Beth’s daughters, picking potatoes
— by Faith Groesbeck
Some social scientists believe that human evolution is closely linked to the need for animal protein to meet the nutritional needs of gestating a primate with a very large brain. The nutritional requirements of humans during pregnancy has been studied over time as they relate to nearly every complication of maternal and infant health. Perhaps due to our origins as hunters and gatherers, vegetarian and vegan diets have received a lot of scrutiny as being unnatural and harmful.
The Western history of dietary recommendations during pregnancy has swung like a pendulum of extremes from starvation to overeating and for the moment has landed in the middle. In the 19th C., when maternal mortality was high and cesareans were life-threatening, pregnant people were cautioned not to overeat to prevent large babies. Starting in the 1920’s, maternal weight gain was recorded at every prenatal visit. As late as 1974, text books advised women to gain no more than 25 pounds during pregnancy.
Then, in 1977, Dr. Thomas and Gail Brewer published What Every Pregnant Woman Should Know. Their research showed that preeclampsia was the result of protein deficiency. Subsequently, they advocated for a diet containing at least 100 grams of protein per day. They provided lists of food combinations to obtain “complete” protein that were difficult to comply with for vegetarians and nearly impossible for vegans.
Although researchers who followed were unable to replicate their studies, their teachings became very popular among healthcare providers. The Bradley Method and Childbirth Education Association of Metropolitan New York, where I received my training, both advocated the Brewer Diet for many years. Despite the lack of evidence, many providers believe that a vegetarian diet is dangerous during pregnancy. In fact, I was eating a vegan diet when I became pregnant for my son in 1997 and was advised by my midwife to at least eat canned salmon with the bones!
I had been influenced by books like Diet for a New America, written in 1987. That book’s popularity was followed by the low-carb craze and the Atkin’s Diet. I was working for Dr. Ronald Hoffman at the Hoffman Center for Holistic Medicine in Manhattan in the mid-1990’s. Dr. Hoffman promoted his own diet, the Salad and Salmon Diet, which was a little less extreme, but still focused on increasing lean protein.
Today, the pendulum has swung back again toward a plant-based diet. Thanks in part to the many documentaries in recent years that explore the negative environmental and health consequences of meat consumption, more people in the United States identify as vegetarian or vegan than ever before. Not surprisingly, many of my clients abstain from meat during pregnancy. Unsure of the most current research, I decided to explore the issue to learn the health impact of vegetarian and vegan pregnancies.
I found a systematic review, published in the British Journal of Obstetrics and Gynecology in 2015, that got me up-to-date and answered my questions. What they found was that studies finding poor outcomes in pregnancy did not always distinguish between those that were vegetarian by choice and those whose circumstances forced it upon them. It also found that, over time, in developed countries, food options for vegans and vegetarians have improved, making it easier to eat a well-rounded meat-free diet during pregnancy. Other than cautioning vegetarians to pay some attention to preventing iron-deficiency anemia and B12 deficiency, they could find no other concerns.
Although I’m no longer a vegetarian or vegan, I am a conscious eater and appreciate those who also eat conscientiously in regards to their own health or that of the planet’s. I can provide herbal teas for my vegetarian and vegan clients to boost their intake of minerals, including iron. I can easily modify my lactation cookie recipe by substituting for eggs and butter. Since educating myself, I can also affirm the health of a vegetarian and vegan diet during pregnancy.
How about you – were you vegan or vegetarian during your pregnancies? Did you feel supported by your community and providers? Please share your stories!
“3 Historical Trends in Clinical Practice, Maternal Nutritional Status, and the Course and Outcome of Pregnancy.” Nutrition During Pregnancy: Part I: Weight Gain, Part II: Nutrient Supplements. Washington, DC: The National Academies Press, 1990 .
Brewer, Gail Sforza. What every pregnant woman should know: the truth about diets and drugs in pregnancy. Random House, 1977.
Milton, Katharine. “The critical role played by animal source foods in human (Homo) evolution.” The Journal of nutrition 133.11 (2003): 3886S-3892S.
