    • Residents who graduate from programs at Catholic institutions report dissatisfaction with their training. Although they may not be able to provide abortions, they can still be taught how to do them, through online modules and off-site collaborations.
  • Zika Virus:
    • Many of the countries affected by Zika also have some of the most restrictive abortion laws in the world.
    • Zika is not transmitted through breastmilk
    • Men should wait 6 months after potential exposure before trying to conceive. Women should wait 8 weeks.
    • We don’t yet know what the outcomes will be for infants who were exposed, but are “normal” at birth.
    • Vertical (mother-to-fetus) transmission is less likely in the first trimester, due to the impermeability of the placenta, but if contracted, outcomes are worse. Later in the pregnancy, the fetus has a more mature immune system and the mother has transmitting immunity, so the outcomes are better.
    • Affected countries are advising that women avoid pregnancy, without giving them access to contraception and abortion, which is an unfair and unreasonable expectation.
  • Immediate Postpartum Long-Acting Reversible Contraception (LARC)
    • LARCs can be inserted immediately postpartum.
    • 50% of women ovulate and 60% resume sex before their 6-week postpartum visit
    • Up to 35% of women never attend their postpartum visit
    • Subdermal implants inserted 1 to 3 days postpartum have shown no negative impact on infant health or breastfeeding.
  • Male Contraception
    • There are 3 options for male contraception:
      • Injectables
      • Pills
      • Gel
    • Acceptability determines if men will use available options.
      • Surveys show 44 – 83% of men would use, if available.
      • Lowest acceptability is in Indonesia; highest is in Spain.
    • Women play a role in acceptability – men are more likely to participate in studies when encouraged by their spouses.
    • A barrier is that men don’t have a designated healthcare provider for birth control, but family planning clinics may be the most logical place for them to go.
    • Methods exist, but are not yet labeled for use as male birth control.
    • LARC methods exist for men, but are hindered by lack of precision and research.
    • There is likely to be less of an environmental impact with male hormonal contraception methods than female methods because those are excreted into the waste-water and impact fish reproduction.
    • There are potentially non-contraceptive benefits to male hormonal contraception, such as an increase in lean mass, decrease in fat mass and decrease in bone loss.

Overall, I left the conference feeling that the training of most doulas in family planning is inadequate. Doulas and childbirth educators play a role in reducing infant mortality, poor birth outcomes and perinatal mood disorders when we have knowledge of family planning to decrease unplanned pregnancies and increase interpregnancy intervals. We can also help educate clients about the wide range of birth control options and their potential impact on breastfeeding and future fertility. As a full-spectrum doula, it’s important to provide information and support that is respectful of the values of the families I serve, across the wide-range of reproductive health decisions they face.

Cooperative Childbirth Education: Class Descriptions

Cooperative Childbirth Education classes in Muskegon

Birth Quest’s fall 2017 and winter 2018 childbirth education classes can be taken a la carte.

Interested in attending childbirth education classes, but don’t have the time to research your options, travel outside of Muskegon or attend a full series?

Busy families like yours want to be able to make the best use of their valuable time when expecting a new addition. That’s why Birth Quest offers a la cart classes so that you can seek out knowledge according to your unique interests and circumstances. I have taught a wide variety of classes privately, in group settings, for non-profit organizations, and as a guest presenter in classrooms. Since 2014, I have taught classes in the following settings (places in italics were as a volunteer):

Please contact me if you would like to host a class!

Are you having trouble deciding which classes to attend? Check out the class descriptions below:

