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Natural Health Management During Pregnancy - This week: HEART BURN

HEART BURN by Melissa Tuton

Why is heartburn so common in pregnancy?

During pregnancy the placenta produces the hormone progesterone to relax the muscles of the uterus. Progesterone unfortunately also relaxes the valve that separates the stomach from your esophagus (Lower Esophageal Sphincter / LES), allowing stomach acids to travel up and cause the dreaded heartburn. And later on in pregnancy, the added pressure from your growing baby is pushing on your stomach, causes acids to travel up your esophagus.



Prevention is really the best medicine for heartburn!

AVOID:

• Antacids. Believe it or not, they will not help your LES valve to work properly. They will, however, cause acid levels in your stomach to drop; resulting in defective digestion. This allows food to sit in the stomach environment for longer than it should, putrefying as it does so and emitting acidic gases making your heartburn even worse!
• Acid forming foods: sugary, processed, refined carbohydrates, carbonated beverages
• Large meals
• High amounts of liquids during meals
• Caffeine containing foods and beverages
• Lying down after eating

So what CAN we DO?

• Eat alkaline foods: fresh, raw fruits and vegetables
• Eat SMALL meals and snacks SLOWLY throughout the day
• Sleep at a slight incline by propping your head and shoulders up
• Here are some home-remedies to consider adding to your diet:

• Apple Cider Vinegar - 1-2 tbsp. in 1-2 cups water, or however you can get it down! Those of you who know me, know that I'm an ACV advocate, nut, one of the two or both! Not only can it help with digestion and keeping heartburn at bay, but it can also help fight bacteria forming in your system - this one for sure is my Number 1 for a lot of things!!!
• Fermented Foods like pickles, kombucha, or kefir - aids in digestion
• Papaya - digestive enzymes - can be taken in the form of fruit or chewable supplement
• Pineapple - digestive enzymes - available in same forms as Papaya and sometimes offered together
• Coconut Water - help cool the burning feeling (more of a temporary fix, but has plenty of other benefits such as hydrations which as pregnant women, you know is super super important!)

A Must Read - The Hidden Risks of Epidurals

This is a very important read for those out there trying to figure out if the "possible" benefits of an epidural outweigh the risks. It's important to do your homework now, before you head to the hospital or birth center as you won't receive full disclosure on the risks of the epidural when you're actually in labor. Yes, you will be given a quick rundown of some of the potential risks as they call them and given an informed consent form to sign. But what if the anesthesiologist were to explain each of the significant risks involved from start to finish just after you had asked for your epidural? Would you choose it? I guarantee that by the time they had gone though all the associated risks (short term and long), you'd already be through the most difficult part of labor, transition, and be halfway through pushing your baby out. (Transition - this is usually the part of labor when most women call for medication. It is also, in my experienced opinion, the most cruel time to offer medication simply because the mountain of active labor is peaking during this time, and pushing is literally just on the other side - where confidence, control, energy, and excitement are usually restored and where women can really do something about getting that baby out. Evidence shows that the pushing stage is most effective without medication - please read more about the detrimental effects of epidurals on pushing in the article - The Hidden Risk of Epidurals ).

Labor is hard and everyone has different levels of pain tolerance, but education is power. And if for a very brief moment in life, we are able to experience our full potential as women for the sake of not only knowing what we are capable of, but to give our precious little ones the best start possible, why not then, at the very least commit to a drug-free plan, prepare in the best ways possible, surround ourselves with positive affirmations, and hire birth professions, shown by evidence to successfully assist us along this path, help us reach our goals, and ensure positive birth experiences and outcomes?

We can't exactly commit to anything if we don't prepare properly - this is simply a fact. True, we'll never know exactly what childbirth will feel like until we get there, but if we have a comprehensive education, the right support, the ability to find calmness and breath (practice makes perfect or at least accessible here), and perseverance, our chances of having safe, drug-free, no/low-interventive/injury births are far greater than simply walking into the hospital with an "open-mind" as 'they' put so eloquently. Not that having an open-mind is necessarily a bad thing, but from the hospital's perspective, it actually can be.  If you don't know what to expect and you don't know the risks and you haven't prepared and you haven't gathered the proper support, your "open-mind" isn't going to help you reach your goals - having an open-mind is not the same as making wise informed decisions.

Having an open-mind in labor to me means to try not to worry too much about how long you have been or will be in labor as long as the health of mom and baby are good; understanding that labor takes time and timing has a purpose and is an important exercise in having an open mind. Open-mindedness also means to be willing to move or try a different position that you haven't tried before and letting the pressure/pain you feel guide you through your labor and literally help you to open up. It means to accept that your body in labor is you in labor, and though you haven't been there before or maybe you have but had a different/negative past experience, your body inherently knows what to do, you must trust it and work with it. Having an open-mind in labor is helpful when you think of it in terms of an understanding of the body's natural normal physiological process, it is not helpful when it means letting others tell you what you need without having the evidence to back it up, or without allowing you to try other options before resorting to a typical protocol.

It's true that things may come up in labor where you need to detour from your original plan, but again, understanding and planning for these variations and interventions is key in making safe, informed decisions for you and your baby, and is also a determinate in your level of satisfaction of your birth experience and both you and your baby's overall health. It's your life - you expect to have a choice and control in every other area, why not in childbirth? It's your birthright, use it to fuel your choices and to create a plan that supports the safest journey with the most positive outcomes.

Conclusion from the Article:
Epidurals have possible benefits but also significant risks for the laboring mother and her baby. These risks are well documented in the medical literature but may not be disclosed to the laboring woman. Women who wish to avoid the use of epidurals are advised to choose caregivers and models of care that promote, support, and understand the principles and practice of natural and undisturbed birth.

Important Points from the Article: Including  Epidural Effects on Newborns, Breastfeeding, and Overall Satisfaction of Birth Experience. (If you don't read the article above, please read these important notes below, thanks!)