Piccoli, G. B., et al. “Vegan–vegetarian diets in pregnancy: danger or panacea? A systematic narrative review.” BJOG: An International Journal of Obstetrics & Gynaecology 122.5 (2015): 623-633.
— by Faith Groesbeck, BA, CCCE, CD (BAI)
This month, the results of the ARRIVE study, or A Randomized Trial of Induction Versus Expectant Management, were presented at the Society for Maternal-Fetal Medicines annual meeting, called the Pregnancy Meeting™. This study is explained in more depth on the Evidence Based Birth® website, in the article on due dates.
The research showed that in over 6,000 women, inducing labor at 39 weeks without any other medical indication, reduced the overall risk of cesarean, developing pregnancy complications and harm to the baby. While advocates warn that this may mean that we face a future in which all pregnancies will be forced to end before reaching their due date, I’m a little more optimistic. In my experience, I’ve found it more likely that the pregnant person will choose an induction once this becomes an option for them rather than their healthcare provider imposing it on them. Provider practices vary greatly across the country, so I’m not sure this is the case everywhere, but to date, no professional organizations have said that this should become the standard of care (SMFM).
This research brings attention to two sides of the coin when it comes to the induction debate between those who advocate for physiologic birth versus those who seek better outcomes through technology. On the one hand, birth is a normal process, best left unhindered when possible. On the other, the longer a person remains pregnant, the more likely they are to develop pregnancy complications and the more time the fetus has to grow inside the uterus. I’m not saying our bodies are not marvelous and capable of birthing babies much larger than average, which is around seven and a half pounds. I’m sitting somewhere in the middle of do nothing and intervening thinking, is there a way to prevent the need for induction and still have good outcomes?
While I realize the tremendous pressure parents are under to do everything “right,” I’ve also spoken to a lot of women who have said that if they had known that there was any chance that they could have possibly prevented the need for an induction or a cesarean, they would have gladly made changes in their lifestyle to at least reduce the risk.
So, here are some tips that may help to reduce the need for induction. I’m not saying that if everyone follows these ideas that they are guaranteed the outcome they desire or that women who do not do these things are at fault if intervention is necessary. I am saying that we may have some control over outcomes if it is our desire and within our means to explore these options. As always, please consult with your healthcare provider before making dietary or fitness changes during pregnancy.
- Hire a doula. Having a doula present at your birth increases the likelihood of having a spontaneous vaginal delivery (Hodnet). A spontaneous vaginal delivery is when the pregnant person goes into labor on their own, without the use of drugs and that the baby is born without the use of forceps, vacuum extraction or cesarean.
- Eat Dates. Several studies have shown that eating dates at the end of pregnancy, can reduce the need for an induction (Al-Kuran; Jadidi and Kordi). The general recommendation is to eat 6 dates per day, starting at 36 weeks.
- Practice Yoga. While yoga has many health benefits throughout a person’s life, a study done in Iran found specifically that doing one hour of yoga, six times per week, starting at 26 weeks, reduced the need for induction and resulted in fewer cesarean births (Jahdi).
- Quit Smoking. Smoking is a risk factor for having a smaller than expected fetus or having the amniotic sack, or bag of waters, break before their due date. Both may, under certain circumstances, be indications for induction of labor.
- Eat a Low GI Diet. While early induction for those who develop diabetes in pregnancy is not evidence based, gestational diabetes does increase the risk of developing other complications which may then make induction the safest choice. Eating a low glycemic diet during pregnancy decreases the risk of developing gestational diabetes and thus the risk of developing further complications (Brand-Miller).
As a doula, I’m here to support families, often with otherwise healthy pregnancies, who face decisions around inductions. I’m also glad that through childbirth education, families can adopt healthy lifestyle practices that may be able to prevent the need for an induction in the first place.
