Birth Ways’ Cheat Sheet for Doulas: When clients should go to the Hospital?March 15, 2022
Many clients want guidance on when to go to hospital during labour, especially if they wish to do most of their labour at home or don’t want to get there too early. Doulas don’t talk people out of going to the hospital. However, many people chose to stay home longer if they are being supported and can be reassured that they are still early in the process.
One little trick is to ask the labouring person if they feel like eating. If the answer is yes, then it’s likely still early in the birth process. Most people will not feel like eating once they’re in active labour!
Sometimes we urge our clients to get going!
When to go to hospital:
- When labouring client feels safer/better there
- Any concern about pregnant person or baby
- Can’t walk or talk through sensations (combined with other signs in this list)
- Decrease in fetal movement
- 311 (prime) or 411 (multip); longer with a history of fast birth
- Lots of pressure / pushing sensations
- When waters release?
- Want pharmaceutical help coping with pain
- If we hear grunting at the end of a contraction or any sounds that indicate labour is progressing into stage-2 (a.k.a. bearing-down, pushing)
Before Leaving Home
- Provincial Health Card or Insurance docs
- Prenatal records with Birth Plan
- Prescription medications
- Have a snack or juice - good blood sugar
- Notice fetal movement
Tips for Hospital Arrival
- Need health card
Assessment / Triage in Birth Unit
- Health card, prenatal records & birth-plan
- Lots of questions; no one should ask / talk during contractions
- 3 questions:
- Labour pattern - show app
- Amniotic fluid - ROM? Colour?
- Is Baby moving normally?
- Cervical check - pee first
- Can wear own clothes but be ready for maternal physical assessment
- No need to lay on bed until staff is ready to do physical assessment immediately; stay in positions that feel good.
Warning signs (during labour or anytime in preg):
See your BWI Doula Training Manual or local health region’s list of warning signs. Below are some signs that doulas must know.
- Frank (flowing) red bleeding or clots - 911
- Sudden / severe / intense / sharp pain that doesn’t pass - 911
- Cord prolapse - 911
Seek medical attention today and in a timely manner but drive calmly:
- Decreased fetal movement = seek medical attention TODAY
- Visual disturbances
- Maternal fever
- Coloured/smelly waters; may = meconium, infection
Here is this cheat sheet as a downloadable PDF. Do you have tips to share on knowing when clients should go to the hospital?
Clothing for Birth: What can you wear during labour?March 8, 2021
When you are packing your birth bag, it's the perfect time to choose your clothing for birth. What are some things that you would be comfortable labouring in?
However, if your first thought is, "Will they let me wear my own clothes?", stop and remember that this is your choice. A hospital gown is a garment that has been worn by hundreds of people before you and one which we can only hope was properly sanitized. It is not comfortable for moving around in.
If you are invited to change into a hospital gown, you can if you wish or you can decide to keep your own clothes on - you are not there as a patient but as a labouring client receiving support and services from great care-providers. Lots of our clients labour in their own clothes. Your clothes might get sweaty or wet but they are easily laundered.
For some, the hospital gown might actually be a trigger that reminds them of previous negative experiences within the hospital setting, so that is good to be aware of.
And the standard gown is just not good for all-fours postures or whenever you lean forward to stand and sway - whereas your own clothes can be tried out, lived in and very comfortable in any position.
If an epidural is part of your plan, then the hospital gown allows access to your back so it might be a great option in this case.
The keywords are it's your birth. So you get to think about this and decide.
Another way of phrasing that is: what do I want to wear to my birth?
Deciding what you will wear is a great way to plan something, control something and exercise your choice.
Most women choose comfortable, soft, stretchy clothing.