Neurobehavioral Effects (from Epidural Exposure)
Ann Murray et al. compared 15 unmedicated with ⁴⁰ epidural-exposed babies and found that the epidural babies still had a depressed NBAS score at five days, with particular difficulty controlling their state. Twenty babies whose mothers had received oxytocin as well as an epidural had even more depression of NBAS scores, which may be explained by their higher rates of jaundice. At one month, epidural mothers found their babies "less adaptable, more intense and more bothersome in their behavior." These differences could not be explained by the more difficult deliveries and subsequent maternal-infant separations associated with epidurals.⁹⁰

Carol Sepkoski et al. compared 20 epidural babies with 20 unmedicated babies, and found less alertness and ability to orient for the first month of life. The epidural mothers spent less time with their babies in the hospital, in direct proportion to the total dose of bupivacaine administered.⁹¹ Deborah Rosenblatt et al. tested epidural babies with NBAS over six weeks and found maximal depression on the first day. Although there was some recovery, at three days epidural babies still cried more easily and more often; aspects of this problem ("control of state") persisted for the full six weeks.⁹²

Breastfeeding
As with neurobehavior, effects on breastfeeding are poorly studied, and more recent randomized controlled trials comparing exposure to epidural and opiate drugs are especially misleading because opiates have a well-recognized negative effect on early breastfeeding behavior and success.^103-107

Epidurals may affect the experience and success of breastfeeding through several mechanisms. First, the epidural-exposed baby may have neurobehavioral abnormalities caused by drug exposure that are likely to be maximal in the hours following birth "the critical time" for the initiation of breastfeeding. Recent research has found (rather obviously) that the higher the newborn's neurobehavior score, the higher his or her score for breastfeeding behavior.¹⁰⁸

In another study, the baby's breastfeeding abilities, as measured by the Infant Breastfeeding Assessment Tool (IBFAT), were highest among unmedicated babies, lower for babies exposed to epidurals or IV opiates, and lowest for babies exposed to both. Infants with lower scores were weaned earlier, although overall, similar numbers in all groups were breastfeeding at six weeks.¹⁰⁹ In other research, babies exposed to epidurals and spinals were more likely to lose weight in the hospital, which may reflect poor feeding efficiency.¹¹⁰ Other research has suggested that newborn breastfeeding behavior and NACS scores may be normal when an ultra-low-dose epidural is used, although even in this study, babies with higher drug levels had lower neurobehavior (NACS) scores at "two hours."¹¹¹

Second, epidurals may affect the new mother, making breastfeeding more difficult. This situation is likely if she has experienced a long labor, an instrumental delivery, or separation from her baby, all of which are more likely following an epidural. Hormonal disruptions may also contribute, as oxytocin is a major hormone of breastfeeding.

One study found that babies born after epidurals were less likely to be fully breastfed on hospital discharge; this was a special risk for epidural mothers whose babies did not feed in the first hour after birth.¹¹² A Finnish survey records that 67 percent of women who had labored with an epidural reported partial or full formula feeding in the first 12 weeks compared to 29 percent of nonepidural mothers; epidural mothers were also more likely to report having "not enough milk."¹¹³

Two groups of Swedish researchers have looked at the subtle but complex breastfeeding and prebreastfeeding behavior of unmedicated newborns. One group has documented that when placed skin-to-skin on the mother's chest, a newborn can crawl up, find the nipple, and self-attach.¹¹⁴ Newborns affected by opiate drugs in labor or separated from their mothers briefly after birth lose much of this ability. The other Swedish group found that newborns exposed to labor analgesia (mostly opiates, but including some epidurals) were also disorganized in their prefeeding behavior "nipple massage, licking, and hand sucking" compared to unmedicated newborns.¹¹⁵

Satisfaction with Birth
Obstetric care providers have assumed that control of pain is the foremost concern of laboring women and that effective pain relief will ensure a positive birth experience. In fact, there is evidence that the opposite may be true. Several studies have shown that women who use no labor medication are the most satisfied with their birth experience at the time,¹¹⁶ at six weeks,¹¹⁷ and at one year after the birth.¹¹⁸ In a UK survey of 1,000 women, those who had used epidurals reported the highest levels of pain relief but the lowest levels of satisfaction with the birth, probably because of the higher rates of intervention.

Finally, it is noteworthy that caregiver preferences may to a large extent dictate the use of epidurals and other medical procedures for laboring women. One study found that women under the care of family physicians with a low mean use of epidurals were less likely to receive monitoring and Pitocin, to deliver by cesarean, and to have their babies admitted to newborn special care.¹¹⁹

 

 

Beautiful Birth from One Tree Photography (Doula: Kristin Dibeh from Kind Birth)

I really wanted to share this with my Belly Blossom Families!

This birth is near and dear to my heart, as my doula, Kristin, was the doula here, and it took place at the same birth center where Violet was born, Eastside Birth Center, in Bellevue, WA.

Please Enjoy!

Summer's Birth and One Tree Photography

Good Mothers Don't Ask Questions, article from ImprovingBirth.org

Good Mothers Don't Ask Questions suggests that we change the way we look at what it means to be good mother through education and support. And poses the question: Why are we still struggling to have the right to-be-informed and make decisions that feel authentic and healthy from our own perspectives, experiences, and knowledge about our own bodies when it comes to maternal care? This is a short, really well-written article. 

Expecting Kindness Childbirth Education Series at Village Pediatrics starting October 9th 2013

I am so excited to invite you to my very first 8-week comprehensive childbirth education series for expectant parents in Issaquah this October, called Expecting Kindness. 


Expecting Kindness, written by Kristin Dibeh, is a childbirth curriculum focused on a kind, holistic, family-centered approach to maternal health, childbirth, and early newborn care. The 8 weeks series covers prenatal health, detailed discussion of each stage of labor and delivery, variations that might cause intervention and how to avoid them, guidance through writing a birth plan, healing from labor, and breastfeeding and other newborn care in the first few days after birth. Each class will run about 2 hours. To preview the Expecting Kindness curriculum on Amazon.com, click here, no need to purchase for the class, as it will be provided for those who attend.

The series will take place at Village Pediatrics, a Pediatric Nurse Practitioners located in Gilman Village that can be accessed from the southwest parking lot near the Issaquah Coffee Company.

 

 The series will begin Wednesday, October 9, 2013 and run thru November 27, 2013

Specific dates are 10/9, 10/16, 10/23, 10/30, 11/6, 11/13, 11/20, 11/27
Series starts at 6:30 PM and will go to about 8:30 PM
This series costs $300

To sign up for series please contact me either by Email: bellyblossomdoula@live.com

A special thank you to Staci Scott and Kristina Garrido for opening Village Pediatrics and Village Family Clinic & Wellness Center as a new home for teaching Expecting Kindness Childbirth Education. And to Kristin Dibeh for putting your life work onto paper, and for sharing your experience and wisdom so that other birth professionals can journey alongside women and their families, empowering them to reach their healthy birth goals and to intuitively transition into parenthood.  