*** *** ***
Al-Kuran, O., Al-Mehaisen, L., Bawadi, H., Beitawi, S., & Amarin, Z. (2011). The effect of late pregnancy consumption of date fruit on labour and delivery. Journal of obstetrics and gynaecology, 31(1), 29-31.
Brand-Miller, J., Marsh, K., & Moses, R. (2013). The Low GI Eating Plan for an Optimal Pregnancy: The Authoritative Science-Based Nutrition Guide for Mother and Baby. Workman Publishing.
Hodnett, E. D., Gates, S., Hofmeyr, G. J., Sakala, C., & Weston, J. (2012). Continuous support for women during childbirth. Cochrane Database Syst Rev, 10.
Jadidi, M. Y., Sang, S. J. B., & Lari, H. (2016). The effect of date fruit consumption on spontaneous labor. Journal of Research on Religion & Health, 1(3).
Jahdi, F., Sheikhan, F., Haghani, H., Sharifi, B., Ghaseminejad, A., Khodarahmian, M., & Rouhana, N. (2017). Yoga during pregnancy: The effects on labor pain and delivery outcomes (A randomized controlled trial). Complementary therapies in clinical practice, 27, 1-4.
Kordi, M., Aghaei Meybodi, F., Tara, F., Nemati, M., & Taghi Shakeri, M. (2014). The effect of late pregnancy consumption of date fruit on cervical ripening in nulliparous women. Journal of Midwifery and Reproductive Health, 2(3), 150-156.
Society for Maternal-Fetal Medicine. (2018, February 1). Induced labor after 39 weeks in healthy women may reduce the need for cesarean birth: More information is needed before changes to clinical practice are made. ScienceDaily. Retrieved February 16, 2018 from www.sciencedaily.com/releases/2018/02/180201115718.htm
I’ve wanted to write about this for years. The profound effect crying has on people has always fascinated me. How can something that must seemingly come from a place of hurt lead to what can only be described as relief?
Now, for some people, crying comes easily. Maybe they are just instinctively good cryers or were fortunate to have the support from others to cry; I’m sure there are many reasons. But for others, like me, crying doesn’t come so easily. For pregnant women, this makes breaking through barriers during their pregnancies and labors more challenging.
Crying has always been hard for me, even though I know I need to do it. I know how much better I feel, how much less cloudy my mind is. But I also know it takes a willingness to be vulnerable, something I seldom allow myself to do. I need privacy and safety, as many others likely do. Often, those two elements don’t come together and so the need to cry builds. At some point, there’s no moving past what’s causing the hurt and the only way out is to be honest and let the tears flow.
Possible Hang-Ups About Crying
I know what my hang-ups are when it comes to crying. As someone who was bullied all through school, I did my best to hide my tears because I didn’t want to be seen as weak or give them the satisfaction of seeing me hurt. Like many other kids, I also remember being disciplined or scolded at times for crying too much. It’s about safety for me; I’ll cry when I need to, but never in front of anyone…not if I can help it. I also fear that I’m “too much” when I do get emotional, and that’s embarassing to me. So finding the nearest bathroom, bedroom, or private place is a must if the tears are going to fall.
And doesn’t anyone else think crying hurts? I hate how I feel when I’m doing it. I also hate how sometimes, it’s like an earthquake with aftershocks that pop up out of nowhere in the hours after the initial round of tears. Despite how much I hate it, though, I can never deny how necessary it is. It’s freedom, it’s relief.
So, for women who are pregnant, what are some hang-ups they might have about crying prior to and during labor? Here are a few possibilities:
- Fear of judgement
- Fear of appearing weak
- Fear of being vulnerable in front of others
- A belief that crying is a sign of weakness
- A belief that she’ll be “too much” for others to handle
- Fear of being seen as overly emotional
The reasons for these hang-ups no doubt vary from woman to woman, based on her individual life experience. Some of these impactful experiences might include:
- Upbringing (cultural, religious, etc.)
