Doula Diaries: Sunday 6/26/16 Inductions

Ever wonder what it's like to be a doula with a family? I'll tell ya! Welcome to my doula life! My main characters are Mike, my superhero of a husband and father to our three children; Jace, my 11 year old guitar-playing, x-box loving, sharp-witted son; Kaia, my 8 year old sunshine daughter; and Ty, my 21-month old whirlwind of a toddler. And then there's me! I've been doulaing since 2011 and have attended more than 60 births to date and have taught over 90 couples in my childbirth classes. This is my full-time gig! With three children and a doula business, private and group childbirth education classes, evening sports and afterschool homework, staying at home as a full-time mom and also creating space for my own health and fitness, there is, as they say, never a dull moment.

What *do* doulas do all day, when there are no babies being born? Let's take a peek.

I spent the week catching up with my current clients, Distance Doula clients, and prospective clients. I spent a LOT of time with my children, playing in the pool, arranging playdates and an impromptu art lesson from a neighbor who is a retired art teacher. I took my dad shopping for a gift for my mom for their 50th wedding anniversary. I read a LOT of board books.

I got curious about something that a past client had used as a cervical ripening agent, prior to induction. I've been a doula for over 5 years and had not yet heard of it. It's called the Cook Cervical Ripening Balloon and it's apparently the go-to used at Tampa General. It's not as popular here in SWFL; usually Cervadil is used to ripen the cervix and then Pitocin is administered. An alternative is the Foley Catheter as a means of induction. I came across this article from 2015 titled "Foley Catheter Beats Cook Cervical for Labor Induction." (You may have to sign up for a Medscape account to read the article, which can be annoying but not a super big deal). I linked the article here and pass this information on to you, and invite you to become familiar with all forms of cervical ripening and induction, in the case your labor ends up including labor induction. Side note: Tampa General is a teaching hospital with really great statistics, and in some instances the Cook balloon may be just what is needed. Bottom line, talk to your provider about your options if an induction becomes a medical necessity for you.

I see mothers-to-be get very worked up when their provider suggests or offers an induction. Sometimes, though, a provider offers an induction because it's what many mothers have requested in the past. Now, if the mothers I doula for are induced, they are generally in medical need of an induction, not an elective induction. Elective inductions and medically necessary inductions are very different things. Remember, there is no reason to rush a baby; baby knows best and will be born when he's ready. I don't even blink an eye until much past 41 weeks, as a doula. I will generally lead my clients to their own questions about any potential induction including some ways they can engage their doctor in a discussion about why or why not it might be a good idea for them. I'll never say "don't be induced!" because it's not my call and I'm not in the business of making medical decisions. But I certainly will offer perspective, studies and questions, including what I know about natural induction methods, and ultimately support for whatever the birthing mother chooses. The thing is, if you're looking for someone's permission to try natural induction methods, you won't get it. Your doctor will never say, "Castor oil? Sure! Why didn't I think of that?" "Nipple stimulation? Yes, here's how!" Birth is this amazing time of "Mama'ing Up" and doing what needs to be done without looking back. (p.s. there are other ways to use castor oil aside from ingesting it!)

Why on earth might someone choose to be induced, you might ask? What if you were delivering twins and one had a medical issue like IUGR? What if you were diabetic and your baby was truly large as a result and the risks of longer gestation began to outweigh the benefit of a spontaneous delivery? What if you delivered a stillborn in the past and the best thing for this baby as well as your emotional health as the mother was to induce prior to 40 weeks? It's for reasons like these and thousands more that we cannot predict. Birth is such a personal journey, and it's not up to us to judge another mother's walk through it.

How about those natural induction methods? I've used 'em myself! I'm what I like to joke as a "Super Gestator," i.e. my babies like to come closer to 42 weeks. I would cry, how it wasn't FAIR that some mothers got to birth their baby at 37 weeks and I had to stay pregnant a WHOLE MONTH longer then them!! (I don't do pregnancy well, which is one of the greatest ironies of my lifetime). For my last two pregnancies I used castor oil (your gasp is audible!) when the going got tough and I was up against a serious wall. I don't recommend this to my clients but I'm always willing to share information. It came down to, would I rather be induced in the hospital with Pitocin or continue to birth at home and try some natural methods.

I can easily list 10 natural induction methods. Let's do it for fun. 1. Nipple Stimulation 2. Castor Oil 3. Spinning Babies, specifically the Side-Lying Release 4. Chiropractic 5. Acupuncture 6. Acupressure 7. Sex 8. Membrane sweep 9. Evening Primrose Oil 10. Herbal blends I've actually used all of these when I think back on my three births! If you find yourself past your due date, as the overwhelming majority of first time moms do, let's hope you have a midwife and doula on your team so you have some direction on how to navigate these methods. (Remember, there is no reason to rush a baby; baby knows best and will be born when he's ready! These methods are listed in the case that there is a reason your baby needs to come sooner rather than later, like if mom is becoming pre-eclamptic, or the amniotic fluid is declining, or a host of other scenarios you cannot predict until you get there.) If you have a doctor at a hospital, I assume it's for a medical reason and in that case, if a medical induction becomes necessary then I like to err on the side of trusting those who I've chosen to be on my birth team. You may not like what's happening but you can get through it with clarity and strength. Again, let's hope you have a doula on your side at that point.

So I continue to read and learn. That's what I'm doing with my down time this week. If you were induced, tell me your story. I'd love to hear if you tried natural induction methods, or were induced at the hospital and if so, what did you use to start your induction? Did you know you had choices? Were they presented as such? How did you and your birth partner decide what to do?

Send me a message or comment on my facebook page! And don't forget to peruse my website by clicking on the headings at the top of the page: Doula Care, Henna, About Christine, Free Consultation, Birthing From Within and my blog. Talk with you soon!