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Friends & Family At Births

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This post might not be popular with some people, especially if you are a family member or friend who finds they resemble some of these descriptions. However, I work for my doula clients to make sure their birth experience is one they can cherish and this needs to be said:

If your pregnant daughter, friend, niece, granddaughter, cousin (or any imaginable relationship) requests that you not come to the place of birth while she is in labor — respect her wishes.

I can hear the excuses now. But we want to be there. But we want to see baby be born. But we want to be the first in the family to hold the baby. But she is my (insert relation). But the partner is (insert relation). But, but, but.

She said she didn’t want you there. Actually, she probably didn’t say I don’t want you to be there. She probably said something polite and nice like, please respect our privacy. I will be working hard to bring a child into the world. We would like our privacy. We will call you once we want you to come or once baby has arrived. It may take a long time and we don’t want you hovering. Please respect our privacy.

Please listen and respect her wishes. Please know this is an important day and if she has made any attempt to ask you to not intrude on her privacy and concentration, she has thought long and hard about how to convey this to you without hurting your feelings.

Let me tell you what happens in some scenarios when people don’t listen to and respect a laboring woman’s wishes. At worst, you can cause her labor to stall or completely stop or contribute to a dysfunctional labor that can put her at risk for interventions she has been wanting to avoid. This is especially true when a woman is attempting a natural birth, but it can happen even with an epidural for pain relief. On a less serious level you are disrupting her concentration and possibly creating a memory she would rather not have attached to the day her baby and your (insert relation) is born.

Why do I sound so harsh about this? Because after 16 years of being a doula I can tell you I have seen some family members behave in peculiar ways. Yes, I understand you are coming from a place of love and concern but it boils down to people making choices to disrespect what a laboring woman has requested. Here are some scenarios I have witnessed:

  • A laboring woman tells her family she is going to the hospital to be checked out and she will give them an update. Upon her arrival, she finds there is a room full of family eagerly asking private details she may not want to share and interfering with the staff assessments. Her labor stalls or stops and she is sent home, only to return a few hours later and this time to keep it to herself.
  • Despite clear instructions and a sign on the door that the laboring woman does not want visitors, family members continue to come in because they “just have to know what is going on.”
  • Family members falling down and wailing on the hospital floor when they hear a woman requires a cesarean for safety, disrupting the precise and necessary care from the medical providers.
  • Family members physically grabbing me and shaking me for updates.
  • A laboring woman finally getting a break from her labor either via a natural spacing in her contractions or some medicinal pain relief and taking a well deserved and needed nap only to have family members barge in wanting updates even though they had been told she is napping.
  • Family members bringing cheeseburgers and fries into the room of a laboring woman who hasn’t eaten in 12 hours.
  • Family members threatening to sue the staff if the baby isn’t here soon.
  • Family members accosting all staff, doulas, partners, and even the woman if any of them come out of the room and going so far as to be standing in the hallways eavesdropping with their ear against the door.
  • Family members making comments that they have never seen such a large belly, telling her to get an episiotomy, random myths and outdated advice, asking her why she is trying to go natural, telling their own birth horror stories, or one of the worst, saying I just don’t know what I would do if you or the baby died.

Are you thinking this is fabricated? It isn’t. This actually goes beyond a case of bad manners. These sorts of behaviors can be dangerous, especially if there is a medical situation going on. When an emergency cesarean is needed, staff needs to move fast. As a doula, I move out of the way and let them do their job when something becomes medical. Family members falling down in the hallway is hindering the staff and the well-being of mother and child, and possibly even other mothers and children. People expressing their love and projecting their fear by voicing that the process is taking too long or they are bored or that something negative will happen to the mother and baby is not only not helpful, it is harming the process and the persons you profess to love. Showing up at a hospital when you have been asked to wait for instructions is crossing a boundary of respect and can make a woman feel like she needs to hurry up. Speaking of, many family members actually say, can you hurry up and have this baby? I have had women hiding in their bedroom or hospital room and sometimes locking themselves in a bathroom simply to find the privacy she desperately requires.