- Lack of privacy
- Lack of support
- Suggestion from others not to cry
The Benefits of Crying
Believe it or not, even if it doesn’t always come easy, crying is good for you. The list of benefits include:
- reducing emotional stress
- ridding the body of toxins
- improving mental clarity
- moving past barriers
- releasing tension
There is science behind the benefits of crying. One study found a difference in the make-up of reflex tears and emotional tears. While the reflex tears consisted primarily of water (approximately 98%), emotional tears included more chemicals. What I really thought was interesting is that one of the hormones found in emotional tears was prolactin, which is also associated with a mother’s let down reflex.
You can Google it all you want; the benefits of crying are real.
But what if you’re like me? What if crying doesn’t come so easily?
Practice is the Key
If you struggle to let those tears flow, consider the growing trend in Japan. I saw an article online that struck me a couple of years ago: Japanese men getting together to watch sad movies so they could learn how to cry. In a society where it’s considered a virtue to keep emotions in check, this trend is helping to “normalize” crying. Not to mention how much better the participants feel after a good cry!
Life is already stressful enough. Add to it the changing hormones, anxiety, and fears common in pregnancy. It’s very common for women to “get stuck” or plateau during pregnancy and childbirth. What isn’t so easy is giving in and letting it go with a good cry.
Any number of things can give a pregant woman reason to cry. From financial strain, physical changes, discomfort, to anxiety and fears surrounding birth and past trauma, it’s completely understandable to feel the need to cry. Pregnancy tends to be a time in the lives of many women where such issues emerge to be dealt with.
For a woman nearing the end of her pregnancy, it’s the perfect time to let the tears flow when she feels the need. Not only will it help her feel better, it’s great practice for labor. One of my favorite birth-related books, Natural Hospital Birth by Cynthia Gabriel, points out just how significant crying during pregnancy, and especially during labor, is. I was trying to come up with a good analogy to describe the way holding back from crying affects moving beyond barriers for pregnant and laboring women. All I could come up with was having to pee.
We all have to do it. We all know that if we hold it in too long, it’s all we can think about. There’s nothing else taking up residence in our minds when the need to pee has reached its nagging peak. Same goes for needing to cry. At some point, the dam will break.
I also think that Ina May Gaskin used a similar analogy that also applies here. She pointed out how most people have a hard time peeing in front of others. This, too, applies to crying. Having an audience, especially one that you aren’t sure supports you, is a real hinderance. Call it what you will (I think of it as a sort of stage fright), crying openly in front of others isn’t always easy.
As with just about everything else in life, practice is the key. Pregnancy is the perfect time to get in touch with your emotions and address any mental roadblocks you may be facing. Crying helps with this. A few ideas to help you with getting those tears to flow are:
- Find time to be alone
- Find safe people to talk to (your partner, a trusted friend, family member, counselor, or doula are excellent options)
- Journal about your feelings
- Watch a movie that makes you cry
- Listen to music that helps you cry
- Be honest with yourself about your feelings
- Give yourself permission to cry
As challenging as it may be, even one good cry during pregnancy can help to straighten out jumbled thoughts and emotions. It also helps to set the stage for the transition to childbirth. If crying during pregnancy helped to move past emotional barriers, remember that it can do the same during labor. Physically and mentally demanding, childbirth is no time to hold back from crying, especially in the instance of a plateau or intense transition. Tips for crying during labor include:
- Requesting privacy if there are too many people in the room
- Letting your care provider know ahead of time you plan on crying as an aid to help labor progress
- Making sure you have good support (your partner, doula, friend, or relative)
- Shutting out negative comments or advice from others (a support person can help with this)
- Practicing during pregnancy
- Trusting that crying is purposeful
- Reminding yourself of other times crying has helped you to feel better (a support person can remind you of this as well)
There will always be obstacles to crying, though. Many people, even medical care providers (they’re people with feelings, too), are made uncomfortable by crying. It’s possible that they or others (your partner, friends, family, etc.) might tell you not to cry. They may or may not give you a list of reasons why you shouldn’t cry or tell you what to do instead. Odds are, they are simply just uncomfortable with it. Generally speaking, I don’t believe most people like to see others hurt. It’s also without question a learned response. I know I’ve heard it and hate to admit I’ve said it… “Don’t cry”. While no ill is likely intended by telling someone not to cry, it takes away from the validity of a person’s emotions.
