Tackling Your Birth and Labor Checklist

I am so pleased to have you join us as Michelle-Nicholle Calareso, owner of Sunflower Doula Services in Colorado and the Multicultural Director of DONA International shares with us information about how to Tackle Your Birth and Labor Checklist! Michelle-Nicolle has been serving women as a doula for three years. Please visit Michelle-Nicolle's website at www.sunflowerdoula.webs.com and blog at www.sunflowerdoula.blogspot.com With all of the books, resources, and websites out there on having a baby one can get overwhelmed and anxious about giving birth.

Tonight you will find out how to gather all the necessary information and support team personnel that you need to go into your labor room feeling at ease and in control of the process. Discover what books to read, how to hire a doula, and how to set up a schedule for meals before your postpartum period. And now, I would very much like to welcome Michelle-Nicolle!

Michelle-Nicholle Calareso: I am very excited to discuss how to take the anxiety out of preparing for birth and labor. I also want to thank Tiffani for putting together this educational site and service. Thank you Tiffani, for allowing me to be a part of the Pampered Pregger and Beyond chat series.

Tiffani Lawton: My pleasure!

Michelle-Nicholle Calareso: As a doula and a mother I have found that preparing for labor and delivery can be extremely stressful for a majority of expectant parents. There are dozens of books, movies and media sources giving a myriad of opinions on how to labor. There are numerous childbirth preparation classes ranging from Lamaze to HypnoBirthing to chose from. It can be daunting. Not to mention the information that we receive from family members and friends. I hope that this chat will help narrow down all of the choices. Tonight we will discuss how to assemble the birth team for you, birth plans, childbirth preparation class, books that I love, and what to prepare now for the postpartum period. Let's start with the birth team.

Your birth team is the most essential piece to an anxiety free labor and delivery. Birth teams range in number and type. The most important thing to remember is that your team is there just for you and they are your advocates. Studies have shown that 82% of mothers who received support during their labor rated their birth experience as satisfying. While 58% perceived their bodies as strong. There are several options of professionals that you can include in your birth team.

The first place to start is to chose between an obstetrician or a midwife. Many of my clients have asked how to decide and I usually answer that the first thing you must do is figure out your own philosophy towards birth. (Be careful of stereotypes surrounding both fields; not all OB's are entirely medically minded, and not all midwives take a holistic approach) The second step to finding the right match is to interview several providers. Do you feel listened to? Are they receptive to your quest? Ask them what their cesarean rate is. The national rate is climbing up to 30% because some hospitals are refusing to do VBACs.

The second member of your professional team should be a labor companion or a doula. Just like your care provider I suggest taking the previous steps and asking these questions:

1. Is the doula trained and certified?

2. What is her level of experience?

3. What is her philosophy towards birth? (hopefully this will match yours)

4. References?

5. What services does she provide and what are her fees?

6. Does she work with a back up?

7. What does she perceive to be her role at the birth?

8. Does she have any expectations of you (contract, contact before and after the birth)

I want to stop here and ask if there are any questions.

Malika Aliya: What is a VBAC?

Michelle-Nicholle Calareso: Vaginal Birth after Cesarean

Because everyone is working with a limited amount of time I suggest asking some of these questions over the phone or at a 'Meet the Doula Night", in order to discover those that you would really like to interview more at a later time. A great place to find a doula in your area is www.DONA.org. All of the doulas on the website are trained and certified through DONA International.

Jennifer Mossholder: Do you feel it is necessary for a doula to maintain a certification?

Michelle-Nicholle Calareso: Yes and no.

Shawnna Baldwin: I don't feel certification equates to competency.

Tiffani Lawton: I agree with Shawna...

Michelle-Nicholle Calareso: I feel that a doula should ideally be the best fit for you and whether or not she is certified doesn't make that happen. I definitely think she should be a part of the birthing community in some way. Your doula will be able to also recommend massage therapist, acupuncturist, lactations counselors, moms groups, and much more in your local area. By hiring the right doula you will be able to cut down the search time for other key birth professionals to add to your birth team. I think of doulas as the birth concierge. Allowing you to rest and relax during the remainder of your pregnancy and upcoming labor. Prices range from $0 to $1000. Most doulas will work with you to fit into your budget.

Tiffani Lawton: I like that...a concierge!

Shawnna Baldwin: Except for I think it implies that one should allow someone else to do the "homework"

Michelle-Nicholle Calareso: I feel like your doula can make it easier for you to pull together the larger picture. Oh no. I wouldn't just take anything at face value. Homework is important and should be done by you.

