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Filtering by Tag: Pregnancy

Episiotomy and Natural Tear

Rachel O'Reilly

Once a routine part of childbirth, an episiotomy is now recommended in certain cases only.

First and foremost: what is an episiotomy exactly?

  • An episiotomy is an incision made in the perineum - the tissue between the vaginal opening and the anus - during childbirth.

And why would you want anyone to cut your vagina during childbirth??

  • For years an episiotomy was thought to help prevent more extensive vaginal tears during childbirth and heal better than a natural tear. The procedure was also (incorrectly) thought to help preserve the muscular and connective tissue support of the pelvic floor.

Thankfully over the years research suggests that routine episiotomies don’t prevent these problems after all. The recovery is very uncomfortable since it requires a deeper layer of tissue to be stitched. And it’s often said that the incision is more severe than a natural tear would have been. One midwife helped me understand this by explaining trying to tear or rip a piece of fabric with my bare hands. She said it’s very challenging and takes a lot of effort. But, if you just snip a little bit of the fabric with scissors and then pull it’s a breeze. The incision in your pelvic floor tissue reacts very similarly. Once you cut the tissue it gives much more leeway to cause a deeper longer tear from the pressure of your baby making its way out. OUCH. NO THANK YOU.

Just like any medical intervention during birth, I’d prefer something like an episiotomy to be done only when it is really necessary. Often during emergency cases your healthcare provider will need the extra space at the vaginal opening to allow for an easier instrumental birth, i.e. the use of forceps or vacuum extraction. A few other reasons I’ve heard of episiotomies being absolutely necessary are if:

  • Your baby is in an abnormal position and needs more assistance to make it out

  • Your baby is very large (fetal macrosomia)

  • Your baby needs to be delivered quickly

Now that episiotomies are not a routine function in birth (please ask your healthcare provider what their percentage of episiotomies are, some still practice them more frequently than I’d like to see) there are a few things that many healthcare providers suggest doing in preparation for birth and during the birth process to lower the chances of needing an episiotomy.

Once you are 34 weeks it’s common for your healthcare provider to recommend doing perineal massage at home. This can be an uncomfortable exercise for some, but if it can help avoid a longer, harder recovery from birth, it’s worth reaching out of your comfort zone and getting busy. Make sure to have natural lubricant near by and lay in a supported position on your bed so that you are able to reach both of your thumbs to your vaginal opening. Place your thumbs just inside and press downward toward your rectum. Hold for one to two minutes and repeat for a total of ten minutes. If you are enjoying baths in your pregnancy this is a great place to give yourself a daly perineum massage and even more effective when your tissues are relaxed and warm.

During the second stage of labor, your OBGYN, Midwife and sometimes a nurse or doula will often use a hot compress to apply pressure against the perineum and vaginal opening. Sometimes a warm oil will be used along with applied pressure to the lower part of the vagina to encourage stretching (not too warm, don’t worry!). The goal is to soften the tissue with heat to allow it to stretch easier and to avoid tearing.

What are the benefits of a natural tear?

There have been several studies conducted to show the frequency of a natural tear versus an episiotomy during childbirth. Many studies show the occurrence of a natural tear of the perineum over an intentional cut of an episiotomy during childbirth. Part of the reasoning for this is the data suggest that women who have an episiotomy do not have significantly improved labor, delivery, or recovery compared with those who do not have one (ACOG statement). Also, by foregoing a routine episiotomy, the mother has a chance to stretch the perineum during the course of the second stage of labor (the pushing phase) and may avoid any perineal damage altogether. With an episiotomy, the connective tissue, muscles, and skin are cut and therefore their strength will be permanently compromised.

I know I want to give my body the chance to do what it is naturally capable of and to be supported during the second stage of labor in a way that allows my perineum to take its time to stretch and allow my baby to enter this world with as little medical interventions as possible.

Have you ever experienced an episiotomy or severe natural tear? If so, how was the recovery for you? How long do you feel like it took to have your body feel normal again?

This brings me back to thinking about postpartum support and care after delivery. It’s essential after all types of birth, especially when your pelvic floor experiences any trauma due to tearing or cutting, to search for additional support to help heal your body from birth.

My body, my choice, my birth

Rachel O'Reilly

Tiff Delancy

Tiff Delancy

By Aaryn Leineke

I’ll admit it. I am a bit indecisive about how I want to present this post. Should I state a bunch of facts that support how safe a home birth is? Could I suggest to others that home birth might be the best choice? Do I want to list all the reasons why a hospital birth is not right for me? Although doing all of those things might be helpful, none of those things really speak to the honest reverence I have for wanting a homebirth for my impending first child and any other children my husband and I might have in the future.  

Homebirth is instilled deep in my core, it runs through my veins and fills my body and mind with so much light and a passion I have lived for my entire life. I have photos and newspaper clippings of my mother and auntie fighting for their rights to have their own home birth and for the rights to legalize midwifery and homebirth everywhere. I have had the pleasure of watching my very own homebirth on video and ever since I can remember, I have marveled at photos of my mother working so hard to bring me earthside. She did this in her home, lovingly surrounded by those she trusted most to support her. Now, as a doula, I’ve been fortunate to assist with some incredible births at homes as well as many in hospitals.

Having a homebirth wasn’t a decision I had to think about once I became pregnant. There wasn’t any other way for me to even consider.  And when I say there isn’t any other way for me, it doesn’t mean that I’m not aware of complications that can arise in birth or even early on in pregnancy. I work very hard to stay current with my education on all of the important advances in obstetric care. I acknowledge and commend how far formal practices have come and how many lives have been saved over the years, in the last century particularly. That is precisely why, if and when I need any medical assistance, my baby and I will be taken care of both at home, with my very qualified midwife and/or in the hospital if we need to make a transfer for any reason.

One of the most frequent questions I am asked is how will my midwife know if something's not right? How will I make it to the hospital in time if I need to? What if something goes wrong? It’s actually really simple, my very qualified and licensed midwife is trained for this very thing along with countless other scenarios. She will be monitoring me and my baby continuously while in labor, just like she would at a hospital, and she will know if a transfer out of the home is needed. That decision is made well in advance in order to avoid an emergency situation, so there is time to get to a hospital to have any medical interventions that may be needed.

It is my fervent belief that if I am healthy and my baby is healthy the safest place for me to give birth is at home. And it’s the safest place for me, because home is where I feel most comfortable and relaxed and at peace and that is exactly the type of environment in which I want to bring my baby into this world. I have unshakable confidence with this decision. The real question is how can I convince anyone who is doubting me? It’s tricky because although I know what is best for me and my baby (as do all mothers and fathers), these doubts, whether they mean to or not, call into question my strength, my intelligence and my capability to make responsible decisions for myself and my baby. I know the answer is I can’t change others’ minds, but wouldn’t it be wonderful if everyone respected and celebrated women’s choices, especially when they differ from our own? This is why I will forever fight for a woman’s right to choose. And I am so thankful for my mother and aunties before me who fought, so I can choose and write my baby’s beautiful birth story.