  • Choices in Childbirth: Providers and Settings — Did you know that the choice of where and with whom to give birth best predictor how it will turn out? The purpose of this class is to educate you about all of your choices are so that you can give birth where you feel safest and the most supported.
  • Self-Care for Your Changing Body — This class is for those who are motivated to optimize their health during pregnancy through diet, movement and tending to their emotional needs. Strategies for alleviating common pregnancy discomforts will also be shared.
  • Holistic Pregnancy Care Options — Many families are turning to less invasive and more natural solutions during pregnancy and birth. This class will look at several different complementary and alternative medicine options, along with where to find practitioners in the Muskegon area.
  • Birth Plans: What Parents Need to Know — There sure are a lot of choices to be made when having a baby! You will leave this class confident, knowing what the available research says about birth plans, staff responses and birth outcomes. Parents will be provided with multiple templates for creating a birth plan, as well as advice for forgoing a birth plan altogether. Whatever families decide, they will learn all the key decision-making points from early labor to common newborn procedures and everything in between.
  • Labor & Delivery: Prepared & Informed — Birth is unpredictable, full of unexpected twists and turns, making it something families anticipate with both excitement and apprehension. Highlights of this class include indications for, risks and benefits of and how to prevent common interventions, such as inductions, episiotomy and cesarean. Childbirth education does not guarantee an outcome, but it can lead to empowerment: knowledge is power!
  • Essentials of Labor Support: What Birthing People Need — This class is for the birthing person and whoever they choose to support them during labor and delivery, including spouses, partners, friends and family members. Topics include communication skills, practicing massage comfort techniques and so much more!
  • Pain-Coping Strategies: A Smorgasbord of Options — Pain relief during labor is a primary concern for many pregnant people. Some believe that they must choose between no pain relief or an epidural. Fortunately, we’ve come a long way since the days of a one-size-fits-all approach. We will explore a full spectrum of both pharmaceutical and natural ways to lessen and cope with the pain of childbirth.
  • Postpartum Wellness: The Fourth Trimester — This class is focused on the physical and emotional health of parents after a birth. We will cover recovery from a vaginal or a cesarean birth, movement, nutrition and mental health with lots of resources for further exploration. This class is appropriate for any expectant or new parent.
  • Newborn Care — Babies aren’t born with an instruction manual, but the good news is that you are the expert on caring for your baby! We will cover what to expect from newborns in terms of appearance and behavior, as well as bonding, development, diapering, bathing, safe sleep and more!
  • Breastfeed Successfully with Knowledge & Support — This class is for anyone interested in learning more about the benefits of breastfeeding how it works, and how to avoid common pitfalls, as well as community resources to support breastfeeding families.
  • Childbirth After Cesarean: Making Informed Decisions — With about 1/3 of West Michigan moms delivering their babies via cesarean, many are faced with limited future childbearing options. This class seeks to inform and empower families before and during pregnancy to make the best decisions for themselves and their families.
  • Introduction to Birth Work: Doulas & Childbirth Educators — This class explains possible career paths for doulas and childbirth educators, what they do and how they positively impact birth outcomes. The presentation concludes with a sample childbirth education class.

You can find out about upcoming classes on my calendar or under “events” on Birth Quest’s Facebook page.

Classes can be tailored to suit the needs of any setting or population, like youth, maternal and infant health professionals, homeless shelters, or places of worship. Presentations can also be developed to cover other specific topics, like pregnancy complications, anger management during pregnancy, substance abuse prevention or parenting. What topics would you like to see Birth Quest offer?

Introducing: Beth Singleton, Birth Doula

As a doula, two of the most important people in my life are my sitter and my back-up doula! Through the Lakeshore Doula Network, I have been fortunate to have had several area doulas willing to support my clients in the rare event that back-up is needed.

One time, I had two clients due the same week. Beth Singleton was my back-up doula. When they both went into labor at the same time, she was there for me. I cannot tell you what a relief it was to know my client was in good hands!

Beth and I have met to talk about working together since then. After making lists of our strengths and weaknesses, we identified ways that we are similar as well as ways we can mentor and support each other as we continue to develop our businesses. We recently signed a formal agreement outlining our commitment to provide back-up for each other.

Let me introduce to you, Beth Singelton, Birth Doula!

Beth Doula blog pic

Hello! My name is Beth Singleton. I have lived in Muskegon my entire life and graduated from Reeths Puffer High School in 2000. I am the proud mother of 4 awesome kids and have been married to my husband for almost 14 years. I have given birth in both a hospital setting and at home. In 2014 while pregnant with my 4th child, I completed my DONA training and am currently working towards my certification. Aside from my life as a wife, mother, and birth doula, I have spent many years working as a floral designer and I LOVE writing poetry (I have self published two poetry collections so far!). Free time with my family is best spent in nature, preferably by the river or in the woods, with my camera in hand. I am also a huge fan of watching the sun rise.

