EenEy, Meeny, MinEY, Midwife
There are several pathways to midwifery. Choosing the best midwife for you may mean considering a different birthing environment.
CERTIFIED NURSE MIDWIVES (CNM)
For those wanting a hospital environment for their birth, but a more balanced approach with expectant management of their maternity care through the pregnancy and birth of their baby, Certified Nurse Midwifery should be considered.
A hospital-based nurse midwifery team follows the same ACOG recommended visit schedule of care and screening options as any standard OBGYN practice. A certified nurse-midwifery practice has several midwives whom you could meet with prenatally. Typical prenatal office appointments last approximately 15-30 minutes. During labor, they often provide an initial pelvic exam to determine dilation and if you should be admitted to the hospital after you have been triaged by a registered nurse. CNMs have an on-call rotation, so it’s uncertain who will be with you when you are birthing, or if you will have the same provider catch your baby as who has been with you throughout labor. Your midwife will ensure the safe delivery of your baby with intermittent check-ins with you or your nurse, considering changes from the curve of normal physiological birth, facilitating any interventions, catching your baby or transferring your care to an Obstetrician (OB/GYN). After the birth of your placenta and routine check of your perineum and fundus, your provider will leave your recovery care to the nursing staff who will be in charge of the care for you and your baby for about 2 hours following your birth. You will then be transferred to a postpartum floor and assigned a new nurse for each shift for the duration of your hospital stay.
Most Medical insurances will cover certified nurse midwives for a planned hospital birth. However, Nurse midwives are not available in every hospital, or may not be available 24/7.
Some Nurse Midwives will attend home birth. Though CNMs have licensing in the state of Massachusetts, medical insurance will not reimburse home birth any more than other midwives.
CERTIFIED PROFESSIONAL MIDWIVES (CPM)
Research has shown the home to be a safe location to birth for low-risk pregnancies, allowing the natural birth process to unfold with the skillful and compassionate care of professional midwifery services. Home birth midwifery care decreases unnecessary interventions and increases a new family’s confidence and satisfaction in birth and parenting. A professional home birth midwifery team follows the same ACOG recommended visit schedule of care and screening options as any OBGYN office. Midwives offer evidence-based care, unencumbered by routine practice or hospital policy. Instead of a 10-15 minute appointment, they are typically with you for 60-90 minutes every meeting. Rather than planning birth under hospital lights with strangers, you’re planning your birth in the comfort of your home with providers you’ve come to know and trust. While you enjoy getting to know the sweet newborn baby in your arms, the team will prepare nutritious postpartum food and tend to your home before tucking you into bed for a truly good night’s rest, often leaving 4-6 hours following the birth of your baby. Your midwife returns within several times within the first week postpartum for check-ups.
Some medical insurances cover home birth, and often if they do not cover the birthday, they will often cover your prenatal and postpartum care with a homebirth midwife. Contact your insurance company to find out if birth at home is covered. Do not let finances be the reason for choosing your birth setting or provider. Deductibles for a hospital-based birth may be more than the cost of birthing with a home birth midwife. Many CPMs will offer a payment plan to help you afford a home birth in Massachusetts, Connecticut, or Rhode Island.
Community midwives have followed a traditional education before organized learning opportunities. Their education has been received by hands-on learning and the passing down of knowledge from the generations of midwives before them. There is a variety of care in this midwifery title, and it's important to ask questions about education, continued education, care practices, and about emergency protocols.
THE DOULA vs. MIDWIFE DIFFERENCE
It’s important to note the difference between doulas and midwives. A doula is more like a birthing coach, but a midwife is a similar trained professional with special expertise in supporting women to maintain a healthy pregnancy birth, offering expert individualized care, education, counseling to a woman and her baby throughout the childbearing cycle. While a midwife and doula may offer many of the same philosophies and qualities, it is the midwife that will deliver or “catch” the baby and perform necessary medical examinations throughout pregnancy, labor, delivery, and postpartum.