First Trimester Survival Kit

Rachel O'Reilly

Cherish_First_trimestest

 

By Aaryn Leineke

I’ve been lucky to have had a very easy pregnancy thus far, but I know this is not the case for every woman. Many suffer from typical and not-so-typical symptoms and my heart goes out to them. I know that when you are suffering from all the symptoms at once it’s hard to imagine how to  go on each day. How do you get up,  put makeup on or do your hair so it doesn’t look like you just rolled out of bed when you show up at work? How do you not suffer from the blues when you are now harder on your ‘type-A self’ than ever when you cannot make it to the gym and only want to eat donuts and ice cream for dinner?

You’re not alone. It is common for many women to feel the blues of pregnancy during the first trimester and what’s most important is to know your body is beginning the very challenging task of growing a baby. During these first essential months of  growth it’s no wonder it takes all the energy out of you. It’s important to listen to your body during this time by getting all the calories you need, and the vital rest your body is begging for. Feel good about heading straight to the couch with a blanket once you get home after a long day at work. You have a whole other full time job happening inside of you now.

To help you through your first trimester, here are a few must haves to keep you comfortable, happy and healthy:

Bellybelt - When I was 6 weeks pregnant I wasn’t showing but that was a week that I could not comfortably wear my normal pants. I think bloating and gas was a real thing for me, and I just needed that extra space in my pants to help me get through my day at the office in comfort. I used a rubber band, but will absolutely purchase this bellybelt for my next pregnancy to get through the first few months when the true maternity pants are not quite necessary yet.

Ginger chews - Not everyone loves these, but I’d say they’re worth a try. Only caveat is that you may never be able to eat them again if you eat them daily for the first trimester of your pregnancy.

Sea Bands - These are nausea wrist bands that I personally haven’t needed to use, but when you’re not able to cope with your day to day life due to debilitating nausea, try these out. Try anything.

Essential Oils - A couple suggested combinations I've recently heard of are ginger and geranium behind the ears or grapefruit and peppermint as well. Both combinations or use of one or the other could be tried to help with nausea.

Rest - Sleep. Just do it. Have your husband get takeout for dinner or be the meal planner during those first few months. Throw that dreaded movie or show on for your toddler so you can sneak in a nap until your partner comes home. You have to sleep. I’m a firm believer that lack of sleep will increase  all of the first trimester blues and symptoms.

Mamas tea - There are many teas that are recommended during the first trimester; mint, ginger, nettle to name the top few. But when a great friend and the women my husband and I chose as our doula made me her special mama’s tea, let's just say it was a life changer. Her sisters both made this tea for each of their pregnancies and she gave it to me as a gift as soon as I shared the news that we were expecting. The delicious and nutritious ingredients are below, (look for upcoming post all about this mama’s tea coming soon!):

  • Peppermint

  • Alfalfa

  • Red Raspberry leaf

  • Nettle

  • Oatstraw

  • German chamomile

  • Rosehip

B12 happy hour shots - Weekly B12 shots the first trimester saved me! I got mine with extra boost of folate, vitamin D (for nausea) and sometimes the extra immune boost mixer. These B12 shots help balance your moods, allow for a deeper sleep, boost energy and completely cured my nausea. I did not suffer from nausea for long, but as soon as I got my B12 shot my nausea subsided, my sleeping balanced out after jet lag from my honeymoon, and my energy increased for a few days after each shot which helped inspire me to go on that walk after work with my pup.

Dr. Shannon Wood Gallegos helped me choose the best prenatals and additional vitamins to take during my pregnancy all of which my body has received very well! See below:

Tylenol - Headaches were what I had to overcome often during my first trimester, and one day when I was ridden by a migraine my husband did some research and saw that tylenol was safe for me to take. I have taken only a few tylenol’s in the first 6 months and I’m so grateful I had them in my emergency kit.

What has brought you comfort in your first trimester? We’d love to know!

Pregnancy Myths: Not all waters break

Rachel O'Reilly

Kimberly Gordon

Kimberly Gordon

There are many signs you can be aware of to give some inclination that early labor/labor could be starting. One very obvious sign is the infamous “water break.” Does that mean it’s the only sign you should look out for when your due date comes, (and sometimes goes)? No.

Does that mean if you are experiencing very strong signs of labor and your water hasn’t broken then you’re having “false labor?” No.

There’s the possibility to birth a baby in their fully intact amniotic sac. Its called born en caul, an incredibly rare and beautiful occurrence.

Other signs of the onset of labor:

  • Contractions, (also known as surges) - You won’t question a contraction once you finally have one. Many women experience Braxton Hicks towards the end of their pregnancy. These are great toning surges that your uterus will do without being painful, but they aren’t necessarily signs of labor. Early labor contractions can feel like gastrointestinal upset, heavy menstrual cramps or lower abdominal pressure. Pain may be just in the lower abdomen or in the lower back and abdomen. It may also radiate down the legs, particularly in the upper thighs. It’s difficult to prepare a woman, or give them an exact explanation, as to what to expect for contractions. Rest assured that once a true contraction is experience, a mother will no longer ask if it was one or not.

  • Loss of mucus plug - At the very beginning of pregnancy, mucus generated during ovulation is accumulated in the uterine cervix. As the mucus thickens it seals the cervix tightly, blocking the way for any infection from the vagina to the cervix and thereby protecting the fetus. When your cervix begins to dilate and thin out, it is possible you will lose your mucus plug; a clear sign that your body is getting ready for labor.

  • Cramping - You may feel cramping in your uterus towards the end of pregnancy which is a good sign that your body is getting ready to birth your baby.

  • Lower Back Pain - Lower back aches and pains are often felt in early labor.

  • Loose stool - Your body may create more room for your baby to enter through the birth canal.

  • Bloody show (stretching of the cervix) - You will often see this when you are in more active labor, but it is a very good sign that your cervix is stretching and thinning, therefore showing light blood within the mucus discharge.

  • Pressure in lower abdomen.

  • Membrane rupture (also known as water breaks) - When your “water breaks” that is a sure sign labor will be coming. It may not activate contractions and labor immediately, but you should let your primary care giver know. Usually they would like to see labor start on its own within 12 - 48 hours (dependent on your healthcare provider).

All of these are really good signs that things are happening! Does it mean baby will be born tomorrow or even that evening? No. Therefore, if these signs are manageable, go on with your day or evening as best as you can. Draw yourself a bath or take a warm shower. Go on a walk around the neighborhood. Lay in bed with support from all your pillows and possibly a heating pad for the achy places in your body. Speak to your baby and let them know you’re ready for them, and for the journey that you both will soon undertake. Find pleasure, comfort and joy in each sign that your body sends you, because it is what you’ve been waiting so patiently for these past nine months.

What are the signs you remember the most when experiencing the onset of Labor?

 

 

Nurturing your woman during pregnancy

Rachel O'Reilly

Dearest Daughters

Dearest Daughters

Pregnancy is very hard work. I have always been sensitive to that and now know firsthand that growing a baby is tough! It takes a toll, physically and emotionally, and it’s really really important to be aware of that.

In my household I’ve always been the meal planner and executer. That’s not to say I don’t have a LOT of help, but I usually like to take control in the kitchen. Now that I’m pregnant, and just made it through our first trimester, I’m feeling so grateful to my loving husband as I write this post for stepping up to help.