I look forward to sharing this amazing piece of work with expectant parents in our community. My mission is to empower women and their families to realize the strength and wisdom that already lives inside each of us, to inspire a healthy vision for the birth process through education, discussion, and application, and to offer support and encouragement to all.

 

Shine Bright,

Melissa Tuton
Belly Blossom Doula

 

 

Kind Birth Services, Kristin Dibeh: Collaboration

Kind Birth Services, Kristin Dibeh: Collaboration: My word of the day. I had the awesome privilege today of meeting with two incredible women/professionals. Now, I have always said that I ...


From my dear friend and partner! Please read!!!

Village Pediatrics (Now excepting new patients!!!!)

Good Afternoon Friends,

I am privileged to welcome Staci Scott, a Pediatric Nurse Practitioner with Village Pediatrics in Gilman Village in Issaquah, to our community!

Staci is extremely passionate about pediatrics. Her medical interests include asthma, cardiology, and infant and child growth and development. She is a huge supporter of breastfeeding, integrated medicine, and healthy births, which you know I am excited about!!!

Village Pediatrics has opened their doors to Belly Blossom Doula to teach Kind Birth's Expecting Kindness Childbirth Education Series this October-November (schedule coming soon, please stay tuned).

If you are looking for genuine, quality, individualized care for your precious child(ren), in your neighborhood, please call her or visit her website today, where you can read her bio, register online, make appointments, and view insurance providers she is covered under. You and your child(ren) will be so happy you did.


Staci Scott's Contact Information:

Village Pediatrics, PLLC
317 NW Gilman Blvd Suite 48
Issaquah, WA 98027

425.996.3396 ~ Fax 425.274.7294
Please visit www.villagepediatrics.biz for more info, to register and make appointments.

Staci Scott
ARNP, CPNP, MSN

5 Biggest Myths About Midwifery

http://thestir.cafemom.com/pregnancy/160193/tk_biggest_myths_about_midwives?utm_medium=sm&utm_source=facebook&utm_content=natural_fanpage

I just love this blog! Sharing her fun article!

Purpose and Value of Labor Support - Slightly Revised

 

Undoubtedly, women deserve access to and benefit from continuous labor support. No matter at what point a doula or labor support professional accompanies a woman in labor, her presence alone, can bring calmness, confidence, and normalness to the labor process.  The doula’s specific set of skills and experience balance the mom’s worries and concerns of labor’s unknowns, helping her maintain a sense of control throughout the process allowing her to trust in her baby's and body's inherent wisdom of birth. 

The health and safety of mom and baby are among the doula’s top priorities. Being able to identify when and where mom is in the labor process, understanding the needs of each individual laboring woman during each of the stages of the labor process, helping mom labor in ways that feel natural to her, and keeping her well informed empowers mom to follow her instincts, keep perspective, and advocate for herself. When women receive continuous support and make decisions about the course of labor that are evidence based, women need less medications and interventions. Healthier outcomes for both moms and babies usually tend to follow. 
  

I’ve found great importance in supporting the laboring mother’s partner as well, and encouraging his/her involvement in the labor process. The doula’s experience with labor and understanding of mom’s needs, pair beautifully with partners and the rest of the birth team. Women who feel connected to their partners during labor, who feel they are seen in a positive and beautiful way, seem happier and more relaxed, they remember their births in a more positive light. When love is in the air, more Oxytocin is released in the brain which we all know encourages labor progression!  

Doulas tend to mom with kind emotional and physical support, medical advocacy, and celebration in the abundance of love and joy that comes with birth and becoming a parent. Most doulas provide some postpartum care, when needed connect her to helpful resources, and encourage mom to reach out and surround herself with loving, helpful family, friends, and mommies groups. 

My experience has shown me the immense gratitude women and families have for the doula’s presence and help in achieving their goals. Commonly, I hear the phrases, “I couldn’t have done it without you!”  Or, “I couldn’t have imagined what it would have been like without you!” Truth be told, there is no replacement for a doula. Just like dad, partner, mom, or friend, just like the health care provider and her assistants, the doula has a special place before, during, and following labor. Those of us who have labored with a doula, (myself included), we have found value in: her expertise, the anticipation of, and ability to tend to mom’s needs, the ability to remain calm and objective, her kind, loving nature, and her ability to keep us informed, in the moment, feeling safe, secure, and confidently achieving our goals of positive birth experiences and healthier birth outcomes.

No Induction Please!

http://www.scienceandsensibility.org/?p=6256

Very Interesting Article!

6 Healthy Birth Practices

http://www.lamaze.org/HealthyBirthPractices

1. Let Labor Begin On It's Own
2. Walk, Move, & Change Positions
3. Have Continuous Support (Doula!)
4. Avoid Uncessary Interventions
5. Get Upright & Follow Urges To Push
6. Keep Your Baby With You After Birth

Bethany's Story

9:45 AM Text: "They are not regular at all. I have to breathe through one here and there. But they are not close and not regular. Def not in "active labor" yet."

10:22 AM Text: "We are on our way home. I'll call you when we're close.

10:23 AM Text: "Okay. Drive safe."

 

And I was on my way to check in with my client. A "typical" start to "possible" early 1st stage labor...

 

Bethany and Josh are dear friends and clients of mine. I met Bethany through her sister almost 12 years ago now. I remember when she had her first baby, and although she'd never loved anything so much in her life before, the first-year battles she experienced recovering from the birth were difficult. She and her family believed based on her experiences that she would probably never want to have another baby again. She would leave that up to other family members after all she has three other sisters! The amazing part, looking back on it now, was not yet knowing that one day I would play a part in Bethany's realization of her inner-strength as a woman and mother, and help ensure a birth experience with positive outcomes so that she could move forward happily, abundantly enjoying the new addition to her family.

Bethany approached me months before she was even pregnant, actually on her birthday, revealing the things she had learned regarding labor and birth and how she felt robbed by the course the birth of her first baby. She seemed determined to have a different experience the next time around, whenever that might be. It actually came as a bit of a surprise to me, (along with extreme delight), that she was interested in hiring a Doula when she found out she was pregnant a couple months later that December. I then knew that if she was to choose me as her Doula, I would do everything I could possibly do to help her feel confident and prepared.