Birth Doula Support can be a complimentary team member for your family. They provide childbirth education, support during pregnancy, and continuous physical, emotional and informational support to you and your partner during your labor and birth. Birth doulas are meant for those wanting natural birth, epidural birth, home birth, hospital birth, hypnobirthing, and cesarean!
After the birth of your baby, there may be new challenges during the first weeks of parenthood. Postpartum doulas provide a wide spectrum of support which include breastfeeding assistance, newborn care, sibling care, physical help around the home cooking healthy meals, laundry, and emotional support to new parents who may be experiencing the new anxieties of parenthood.
We help provide RESPECT, SUPPORT, ENCOURAGEMENT, and nurture your transition to parenthood with CONFIDENCE and PEACE!
What is a doula?
Over the last decade, increasing media attention has people asking, “What does a doula do exactly?” With tv shows White Collar and Season 21 of The Bachelor to celebrities Alanis Morrisette and Alicia Keys, the word “doula” is a buzz!
A doula is often mistaken with a midwife, but more accurately referred to as a birth coach, birth assistant, childbirth educator, or pregnancy concierge. However, these are incomplete definitions. A doula is an assistant, but there are several different types of doulas; Antepartum, Birth, and Postpartum Doulas.
Antepartum doulas specifically care for families during pregnancy. They often provide guidance in navigating emotional and physical changes as they grow a little human or may physically care for the mother or birther while on bed rest. They provide considerations for deciding which new hip products on the baby block are important on your baby shower registry or help organize a nursery.
Birth Doulas are trained professionals able to assist childbearing families with emotional, physical, and educational support. Birth doulas fill a gap in modern obstetric care. Though they provide many of the same services as an antepartum doula, their main focus is meeting with families prenatally to prepare for labor and delivery, and the initial breastfeeding. The cascade of interventions can lead to 1 in 3 women having a surgical cesarean birth. Studies have shown doula support can decrease unnecessary interventions and increase maternal satisfaction. Birth assistants can decrease the need for pain-relieving medications like an epidural. They are skilled in techniques for natural pain relief, such as massage and touch, counterpressure, acupressure, rebozo, aromatherapy and offer suggestions throughout labor to help a birther feel more comfortable. We help facilitate communication by considering questions you may ask and offer alternative methods to discuss with your birth team. Most importantly, birth doulas provide a complimentary care that not only brings confidence as mothers approach their birthing time, but helps new parents feel calm, capable, and a ready to take on parenthood!
Postpartum doulas work within the budding family’s home to help for the new mom, dad, parents, grandparents, siblings and newborn adjust. They may prep food, provide breastfeeding support, bottle feed your baby, attend to older siblings, or care for baby as parents recoup with a shower and much-needed sleep. Sometimes a postpartum doula may be referred to as a night nurse or night nanny when providing overnight baby care so families can feel more rested. They may help with the emotional changes the whole family experiences in the postpartum or postnatal period and guide the strengthening of bonds.
There are dozens of doula training organizations and all doulas are not created equally. Although all doulas are sincerely passionate, all doulas work differently! Some doulas are hobbyists, others balance a full-time work/doula life, while still others have built a full-time professional service. They offer different services, different packages, have different skills and experience ranges. They may have stopped their education after a 2-day online doula training, taken an in-person hands-on training and certified, or have additional hands-on complimentary education such as rebozo, Spinning Babies, or massage.
It’s important to ask questions when determining if the doula you’d like to hire may fit your expectations and is the right fit for you!
New Life Blessings offers Birth and Postpartum Doula services including overnight support for you and baby. Read more.
Pregnancy is a fantastic time in a woman’s life. Her body becomes a nurturing home for a precious life, providing everything needed until the baby is ready to make their entrance into the world. To watch the growth of a pregnancy occur is quite amazing and can be seemingly simple. However, the start, progression, and ending of a pregnancy all involve a special and specific interaction of a variety of hormones that flood a woman’s body from even before the time the sperm meets the egg. Parents Magazine identifies six major hormones that play a major role in pregnancy.
