Prince William County Doula Services

ACOG Finally Clarifies Standards for VBAC

Shelli — Thu, 22 Jul 2010 12:37:36 +0000

After about 15 years of increasing VBAC rates due to poor interpretation of what was known as ACOG #5, they finally adjust the guidelines and clarify their recommendations. “Given the onerous medical liability climate for ob-gyns, interpretation of The College’s earlier guidelines led many hospitals to refuse allowing VBACs altogether”. Around 1996 ACOG issued guidelines for VBAC that were interrpreted to mean that a trial of labor option was only safe in hospitals that kept a cesarean team in-house, ready to go. That struck fear in the hearts of malpractice lawyers because of how malpractice is defined, and gave hospitals and insurers a way to lower costs. If hospitals didn’t fund an around the clock team, they required scheduled cesareans. Planned surgery is always cheaper than having to pay for emergency ones. ACOG is finally doing some good and trying to fix this. Let’s see if OBs and hospitals listen.

http://www.acog.org/from_home/publications/press_releases/nr07-21-10-1.cfm

Big Breasts and Small Mouths

Shelli — Tue, 20 Jul 2010 22:15:10 +0000

One of the common complaints that we see with new moms nursing is: Mom has large breasts and babe either has a small mouth or just isn’t opening wide enough. The common advice for this is the “Nipple Sandwich”. But sometimes that doesn’t work, or mom can’t quite get the hang of it. So Bronwyn has come up with this wonderful method that I have heard great things about!

breastfeeding latch method for new moms from bronwyn millar on Vimeo.

My First Official Doula Birth!

Shelli — Tue, 13 Jul 2010 01:53:06 +0000

Posted with permission of the family

This past Friday was my first birth as an official doula. M was being induced for hypertension with a prior history of pre-eclampsia. This was a big test for me. Induction starts off meaning two things, restriction of movement, and increased pain due pitocin not being able to cross the blood-brain barrier and not providing pain relief like it’s natural companion, oxytocin, does. Add to that the client being hypertensive which means much more restriction on movement and I was a bit concerned I wouldn’t be able to do what needed to be done to support her through it without an epidural. I was also concerned because baby and cervix were not ready yet, could we do this, with pitocin, with little movement, with a high up baby and an unripe cervix, and not only avoid an epidural but a c-section?

During our prenatals, it had been discussed that M’s husband, A, wasn’t the best labor partner. She was okay with him not being her go to, and he was too. So it was amazing to watch the change in A when I gave a couple small suggestions throughout her labor, and he just stepped up and really found himself! They really came together as one to support her as baby made his way out. I can clearly remember the minute that I switched from her support person, to the tool that would help them get it done, and it was glorious!

During a contraction

M went inside herself, she would meditate through each contraction, going somewhere else. I could tell though that she was struggling though. We were trying positions to both help her pain and to assist baby because he was not in the mood for this, and while she always seemed like she could make it through, I could tell she wasn’t always getting by so well. There was a point though that it clicked for her. Through her high pitched vocalizations, I kept moaning and telling her “low”, “down” trying to prompt her to change the way she was using those muscles. When she switched, WOW! M, A, and I all just moved into the singular purpose of getting this baby out. The midwife and nurse wouldn’t interrupt any of us.

Baby T!

When it came time to push, the midwife had M do one push to get the last little lip gone and expected that she would stop and let the midwife get situated at that point. I stood on the side of M, physically supporting her while she pushed, and I felt her not fully release from that push and looked at her and said, “Do you still need to push? If so, go ahead!” She changed again there, it was her body and her baby and they didn’t need to wait for the midwife to do business. She went all in and pushed and pushed until the midwife had to sort of yell at her to look, her baby was out enough for her to see! And of course, she, with her body, said, “not enough of him” and got her the rest of that baby!

It was exhilarating and amazing, and I’m so privileged to be asked in on these special times to help these families. I’m excited about my new career and the places it will take me.