Jennifer Mossholder: Yes, but sometimes, clients are all over the place. Gentle re-direction is necessary.

Michelle-Nicholle Calareso: I agree.

Shawnna Baldwin: I agree

Michelle-Nicholle Calareso: Are there any other questions about the birth team?

I hear from a lot of parents that their childbirth preparation class was a waste of time or that they didn't remember everything in the moment. Time and convenience are usually the reason that most parents take a certain class. Before you register for a class ask the instructor these questions:

1. What is the instructor's philosophy about birth? Her philosophy doesn't have to be exactly the same but it would be difficult to sit through a class that is drastically different from your idea of birth.

2. What is the class size? Some do well in large settings while others strive in smaller ones.

3. What methods of teaching are utilized in the class? Lecture, discussion, hands-on.

4. Is the instructor certified?

5. Are comfort measures discussed and practiced during the class?

6. Are all aspects of birth discussed from medical interventions to natural childbirth?

7. References?

I have taken a large majority of the classes and found that I was more receptive to the classes that had a similar philosophy to mine. Does anyone have a specific class that they would recommend?

Tiffani Lawton: I would prefer a class in the community setting vs. the hospital setting. The instructors seem to be able to give all info more freely, without the administrative confines.

Jennifer Mossholder: I tell people to go with what they want, but in the end anything with patterned breathing is just going to mess you up. If they go with Bradley, I question why they want a doula. But I do advise them to take the hospital tour and ask questions.

Shawnna Baldwin: Birthing From Within

Michelle-Nicholle Calareso: I have heard that time always a big factor.

Jennifer Mossholder: I offer a 2.5 hour class that covers everything those 6 week classes do.

Shawnna Baldwin:http://www.birthauction.com is where mine are temporarily hosted. They are online... I also do phone support for those choosing Unassisted Childbirth.

Michelle-Nicholle Calareso:www.Hypnobirthing.com and www.sunflowerdoula.webs.com for private childbirth education classes.

Jennifer Mossholder:www.doulamom.com Well, my theory is, if you are going with a doula, you are generally looking to go natural. But your doula should either offer you a quick "free" CBE class or refer you out. I strongly advise all new parents to tour the hospital even if they are not taking the hospital classes. They should know what the policies are.

Shawnna Baldwin: If they are having a hospital birth.

Jennifer Mossholder: Shawna, but they should also tour the back up hospital if they are using the Birth Center too.

Michelle-Nicholle Calareso: Thanks. Ready for Birth plans? A birth plan is a way to communicate your wishes to your care provider and discover more about what your feelings surrounding your birth are. Many critics of birth plans feel that you are setting yourself up for disappointment. You should see your birth plan not as a list of demands but a way to communicate special needs or concerns during your labor. I always tell my clients that a birth plan should be about a page or less and non-confrontational. The best thing to remember when writing your birth plan is that it is a guideline for how you would like to approach certain situations.( Keep it flexible!!!)

You should include the names of your support people and their roles. Any important information about yourself (GBS+, special diet, etc). Preferences regarding environment, labor positions, positions for pushing, pain relief methods (non-medicinal), perineal support, any important preferences in an unexpected outcome.

The key to having your birth plan accepted by all involved is to share it with your care provider at a prenatal visit and use it as a jumping off point for more discussion. It should also be presented to your nurse upon admission to your place of birth. I find it helpful as a part of the birth team to know what is important to the woman.

Tiffani Lawton: For consumers who will be reading this, can you elaborate on options for perineal support?

Michelle-Nicholle Calareso: Sure, perineal support ranges from perineal massage, to warm compresses, to lightening up on pushing to allow the perineum to stretch. It is important to discuss with your care provider how they support you during pushing and delivery. Most care providers can describe their techniques during a prenatal visit. Are there any questions about birth plans?

Jennifer Mossholder: In general, I would say, always come to the office with your questions written down for your prenatal visit. The docs run in and run out!

Michelle-Nicholle Calareso: Discussing the birth plan is the most important part of the preparation. It is easier to know where your care provider stands before labor than during a stressful period during labor.

Jennifer Mossholder: MN, how do you feel when docs say 'You have a doula, that's your birth plan.

Michelle-Nicholle Calareso: I haven't heard that one before but I like to let people know I am not an insurance policy.

Shawnna Baldwin: Many won't even take a look at birth plans.

Michelle-Nicholle Calareso: I am an advocate and can only advocate wishes that have been communicated by the parents. There are some providers who I thought didn't look but later came back and referenced it later.