We began meeting in June and decided our first course of action was to discuss what happened in the first birth that she wasn't satisfied with. But, rather than compiling a list of what she didn't want for her current pregnancy and birth, we compiled a list of the things she wanted to do differently. Her list looked something like this:

Though I am fearful of what the sensations of labor might be like without medication, I believe in the body's process, and want to be present before, during, and most importantly after the birth.
I want to avoid induction and medication.
I want a competent, supportive team surrounding me that encourages and respects me throughout the entire process. This includes a Midwife & Assistant, Husband, Mom, and Doula.
I want to encapsulate my placenta to help with recovery and avoid postpartum depression.
I want to labor in the tub and give birth to my baby in the water.
I want the baby to receive the remaining nutrients from her umbilical cord.
I want my baby to be with me immediately after birth.
I want my baby to be healthy and alert and to nurse immediately after birth.
I want my family close and available.
I want to be able to go home at my leisure and recover at home with my new baby and family.

With her plan in hand, we set out to re-educate Bethany and Josh about natural, un-medicated birth. We discussed, in depth, the different stages in labor and what her body was doing during any particular moment in the process, that the beginning part of labor would allow her time in between contractions to establish her rhythm, we discussed how to breathe, relax, and use different positions for pain management to provide comfort and relief, we spent a lot of time on what transition looked like and how that meant labor was in the home stretch. We talked about how pushing offered an opportunity to do something about the intense sensations she would feel during transition and the amazing feeling she would have after she delivered her baby... It was really wonderful teaching and discussing birth as a normal process.

I left the Lake at 10:20 AM, having received an email from Bethany. I sensed her calm control immediately, and felt assured that she had some time ahead of her.

11:30 AM: I was driving into Tacoma, about 45 minutes from home. I called Bethany's phone, Josh picked up…
Doula: "How is she doing?"
Josh: "Very good."
Doula: "When was the last time she ate or drank anything?”
Josh: "She ate at breakfast this morning, at about 9:20. She’s been drinking water all morning.”
Doula: "Okay, let’s get her something to eat."
Josh: "Okay. Here's Bethany." His phone rang, so he handed me the Bethany.
Doula: "Hi, how are you?"
Bethany: "Pretty good. I'm breathing through contractions and I feel pretty good. They are getting a little harder, but I can handle them. Oh, here comes one, hold on..." She said as she proceeded to take about four or 5 slow deep, breaths, two small soft moany-type sounds.
Doula: "You sound great! Good job! Sounds like you’re handling them pretty well…"
Bethany: "Okay, thanks Melly. Got to go..." They were on Josh's phone with the birth center, just letting them know they had begun labor. It sounded like things were starting to rev up a bit, but nothing to be concerned about.

11:58 Text from Doula: We're in Maple Valley, grabbing a quick bite and gas. Should be in Snoqualmie in about 30 minutes…
12:11 Call from Doula: "Hi, what's happening?"
Josh: "Contractions are right on top of each other, did you get my text?"
Doula: "Not yet, but I thought I would call you back and get an update because I hadn't heard back from you." (‘Ding’ text came over as we were speaking: Contractions are right on top of each other…)
Bethany in the background: "Oh my god, Oh my god, Aaaah, Uggggh!!!!” I had that feeling in the pit of my stomach, What if all that time had slowly done work without her knowing and things are turning? I need to get to her! I was comforted my Josh’s calm and loving demeanor with Bethany, but thought – it’s time to go to the birth center or at least call them again – maybe the Midwife will have to come to them…So, I said, "have you called the birth center?"
Josh: "Remember? I did about 30 minutes ago?" I could tell he was a little more concerned this time, excited, but also maybe thought I wasn’t picking up on the urgency of the situation.
Doula: "Yes, but, um, have you called them since things have changed? Have Bethany slow her breathing down and try holding in the yelling." I was trying to see if we could bring her back down at all, see if she had really turned that corner or not…
Josh: "No. I haven't called.” To Bethany, “Honey, good job sweetie. Breathe..." Bethany in the background: "Hold it in? Ugh… Aaaah!!!!" Oh, boy, things have changed…I thought.
Doula: "Ok Josh, what I want you do to is get off the phone with me and call the birth center right now."
Josh:"Ok, got to go..."

12:15: Call from Doula...
Doula: "Did you call the birth center?"
Josh: "Yes....we're heading there now..."
Doula: "Ok, good, I'll meet you there."
Josh: "Ok, great. Got to go…"

12:35: Call from Doula: "How's it going?" A clear ‘transition’ sound of hitting the dashboard and grunting at the same time came from the background...
Josh: "We're almost there, got to go…" contractions were still right on top of each other, and I’m assuming an extreme amount of pressure…

12:55: Call from Josh: "We made it to the birth center; Bethany is 9 1/2 cm!"
Doula: "Awesome! I'm about 2 minutes away..." HOLY… WOW, transition in the car. OUCH. She is a rock star! I thought to myself as I sat at that forsaken light on NE 8th St. for a whole minute!!!!! GREEN LIGHT!!! I turned, pulled into the parking lot, parked, and ran into the birth center…

Midwife: "She's right there, Bethany...okay...breathe" (Crazy energy in that room)
Bethany, clear as a bell: "Oh…I'm going to die."
Kelly, Bethany’s Mom: “Bethany, Melly's here.”
Bethany – in between contractions: "I'm so glad you're here Melly."
Doula: "Me too. Breathe honey.” I stroked her hair and rubbed her shoulders.
Bethany: "Okay..." And as the first of two remaining contractions came on, she re-focused...and pushed once...
Midwife: "Okay, hold it…that's it… That's it, Bethany! Here she comes…"
Doula: "Baby's is right there Bethany, you can do this."
Bethany: "Okay…" SHE knew it – that last push WOULD do it – SHE did it!
Roxanne was born...

Doula: "Baby is out, Bethany. She's coming up to your chest."
Bethany: "Huh? What?" The Midwife brought baby Roxy to her chest!
Bethany: "My baby, here's my baby..." She looks at her baby then looks at Josh, then at me...
Josh: "You did it Bethany, you did it!" He was so amazed by her strength and accomplishment and relieved that they were both healthy and safe.
Doula: "You did it. She's here!" (Amazing energy in the room now: smiling, tears, hugs, kisses)
Bethany: "That was so hard...” She then immediately back at her baby, “Hi Roxanne! Hi Baby..."