I have always had a passion for pregnancy and birth and am very grateful to the women in my life that have allowed me to be present during the birth of their children. What I’ve witnessed while watching other women labor and experienced during my own is that having support is vital to a positive birth experience yet, it is something so many women do not have. Giving birth is one of the most challenging and life changing experiences a woman can go through and how she experiences it can have a lasting effect on how she feels about herself, her baby, and the bonding experience. I know the importance of achieving the desired labor and birth and it is my hope to provide women with the information and support needed to do this. There is no crystal ball that can predict how labor will go. That is why I think it is so important for a woman to have support.

During pregnancy, I believe it is pertinent for women to educate themselves and build a good support team. It is also the perfect time for a woman to learn about self care and begin implementing this into her daily life if not already doing so. As your doula, I will be there for you during your pregnancy to answer questions, provide moral support, go over the importance of self care, help you with a birth plan if you’d like one and go over what you ideally think you will need from me. When you are in labor, it is my goal to be there for you and do all that I can to make sure you feel in control and empowered, providing you with the support you need to be a better advocate for yourself. Whether it is simply my presence that is needed, encouraging words, a shoulder to cry on, or hands on support like massage, I will be there for you. In the instance that complications do arise, I will remain with you and support you through those challenges as well. I believe all women have an inherent sense within them that guides them instinctively through labor and childbirth. My hope is that in all I do, I am able to hold that space for you, allowing you as an individual to experience labor and birth in whatever way you so desire. After birth I will visit with you, talk about the birth, talk about how you are feeling, and I can provide some help with breastfeeding if you need it.

I view birth as something sacred and a laboring woman as someone to be respected and held in the highest regard. There is a transformation that takes place whether a woman is having her first baby or her fifteenth and I consider my being allowed to bear witness and provide support during that transformation an honor. I also believe that a doula’s support is meant to complement and enhance the care that is already being provided by those who are giving clinical support and by loved ones who are also present to help. In birth (as in most of life), there are no do-overs. That is why I feel it is imperative that a woman who will be giving birth is surrounded by people who understand and are sensitive to the significance of the moment.

“Any amount of liquid gold is better than none :)”: Results of my Breastfeeding Survey

As a doula, I hear many stories of the difficulties some women experience with breastfeeding. Although I have lots of training in the basics, my role is to help facilitate early initiation of breastfeeding through skin-to-skin contact immediately after birth. In the postpartum period, I can provide referrals to lactation specialists, but my main form of support is informational and emotional.

What if I could provide education prenatally that would help women prevent the most common challenges? If not properly identified and corrected, many breastfeeding issues can get out of hand in a short amount of time, before some women are even able to identify who to seek help from!

This gave me the idea of a survey.   What better way to improve my understanding of the experiences of local women than to ask them? The response was overwhelming: in 48 hours, I had over 80 responses!

Before I share the results, I have to clarify that this is not the same as research. Most of the respondents found the survey through My Breast Friends, a Muskegon-area Facebook group started by Mercy Health to provide a social media extension of their twice weekly support groups.  For this reason, they are not representative of the general population, but it’s a great group to ask if you want to know what works!

For example, the WIC (Women, Infants and Children) program collects data on breastfeeding for program enrollees. While not all breastfeeding women are enrolled in WIC, the program provides some data to compare our group to. As of Spring 2015, 81% of infants in the program were breastfeeding at 1 week, dropping to 12.8% at 6 months and 1.29% at 11+ months. In contrast, among the women who responded to my survey who had stopped breastfeeding, 20% had done so at more than a year! Even so, 23.5% of the women did not reach their breastfeeding goal, indicating that improvement is still possible.

What was most interesting to me was what and who women found helpful. With few exceptions, when women do seek support, they find it! At the top of the list were:

  • Hospital Breastfeeding Support Group: In Muskegon we are so lucky to have a support group that meets twice weekly at the Mercy Health Hackley Campus on the second floor, 2210A. Mondays 5 – 7 PM and Thursdays 11 AM – 1 PM.
  • Husband/Partner/Father of the Baby: 80.25% of respondents found their partner to be very or somewhat helpful. Let’s hear it for dads! (Want to learn how to best help your breastfeeding partner? Click here!)
  • The Internet/Social Media: Since the survey solicited responses from a Facebook breastfeeding support community, this should come as no surprise.

Great bonding, a healthy baby and confidence as a mother topped the list of benefits. One respondent reminded me of the cost savings of breastfeeding, while others let me know that the confidence and sense of accomplishment they enjoyed extended beyond that of parenthood. Said one mom, “It was the best thing I ever did”!

