Have a Doula at your Labour and Birth

Many of the HypnoBirthing practitioners of HypnoBirthingGTA are also doulas.

Imagine the double advantage of having both a doula and a HypnoBirthing practitioner at your birth (especially if you took your HB classes with her!). A doula trained in HypnoBirthing is familiar with the exercises and techniques you learned in your HB classes and can help remind you and reinforce what you need to do during labour and birth — RELAX!

The following HypnoBirthing practitioners are also trained doulas or also attend births. Please contact them directly for more information:

Sarah Baker

Carol Anna Skorvaga

Tahira Mohammed

Deborah Orenstein

Dr. EeVon Ling ND

Jennifer Elliott

Karen McWilliam

Eloisa Slimmon-Weber

Dr. Olivia Chubey ND

Kris Pedder

 

What is a Doula and How Can She Help Me? 

A doula (also referred to as a labour attendant or labour coach) is considered the person who provides continuous physical and emotional support and assistance to a woman before, during and after childbirth. Having a different role than a midwife, OBGYN or RN, the doula provides important care from a non-medical aspect.  A doula also helps the birthing partner and/or family by providing information, physical assistance, and emotional support. Having this continuous support during labour and birth is associated with improved maternal and newborn health and a variety of other benefits.

While the goal of an OBGYN or midwife is a safe childbirth, the goal of a doula is to ensure the mother feels safe, comfortable, confident, informed and supported before, during, and after the birth of her baby. Doulas cannot make or voice decisions for the birthing couple nor can they intervene the actions of the attending midwife, RN, obstetrician or other medically licensed professional active during labour and birth, but they can help the birthing couple ensure that they are active participants within their healthcare team every step along the way.

A mother who feels safe, comfortable, confident, informed and supported is able to relax and allow the natural process of labour and birth to happen in a healthy normal way.

Many studies have shown significant benefits of having a doula present during labour and birth:

Benefits to mother

  • Continuous ongoing support during labour and birth
  • Shorter labours
  • Lower rates of intervention use during labour and birth
  • Lower rates of epidural use
  • Lower C-section birth rate
  • Higher levels of reported satisfaction

Benefits to baby:

  • Lower rates of fetal distress
  • Lower rates of low APGAR score at 5 minutes after birth
  • Higher rate of breastfeeding initiation
  • Lower admittance rates into the NICU

 

 

 

References:
Hodnett ED, Gates S, Hofmeyr GJ, Sakala C, Weston J. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2011 Feb 16;(2)

Kozhimannil KB, Attanasio LB, Hardeman RR, O’Brien M. Doula Care Supports Near-Universal Breastfeeding Initiation among Diverse, Low-Income Women. J Midwifery Womens Health. 2013 Jul;58(4):378-82.

Kozhimannil KB, Hardeman RR, Attanasio LB, Blauer-Peterson C, O’Brien M. Doula care, birth outcomes, and costs among Medicaid beneficiaries. Am J Public Health. 2013 Apr;103(4):e113-21. doi: 10.2105/AJPH.2012.301201. Epub 2013 Feb 14.

Vitamin D Supplementation in Infants

The “Sunshine Vitamin” is Very Important for Babies

 

For several years the Canadian Pediatric Society (CPS) and Health Canada have been recommended that all breastfed infants receive 400 IU (international units) of Vitamin D supplement per day. Lack of vitamin D, a vitamin that is usually gained from exposure to the sun, can lead to rickets, a disease leading to poor bone growth and development. There is also evidence that increased exposure to vitamin D during key points of fetal and infant development may offer protection against asthma, osteoporosis, dental cavities, inflammatory bowel disease, diabetes and multiple sclerosis.

Vitamin D is present only in low amounts in breastmilk, regardless if the mother is taking Vitamin D herself. Therefore, some breastfeeding advocates argue that since breastmilk is a baby’s natural food it contains all the nutrients a baby needs.  However, it is known that those living in the northern hemisphere tend to be low in Vitamin D, especially during the winter months. This is especially true for babies born during winter and early spring, when the mother may be low in Vitamin D and the developing baby does not receive enough of the nutrient in utero.

Now the CPS is suggesting that pregnant women talk to their caregivers about taking a supplement of 2000 IU/day. The Canadian Cancer Society also suggests a daily supplement  (1000 IU per day) for adults under 50 from October to March when our Canadian sun is reduced. Vitamin D is believed to reduce the risk of cancer and Multiple Sclerosis.