Bethany was in one moment changed by her experience. In the minutes immediately following the birth she was amazed at how good and happy she felt and how perfect her baby was. To boot, Roxanne nursed like a champ right away - latched on and ate as if she had been doing it all along. Bethany's mom was there to witness her daughter do the unthinkable, deliver her baby in the water, naturally, with purpose, ambition, and confidence. As if the universe had known all along she would give birth at that very moment, her dad and step mom happened to be in the neighborhood and arrived at the birth center within Roxanne's first hour of life. It was beautiful to watch this family come together and celebrate the hope and wonderment new life brings.

I spent about 3 1/2 hours with her after the birth and massaged her and helped mom and baby get acquainted as we talked about the excitement they had just experienced, recounting all the little things that happened and changed so quickly. We talked about all the preparation we did, and how much time we spent understanding transition, as well as acknowledging the calm, resourceful, informative, consistent presence her strong husband was for her. It was at that moment, I realized something I had already known deep inside: Babies are a miracle. Birth is a mystery. It was at that moment, I felt changed by her experience, and remembered how much Life is a Gift.

Thank you Bethany, Josh, Hunter, and Baby Roxanne

 
Love,

Your Doula

Auntie Melly

Violet's Birth and Why I Heart Doulas

While it is a blessing to have a great nurse and an attentive doctor, it is every woman’s right to have a Kind Doula. Before I was pregnant with my daughter, Violet, my dear friend, Kristin, challenged my husband, Scott and I to think about birth and how it matters. She wanted us to do research about different places to give birth and what types of procedures, policies, and statistics each have. She wanted me to figure out what type of birth experience I would want and how I might go about making that happen. She challenged me to think critically about these things and choose a path that supported my desires and goals for my birth. She and I both knew that Scott would support me no matter what.

I hadn’t quite figure out much about where I would want to deliver my baby so much as I had figured out I wanted an un-medicated birth when I found out I was pregnant with my first baby. So, like most people I thought I would go the hospital route. I found a lovely Family Practitioner/OBGYN. She did an ultrasound right away confirming our pregnancy, took a bunch of tests, and gave me some guidelines like don’t eat tuna more than once a week, it was very routine.  With a smile on her face and a great birth attendance rate, I felt like I was in good hands. As the weeks went on, learning more and more about childbirth and what I wanted for my birth experience, I began to feel unsure about delivering a baby in a hospital with a 15% un-medicated birth rate.  Although possible, I still wasn’t exactly sure how my goals of having an un-medicated birth experience would be supported in that setting and decided I wanted to interview a midwife at a free-standing birth center. We met the midwives at the Eastside Birthcenter, toured the facility, and changed care immediately. One of the first questions at our first appointment at the birth center was have you hired a Doula yet?  We hadn’t, but of course were thinking about it.
The weeks went on and we attended Kristin’s 9 week childbirth education series, and about halfway through I decided I wasn’t about to labor without having a Doula with me. We hired Kristin. Not only did she know the ins and outs of labor and birth but she had attended hundreds of births, mostly un-medicated, but had had more than her fair share of variations – pitosin, epidurals, and c-sections, and had accompanied women in labor in birth centers, hospitals, and home births.

I went into labor the evening of March 17^th. Contractions were about 20 minutes apart, and fairly light. They were easy to cope with, though I wasn’t getting much sleep, mostly because I was feeling excited. Finally around 4 AM on March 18th, the contractions were getting closer together, about 7 minutes apart lasting about 50-60 seconds, we called Kristin. She listened to my contractions over the phone at first. She was feeding me encouragement and complements with her loving tone. I asked her, so, what do you think? Am I in labor, are we getting closer? She said, yes, and you sound great. Why don’t you eat something and keep doing what you’re doing.  I thought they were getting serious since I had never experienced anything like this in my life, but Kristin remained calm and politely suggested that we stop timing them and after I had a snack and to try and get some rest since I hadn’t been sleeping much.  At about 6 AM, my contractions were about 5-6 minutes apart and much more intense than before. I thought it might be time for her to come. She met us at our house. I felt this amazing amount of comfort wash over me when she arrived. We went for a couple walks, talked, laughed, listened to music, and snacked. Scott and I even got to take a nap. It was really nice to have her with me and still be in my own comfortable home.  I labored for a while longer, my mom showed up and then at about 2:30 PM, I felt pretty ready to get going to the birth center. Contractions were happening every 3 minutes or so and were really intense. We hopped in the car and headed to the birth center.

I had 7 contractions in the car on the way to the birth center. Labor was not letting up, which was a great sign! We arrived at the birth center and hung out for about an hour while the midwife and assistant set up the room. I continued to labor, I was in good spirits, getting a boost of energy by traveling to my birth place! The midwife checked me and I was about 8 cm! The amazing thing for me here was that I had labored for a good long time at home with no interruptions, because my doula was with me in addition to my husband and my mom, I felt comfortable trusting my body and giving into labor, letting it take over, and I received huge confirmation with that 8 cm check!

I continued to labor for quite some time. I was in the tub, I was swaying back and forth and walking in the room I was doing squats and sitting in the bathroom. My family was there but Kristin was really my main support, walking with me, going to the bathroom with me, quietly yet powerfully encouraging me when I was experiencing challenging contractions, she knew just what to say and just what to do. It’s like she could read my mine. Meanwhile my midwife was next door delivering another baby! The mother had arrived after me, was only 6 cm and delivered her baby before me. Ugh. After about 7 ½ hours or so of laboring, I had progressed 1 cm. Feeling my frustration, my midwife offered to break my water. We talked about the risks and benefits, and I felt good about it, I was ready to get things moving again.  Once my midwife broke my water, contractions came on strong – much stronger than before. I continued to labor for another 3 hours, and endured major back pain through transition. Kristin had me lie on my side and applied constant counter pressure to my lower back. I don’t remember how long transition was for me, maybe 30 minutes, but I remember feeling ‘out-of-body’, my mom saying “you can do this, you need to separate yourself from the pain”, and Kristin reminding me to breathe and touching me, and Scott leaving the room to eat. All of the sudden I felt like I had to pee and then bear down! I was complete and ready to push. The energy in the room was insane. Scott’s parents were outside the door of our room. My mom, my sister, Scott and Kristin, the midwife’s assistant and the midwife were all in this with me. I pushed in the tub for 2 ½ hours. Violet was born “sunny-side-up” or occiput posterior and acynclitic (Google it - it explains the long labor and difficult-lengthy pushing stage). Most babies in this presentation and position are born via c-section. Not my baby. She was born into this  world, calm and alert, neither of us were medicated, and the amazing feeling I had being sober through the whole process, brought me to an elated, euphoric feeling for the hours following my birth as I held my baby close to me, looked at her beautiful face, and eventually nursing her. Though, it was always within me to birth her naturally without medication, given all of my challenges and my lack of experience at the time, I still feel like I could not have done this without the support, respect, and encouragement of my Doula, Midwife, Husband, Mom and Sister.  Though, my Doula would say, “yes you could have,” and that is precisely why I love her.