Since I’m the one that has the food aversions and/or cravings, I still feel like I’m doing the menu “planning” (which are usually last minute “I want beef stew for dinner” statements and very real requests). What’s amazing about this is my husband who is not as comfortable in the kitchen takes on the tasks to figure it out. Most of the time I’ll still be in there helping, but what a joy to hear him say, “Great, I’ll go to the store now.” As soon as he’s home he starts the prep. In addition to taking over cooking and meal prep duties, below are a few other thoughtful ways to nurture your partner during her pregnancy.

  • House chores (e.g. taking the trash out, without being asked :))

  • Make sure bed is ready for your exhausted (read: passed out) partner on the couch, when she’s ready for it

  • Have water at her bedside

  • Warm up the room on cold winter nights

  • Make sure she’s taken her vitamins

  • Warm up some water and make her some mama’s tea (link to mama’s tea post)

  • Meal prep and execute as best as you can :)

  • Draw her a bath with epsom salt and essential oils

  • Book her a massage at her favorite local spa (prenatal of course)

  • READ the books that are given to you, and be proactive about preparing for birth

    • Prepare questions for your midwife or doctor

    • Prepare dialogue with your wife that will be communicated to family

I believe that there are many ways to comfort a woman in pregnancy. Each trimester has very specific common “growing pains” but not every woman feels each one or feels them the same. And keep in mind that just because she doesn’t get morning sickness (lucky woman) during her first trimester, it doesn’t mean she’s not feeling extremely exhausted and/or emotional. Be sensitive and cater to your woman’s needs. If you’re not sure how to help, the best thing you can do is ask. She will be grateful, and hopefully will be honest when she’s feeling like she needs help.

Hypnobirthing and the Beauty of Natural Childbirth

Rachel O'Reilly

 

GUEST POST by Jessica Bary

I am not from Northern California. In fact, I’m not even from the U.S. I fell in love with a wonderful man from Occidental, Sonoma County, about 11 years ago. And as we were learning from each other I came across one small, intriguing fact; he was born at home, as were his 10 other cousins. That revelation BLEW. MY. MIND!!!! All I could say was: "Do you know there are hospitals for that kind of stuff?!"

And there I was, an ignorant 20 year-old girl who had never even asked the story of her own birth, while falling in love with a wonderful human who knew almost every detail of how he came into the world. When you think about it, it seems pretty crucial to know the history of our journey on this planet, which starts with our arrival earth-side, right?

So for the next eight years, I informed myself about home births, natural births, hospital procedures, and so on. I watched documentaries like. "The Business of Being Born", read blogs, talked to my husband's family.. Nothing drastic, but the more I learned, I was slowly changing my perspective on birthing a baby. I was finally seeing natural birth as my own power as a strong woman, and it moved away from those crazy movie scenes; A woman in a wheelchair screaming her way up the elevator and then cursing at whoever is in the room while pushing with a purple breathless face.... You know those scenes. Horrific. Why would ANY woman want to put themselves through that?! If those movie scenes are all you know of childbirth, it’s no wonder our natural reaction is, No, thanks, shoot me up with all the medicine you have, so I don't feel a thing. Please.

You might still be at that point yourself, and will never change your mind, and that's totally okay. Take the drugs if you want to. I just want to tell you what I experienced as a woman whose perspective shifted from one side of the spectrum to the other: that it’s also wonderful to feel it all.

Is natural childbirth painful? Yes, of course! Have you seen the size of a baby's head in comparison of the size of the entry to your wonderful vagina!? 10 centimeters indeed. But, it's not like it's all happening at once. Labor is the process of your body preparing itself to push your baby out. So with every contraction, surge, or wave, you are getting closer to bringing the newest member of your family into the world. Without painkillers, you are able to feel your baby working with your body to come meet you. That's why labor is magical and fundamental.

And this is where my hypnobirthing tool worked so well for me.

Hypnobirthing, a coin termed by Marie Mongan, is a childbirth education course that emphasizes special breathing, visualization, meditation and other hypnosis-like techniques to promote relaxation and combat fear and pain during natural childbirth. After meeting with my midwife a few times, I asked her what she thought about hypnobirthing classes. She responded that hypnobirthing is a wonderful tool, along with many other things you will use during labor, but she didn't want me to get stuck on the idea of a painless birth - because she didn’t want me to be surprised or disappointed if I ended up feeling pain. Well, thank you for the genius advice. Pain was there, but the language I learned through hypnobirthing helped me see that pain as a wonderful progress to meet my baby, instead of seeing it as something I had to endure or survive.

Here are some of the phrases that stuck with me throughout my births:

-  Slip into tranquil state.

- The body fills with its own natural relaxant during labor, a wonderful effect that permits easy birth.

- Go DEEPER within, to your baby and your birthing body.

- Leave ALL distractions behind.

- CONNECT with your baby and GIVE birth.

- To view birth as a POSITIVE, NATURAL and JOYOUS experience.

- It's a UNIQUE experience to welcome your baby Earth-side. It only happens ONCE for each child.

- Opening yourself to the JOY of experiencing BIRTH. Being PRESENT. Calmly and serenely.

- The art of LETTING GO.

- Birthing with JOY & LOVE.

- SMILE, LAUGH, SURRENDER.

- Your body knows what to do.

- You are not helpless, you are the main ACTOR, take charge, be CONFIDENT.

- Be HAPPY, celebrate life coming to you!

- You are not a victim. You are the DOER, the ACTIVE participant.

- I AM knowledgeable, powerful, fulfilled, directing, decisive, self-sufficient, confident, satisfied.

- I AM VERY MUCH IN CHARGE.

I had two beautiful all natural home births. The first one was 12 hours from start to finish. The second one was just under five hours. My small birthing team was formed by my husband, my doula, my midwife and the assistant midwife. For the first birth, I had my sister as well. It was extremely quiet around me. My eyes remained closed for the majority of the time. But yes, it was loud inside my head. Focusing inward, having a few go-to calming visuals (like a rose opening in my case), breathing, and cursing a little indeed. ;-) For my second child, the song, "you are my sunshine" was stuck in my head and I was so focused on that song, getting emotional to meet this amazing second son of mine. It was the first song my oldest son learned to sing. All intertwined and meaningful only to me, I was birthing a baby while singing in my head.

During those two births and even during the aftermaths of those births, I never even thought of asking for drugs or medicines. I don't know how that was possible. IT DID NOT cross my mind, not even once. I was blown away by my own mind. I think for me, it was partly because I was away from a hospital or a doctor and partly because my mindset, which I learned from the hypnobirthing classes and book, was that I WAS in control and my birthing body knew what to do.

After birth, STAY IN BED. Let people serve you. Ask for help. Try to sleep. The Wonder Woman part of yourself did her job, and after labor and childbirth, it’s time for her to rest.

If any of this sounds interesting to you, you have options. There are hypnobirthing classes, a book, and even hypnobirthing relaxations on iTunes (Relaxation, Hypnobirthing: The Mongan Method, by Marie Mongan, and Birth Rehearsal Imagery, Hypnobirthing: The Mongan Method, by Marie Mongan). I listened to these before bed, and it worked wonders. It even had my husband falling asleep more easily. :)

I was vaginally born in a hospital in the 80's. With a lot of interventions. I wasn’t breastfed because my mother's milk didn't come right away (which is normal), but then the nurses gave her medicine that stopped any milk from coming altogether, thus I was bottle-fed. I am thankful to have been more in charge and informed than my mother. For me, homebirth was a gift. What's better than my own bed, shower, people, and comforting smells? That said, if you know you would feel more comfortable in a hospital or birthing center (or if you have a high risk pregnancy), you should choose the surroundings you would feel most comfortable in.