Each woman is different on how she views the need for privacy during labor. In the early stages of labor, a room full of chatter and excitement may be helpful for some and unhelpful for others. As active labor begins, most women prefer a quiet and private environment. There are times I will step out and allow partners to work privately during labor. There is a reason nurses, midwives, and doctors do not sit and stare at their patients. We know that disruptions are disrupting, it is as simple as that. Childbirth is not glamorous and is usually messy. We have not arrived at a point in our society where it is acceptable or comfortable for women to ooze bodily fluids in front of others. Would you want someone to watch you moving your bowels? No, you would probably try to wait until you had a private moment and birth is much the same. Women need to feel supported and one way to support them is by listening to their wishes. If you have been asked to respect their privacy, please listen.

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As the mother of an adult daughter, I have often wondered how difficult it would be for me to know she is in labor and to have been asked to not participate in or view my grandchild being born. I understand it must be hard. I understand that our society has created much fear about birth. I understand that Hollywood makes it seem that a woman’s water releases/breaks and we have a baby born at the hospital mere minutes after a screeching ambulance races her there.

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That’s not how it works. That’s especially not how it works for first time moms. Average labor time is approximately 15 hours. Average pushing time is 2 hours for first time moms.The placenta may take several minutes or longer to be birthed after the baby.  Unless you live many hours away, there will be time for you to arrive. After a baby is born we want mom, partner, and baby to have a minimum of one hour for bonding and breastfeeding and that is after the clean up, physical assessment of baby and mother, and any repairs. Your loved one just birthed a baby into the world and needs that time to de-escalate and bond with and nurse her baby. You could be notified the moment the baby is born and if you live locally would still have time to be waiting to see the baby.

The baby will not grow 2 heads or horns or grow up and go to college before you get there. I promise. And you might be able to bring that new mama a wonderful favorite meal on your way to visit (don’t forget daddy or partner!).

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If you are anxious, excited, nervous, antsy (and who wouldn’t be) I have a list of suggestions for you.

  • If you are crafty, work on creating something for baby
  • Go grocery shopping or cook freezer meals for the new family
  • Clean their home (with permission of course)
  • Walk their dogs, do any errands they may need
  • Write a letter to your loved one(s) and the new baby arriving
  • Go shopping for last minute essentials or just for fun
  • Assemble any baby items that need assembling (swings, bouncers)
  • Make every attempt to send peaceful and positive thoughts, prayers, and vibes
  • Trust that her request for privacy is in her best interests and what she needs

If you simply must be at the place of birth, find the waiting area and occupy yourself with something and wait for more information. Family members can be a wonderful source of encouragement. I am in no way advocating that family and friends be kept out of the loop or prohibited from being at the birth if the mother wants their support and company. I have seen mothers, sisters, cousins, best friends, brothers, fathers, mother in laws, etc., be a positive and useful source of support and encouragement– but please be invited.

Kimberly Sebeck, AKA Knoxville Doula, 2016

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Pelvic Floor Therapy Guest Blog

Please enjoy this guest blog from a Pelvic Floor Therapist in the Knoxville, TN, area.

This does not have to be your current or future experience.

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Hello! My name is Autumn Synowiez and I am a pelvic floor therapist.

A pelvic floor therapist (PFT) can help treat many different types of problems that women have such as:

  • urinary incontinence (it is not normal to wet ourselves)
  • stress incontinence (when we cough, laugh, exercise) or urge incontinence (always feeling a strong urge to go).
  •  pelvic organ prolapse (yes we can reduce prolapse without surgery by two stages!).
  • perineal/episiotomy scars, cesarean scars.
  •  diastasis recti
  • pelvic pain, pressure, dyspaurenia (painful sex)
  • preparing your pelvic floor for birth to reduce these symptoms after birth and help coordinate your pelvic floor for optimal pushing.
  • postpartum check ups to make sure you truly are ready for exercise and have sex again (if not we will set you up with all the exercises needed to get you on the right path, surprisingly most women are not ready for either).

    Countries like France and Sweden have women going after their 6 week postpartum check up with their OB as the norm to make sure women are healing properly after child birth. These countries have much better outcomes for women long term (fewer women suffering from incontinence, pelvic pain, organ prolapse, etc).

    Do you have to have had a baby to need pelvic floor therapy? No! Most of us are unaware of our pelvic floor and how it works with our everyday movement. A lot of women who run, heavy weight train, cross fitters, etc.,  are not coordinating their pelvic floor properly when exercising and actually causing injury and weakness in that area.

    Having chronic pelvis or back pain? No one can fix it? Could be in your pelvic floor! We have success stories of people seeing multiple doctorss and physical therapists with no relief and sometimes after just one visit with PFT they have relief.