But crying isn’t about weakness or defeat. So in spite of your own hang-ups, or what others might think or say about it, it’s important to remind yourself that crying is an essential release that leads to renewed strength.
It’s kind of like the difference between transition in labor and the pushing stage: considered the most intense part of labor for many women, transition is often the time women are pushed to the limits of what they think they can take. Those viewing on will inherently want to help. If a woman is encouraged and supported through this stage, pushing often yields a more focused and less distressed woman. With the pain and intensity of transition over, women can catch their breath and get ready for the purposeful work of pushing their babies out.
If, instead of receiving encouragement and support during transition, a woman is told not to cry or is offered other options, she may miss out on the relief and satisfaction that waits on the other side of safely expressing her emotions through tears. Anxiety, fear, and other pent up emotions that are not let out cause more physical pain, as well. This is often the point where women face decisions that will affect how their babies are born. This is a very tender period for the mother. Practice in supporting a woman in this delicate phase is essential. Not only does it reduce her risk of interventions, it increases her odds of reflecting positively on the birth experience.
Just like transition, crying is temporary. It’s simply a part of the process.
Seeking out the support of a doula is an excellent idea if you fall into the category of women who struggle to cry as a way of dealing with pent up emotions or who lack needed support. Trained to listen non-judgmentally, provide encouragement and a feeling of safety, doulas know the difference that positive support makes possible.
For information about resources in the area or to inquire about our services, please contact us.
“Although this moment is bittersweet, it’s one of my favorite photos and I’m glad it was captured. Just before I was taken into surgery, after 24 hours of hard labor at home. My #doula, Faith, never left my side.”
— Ottawa County client, after a homebirth transfer to hospital
“[Faith] provided me with many resources, and I also really appreciated the teas she made me. Her evidence based approach was very unbiased and nonjudgmental. I felt like I could be honest about my needs with her… She really proved herself when the birthday came. She was my knight in shining armor! She made me feel so confident and comforted through my labor. Her knowledge of a birthing woman’s body and need for support was obvious. I credit my smooth labor and delivery to her…”
— Norton Shores mom, of her homebirth with Birth Quest
When I tell people that I’m a birth doula, the most common response I get is, “Oh, so you help women having their babies at home?”. To which I reply, “Yes, doulas support women at homebirths, but all of the women I’ve supported have given birth in hospitals”.
Because the word doula is not a part of everyday vocabulary for most people, I think many confuse a doula with a midwife. This is usually the second thing I have to explain to people about my job. I don’t catch the babies; I hold space for mom and support her through the process.
The next question usually revolves around why doulas attend more hospital births than homebirths. Several factors impact a woman’s decision on whether or not to hire a doula. For the woman choosing to give birth at home, the biggest factor is likely financial. Homebirths are generally paid for out-of-pocket, as are doulas. Since doulas don’t provide the clinical support a pregnant woman needs and they don’t catch babies, women who desire a homebirth are often faced with the decision to choose between hiring a midwife or a doula. In this scenario, the midwife is usually chosen because of the necessity of her services.
But what if having a doula AND a midwife were an option?
It’s true that your midwife will spend more time with you while you labor and provide a different model of care during pregnancy and delivery. It’s also true that she will likely have assistants who can attend to some of your needs. However, with their focus primarily on the clinical aspects of care, there are other elements left unaccounted for.
Generally, a doula will meet with you in your home at least a couple of times before you have your baby. She’ll be familiar with you and your surroundings. It’s during these meetings that doula and mom become acquainted and comfortable with one another. If there are pets, the doula will get to know them. If there are other children or family members, the doula will get to know them, too. This process is vital in developing a safe relationship as the mother will depend on the doula to cover the non-clinical elements that are a part of the birth process. It’s during these visits that mom can share her hopes and her fears. While she’s probably also done this with her midwife, the doula provides more time for mom to process and plan. The more informational and emotional support a woman receives during her pregnancy, the better.