Remember, I once thought natural birth and especially homebirth were archaic processes. Nowadays we have hospitals, doctors and drugs for that! But what that actually means is that we have more choices. Whether hypnobirthing and natural birth are for you or not, the most important pre-childbirth thing I can tell you is, learn to LET GO. A lot of events in life don't go the way we expect, and birthing will likely be at the top of this list. You may plan for a homebirth and end up having a C-section. You might end up somewhere between those two situations. But whatever happens, you will do your best. That's it. Your baby will come into the world the way they are meant to, and once they’ve arrived, and everyone is healthy, that's all that matters. You are MARVELOUS, ALWAYS.

 

Yoga Poses & Stretches for Pregnancy

Rachel O'Reilly

By Aaryn Leineke

Prenatal Yoga is one of the best things you can do for yourself and your baby. Not only will yoga help strengthen, it will help stretch and open your body for childbirth. Practicing yoga can increase stamina and energy, yet at the same time calm the nervous system. It provides a wonderful balance for you not only physically but emotionally as well. 

Yoga is a practice of love and compassion. Your body will be facing a full transformation while growing a fetus. It's a time to truly let go, accept, appreciate and love your body, for it is giving life to your unborn child. When practicing yoga and meditation, it is likely that you will be more in tune with your body during the different stages of pregnancy and labor. It is a practice of breath, and finding comfort at times when you are potentially most uncomfortable. 

Some women that I've worked with who practice yoga have been able to tell me they feel their baby's movements, growth, and can give detailed descriptions about where their baby is in the womb. They can feel when their baby has adjusted to a head down position, or even if they've dropped further, deeper into the pelvis. This is not a guaranteed result from practicing prenatal yoga, but it is a pretty special experience I've witnessed.

Forming community for yourself during this time in your life is really important. If your closest family and friends are not on the same stage of parenthood that you are, joining a prenatal yoga class is a wonderful way to meet other moms!

Camel Pose (Ustrasana variation)

Stretches the spine, back, hips, chest and shoulders. Increase stamina. Invigorates and tones the nervous system and relieves stress. Opens the chakras and the heart.

Extended Side Angle Pose (Utthita Parsvakonasana)

Increases flexibility in hips, spine, shoulders & neck and strengthens lower body. Massages & stimulates abdominal organs. Increases endurance and stamina. 

Extended Fierce Side Angle Pose (Utthita Utkata Parsvakonasana) 

Builds stability in inner thighs and outer hips. Strengthens and lengthens the pelvic floor. Lengthens the side body and stretches side abdominal muscles. Increases grounded energy. 

Goddess Pose (Utkata Konasana)

Increases circulation to the pelvic floor and abdomen. Stretches groin, hips and chest. Strengthens inner thighs, hips and shoulders. Prepares the body for child birth.

Squatting Pose (Malasana)

Stretches the groin, lower back, sacrum and hips as well as stimulates metabolism and digestive organs. Helps to tone the belly and prepares the body for childbirth by opening and softening the hips.

Bound Angle Pose (Baddha Konasana)

Stretches inner thighs, groin and knees. Stimulates the heart and improves circulation, stimulates the digestive system. Soothes sciatic pain. Reduces menstrual cramps. Regular practice is shown to ease childbirth.

Postpartum Care & Awareness

Rachel O'Reilly

By Aaryn Leineke

Now that you’ve had your baby, the hardest part is over, right? Well, maybe. My first word of postpartum advice is, TAKE IT EASY. I cannot stress this enough to all the moms I support during birth and into their first few days postpartum.

You must prioritize yourself, your body and your spirit during the early stages postpartum. It’s unfortunate that our society has lost touch with the importance of taking the time to allow your body to heal from birth, establish good breastfeeding habits and bond with your baby.

Must-have home remedies for postpartum care:

  • Arnica homeopathy: Arnica is used for muscle pains, aches and bruising. You can take arnica tablets during childbirth to minimize pain and bruising, or after childbirth to speed up healing (for both a natural birth or in cases of a c-section).

  • Postpartum herbal sitz bath: Soaking in a warm herbal sitz bath can help speed up your body’s natural healing process. Sitz baths are good for all forms of birth recovery, natural, episiotomy, hemorrhoids and sutras from c-sections.

  • Soothing postpartum pads: DIY with aloe vera, witch hazel and essential oils (one example using lavender, chamomile, rosemary is here).

  • Cold pads/ice packs: For vagina and perineum swelling.

  • Soothing cold nipple pads: To help relieve sore nipples.

  • Nipple balm: To help heal chapped nipples.

  • Mama’s rich milk tea (or an ice cold Guinness beer ;) : To help with milk production.

  • Placenta capsulation pills: Believed to help balance hormones, replenish depleted iron levels, assist uterus to return to its pre-pregnancy state, reduce postnatal bleeding and increase milk production.

  • Wholesome, organic, nourishing meals - Our nutrition expert Erica Favela has wonderful suggestions here

  • Pelvic floor therapy: Read more on this below.

In recent years I’ve seen some health centers pop up that focus on pelvic floor health and the importance of this therapy. This type of therapy is especially good for women recovering from childbirth (especially multiple childbirths, or those who suffer severe tears and episiotomies during birth). Years ago I read an article from the New York Times that called out the lack of support women in the US have for postpartum care. This article states that in France “making mothers good as new is of national interest.” Pelvic floor re-education as well as abdominal re-education is 40-60% paid for by government and the rest is generally covered by insurance. I’ve heard some cases of women whom have issues including pain during sex, the inability to hold their urine or pee when sneezing or laughing, as well as defecating when exercising for long periods of time. These are issues that can occur, but that does not mean they cannot be prevented, and should definitely not be ignored.

It’s very common for your doctor to take a look at your tissue and let you know if you’ve “healed” from birth. Often, if you tell them you are still experiencing pain or mention other issues with your bowel movements, they’ll suggest giving it more time, and perhaps do some more kegels. Yes, kegels are a wonderful exercise that help many women tone up their pelvic floor for prenatal and postpartum care, but sometimes it’s just not enough. If you are still experiencing discomfort or other possible embarrassing issues after birth, check in with your doctor and do some research on pelvic floor therapy centers around you. Many of these centers take insurance, and most insurance providers will cover it as long as your primary care doctor has deemed it necessary.

If you think about it, when you tear a muscle in any other part of your body, you are given physical therapy to recover from these injuries. When your perineum tears during birth, it is a tear in a muscle, and when you get stitches you will endure scar tissue. Just like every other muscle in your body, this requires extra time and attention to heal properly. The same thing applies for the abdominal tissues affected from a c-section. Therefore, give yourself that time, and don’t be afraid to ask for the extra help/therapy. You’re not alone, and you won’t be the first person to demand more support.