Vitamin D status in adults is a simple blood test that is available through your MD.

Vitamin D supplements for infants are readily available at pharmacies and healthfood stores. Look for a supplement in drop-form that is free of artificial colours, flavours or added sweeteners. It is easily given to your baby by placing a drop on your nipple before breastfeeding or on your finger and letting your baby suck it off.

 

Gentle Birth Breathing, Not Forceful Pushing

Pushing vs  BIRTH BREATHING

An Explanation of the HypnoBirthing® Approach

Prepared by Jennifer Elliott, B.Ed, HypnoBirthing Practitioner, www.lifesjourney.ca

 

The HypnoBirthing goal: a calm, gentle birth for both mother and baby using spontaneous bearing down in second stage.

 

Why not ‘push’?

HypnoBirthing, the book, advises against ‘forced pushing,’ ‘purple pushing’ and the valsalva maneuver. It uses the term ‘pushing’ to refer to all of these that are generally caregiver coached and directed, requiring a woman to hold her breath. This style of pushing may be against a woman’s natural instincts and desires and research has found it leads to reduced satisfaction with the birth experience. Valsalva pushing which requires a closed glottis, is associated with reduced oxygen to the baby and a tense jaw. Tension in the jaw causes women to tighten their vaginas, like a pelvic floor exercise (kegel), causing the baby’s head to meet more resistance as it is pushed down. In an article contrasting Active Management of Labour with physiologic birth, Marie Mongan, author of HypnoBirthing and creator of the program, says, “When using forced pushing, she is closing the sphincters of the vaginal outlet ahead of the baby. This kind of pushing reduces the flow of oxygen to the baby, and his heart rate may decline.

 

Renowned American Midwife Ina May Gaskin believes a relaxed mouth and jaw are directly correlated with the ability of the cervix and vagina to open fully (The Sphincter Law). Research suggests spontaneous bearing down is gentler on the mother’s tissues, reducing the incidence of stress incontinence.

 

What is Birth Breathing?

HypnoBirthing refers to the concept of ‘spontaneous’ or ‘mother-directed’ pushing as ‘birth breathing.’ We encourage women to ‘breathe down’, ‘bear down’, ‘nudge the baby down’ and ‘breathe down and in a J’ (the direction the baby must move to curve under the pubic bone). It may be only the language that is different from how a midwife might guide her client.

 

Does the research support Birth Breathing?

Yes. Spontaneous pushing has proven to be less tiring for the mother and to result in higher APGAR scores for the baby. Women report greater satisfaction and they experience fewer negative effects on several urodynamic indices.

 

How does a woman prepare?

The HypnoBirthing woman has learned to relax her body completely and is working to maintain that relaxation even in second stage. She does perineal massage at the end of her pregnancy, training herself to relax to the sensation of the pressure of the baby’s head. She visualizes the tissues of her vagina gently unfolding in front of the baby.

 

Practice for breathing down is done on the toilet during a bowel movement. She is encouraged to notice how her vagina and anus open as she breathes down on the exhale, sending the energy down her body.

 

What does a woman need from her care providers?

Be patient as she tunes into her body. HypnoBirthing encourages women to begin breathing their baby down when they feel the urge, which may be some time after they are fully dilated. Many women experience a resting phase before the active phase of second stage. Mongan notes that we wait for women with epidurals to allow their bodies to bring their babies down and we should be prepared to do the same for all women.

 

Support the mother’s ongoing relaxation and inward focus. Women may appreciate only quiet, gentle encouragement, using the language highlighted above. They take several breaths with each surge (contraction), in and out through their nose.

 

Mongan describes what she calls ‘the birthing phase’ this way, “Once she has mentally moved into her birthing body, she will follow the lead of her body and her baby and use the Natural Expulsive Reflex (NER) to bring her baby down to crowning. Her baby will be breathed down. She knows that Birth Breathing assists the normal expulsive pulsations of the mom’s body and that a recent study shows it to be as effective as valsalva pushing.”

 

Be positive. Some mothers find their bodies so relaxed, often because they have practiced relaxing while doing perineal massage, that they experience no discomfort during crowning. For this reason we do not discuss the negative possibility of a “ring of fire.” One mother said that she found the feeling of her baby coming out of her body, “exhilarating.”