Human Chorionic Gonadotropin (hCG)
Human Chorionic Gonadotropin is a hormone many women first come to know when using an at-home pregnancy test. These tests measure the level of this hormone in the urine, and if high enough, indicate to the women that pregnancy has been achieved. This hormone is made by cells in what eventually form the placenta. The level of hCG in the body double about every two days, reaches its highest level around 60 to 90 days, then decreases to a stable level for remaining of the pregnancy. One job of this hormone is to sends signals to the ovaries to stop producing eggs. Its main role is to allow the corpus luteum, which is a cyst on the ovary, to continue to make estrogen and progesterone until the placenta is mature enough to handle to the production of these hormones. The level of hCG begins to decrease once the placenta takes over the production of estrogen and progesterone.
No other hormone is more associated with women than estrogen. Responsible for critical fetal development, estrogen allows for the organs and body systems in the fetus to develop. Estrogen also triggers the growth of the adrenal gland of the fetus and the hormones that it produces. Additionally, it allows the uterus to be responsive to oxytocin. Pregnant women can experience nausea, spider veins, changes in skin, and an increased appetite due to high levels of estrogen in the body.
Encyclopedia Britannica explains that progesterone plays a critical factor in a woman becoming pregnant as it allows the uterine wall, or endometrium, to thicken which allows for implantation of a fertilized egg. During pregnancy, the hormone relaxes all the smooth muscles in the body which includes the wall of the uterus. Blood vessels in the body also become relaxed which contributes to the dizziness, lower blood pressure, and some gastrointestinal issues that pregnancy can bring such as gas, heartburn, nausea, and constipation. Progesterone is also responsible for the rise in hair growth on the body during pregnancy.
Oxytocin is the hormone associated with labor. The uterus becomes sensitive to the hormone as the pregnancy prepares to end. It is responsible for stretching the cervix as well as stimulating the nipples for milk production to occur. Women who do not go into labor naturally often require the use of Pitocin, which is the artificial form of oxytocin.
This hormone’s name indicates its function as it is responsible for relaxing certain parts of a pregnant woman’s body. Relaxin increases by about ten times through the duration of pregnancy, and it allows for the ligaments in the body to loosen. This is essential as the pelvic bones must have the flexibility to successfully allow the baby to pass through the birth canal. Relaxin also allows for the uterus to relax in anticipation of childbirth. This hormone can cause some women to become clumsy during pregnancy. Also, it is the cause of the feeling of looseness in some body parts such as the hips, ankles, knees, and shoulders that some pregnant women experience.
After pregnancy, women can produce milk to nourish their young. The hormone prolactin allows for this milk production to occur. Prolactin is produced in quantities 10 to 20 more times than when a woman is not pregnant. During pregnancy, prolactin ensures that the breast tissues are ready to be utilized. After pregnancy, the hormone allows the body to release milk through the nipples.
Pregnancy brings an entire cascade of hormones, all of which are required to perfectly orchestrate the amazing process of childbirth. These hormones can bring a variety of changes, many of which can be uncomfortable, to pregnant women. However, these effects are short-lived and usually thought of as being minor when compared to the amazing result of bringing a child into the world.
The excitement you feel over having a new baby soon is hard to deny. However, your toddler may not understand exactly what it means to welcome a new life into the home. As a result, you want to help ease your little one into this transition by using a few creative techniques.
Involve Your Toddler in Making Decisions
Before the baby is born, begin including your toddler in some small decisions. While you might initially scoff at the idea of your toddlers picking their siblings name or selecting a theme for the nursery, consider if it would actually be harmful in any way to ask them what they think about these decisions. You could look at lists of baby names together or ask them what they think about their top choices. When you’re at the store, you can narrow down the theme yourself and then ask your toddlers what specific items they like. This will help them feel included in the process of welcoming the baby, instead of fostering resentment and the feeling of isolation.
One of the best ways to prepare your toddler for the new baby is to read some books. When your kids are toddlers, they may not have tons of social experiences, but fiction can always help bridge some empathy gaps. Books can help them to get an idea. Many different books exist that can help to get your toddlers excited and assist in quelling any concerns that they feel about welcoming the new baby into the home.