In traditional societies it is very common to see mother stay home 4-6 weeks postpartum and have family members and friends come to her to help with cooking, cleaning, and rest. This is especially useful when the mother happens to be a single parent, or when her partner has to go back to work early. At Cherish, we’re working to implement that traditional care for mothers back into our collective awareness as much as possible in the United States, and to inform new mothers, mothers-to-be, and those in their communities to give proper attention during these precious postpartum weeks. Check out a few previous posts that can help inform you on these topics, including our posts about meal trains and postpartum support.

Embracing Your Postpartum Body

Rachel O'Reilly

By Aaryn Leineke

There is so much pressure for women to lose their postpartum baby weight. Many first-time mothers imagine they will (or should) “bounce back” to their pre-baby body just after giving birth. It’s important to recognize that it takes six full weeks for your body to recover from birth, to even be able to start “working out” and regaining your physical strength. So, don’t be so hard on yourself. Give yourself the appropriate time to recover. Most importantly, give yourself praise each day for how strong your body was, is and will be for growing, birthing, and now feeding your precious baby.

In the months leading up to birth, and the days shortly after, your body will go through incredible changes -- and all the emotions that come with those changes. Hormones are an incredible things that help us feel good, but they can also cause us to feel sad, hopeless, helpless and lost. As a new mom, remember that it’s okay to ask for help, to accept your body, to embrace your body, and most of all to love your body during the early months of postpartum.

Know that you may still be wearing your pregnancy clothes the first few months after birth. Know that your hips and joints may feel jiggly and unstable during your first efforts to work out. Once your body has recovered from birth, treat it with care and ease into workouts, as if you were still growing your baby inside your womb. Take a look at a recent post Keeping Fit While Pregnant here for ways to ease back into your workouts. Swimming, walking, yoga and light weight-lifting are all good to start with. If you are breastfeeding, know that your body will need the extra calories to endure feedings throughout the day and night, so don’t diet or fast to get rid of your precious, well-earned weight. Do stay conscientious of what you put in your body and continue to stay away from processed foods, sticky fats and sugars. Keeping a well-balanced healthy diet will help with your emotions and physical recovery from birth through postpartum.

If you’re feeling overwhelmed, sleep deprived, and a little lost on how to get your bearings again, remind yourself that it’s not only okay, but important to ask for help when you need it. Maybe that means hiring a postpartum doula to help with nighttime feedings, while you rest more. Or someone to help with daytime chores, so you can find time to get to a yoga class, or go for a walk with your dearest friend. Use that call for help simply to take a nap. Rest, nutrition, and love for yourself is what will bring the energy to get your body and its strength back.

Your body will become your own again, but it’s important to remember that it will always be different than it was pre-baby. And for good reason! Admire your post-baby body for the new life it created. Be grateful for it, for bringing you a beautiful child.

Do you have any struggles or motivating words to share about embracing your post-baby body? Let us know in the comments!

What is A Doula?

Rachel O'Reilly

Mothering the Mother during the birth of her baby.
— Cindy Whitman-Bradley

By Aaryn Leineke

The word “Doula” comes from ancient Greek, meaning “a woman who serves.” It is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth.

Every woman can benefit from having a doula. Studies have shown that when a doula is present at a birth labors are shorter, with fewer complications, babies have an easier time connecting with the mother and frequently latch on immediately after birth. A birth doula never leaves the mother’s side, is trained to emotionally "be there" during the most intimate times of birth, and assists the partner and guides them on ways to best support their laboring partner.  A birth doula is an advocate, one that can help communicate one’s desires and to help a laboring mother make decisions based off of all circumstances that may come along.

Women have historically attended and supported other women during labor and birth. It is only recently that modern obstetric care frequently subjects women to institutional routines which don’t include constant supportive emotional care during labor. In a way, continuous support during childbirth has become obsolete. The purpose of a doula is to provide continuous physical and emotional support and to provide comfort measures such as massage, acupressure and a warm embrace. Doulas are educated to recommend position changes when a labor is either stagnant or when a mother is having a difficult time coping with pain. The continuous support from another trained woman may enhance physiologic labor processes, as well as women’s feelings of control and competence, thus reducing the need for obstetric intervention. There are studies that women who received continuous labor support were less likely to use pain medication and were more likely to give birth "spontaneously" (give birth with neither caesarean,  vacuum or forceps).

A postpartum doula is a woman who provides support to the family after the baby is born, too. She may serve as a lactation consultant, help give the mother and partner a break to shower, eat, and rest. They may help out around the house by cleaning up, servicing laundry and preparing meals. A postpartum doula makes sure to assist in anyway possible to facilitate the mama stays in bed and rests while her body recovers from birth. They may also do night shifts to help out with the baby’s feeding soothing while mother and father get a full night’s sleep.

For more reading, here is a wonderful article stating 20 great reasons to have a doula by you or your partner’s side during labor.

 

 

An insightful share from Cherish's Resident Doula, Aaryn, about how she felt arriving home after being part of a birth:

"...Fresh from a birth, I can say that I feel lost today and a bit of sorrow. Not because I am sad, but because I miss that woman so much. I know she is well, happy and has her baby in her arms, but it takes me time to come down from a birth. To realize that my presence was incredibly impactful in those moments and that it is now needed for another mama-to-be in the near future. This sorrow is my labor/birth withdrawals. I was absolutely high on life yesterday. I never feel as clear about anything in my life as I do when in the presence of a laboring mother. I felt eager to come home after 16-hours with Lovely, but as soon as I walked out of those doors I felt empty. I give my all to every woman that I serve. My love, strength, confidence, compassion, knowledge and happiness were all hers in that time. Every mother who I am with, who I offer my support to completely surrenders in my arms, which gives me all the strength in the world to endure the labor with her and to continue to find the strength to encourage her, and remind her how truly amazing she is. I observe, I stay present and focused so that I know what she needs before she opens her eyes to ask for help. My eyes are there to meet hers, and I listen to her even when no words are spoken. I love being a doula, and I am so grateful and honored for every opportunity I am given to serve." 

-Aaryn Leineke, Doula + Co-Founder of Cherish

Mind Over Labor

Rachel O'Reilly

By Aaryn Leineke

It takes a long nine (+) months to grow your precious baby, and before you know it, your due date arrives. Excitement and anxiety build throughout pregnancy and then--BAM! Labor. There can be fear, doubt, and disbelief about what it takes to endure the long and grueling hours of birthing your baby.

Mind Over Labor, by Carl Jones, is an interesting perspective on birth that I respect and have all my mothers buy and use as a resource when preparing for their big day. Grab the book and read it or add to your registry. It’s about the belief that your body is not only capable of giving birth, but made for it. The act of bringing a baby into the world can be restricted if you don’t have that belief, or support from yourself and those around you. Each stage of laboring brings on new waves of doubt and pain, but it can also bring relief. One word I’ve used many times when I’m with a laboring mama is surrender. Contractions (also known as surges) will come, there is no escaping nor stopping them. Most of all, we want to shift the mindset to welcome and be excited for them, rather than wish they would end.

Yes, we women are made for birth, but over time, birth has become something to be feared, covered-up, sterilized, scheduled and held to “normal” standards. When you see birth broadcast in the media it’s usually a frantic, traumatic emergency situation with lots of screaming. Mothers are often rushed through hospital doors in wheelchairs or on gurneys. For many mothers who are educated and prepared for labor, birth doesn’t look anything like this, and in fact, can be a beautiful experience.