Because of my experience, the difficulties, challenges, support and pain management offered by my doula and the ultimate positive outcome, I chose to become a doula myself. I believe that everybody has a purpose.  Doulas purpose is different from any other role in childbirth. If we want more positive outcomes, I not only believe a Doulas presence is beneficial, I believe it’s necessary. The statistics show the positive benefits of having a Doula: 60% reduction in epidural rate, 50% reduction in cesarean rate, 40% reduction in oxytocin/pitosin/induction rate, and more: http://www.beginswithbirth.net/statistics.shtml , http://www.childbirth.org/articles/stats.html.  

The last two years have been the most amazing years of my life with my sweet Violet and positive birth experience. Add to that the support of a loving husband and the beginning of a meaningful career as a Doula and my life’s path feels set. To those interested in having a positive birth experience, look into hiring a Doula. It might just be the best decision you make when planning for your new arrival. It was for me.

Kind Birth
Melissa Tuton

(Kristin Dibeh was my Doula with Kind Birth Services http://www.kind-birth.blogspot.com/)

What I Offer as Your Doula

My Role as Your Birth Doula: I will accompany you in labor, ensure a positive birth experience, and provide physical, emotional, and educational support. During labor, I can help with relaxation, massage, positioning and other pain management and comfort techniques. I can provide encouragement, reassurance, and perspective to you and your partner, and make suggestions for labor progress. I can help inform you so you are able to make decisions and advocate for yourself.

My Commitment: As your birth doula I provide two prenatal meetings, a two-week slot I am on-call for you surrounding your "due" date, and two post partum visits. During our prenatal meetings we will discuss the details of your pregnancy, your expecations and desires for your birth experience, your fears and concerns and prepare for labor and create your birth plan. We will also talk about how to know when to call and when and where we will meet when you are in labor. I will join you when you are in labor and remain with you until your baby is born. After birth, around the third or fourth day, about when your milk comes in, I will visit you in your home to admire your baby of course, see how you are coping, how breastfeeding and care of your newborn is going, and provide any referals that might be needed. At our last post-partum visit, about three weeks after the birth, we will discuss your birth experience, talk more about how things are going and changing, how you're sleeping, and of course more baby admiring! :)

Labor: I prefer that you call me when you think you are in labor no matter what time of day or date it is. When you call, I will help assess where you are in the labor process through questions and listening to how you cope with contractions. I can offer suggestions over the phone to help you relax and keep perspective. Once we decide together that you are ready for me to join you, I will head to where you are so you can continue laboring in comfort. Sometime after I arrive, you will be ready to be in your birth place, when that happens, we will make the calls and head in that direction. I will make every effort to accompany when you go into labor, sometimes this is impossible due to illness or other extreme circumstances. I work with other doulas and have back-ups available in this case, or you can choose a back-up doula of your own choice. When labor occurs outside the two-week on-call slot, I will still make every effort to accompany you in labor, however, I may be attending another birth, illness, or other circumstances and a back-up of your choice may attend in my place as well if you so desire. I will do everything possible to keep you informed of any issues that arrise.

 

Fees: My full fee for doula services is $600. I request a $300 deposit fee to ensure we are committed as doula and client. This covers prenatal meetings and secures the two-week time slot I will be on-call for you surrounding your due date. The remaining $300 birth fee is due at the first post partum home visit.

 

I also do private childbirth education classes upon request for an additional fee.
Coming soon - group childbirth education classed.

 

Julia and Dave

Our relationship started a while back. Julia’s best friend, Melissa, was getting married and I was helping plan and coordinate her wedding. When I first met Julia, I thought, wow, this woman is amazing, strong, in control. I thought I want another friend like that! Fast-forward a couple years and I would receive an email from Melissa again asking if I was still planning weddings, and at the time I was. Her friend Julia needed someone to help set up her décor for her reception. I was in.

Up until this point, this man, Dave, her boyfriend/fiancé was a mystery to me. I didn’t spend much time with Julia, but when I did see her it was at special events, weddings, baby showers, etc. So, where was this amazing man I had heard so much about?

Fast-forward another year and a half, after having a baby myself and becoming a doula, I received another email from Melissa which read, “My friends, Julia & Dave are looking for a doula! You okay with me giving them your information?” Delighted, I said, “Of course!” We were to meet at a coffee shop a couple weeks later; it would be my first meeting with Dave.

Nervous with making a good impression to this powerfully amazing couple, I got there a few minutes early only to find out they were early too! Of course! We talked over coffee and breakfast and I left feeling I did my best and that I would just have to wait and see what they thought.

I was so excited to hear that night that they had decided to go ahead and hire me as their birth doula!

Julia and Dave are active, intelligent, thoughtful, gracious, capable people. They run their own businesses; successfully take on home improvement projects; they are pet owners, and they take decision making seriously. As we met for our prenatal appointments I knew that having a baby was their most exciting and most important venture yet. The pair of them set out to have their baby naturally with no pain medication in a hospital setting. They believed that the risks/side effects of medication on mom and baby were too great and if they could avoid it, they would.  My job would be to help keep Julia calm, encourage and support both of them, provide medical advocacy, offer ways to help manage her pain, and to keep them informed about what was happening to her body and what would be coming next.

The morning of September 6^th, I received a text from Julia, saying that her water might have broken and that she would be heading into her doctor’s office to confirm. This came as a huge surprise for me being that it was her first baby and wasn’t due until the 16^th. I had emailed her the night before with a few helpful notes and my contact info of where I would be the following week – I was leaving for a week-long trip to San Diego with my extended family and would return on her due date, which we had discussed at our interview months earlier.

I called my Kind Birth partner, Kristin, and said, “I can’t believe this… I haven’t quite yet recovered from my last birth, and we have another baby coming into this world! Must be that darn Blue Moon”! I don’t care what statistics say about it, the moon’s pull has a direct effect on pushing mom’s approaching her due date into labor, especially Super, Blue, and Full! She said, “Wow! I guess you scared that baby out by telling her you were going on vacation. You should go on vacation more often!!”