You can wear:
-your favorite nightshirt or oversized t-shirt, with or without leggings
-your PJs or nightie
-whatever you might wear if you were settling in to binge-watch Bridgerton
-a swim coverup or sundress
-an after shower terry towel wrap
- a mumu
-a bikini top, soft bra, sports bra and comfy shorts. Just remember it can be tricky to get a bra off if you want to do skin to skin with baby immediately after birth
Plan this beforehand and have some fun. One client made her own gown out of fun fabric, another ordered a gown that was a duplicate of the one Pam used on The Office with fun polka dots, useful velcro tabs and a sense of individuality. In fact, you can order all sorts of fun gowns to labour in if that feels interesting to you.
Birth Ways International: Get to know the placentaFebruary 11, 2021
The placenta is amazing! Let's take a moment to appreciate the jobs they do during pregnancy!
The placenta attaches to the side of the womb, gets oxygen to your sweet babe through the umbilical cord and removes waste from their blood.
Remember, your birth is not complete until the placenta is also delivered, by you, so while you are holding your newborn, plan to stay warm, calm, and connected to your child so it comes out easily. Do not let anyone tug on the cord!
Delayed Cord Clamping - do some research on this because the blood in the cord belongs to the baby so delaying the clamping allows that.
Who cuts the cord? You? If you do not want to, then it is your choice to ask someone else to do this.
What happens after it comes out? It will be set aside and examined later to make sure it is complete and healthy.
Placenta tour - you can ask someone to show you the two sides of the placenta, the amniotic sac and the cord.
Keeping your placenta - it will be discarded unless you tell the staff that you wish to keep it - so plan for that! Bring a container and keep it cool with ice if you are encapsulating it, or put it in some secure storage bags if you are taking it home.
‘Planting’ your placenta - you can bury or plant it in a garden, yard or special place and plant a tree over it. There are many options for you here and many women follow their traditional practices with the rituals they use. Freezing the placenta gives you time to decide what to do.
Making a print - many doulas do this but you can also do it yourself - a fresh placenta is easiest but if you are not going to consume your placenta you can use colors and paints!
Consuming your placenta - do your own research on this - I have had clients who enjoyed them with raspberry smoothies!
Encapsulation - this is a service we offer where we process the placenta carefully and very safely to capsules, which you take. Most of our clients are repeat customers who thrived in the postpartum and swear that it was the iron, hormones, minerals and components in them. Women request tinctures too. We dry the cord as a keepsake!
Lotus birth - again, do some research as I had not had a client who did this so I cannot say.
Birth Ways International – Postpartum Paper ProjectsFebruary 2, 2021
Here are some easy ways to ease things for your client or friend who just had a baby. And no, this is not a papercraft post!
There are many simple, inexpensive things to do with paper that might bring comfort in the postpartum days.
See if any of these resonate and add other ideas that come up!
- Paper journal or notebook for scribbling, doodling, writing down questions you have so you can clear your mind, recording fragments of your birth - words, images, memories, questions, stories.
- Use tissue paper to cover the bottom half of your windows to create softer light and privacy if that would feel good
- Write out a postpartum plan for things you might need and how you can get help to get your needs met, be they groceries, meals, social connection, support with breastfeeding, care of your pet or other kids.
- Consider putting a note on your front door saying “Thank you so much for dropping off that meal. We are enjoying some quiet time to get to know our baby and rest up. We will let you know when we are ready for visitors.”
- Record poops, pees and nursing sessions for the first while until things get established - in case you feel to connect with your doula, La Leche League breastfeeding support or a lactation specialists for support in getting abundance milk supply.
- Write out your birth story, memories, snippets, phrases, images or questions to ask about how things went.
- Groceries list - keep a list handy of snacks you are craving, hearty food you would appreciate being made for you, food supplies that need to be picked up or delivered.
- Post helpful guides like “Is my baby getting enough?” from LLL that reassure you that your baby is spending enough time well latched or give you concrete suggestions on how to adjust things.
- Read helpful things from a trusted resource book on newborns, nursing or parenting.
- Read a fluffy book that has nothing to do with self-improvement - to relax - because you are ENOUGH!