I find myself speaking to women and men in their 20’s and 30’s who have no idea what to expect when expecting. It concerns me when women say things like: “Women have been doing this for thousands of years, I’ll figure the labor thing out once it comes...” with no research or mental preparation. They’ve never had the birth conversations with their mother, grandmother, or other female relatives. They’ve never heard their own birth story, nor their siblings. They’re not even sure if they were vaginally or surgically born. I always encourage expecting parents to reach out to their own mothers or family members to learn more about how they were born. Insights about their own birth or births in their family can be eye-opening, and starting conversations like this can be a great way to prepare for birth.

I would like to emphasize how important it is to have the support of family, loved ones and especially your partner during this preparation process. If there are people in your life that have strong opinions that differ from yours, don’t waste time trying to convince them of your beliefs, or feel you need to entertain their opinions. It is crucial to have your partner on the same page as you, as you both become educated on what it takes to birth a baby, physically, scientifically, emotionally, etc. When someone is asked to support a loved one through a very emotional and, in many cases, painful time, their first instinct is to react with a fight-or-flight mentality. With birth, if you don’t understand the noises that a mother is making, the fluids that are coming out of her body and intense emotions that are flowing, it can be more challenging - when in fact, these things are all normal.

One interesting case for me as a doula was being with a strong, confident mother who was laboring really wonderfully, doing her best to ask good questions and pushing herself as far as she could. Her loving, sweet husband was by her side letting her know she didn’t have to go through this. He said, “You can have medication anytime now.” It was a gut wrenching experience because instead of encouraging her, he was suggesting interventions that weren’t necessary. This was all out of love, so the father’s intention was not to do a negative thing; it was just a lack of education on birth itself. Birth doesn’t have to be considered as suffering. It could in many ways appear that way, and when you see the person you love more than anything else in life in what appears to be pain, you want to do anything in your power to fix it. The choice is always the mother’s, and I’m someone who truly supports any choice a laboring mother desires. But, from experience, if your partner by your side does not believe in you, your body, and the powers of your mind then how could you do it all on your own?

Epidurals, Cervidil, Pitocin and Fentanyl are all wonderful drugs and tools that have helped so many women bring their babies earth side. They all have risks (all medical interventions and drugs do), and once you start one medical intervention the statistics show that the possibility of needing an additional medical intervention increases by 50% or more. Does that mean you shouldn’t use them? No, I would never suggest that. But, it’s just another thing that’s good to educate yourself on. Most of all, it’s okay to try and be that natural laboring “hero” and when you cannot take it any longer, never feel bad or guilty if and when you ask for help.

I would suggest finding the time to prepare a Birth Preference Plan and to get your partner involved as much as possible. Share the plan with all of those that you would like by your side during your birth and immediate postpartum care. An example of a Birth Preference Plan from Marin General hospital can be found here. It’s such a beautiful thing to see hospitals like Marin General encouraging women to have a voice and use it. The nurses will read your hopes and desires, and will be extremely supportive of hearing you and your partner’s wishes. They are there to support you, and when you and your baby are healthy, the suggestion to use interventions can be avoided if you wish.

Here are a few wonderful books and movies that are good tools to use for educating yourself and your partner on birth:

Birth Partner by Penny Simkin

Mind Over Labor by Carl Jones

Pregnancy Childbirth and the Newborn Simkin, Penny

Spiritual Midwifery by Ina May Gaskin

The Business of Being Born, Director Abby Epstein

Newborn Visitor Guidelines

Rachel O'Reilly

By Aaryn Leineke

Let’s be real, having a new baby is going to be exhausting. People in your circle will often offer to help you, and be sure to take them up on it. One of the easiest ways to ask for specific support is by displaying guidelines for visitors. Asking for help, especially around things like your laundry and cleaning, can be a new experience. By having these guidelines displayed, it is a great way to take the pressure off, especially because people have the power of choice to decide what specifically they want to help with. This can be printed and taped outside the front door to be read prior to entering the home. It can also be posted up throughout the house as a reminder in bathroom, kitchen, before entering mom and babies room, etc. It can even be emailed or texted to your family and friends when your baby is born. Below is a template that can be used to your liking. 

(sign at front door)

Welcome, this home has a new BABY!

We are absolutely in love, and cannot wait to introduce you to our new bundle of joy. Below are a few requests we’d appreciate you to respect while visiting for the first time (or first few times). Mom and baby are doing great, and rest is few and far between so please be conscious of the length of your visit. We’ve created a very sacred calm space here, so please make sure to use your inside voices. We are so grateful for your time to come here and offer your congratulations and support. Please honor requests for advice only when they are asked of you. We are doing our best to get into our groove and know we will get there sooner than later. Thank you, Aaryn, Mark, Roberta, and Mark Jr.

(posted around the house - near bathroom sink, kitchen sink, mom and baby’s bedroom door)

Welcome. This home has a new BABY!

  • Thank you for being on time. Please knock quietly; do not ring the doorbell.

  • Thank you for using your inside voice.

  • Please WASH your hands.

  • Pretty please, come another time if you or anyone in your household is sick.

  • Thank you for leaving your toddlers at home with a babysitter or your partner.

  • Be intuitive and limit the length of your visit.

  • If you are staying for a long period of time (over an hour), we greatly appreciate any help and support with the kids or around the house:

    • Laundry - Please make sure if you start a load of laundry to stay long enough to transfer to the dryer, or mention to new mom and dad that there is laundry in a wash.

    • Dishes - If you notice dishes in the sink, please fill the dishwasher and run the load.

    • Food - Healthy meal prep and/or snacks are always appreciated!

  • Hold the baby or play with big brother/sister while husband/partner and mother rest or shower.

  • If the trash looks full, please kindly take it out.

  • If it’s Tuesday afternoon (trash day!), please bring large bins to the street.

What's in a Doula's Birth Bag?

Rachel O'Reilly

By Aaryn Leineke

I’m often asked what I bring to a birth. Below are a few things that I always make sure to pack in my birth doula bag, both to help myself stay energized and to ensure the laboring mother stays energized and comfortable.  

  • Extra toothbrush and toothpaste - It helps to rest, wash your face, change your clothes and even brush your teeth to stay energized while attending a longer birth.

  • Battery operated candles - Most hospitals and some birth centers don’t allow an open flame. The battery operated candles help keep a highly desired, calming low-lit atmosphere.

  • Hot water bottle - If the mother is cold it helps bring warmth to her bed. Also, the hot water bottle can help soothe and alleviate a laboring mother’s pain on the lower back and hips during surges.

  • Lavender spray (lavender oil diluted in water) - I like to spray a little of this on a cold cloth that’s used to wipe the laboring mother’s hard-working sweat from her forehead, chest and neck. The smell of the oils can help relax the mother.

  • Other essential oils: Peppermint (for nausea), lavender (relaxation), eucalyptus (anti-inflammatory, decongestant, etc).

  • Two tennis balls in one sock - I use this to apply massage-like pressure on legs, hips and lower back during or between surges.

  • Snacks for laboring mother and me to stay energized - Honey sticks, chocolate, coconut water, nuts, fresh fruit (packed day-of) and water.