Buy Toddlers a Present
As you prepare for the new baby to arrive, you are buying your baby plenty of items, from toys to clothes to whole pieces of furniture. Also, people are probably bringing and sending you presents, especially if you are having a baby shower. As a result, your toddlers can begin to feel left out. While you don’t want to make everything about presents, a small item can make a big difference in helping them feel appreciated during the busy months.
Talk about the Future
While making promises that you can’t keep, such as ones about large family vacations immediately after the baby is born, is not the best plan, that doesn’t mean you can’t begin to make some loose plans about life with a new addition to the family. However, you can talk about the future in more general terms. For example, your toddlers might get excited if you tell them about the games that they will be able to play when the baby is older or how they can help to take care of the baby. Your toddlers may worry that they are going to be left out, and these conversations can ease that worry. Maybe even just planning small family outings together can foster communication and quality time together.
Preparing for a new baby involves a number of tasks. But don’t forget about helping your toddlers ease into the transition during this phase. If you are nervous about giving birth and making this transition, reach out to us. We’d love to help you feel completely comfortable with every aspect of your experience.
Mind / Body Connection in Labor
As birth doulas, we see women do amazing things. They struggle, they wonder, they bond, they nourish, they comfort, they love fiercely. The birth with all the power of humanity and in these moments they are vulnerable. They are scared, they are excited, tired, and raw.
Birth reveals much about us to ourselves and to those around us. As a doula, I’ve watched the power of the mind/body connection become more real and tangible than in any other area of the human experience.
The body responds in profound and sensitive ways to stress, thoughts, stimulation, and suggestion. In many cases, whatever a woman thinks about for her birth is exactly what happens. This sounds like it’s in stark contrast to the line that says “things never turn out how we plan”, but there is a difference between a plan and a thought process. So here is what I’ve learned about the mind/body connection in birth work.
Women need to be deliberate in choosing their thoughts for their birth. If they fixate on their fear, that fear will most certainly manifest itself. Fears are real and should be validated, but not given the benefit of too much consideration. For example, if a woman fears that her water will break and contractions will not start on their own, the body interprets this thought process as an instruction. Practicing mindfulness or meditation can go a long way toward honing the ability to be deliberate about thoughts.
The words that a care provider chooses to use during pregnancy and labor have a profound effect on a woman. The phrases “You are only at 4 cm” and “you’ve progressed all the way to 4 cm” convey the same clinical information: cervical dilation to 4 cm. But they communicate profoundly different messages that will be interpreted by women differently. One tells a woman that her body is essentially defective. The other communicates capability. When a woman thinks she is defective, her body may respond to this as stress, which fights with oxytocin. When she is given confidence, her body opens up to its capabilities.
Women should speak what they want for their birth. Affirmations work. Again, the body receives them as instructions and blueprints rather than formless thoughts or whims. Choose your words carefully because both your body and your mind are receiving them.
Women should communicate to those around her that she doesn’t care to hear all the bad stories. Birth stories are like war stories. The worse they are, the more we want to tell them. As soon as someone starts with “well when I had mine….” and you know where the story is going, it’s ok to politely stop the person talking, and ask them to refrain from telling negative stories.
Doulas have seen women dream that their baby has a shoulder dystocia and it happened.
We have seen women say they knew they were going to “need” Pitocin – and they did.
We have seen women say, during their whole pregnancy, “I’m going to show up at the hospital pushing” and they barely make it to the delivery room.
Doulas have stories to tell of women who spoke absolutely everything that ended up happening in their birth, down to the finest detail – both good and bad.
We know of women who desperately did not want a hospital birth, but felt they had no choice, yet they dreamed of delivering at home. Those births happened so fast that moms barely even had a chance to get out the front door.
You get what you speak. You get what you think. And you get what you fixate on. Print some affirmations and say them to yourself every day. You may be surprised to find just how much your mind influences your body.