 

Be prepared. Some mothers experience a very efficient Natural Expulsive Reflex, similar to Dr. Michel Odent’s description of the Fetus Ejection Reflex, which brings the baby’s head quickly and easily to the perineum. If a mother says the baby is coming now, believe her. She is very tuned into her body.

 

Special Circumstances

HypnoBirthing parents are aware that there may be concerns (known as special circumstances) that arise at any time during birth that require a more directed approach.

They are prepared to hear the recommendations of their care providers if a concern arises and to accept whatever path their birthing takes.

 

Thank you for your support of HypnoBirthing and birthing women.

 

Believing in the miraculous design of our bodies makes the miraculous more possible.

 

Please feel free to contact HypnoBirthing Childbirth Educator Jennifer Elliott, B Ed, for further information on Birth Breathing– jen.elliott@rogers.com

 

How HypnoBirthing Compares to Conventional Childbirth

HypnoBirthing versus Conventional Childbirth Report 2010

Between October 2005 and October 2010, the HypnoBirthing Institute received 2001 Parents’ Birth Reports from United States.

For comparison, HypnoBirthing® data are compared to Listening to Mothers II Report of the Second National U.S. Survey of Women’s Childbearing Experiences. New York: Childbirth Connection, October 2006, www.childbirthconnection.org/listeningtomothers, (hereafter abbreviated as LTM II.) Limited comparison data are also available from “Births: Final Data for 2007”, by Joyce A. Martin, M.P.H.; Brady E. Hamilton, Ph.D.; Paul D. Sutton Ph.D.; Stephanie J. Ventura, M.A.; T.J. Mathews, M.S.; Sharon Kirmeyer, Ph.D.; and Michelle J.K. Osterman M.H.S.; Division of Vital Statistics. National Vital Statistics Reports, Volume 58, Number 24 August, 2010

Labor interventions: HypnoBirthing® mothers used far fewer interventions during their labors than mothers in the comparison groups

Medical induction:  18% of HypnoBirthing moms vs. 38% of LTM II

Pitocin augmentation: 21% of HypnoBirthing moms vs. >50% of LTM II

Perineal stitches: 32% of HypnoBirting moms vs. 60% of LTM II

Epidural anesthesia: 21% of HypnoBirting moms vs. 71% of LTM II

Cesarean section: HypnoBirthing® mothers experienced surgical birth (Cesarean section) at a much lower rate (17%) than that reported by LTM II (32%) or the U.S Division of Vital Statistics (31.8%). Data does not differentiate between primary and repeat Cesareans.


Choice of Care Provider: 45% of HypnoBirthing® mothers who birthed vaginally chose obstetricians and 57% chose midwives, including CNMs and direct entry midwives. By comparison 79% of the respondents to LTM II were attended by obstetricians.

93% of HypnoBirthing mothers rated the quality of supportive care they received from their care providers as “good” or “excellent.” 86% percent rated the supportive care from nursing staff at the hospital or birthing center “good” or “excellent.”


Birth Place: LTM II and US Vital Statistics show reported less than 1% of births took place at home or in a free-standing birth center. 7% of HypnoBirthing® mothers birthed at home and 6% chose a free-standing birth center, with the remainder birthing in hospitals.

Low Birth Weight and Large Infants: HypnoBirthing mothers reported fewer low birth weight babies and more large babies than indicated by LTM II and the U.S. Division of Vital Statistics. The fact that more HypnoBirthing babies are born beyond 40 weeks may certainly contribute to the differences, but the two comparison groups include a much wider cross section of the population and the differences are most likely due many factors.


Benefits of HypnoBirthing:

Mothers were asked to rate a series of statements about how they perceived HypnoBirthing benefitted them. 70% or more of mothers agreed that HypnoBirthing:

Adequately prepared them for labour and birth

Allowed them to be more confident in their ability to birth

Helped them make good decisions for birthing

Helped them have a more comfortable birth

Helped them to have a more gentle birth

Helped them have a better understanding of their birthing options

Helped them be able to communicate better with their care provider


Satisfaction with the birthing experience: 500 women wrote responses to the question “Apart from meeting your new baby, what was the best thing about your experience of giving birth? “ The answers most often mentioned feeling powerful, competent, having their partner very involved and supportive, and very often included comments about the ease and comfort of labor and birthing .

77% said they would definitely use HypnoBirthing again and 19% said they may or may not. 87% said they would recommend HypnoBirthing to others.