Still, having just come off a whirlwind 2-hour labor with a previous client, I resigned to the norm on my current client. I thought, okay, maybe this baby is coming now, or maybe she’s coming tonight. I didn’t have my things with me, so if I had to leave, I would have to grab some lotion, a snack, and get gas.

Around 9:30 AM, Julia’s doctor confirmed her water had broken and that they would monitor baby for a bit and then be released to go home and walk around her neighborhood to try and get things moving. She had scheduled an appointment at 1 to install her baby’s car seat, and luckily was able to bump her appointment up so she could get the install done and walk around before she was in real active labor.

11:00 AM, Julia texts me: My contractions are about 4 minutes apart, lasting 1 minute or more. We’re heading to the hospital. I thought, no way. We are going to repeat Monday’s birth. Due to my most recent birth experience, and a conversation we had just had about utilizing the birthing suite at the hospital at our last prenatal meeting, I didn’t deter them from going, even though, normally, I would encourage mom to hang back and wait from me to arrive, from what I could tell, she was definitely working, but not too hard, not vocalizing yet. However, Julia felt more comfortable knowing she would be at her birth place if baby decided to come sooner rather than later.

I arrived at the hospital at 12:00 PM, they had been there for about 30 minutes, and were in the last room available in Triage. There were so many moms in the maternity ward that day, women who arrived minutes after Julia and Dave had to wait to be seen. A few contractions later and minutes after I arrived, the attending Triage nurse checked her. She was already 4-5 cm dilated and 100% effaced. Fantastic! Things were moving along wonderfully. They told her there weren’t any beds available yet and that she would need to walk around the ward for about an hour. Surprised at the wait, Julia looked to me for reassurance. I reminded her that this was what she wanted, the ability to move and walk and do what she needed to do in order to move things along and feel in control and comfortable. I told her it was a good thing and she’d make some progress while they were preparing her room! She agreed and so Dave, Julia, and I roamed the halls for a little over an hour. We talked about how this first part of labor was opening her cervix and that these contractions, although obviously present, were in fact light compared to what was to come. So, only give these contractions the attention they deserve.

Finally for Julia’s sake, a room and a sweet labor and delivery nurse was available. The nurse grabbed most of our things and led us to the room. Julia answered all the nurse’s regular questions and handed the nurse her birth plan. After some confusion and agreement to not burry her placenta, the waiver was given to Dave and Julia, which was signed and approved so they could have Julia’s placenta encapsulated. Ok, side note, hospital policies are sometimes funny and strange, but this one takes the cake!

Julia continued to labor and progress lovely.  She was strong and let her body do the work. Around 2, she was confirmed to be 7 cm. Yay! She was feeling great too. Her contraction pattern was still very regular and seemingly manageable. We agreed that she should wait a little longer before getting in the tub. Dave, Julia and I worked on some ways to keep her body moving and opening up. She swayed back and forth, did plie squats, walked around, leaned over the ball, leaned over the bed, and danced with Dave. It was beautiful. The way that Dave was able to jump right in and speak to Julia in a quiet, calm, reassuring way was amazing.  I remember him saying, “You can do this, you’re okay.” And Julia would repeat phrases that stood out to her in a whisper, “We can do this, I’m okay.” This still gives me chills. I mean self talk happens when things are tough, but the way she was doing was more of a mantra or chanting and very powerful. It created this amazing energy in the room. I stopped many times to let the pair of them work together, taking in their beautiful connection. How strong they were as individuals and as partners. They were going to make fabulous parents, and really enjoy the transformation. She got in the tub after a while, and labored for about 30 minutes there, she thought it felt so great. The warmth and displacement of the water was a great change of pace for her. It gave her body new sensations and took some pressure off of her pelvis and legs.

At about 5 PM, Julia got out and walked around a bit, exercising and enjoying these last few moments in waiting. After another hour, she got to a point where she was feeling pretty tired. She sat down in the rocking chair and I said, “Close your eyes, and relax as much as you can”. It was amazing, she became so relaxed that her body decided to slow down for about an hour and give her about 20 minutes of sleep in between contractions. Once she felt somewhat rested, she was ready to get up and move around again.

We worked together for another hour while her contractions picked up. She was handling them beautifully, although, they were extremely challenging and really starting to build momentum. She felt some heavier pressure and a slight urge to push! The doc came and checked her, she was 9 cm! She labored, walking, dancing, sitting, rocking for another two hours, contractions building and was checked again. She was slightly more than 9 cm, but not much change. That’s when the doc thought she might get in the tub for a bit again and try and relax as much as possible and see if her body couldn’t finish that last centimeter of cervix. After about 30 more minutes in the tub, she was ready to get out and cool down. Do something different. She had about three contractions from the tub to the bed. After about another hour, she was so close, the doc thought he could help complete that last bit of cervix out of the way. It worked. Finally, at 11:30 PM, hard working, amazing Julia was she was 10 cm and ready to push.

Pushing is not always a very easy task. It sometimes feels strange, and you really have to learn as you go, especially for a first time mom who’s never done it before. And as strong and committed as Julia was, that little baby was stubbornly coming tiny tiny bits at a time. I suggested that we try squatting and leaning over the bed, but by this time, Julia was pretty tired and felt more comfortable in a reclined seated squat. With Dave focused on her eyes and counting 1,2,3,4,5,6,7,8,9,10 while she held her breath, she pushed and pushed. Finally, we saw her little head! Lots of hair. “That’s it Julia, that’s it. Hold it! Hold it! Give me more Julia. Come on, come on!” I almost have to talk through this portion of labor to keep from holding my own breath and pushing myself. I know what it’s like. I also know what it’s like on the other side of the pain when you get to hold your baby for the first time too – surreal. “Ok, Julia, come on. This time, you’re going to take a couple of cleansing breaths and you’re going to really push through the pain. You can do this. You’re strong. You’re okay.”

“We can do this. I’m strong. I’m okay.” Julia said. “Okay baby, ready, okay, 1,2,3,4,5,6,7,8,9,10…” Breath in, hold again, “1,2,3,4,5,6,7,8,9,10… deep breath, hold again, 1,2,3,4,5,6,7,8,9,10… Dave counted her though again. Ok, go ahead if you want to go again, 1,2,3,4,5,6,7,8,9,10,” the Nurse said. “Good! Great job Julia, that’s it. Dave, look at your baby’s head. She’s right there. She’s coming!!!” The new nurse and I were saying almost simultaneously. The energy was intense.