And in the event of a hospital transfer?
Your doula will be with you. Your midwife probably will be, too, but if your doula is the one you’ve been leaning on emotionally during your pregnancy and labor, her presence is vital. Odds are, she was with you earlier in your labor than your midwife was, as well. That’s the beauty of a doula: no shift changes and present with you from the beginning to the end. Another benefit is that a doula is likely to be very familiar with the hospital environment and maybe even some of the staff, so she can help to explain what is going on and bridge the gaps between a homebirth and a hospital birth.
Regardless of the outcome, whether you had your baby at home or had to transfer to the hospital, your doula will be there postpartum for you to process the experience. Your midwife will, too, but depending on how the birth went compared to how you had envisioned it, your doula provides added space and opportunity to share things that you might not wish to share with your midwife. I know for me, I’m no good at confrontation and had I been upset with my midwife or disappointed, there’s no way I could have told her that (fortunately, that wasn’t the case for me!). A doula is trained to listen to your grievances and your joys. Validating your feelings and helping you to pick through the pieces and put them together, a doula can offer perspective, encouragement, and reassurance.
Birth is one of the most unpredictable events in nature. No matter how much you know about it, curveballs often appear in the form of all the little things that surface in the midst of the limbo of labor that no one had planned on.
I think back to my last pregnancy, when I had finally planned the homebirth I’d always wanted. It honestly was an amazing experience to labor at home and push my baby out the way I wanted with a supportive group of women (midwives, assistants, my mom and mother-in-law) and my husband. All of it was golden. I was even doing “doula talk” in my head, like focusing on the words soft and open. You see, I’d had my birth doula training through DONA only a few short months before the birth. So at the very least, I was able to focus and feel pretty in control during the more intense moments of labor. Super proud of myself for that!
However, the entire day leading up to my precious little one’s arrival, my anxiety and the negative self-talk going on in my head was relentless. Fourth baby, longest labor. Why? Was I not moving around enough? How long was it going to take? Why were the contractions that woke me in the wee hours of the morning that were 4 minutes apart and very uncomfortable spacing out to 15 minutes and not as painful? And there went my thoughts for the better part of an entire day. It’s the one part of my labor I look back on and wish I’d had a better attitude about. As helpful and supportive as my husband was physically for me that last time around (so grateful for the counter pressure and back rubs!), I needed someone to help ease my mind. I needed someone to remind me that every labor is different and that what I was experiencing was normal. I’d fed my fear of waking in labor and things moving quickly, as they had in the past (with my third baby, I went from 5cm to holding my baby in under a couple of hours after painfully relentless contractions). Instead, I spent the better part of the 24 hours that I was in labor anxious, discouraged, and feeling guilty for having sent my kids away first thing in the morning because I was sure “this is it!”. I wasn’t mentally prepared for a long labor. I’d never had one.
Don’t get me wrong; my birth team was incredible! I’d depend on them again in a heartbeat for their care and support during pregnancy and birth. Looking back, though, I know I needed more in those long hours before my little guy finally made his arrival.
Doulas meet so many needs that are maybe overlooked or not considered.
I know when my son was born, my house was a mess. Pretty sure there were dishes and laundry that needed to be done. I didn’t feel like cooking and no one brought food while I was in labor. It was a long, lonely day. I struggled to find distractions. There were so many things during that entire day of early labor that a doula could have helped me and my husband with. We were both so tired.
When I was in active labor and pushing, I soaked up every encouraging word and touch my birth team provided me. They were tender, attentive, and confident. In hindsight, I realize I had needed that all day to better cope with my apprehension about the imminent arrival of my baby. I needed someone to hold that space for me and remind me that everything would be okay. I needed someone to tend to the things my husband and I couldn’t get to while I tried to rest.