Now for the bad news. Sadly, childbirth educators were found to be the least helpful. Not to say they were harmful, but 36% found them to be neither helpful nor unhelpful. Next came prenatal care providers, whom 12% of women found somewhat unhelpful or not at all helpful. The third least helpful group was workplace/coworkers. One in 10 women found their workplace to be not at all helpful! This may contribute to the fact that over 1/3 of respondents indicated difficulties with breastfeeding and work.

Nearly 60% of women experienced pain when breastfeeding, followed by cracked nipples (56%). Low milk supply and difficulties latching tied at 48%.

The advice moms gave formed a couple of distinct themes:

  • Find a support group: Overwhelmingly, moms who have breastfed want other moms to know that they should connect with others, ask for help when needed and not be afraid to seek professional support. As one mom said, “Find your momma tribe”!
  • Don’t give up: Many moms stated that if you can get through the first few weeks, it gets easier. All agreed that it was worth it in the long run.
  • Be flexible: 38% of respondents supplemented breastfeeding with formula. Said one mom who’s been there, “Don’t be too discouraged if you have to supplement with formula.”

Thanks to everyone who completed the survey! For more information on breastfeeding resources in the Muskegon area, check out the “resources” section of my website.

Galacta-what!? Increasing Your Breastmilk the Yummy Way

galactacookies1

I must start off by saying that most women make plenty of milk for their babies without having to pay any attention to their diet or using herbs or other supplements. However, the truth is, many moms are looking for ways to boost their milk production due to having stressful, busy lives that require them to eat for convenience or be separated from their babies. As a mom, I’ve personally faced these obstacles and looked for natural ways to make more milk.

Galactagogue, from the Greek words for “milk” and “leading,” is the term for something that increases breastmilk production. The Wise Woman Herbal, by Susun S. Weed, suggests many foods and herbs that can be used as galactagogues. Many of these herbs are found in the Traditional Medicinal’s blend called “Mother’s Milk.” Unfortunately, many women do not like the taste of black licorice, which comes from the addition of fennel and anise. One alternative is to create single herb infusions of Red Raspberry Leaf, Nettles, Alfalfa or Red Clover. According to Weed, you can “Rotate, using each one for a week, to derive the unique benefits that each offers” (85).

Ultimately, though, there is no substitute for good nutrition. Healthy fats, whole grains and lots of leafy greens help women with postpartum healing and lactation. Adding fennel seeds to your granola and making your greens with Indian curry, which contains Fenugreek, a well-known galactagogue, are easy ways to “eat your medicine” naturally.

Which brings me to my favorite – galactacookies (named by my friend, Amber, who thought “lactation cookies” would contain breastmilk). Everyone has their own favorite recipe, but nearly all of them contain a few main ingredients: brewer’s or nutritional yeast, wheat germ, flax seed meal and whole (not instant) oats. My recipe is based on my mom’s 10-Cup-Cookie recipe, which is like a meal in a cookie. Feel free to decrease the sugar based on your own taste-buds.

Galactacookies

1 c. butter
1 c. white sugar
1 c. brown sugar
1 egg
1 c. flour (I use a mix of unbleached and whole wheat flour, adding flax seed meal, wheat germ and nutritional yeast to make a cup)
1 tsp. salt
1 tsp. baking soda
1 tsp. baking powder
1 c. oatmeal
1 c. coconut
1 c. raisins
1 c. chocolate (I buy the super dark bars and cut them in pieces)
1 c. nuts (I use walnuts)

With an electric or hand mixer, cream the butter and sugars. Add egg and mix well. Beat in peanut butter. In a separate bowl, mix flour mixture, salt, baking soda and baking powder. Reduce mixer speed to low and gradually add dry ingredients to wet. By hand, stir in remaining ingredients. Drop by spoonfuls onto ungreased cookie sheet. Bake for about 12 minutes at 350° F. Let them cool a bit on the pan before transferring to a cooling rack. Store in an airtight container.

I encourage you to make your own cookies or get someone to make them for you, but I am also happy to bake some special order. I sell them for $3 for 2 or a baker’s dozen for $15. The cottage food law requires me to sell them in person, so no mail or internet orders allowed. They also make a great gift to bring to a postpartum friend! I also supply organic herbs to my birth and postpartum doula clients as a part of my fee and am happy to provide them to women in my area at a reasonable cost.