Julia said to her baby, “Come on Ella! Come on BABY!!!”

A few more rounds of contractions, and 1:15 AM rolled around, “Okay, Julia, she’s right there. This next contraction I really want you to use it…” Another few sets of contractions and with a couple super-pushes, she pushed that baby into crowning position. With a few more, “GET OUT BABY” pushes at about 1:45 AM Julia’s baby’s head was out!! 1:47 PM, little Ella joined the world.
Oh my, gosh, what an amazing feat. Julia had endured 14 hours of active labor and a little over two hours of pushing. Julia’s perseverance and hard work paired with strong support from her birth team including her amazing husband who was there for her in the toughest times, finally paid off.

They placed Ella on Julia’s chest. Julia looked at her baby with awe and relief, and within seconds of the most amazing moment, a concerned feeling arose. The doctor instructed the nurses to have Dave cut the cord immediately and then move her to the warming table to help clear her lungs. Ella wasn’t quite breathing enough, grunting a little, they felt they needed to act fast, and that they did. The nurses fed a long skinny tube down her esophagus to remove any remaining fluid in her lungs. I kept Julia’s focus on me while Dave seemingly had everything under control and while the nurses encouraged Ella to breathe better. I didn’t know it at the time, but Dave was extremely concerned with Ella’s condition and wasn’t sure what was going to happen next. Although the staff did what needed to be done, had we known what and why they were doing what they were doing so urgently, (a common lack of communication commonly practiced at the hospital), the two new parents would have felt much more at ease. I was confident that she was going to be okay, although, I couldn’t really tell them exactly what was happening either, I just knew that she had “pinked” up right away, and I could hear her, I tried to assure Julia Ella would be okay, and noted every time she moved and made more and louder and louder noises. I asked Julia to breathe and felt her relax slightly knowing that things were under control. She was still in the process of finishing her third stage of labor as the nurses encouraged Ella to take her first full, deep breaths, they were rubbing her body and talking to her, after about 20-30 seconds, and some definite cries, a sure sign she was breathing normally, they had Dave take some photos. The nurses quickly examined her, and finally after what seemed like an eternity, but probably less than a minute, little Ella was placed back in the arms of her mother. “My baby!” Julia said. “Hello Ella. Hello Baby Ella.” Sigh of relief…and then back to amazement!

As soon as Ella was about 15 minutes new, we tried breastfeeding for a little bit. She wasn’t making a sucking motion with her mouth quite yet, but she was looking for food. Julia hadn’t quite finished the final stage of labor. We gave the two a break to let mom enjoy the little one while her body completed its process. We tried again, and saw some good progress!  Another 5-10 min try with a little more progress, but not quite latching on, Ella was getting a little frustrated with all the movement and effort so we thought it best to give the two another rest.

We moved Ella upright, with her head and tummy against Julia’s chest. She melted into Julia’s warm skin and was comforted by the familiar thump of her heartbeat. Ella was calm again, and that’s when I saw it, that moment when husband and wife become Mommy and Daddy. It was beautiful. While Mom was comforting Ella, Dad was comforting Mom and had his hand on his new baby’s back. The new parents looked at each other, and without even saying a word you could see everything they were feeling at that moment. I could see love, relief, and the amazement of new life, the pride Dave felt for his wife, the realization of hard work and determination paying off, the gratitude they felt for a healthy baby, and to have gone through it all together. I think they were in as much awe of their experience as I was (they were probably more in awe of their baby than their experience, but we’ll just say they were certainly aware of the amazing effort and equally extreme relief and love they felt once baby and mom were relaxing and enjoying each other’s presence). What a beautiful memory they have for themselves and have also given to me.

After about an hour and a half of gawking over the new baby and recounting Julia’s strength and determination and Dave’s supportive nature, I decided it was time to let the new family have a rest. The next morning, I checked in at around 10, and was so pleased to hear that Ella had had 2 successful nursings! Yay!! I knew she would do it! What an amazing little girl, and amazing parents! They three are home now, with a thriving baby, and loving every moment of their new world together.

Welcome baby Ella!

Sharon Muzza Shares Amazing Information About Skin-to-Skin in the OR

A Doula Facilitates Skin-to-Skin in the Operating Room

http://evidencebasedbirth.com/2012/08/21/a-doula-facilitates-skin-to-skin-in-the-operating-room/

We can make a difference!

My Philosophy as a Doula

We provide constant physical and emotional support to women in labor. We are coaches, physical trainers, teachers, massage therapists, medical advocates, best friends, and moms.  Our ideal birth is the birth you want, in a place where you and your baby are safe, supported, and respected.

I believe in pregnancy and childbirth as a natural process. I trust that women's body's were designed with the specific intention of giving birth, among a multitude of other amazing abilities. Of course not every woman decides she wants to have a baby or can, but every woman is born with the inherant nature of connecting with their bodies and the ability to believe in their own inner power.

Becoming a mother, and specifically, birthing a child is one of many, and in my opinion, the most amazing rite of passages for a woman.  I believe that when given ALL the information, women naturally choose what is healthiest for themselves and their babies. That is different for different women, so I realize that can be interpretted in many ways. My take away here is, because of the importance of carrying a child and bringing him/her into the world, great care should be taken, women and those who support women who choose to have a baby should make time to educate themselves, and should prepare as best as they can for the journey they are partaking in. The 9 months we are gifted prior to meeting our babies are exactly what is needed to welcome the joys and prepare for the challenges of childbirth and becoming a parent. This process is what we put into it.

My goal is to help mothers realize their potential, to honor their choice, and to respect their ability to connect with and trust their bodies, by providing constant loving support before, during, and after the birth of their children. My connection to the families I work with and the gratitude I have for letting me in is never ending.

Kind Birth
~Melissa Tuton

I can, therefore I am. ~Simone Weil



5 Reasons to hire a Doula...

Welcome to Melissa Tuton's Kind Birth Page. Yes, I am affiliated with Kind Birth Services and Kristin Dibeh, however, I decided I wanted my own page so you could get to know me and what I offer, as we offer most of the same things but a few different.

This blog will have information about my services, birth stories, links to great information, contact info and more. So, check in often to see what's new!