My other children were born in the hospital, where food and laundry weren’t an issue. While the hospital environment is not my personal favorite for giving birth, those two things ended up being huge oversights for me with my homebirth. I don’t have sisters or super close girlfriends that I would have felt comfortable having with me while I labored; and I wanted my mom and mother-in-law present for the birth, not running around my house cleaning and cooking. While having my son at home was truly a dream, waking up the next day to the reality of…well, real life, wasn’t. Looking back, I hadn’t planned for how to handle those seemingly tiny details. Who knew that while I did the hard work of bringing life into the world that my house wouldn’t clean itself or cook a meal for me! Or take care of my other children when they returned home the very next day (totally needed a postpartum doula, too).
My business partner and Birth Quest founder, Faith, also had her last baby at home. Her labor, which was the complete opposite of mine, was quick and intense. Despite her doula training, she found herself in need of one and speaking the words women the world over often say when it’s become too much…“I can’t do this! Make it stop!”
I needed a doula; but even if I’d wanted one, I couldn’t have afforded one anyway.
At least, that’s what I thought. I know better now. I could have asked family to help with the expense or sought a doula out that would take my finances into consideration and work with me to make it affordable. Our vision is to increase access to doulas for every person who wants one, so please contact us if you have a financial hardship, especially if that is due to the unreimbursed expense of an out-of-hospital birth. Everyone deserves a doula!
As one Birth Quest client of her having a doula for her homebirth said, “My parents paid for my doula as a gift for our Homebirth. If they hadn’t, cost might had been an issue but I definitely would choose to hire a doula again. Their knowledge and support are so priceless if you can find one you love!”
My story and Faith’s are just two of many stories. Doulas do so many things. If any one part of your labor and birth could be considered customizable, it’s who you choose as your doula. With you from the moment you feel like you need her, she’s the one you’ll have expressed your desires to about labor and birth. Whether you need someone behind the scenes – doing your dishes, folding laundry, or getting a meal ready – or someone to be a part of the action – holding your hand, taking pictures, or showing your partner where to apply counterpressure – your doula is the one person attuned to your wants and needs. And if at any time you want what your doulas doing to change, just say the words…that’s what she’s there for.
What does a doula do at a homebirth anyway?
At a homebirth, a doula is going to do everything she’d do for you in a hospital, except that she is in your space where there are more personal elements that might need tending to. Because the list could go on and on, here are a few examples:
- Ideally, she arrives earlier in your labor to provide support (informational, emotional, physical, etc.)
- Support for your partner (in the form of breaks, encouragement, direction on how to apply pain management techniques, etc.)
- Support for others present during your labor and birth (friends, relatives, children, etc.)
- Light household chores (dishes, laundry, etc.)
- Meal preparation
- Tending to the needs of pets
- Taking pictures
- Crowd control (making sure mom has the space and privacy she desires)
- Immediate postpartum support
- Assistance with breastfeeding
- Preparing a place to rest postpartum
- Meeting needs specific to the individual
- Hold space for the woman in labor
- Create/maintain a peaceful and calm environment
Who could use a doula at a homebirth?
There’s no denying that as a doula, I feel the benefits are universal and for all women. With that being said, specific reasons a doula is perfect for a homebirth include:
- Women whose family/friends are not near enough to provide support
- Women without a partner or whose partner might not be available for support
- Women with anxiety or other health issues that might impact their confidence in their ability to give birth
- Women who want to be prepared in the event of a hospital transfer
- Women who know they need a lot of support
- Women who don’t want to worry about meals or cleaning during labor and after birth
- Women who know their partners will need additional support
- Women who want support but aren’t comfortable with family/friends present
- Women who have specific wants and needs
- Women who have other children that will be present that need support
- Women who want someone to promote and maintain a calm, peaceful environment
- Women who want a safe person to hold space for them
Since doulas aren’t as commonly present at homebirths as they are for hospital births, we did a little investigating into why.