Jennifer Mossholder: A lot of people don't get that doulas are advocates and don't talk to the doctors on a medical level.

Judy M. Schneider, IBCLC: Many nurses roll their eyes at birth plans and think here comes trouble.

Shawnna Baldwin: True.

Michelle-Nicholle Calareso: Presentation is the key. I think too many times they get confrontational pieces of literature rather than what is truly important. I have a sample available on my website. I also teach a teleseminar on writing a birth plan that your doctor and nurse will love. Let's move on to postpartum.

It is important to plan now for your postpartum period now. While you are fresh and loved ones are asking for things to do. If you have friends and family around ask a close friend to set up a food drop off for the first month.

I used to tell parents to stock up their fridges with easy to cook meals and then when I had my second the MOMS Club that I was in had a food drop off program for new mothers. Every week someone would drop off a ready made meal that was meant to last a night or two. It was fantastic! We got a warm meal that included the foods we liked in dishes that were disposable or at least that we did not have to wash and return.

The best part was that I got to briefly see a friend when she dropped off the meal but who knew not to stay too long.

Another tip that I give to my clients is, rather than unpacking all of the wonderful baby gifts and clothes that you receive now I suggest having your doula or a family member comb through with you to find the most important items and later have another friend or a postpartum doula come by after a month and help set up the rest. Your postpartum doula can also help prepare meals, help with sibling care, or give you a much needed massage.

Judy M. Schneider, IBCLC: Our family has casserole 2nd baby shower for the freezer.

Tiffani Lawton: Great ideas!!

Michelle-Nicholle Calareso: Food and support are the biggest components to the postpartum period. I have to say support is the #1.

Tiffani Lawton: I second that!

Michelle-Nicholle Calareso: For those living from family it can be difficult to find that. I think it is important to take stock in what support systems you already have in place.

Judy M. Schneider, IBCLC: In the first hour moms need to know the importance of Skin to skin contact and the benefit of early breastfeeding.

Michelle-Nicholle Calareso: I agree Judy and it is easier to breastfeed with support. A great lactation counselor or La Leche League is important to find before baby comes. Mother's groups are great also but can also be intimidating for a new member. Are there ways that you have found support in your community?

Tiffani Lawton: The mother's club that I belong to offered meals 3 times a week...it was such a blessing...I had not received this support with my first three.

Michelle-Nicholle Calareso: I found that my Meeting was also a great place for support.

Judy M. Schneider, IBCLC: Many moms are so concerned about labor that they forget to prepare for breastfeeding. It is normal and natural but it is a learned art. Skin to skin let's mom and baby follow their instincts and get a great start early in the first hour.

Michelle-Nicholle Calareso: Taking a breastfeeding course now is also helpful to get the information ahead of time and allow it to process.

Tiffani Lawton: And like a postpartum doula, to have an in home lactation consultant available...is instrumental in success.

Michelle-Nicholle Calareso: I agree! I have three books that I like to recommend. I love... Penny Simkin's "The Birth Partner" and Ina May Gaskin's, "Ina May's Guide to Childbirth"

Shawnna Baldwin: Those are great books!

Michelle-Nicholle Calareso: Breck Hawk "Hey Who's Having This Baby Anyway?"

Shawnna Baldwin:Birthing From Within by Pam England

Michelle-Nicholle Calareso: I know that time is short and I find that these three are too the point but great to read. They give all sides of labor and are not fear driven.

Tiffani Lawton: Penny is a member at PP&B

Lauren Hale: What books would you recommend for a woman facing issues with nursing?

Michelle-Nicholle Calareso:The Ultimate Breastfeeding Book of Answers by Jack Newman

Judy M. Schneider, IBCLC:The Womanly art of Breastfeeding by LLL.

Lauren Hale: Our second daughter was born with a cleft palate and I could not find anything on nursing an infant with a cleft palate until I took a CLC course when she was almost a year old and I had stopped pumping.

Judy M. Schneider, IBCLC: Cleft information is usually a lactation consultant resource. I have helped several moms with a cleft baby.

Tiffani Lawton: Thank you Michelle-Nicolle for a very informative chat.

Michelle-Nicholle Calareso: It has been great chatting with you all and I hope that we can do this again. I hope you found this informative and a jumping off point to positively preparing for birth. Thanks Tiffani!

Tiffani Lawton: Weekly teleclasses are free when you join in live. If you miss a class, a recorded option is available for a small fee. Check out the variety of upcoming events we have in our events section at www.pamperedpreggerandbeyond.com Have a great evening!