  • Extra change of clothes (underwear, socks, shirt and leggings) - For long-term support or in the possibility of getting dirty or wet.

  • Knee pad - For kneeling down while supporting a mother laboring in a tub.

For my personal doula bag, I use a Strawfoot custom wax canvas bag, but any lightweight duffel, backpack or purse will work. Check out some of our favorite diaper bags that don't suck (which double as the perfect doula bag!) here.

 

Three Stages of Labor - for Birth Supporters

Rachel O'Reilly

By Aaryn Leineke

Labor can be one of the most rewarding experiences of a woman’s life. It can also be one of the scariest. Even if she’s read all the books and practiced all the breathing techniques, a new mother’s body will go through a change that no book or form of practice can prepare her for. As a birth supporter, your job is to offer comfort, reassurance and guidance throughout the process. Being a birth supporter can be very hard work, so it is important to take care of yourself in order to best take care of the laboring mother and her partner. You can find a few essential things to pack or have on hand if you know you'll be attending a birth here.

The below stages of labor refer to the ideal situations. At any moment of a pregnancy, need for medical intervention can arise. Before labor, be fully informed of the mother’s birth preference plan, and make sure you have all the information you need to contact the mother’s health care provider at any time during labor if things don’t feel right. I also find it helpful to find time to meet with the mother and others on her birth team to go over all questions, fears, excitements, must have's, do's and don'ts.

1. First Stages, 0 hrs - 2 weeks

       a. Early labor: 0 - 3 centimeters

            i. Anywhere from hours to a couple of weeks before birth, the mother’s cervix will dilate up to 3 centimeters. This stage of labor can happen over a lengthy period of time and can range from having relatively few bothersome or painful contractions, to being fairly uncomfortable. As a birth supporter, use this time to advise the mother to stay patient and find rest any time her body allows it.

            ii. During early labor, the mother should try to continue normal day/night activities as much as possible. It can take hours, and often the contractions are sporadic and anywhere between 5-10 minutes apart. Try to help her rest as much as possible at night, encourage her to take gentle walks during the day, and make sure you help with any last-minute preparations around the house.

            iii. As a birth supporter, the first stage of labor is when you should be a calm influence on the mother, offering comfort, reassurance and support. When you think labor has started, you can call the doula, who can help if the mother is feeling anxious.

            iv. If the mother and baby are healthy, it’s best to stay home during early labor or as long as possible. If your birth plan includes a hospital birth, keep in mind that nurses will most likely have mothers go back home who are not in active labor yet, if mother and baby are healthy. If you have a birth doula with you at home, she can help time contractions and provide insight on when the labor is becoming more active.

       b. Active labor: 3 - 6/7 centimeters

            i. Contractions will be stronger, longer, and closer together (lasting 45 - 60 seconds/3-5 minutes apart). At this time, you will usually take the mother to the hospital or call the midwife to support you at home.

            ii. Active labor is when all the labor prep gets put to work. Help the mother practice breathing techniques during each surge, and try to help her relax and let go of the tension between surges.

            iii. The best way to support a mother during active labor is to give her your undivided attention. Offer verbal encouragement and reassurance. Offer to massage areas of her body that you can see are uncomfortable, for example, her hips, lower back, shoulders, legs and feet. Keep track of the contractions and try to keep a log of their patterns or regularity. Go through the breathing techniques with her. Help her change positions and use props, like pillows, to support her when she’s found a position she likes. For example, use pillows between her legs to keep legs open, and under her belly for support of the baby when side laying. Suggest sitting on a yoga ball to inspire movement while working through surges as well as keep her hips open. Offer water, coconut water and other sources of hydration. Remind her to urinate frequently. Encourage use of music and remind her of any mantras she chose to use during challenging times. Tell her how proud of her you are.

       c. Transition: 7 - 10 centimeters

            i. Transition is generally considered the shortest stage of labor, but is typically the most intense. Contractions at this stage can be anywhere from 1-2 minutes apart, and lasting at least a minute, with little-to-no fluctuation on that pattern. As a doula, this stage is when I can see the light at the end of the tunnel for the mothers. But, that does not mean the mother always sees the same light. More than anything, this is when she needs the support of her birth team members.

            ii. During the transition stage, the baby can sometimes be low enough to activate the mother’s urge to push, yet in many cases, her cervix isn’t completely dilated, so she needs to resist. When the mother has urges to push, make sure the doctor or midwife are nearby and aware – and remind her not to push unless the doctor or midwife tell her to. Nausea, hot flashes, vomiting, gas and the need to defecate are all normal.

            iii. Remind the mother to take one surge at a time, and that each surge is what is bringing her baby closer to being in her arms. Don’t be alarmed if the mother is ready to “give up” or becomes very impatient. Avoid small talk, and use this time for encouraging words. If possible, try to use language that wasn’t a part of the many hours of early labor. After the 12th hour of hearing the same two encouraging words, the mother can get annoyed. :)

2. Second Stage, 0 - 4 hours (more or less)

       a. Pushing

            i. As a doula, this may be my favorite part of labor, as the mother will finally be able to find some relief with pushing. This doesn’t mean that pushing isn’t hard, or that labor is over. But, reaching this stage generally does bring some sense of accomplishment.

            ii. Many women need coaching while pushing. There are many techniques of pushing: spontaneous pushing, or bearing down for counts of 10 seconds, squatting or getting on all fours. Any pushing position that feels comfortable for the mother is a good one to let her try,. As a birth supporter it's good for you to then suggest for something new if she seems discouraged after some time.

            iii. Once the mother has found a preferred technique for pushing, she will need to push with everything she has. The feeling of frustration or embarrassment can arise during this stage, and as a birth supporter, you will need to continue to remind her that it is normal, it is HARD work, and the progress is there. Reiterate to the mother that she is doing all the right things to have her baby.

       b. Delivery

            i. Between surges, encourage the mother to rest and catch her breath.

            ii. If she wants it, use a mirror as guidance for the mother. When she can see the head of her baby emerge from her body, it will bring focus and encouragement back into her efforts.

            iii. An increase of bloody show is normal, and the crowning of the baby’s head can be very intense. The healthcare provider may ask the mother to slow down to avoid tearing of the perineum. Once the baby’s head is out, it often will take only one additional push to get the shoulders and remainder of his/her body out. As the floodgates open with tears, joy, laughter, relief and love for the new baby, again, tell the mother how proud of her you are.

3. Third Stage, 0 - 30 minutes

       a. Delivery of placenta

            i. By the final stage of labor, if all goes as planned, the baby will be in mother’s arms. She will be given time to connect with her baby through skin to skin contact. If and when the baby shows interest, the mother can allow her to begin nursing.

            ii. Mild contractions will eventually start up again. The placenta will release from the mother’s body and she will have the urge to push again, with guidance from her healthcare provider. Many moms can experience some discomfort during this final stage, due to tearing and stretching during the birthing process.

            iii. The mother’s body and hormones have gone through so much, so it is normal for her legs and body to shiver and shake during this time.


It is important to recognize that your role as a birth supporter continues after the three stages of labor. For the mother, although her new baby makes the process of labor all worth it, it won’t make the pain and exhaustion from the birthing process immediately go away. She will feel like she’s been hit by a truck. Parts of her body will not feel like her own. But with that new baby in her arms, the mother may be so overwhelmed with the new love she feels, that she forgets to address her own needs. In the hours and days following labor, continue to care for the mother’s basic needs like hydration and nourishment, and offer physical and mental support in whatever ways you can.