Thanks to the women who took part in our Facebook poll (@birthquestservices) to find out why they, women who’d had homebirths, didn’t have a doula. Not surprisingly, the leading reason was cost. A close second were women who felt they already had enough support while the third reason was a desire for privacy.
However, because women were allowed to choose more than one option, some chose both cost and sufficient support as their primary reasons for not hiring a doula. This leaves us to wonder…which was the biggest factor?
Answers to a 2017 Muskegon-area Facebook post asking, “If you had a homebirth and didn’t hire a doula, why not?”
— Blog written by Beth Singleton, DONA-trained Birth Quest birth doula and photographer,
who had her fourth child at home in Muskegon
Young pregnant woman drinking a glass of water in her kitchen while holding her belly
This guest blog was contributed by Drugwatch. This article is not a substitute for medical treatment. Please consult with your healthcare provider if you have any concerns about your health during pregnancy.
Serious Side Effects for a Common Concern
Urinary tract infections are extremely common in women, and even more so among pregnant women. During the second and third trimesters of pregnancy, women are at an increased risk of developing a UTI. Treatment for this infection typically includes antibiotics, some of which can leave life-threatening adverse reactions for mom and baby.
A urinary tract infection is a bacterial infection of the urinary system. It develops when bacteria comes in contact with the urethra, ureters, bladder or kidneys. Women are more susceptible to UTIs because they have shorter urethras, providing bacteria quicker access to the bladder. Symptoms include:
- An intense urge to use the bathroom while your bladder is empty
- Burning sensation while urinating
- Lower back and abdominal pain
- Pelvic pain
- Bloody urine
- Fever or chills (which indicates the infection has spread to the kidneys)
Other contributors to urinary tract infections include sexual activity, a suppressed immune system, certain types of birth control, menopause and any other blockages in the urinary tract.
Treating Urinary Tract Infections During Pregnancy
Bacterial infections need to be treated with antibiotics to ensure the infection completely goes away. Although some antibiotics pose certain risks to unborn babies, not using an antibiotic to treat an infection could cause more harm. For that reason, doctors will recommend the safest option and most efficient treatment. Doctors even use the U.S. Food and Drug Administration’s list of Pharmaceutical Pregnancy Categories to help prescribe antibiotics that are safe to use during pregnancy.
These Pharmaceutical Pregnancy Categories rank in five letters — A, B, C, D and X — to indicate the level of safety of drugs for pregnant women. The most unsafe rankings are X and D, and are strongly advised against. The safest rankings are A and B. Drugs and antibiotics with a C ranking are somewhat safe, but it is important to know they may cause a level of risk. Some of the common antibiotics used during pregnancy include:
- Amoxicillin — B ranking
- Nitrofurantoin (Macrodantin) — B ranking
- Erythromycin — B ranking
- Ciproflaxacin (Cipro) — C ranking
Whenever taking antibiotics, it is important to only take what is prescribed. An excess of any drug, especially while pregnant, can prove to be dangerous to a mother’s health and her baby’s growth. Pregnant women are at an increased risk of developing bad reactions from drugs, specifically from fluoroquinolones. Studies have found these drugs can be toxic to a growing fetus, especially when taken in excess and not as a physician prescribed. Pregnant women taking fluoroquinolones should take only what is prescribed and with a level of caution.
How to Prevent UTIs
It is common for urinary tract infections to resurface over time. However, there are ways to reduce the likelihood of developing another infection. To prevent a UTI, you should:
- Wipe from front to back after using the bathroom.
- Stay hydrated! Increase your water intake while treating the infection, and drink at least 6 – 8 glasses of water regularly.
- Drink unsweetened cranberry juice, which can eliminate the presence of unwanted bacteria in the body.
- Avoid sexual activity while being treated for an infection.
- Wear cotton underwear to wick away moisture and maintain good hygiene habits.
This article was authored by Kiara Anthony.
Kiara Anthony earned her undergraduate degree in Mass Communications from Towson University, and her graduate degree in Communications from Trinity Washington University. She regularly contributes to Drugwatch.com, along with other publications.