If you've ever experience supporting a Mother in labor, please share some of your best tips and props that you've found useful!

Three Stages of Labor - for Moms

Rachel O'Reilly

Screen Shot 2016-05-25 at 1.13.58 PM.png

By Aaryn Leineke

There is no “one-size-fits-all” labor. It can take days, even weeks from when your first contractions or early labor signs start to when you have your baby in your arms. That said, there are a few stages of labor that everyone will go through, and knowing what to expect during each stage can help you see the light at the end of the tunnel.

The below stages of labor refer to the ideal situations. At any moment of a pregnancy, need for medical intervention can arise. Make sure you’ve discussed with your doctor what to do when labor starts, and have your healthcare provider nearby or on-call for any questions or for alerting at any time during labor if things don’t feel right.

1.     First Stages, 0 hours - 2 weeks

       a.     Early labor: 0 - 3 centimeters

            i.     Anywhere from hours to a couple of weeks before birth, your cervix will dilate up to 3 centimeters. This stage of labor can happen over a lengthy period of time when you’re close to full term, without bothersome or painful contractions. It can also happen after contractions (also known as surges) start, and it could take a number of hours to days, and can be fairly uncomfortable.

            ii.     As much as possible, you should continue your day/night routine as normally as you can. It can take hours, and often the contractions are anywhere between 5-10 minutes apart and very sporadic. Therefore, if early labor begins at night, make sure to rest and close your eyes between surges. If you enter your first stages during the day, prep meals, go on walks near your home and handle any last-minute prep around the house, since you know now the baby will be there any day. You’ll notice you will have softer stool and you may feel the need to use the restroom more frequently than normal.

            iii.     When you think labor has started, you can call your doula, who can help if you’re feeling anxious or have some discomfort. If you and your baby are healthy, it’s best to stay home during early labor or as long as possible. If you plan to have a hospital birth and you and your baby are healthy, the nurses will most likely have you go back home if you are not in active labor yet, so keep that in mind if you feel eager to get to the hospital as soon as your first contraction comes, or if your water breaks. If you have a birth doula with you at home, she can help time your contractions and give you and your partner insight on when the labor is becoming more active.

       b.     Active labor: 3 - 6/7 centimeters

            i.     Contractions will be stronger, longer, and closer together (lasting 45 - 60 seconds/3-5 minutes apart). This is usually the time to either call your midwife to assist you at home, or have your partner take you to the hospital. Active labor is when you put all the classes and reading you did during pregnancy to work. Practice breathing techniques during each surge, and practice relaxing and letting go of the tension between surges.

            ii.     Switching positions often, gently walking, and going into the shower or bath are great ways to cope with active labor, and can help with the progression. Staying hydrated and making sure to urinate frequently is very important as well.

            iii.     Rely on your birth supporters to help keep you comfortable, calm and hydrated, and to keep a log tracking your contractions.

       c.     Transition: 7 - 10 centimeters

            i.     Transition is a very transformative stage. It’s when all the hard work from the many hours and possibly days of labor really kicks into gear and when (as a doula) I can see the light at the end of the tunnel for the mothers. But, that does not mean the mother always sees the same light. More than anything, this is when you will need the support of your birth team members. It can be considered the shortest stage of labor, but is typically the most intense. Contractions at this stage can be anywhere from 1-2 minutes apart, and lasting at least a minute, with little-to-no fluctuation on that pattern.

            ii.     During the transition stage, the baby can sometimes be low enough to activate the mother’s urge to push, yet in many cases, the cervix isn’t completely dilated, so you will need to resist. When there are urges to push, it is always good to make sure your doctor or midwife are nearby and aware. Nausea, hot flashes, vomiting, gas and the need to defecate are all normal.

            iii.     During active labor, breathe through one surge at a time. You may feel ready to “give up” or become impatient, but just know that each surge is what is bringing your baby closer to being in your arms.

2.     Second Stage, 0 - 4 hours (more or less)

       a.     Pushing

            i.     As a doula, this may be my favorite part of labor. This is when I see the energy of the mother come back to life. This is when your hard work reaches the point of finally being able to have some control again. Does that mean pushing isn’t hard, and labor is over? No. But, it brings a sense of accomplishment to know that your body made it to 10 cm. and has finally opened enough for you to push your baby out.

            ii.     In candid terms, birthing a baby will feel like taking the biggest bowel movement of your life. It can be difficult to comprehend, until you’re in that moment, the intense rectal pressure that you will feel, and will need to continue to push toward. There are many techniques of pushing: spontaneous pushing, or bearing down for counts of 10 seconds, squatting or getting on all fours -- all are wonderful ways to bring your baby earth-side.

            iii.     When you’ve found your preferred technique, it’s time to push with everything you have. The more efficiently you push, the more energy you are able to pack into each push, and the further you are able to bring your baby through the birth canal. The feeling of frustration or embarrassment can arise during this stage when you feel like it’s taking longer than you had anticipated. But, your birth support team will continue to remind you that it is normal, it is HARD work, the progress is there, and you’re doing all the right things to have your baby.

       b.     Delivery

            i.     Rest between surges/pushes and catch up on your breathing and oxygen intake.

            ii.     Use a mirror as guidance. Someone can hold or at hospitals and birth centers they have standing mirrors just for this. When you can see your body opening and the head of your baby emerge from your body, it will bring focus and encouragement back into your efforts.

            iii.     An increase of bloody show is normal. The feeling of tingling, stretching, burning or intense pressure on the vagina or rectum is normal when the baby’s head is passing through the birth canal. The crowning of your baby’s head can be very intense, and your healthcare provider may ask you to slow down and grunt your way through this time to avoid tearing of the perineum. Once the baby’s head is out, it often will take only one additional push to get the shoulders and remainder of his/her body out. Then, let the floodgates open with tears, joy, laughter, relief and love for your baby and appreciation for all of your hard work, and the support of your birth team.

3.     Third Stage, 0 - 30 minutes

       a.     Delivery of placenta

            i.     By the final stage of labor, if all goes well and you and your baby are healthy, your baby is in your arms. The doctor will give you time to connect with your baby by having skin to skin contact while they check on you. If your baby shows interest in your nipples or is bobbing her head up and down, you can allow her to latch onto your nipple to nurse.

            ii.     Mild contractions will eventually start up again. The placenta will release from your body you will have the urge to push again, with guidance from your healthcare provider. Many moms can experience some discomfort during this final stage, especially if you have tears along the opening of your vagina or on your vaginal wall from intense stretching.

            iii.     Your body’s hormones have gone through so much, so it is very normal for your legs and body to shiver and shake during this time.

After labor, your body may not feel like your own. You will feel like you just ran a marathon, and in many cases I've been told "I feel like I've been hit by a truck." Your body has just done the most powerful, amazing thing: it birthed a baby. You will need time to recover, and you will need more support in the weeks to come. But, know this: once you have your baby in your arms, and both of you are healthy, it will all be worth it.

Stay tuned for a follow-up post on the best ways to support a mom during these three stages of labor!