    C section only? Yep! Pregnancy alone can weaken your pelvic floor muscles and with your abdominal muscles being cut into, that can lead to an even more weaker pelvic floor and core. They go hand in hand.

    PFT is amazing cutting edge stuff that most women know nothing about. Women in our country have been neglected in this area or are ashamed/embarrassed to talk or look down there! It’s time to change that! You are not alone I can promise you that! There’s a whole set of muscles that are very important that we need to be exercising regardless of our age or whether we have had kids or not. These muscles are our center and help hold our organs in! Can’t wait to discuss more about this soon and offer awesome workshops with Kimberly! Please feel free to ask any questions! I’m sure I left a lot of info out!

    Yours truly-
    Autumn Synowiez OTR/L
    Women’s Health Pelvic Floor Therapist
    asynowiez@gmail.com

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All Rights Reserved, Knoxville Doula, Kimberly Sebeck, 2016

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Knoxville Doula Is Growing

Knoxville Doula is growing! I will be joining a fantastic massage therapist and a fertility and pregnancy acupuncturist at our beautiful office in West Knoxville. I will still be at my current location through the end of this month. We look forward to serving the community as a whole for your fertility, pregnancy, birth, and postpartum needs! You can check out their info atTransformations Massage and Wellness Center and Tennessee Center for Reproductive Acupuncture. ‪#‎knoxvilledoula‬ ‪#‎doula‬ ‪#‎knoxvilletn‬‪#‎professionalsworkingtogetherforyou‬ ‪#‎fertility‬ ‪#‎pregnancy‬ ‪#‎reproductive‬‪#‎massage‬ ‪#‎acupuncture‬ ‪#‎childbirthclasses‬

Knoxville doula is

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One Step at a Time

Recently I had the wonderful experience of hiking up House Mountain, which is the highest point in the county I live in. It has an elevation of over 2000 feet. It was a pretty ambitious hike considering that I am not an avid hiker. I went with my friend, Erin, my daughter, Andin, and our two Great Pyrenees dogs.

As we drove to the area we could see the mountain rising up and a bit of anxiety arose in me that I may have bitten off more than I could physically manage. Fortunately we had fueled ourselves with good coffee and breakfast. We had snacks packed — fruit, trail mix, and of course water. I brought a walking staff for support.

As we started the hike it was a gentle slope with beautiful scenery and little streams. How easy was this? No worries here! Then we got a little lost. The trails were not clearly marked and we had to make some decisions of which way to go while not knowing if it was the correct way. We eventually found a trail we wanted to get to the summit and it got hard. The terrain was rough and uneven — full of roots and rocks. After most of my practice hikes and walks being on pavement or at least well maintained trails, this was a surprise and a challenge. Our large 80+ lb dogs never wavered in their support and having them pull on the harness actually gave extra support when needed.

After a few hours of this, however, I really began wondering why I was doing this or if I even could. I kept looking up to see if I could see the end but it just looked like an unceasing uphill climb. I was getting discouraged and tired. Ah! I thought — I will employ the skills I use in being a doula and supporting women through birth. I began to breathe as I needed — focusing on breathing faster through the hard parts and slowing my breath to a calmer state when we had a plateau or break. My companions and I kept each others spirits up. We took a break for water, trail mix, and oranges. We sat on a bench and looked at how far we had come and reminded ourselves to enjoy the scenery along the way. And I began a mantra in my head through the rough parts — “You are strong. One step at a time to your goal. Your body will give you what you need. Stay in the moment.”

We did reach the summit, of course. It was wonderful. I could feel the endorphins from my body working hard. We took photos and explored the amazing views and exulted in our hard work.

I cannot help but draw the parallel to labor and childbirth.

  • You need a good team to support each other and cheer each other on
  • You need to prepare as much as you can but know the experience requires flexibility
  • You might know exactly which way to go or what is the “right” answer — but you’ll find your way
  • You need fuel — food and water to stay nourished and to help your body
  • You may need extra support, as I did with my walking staff
  • You need to know it’s okay to feel that it is hard or to be discouraged or wonder if there is an end in sight — but keep taking one step at a time and you’ll get there
  • Labor and birth has some easier terrain and some rougher terrain — try to enjoy the scenery and use your breathing and relaxation skills and support team as you need in the moment.
  • You will find exultation, pride, and endorphins at the summit, the birth of your baby

All Rights Reserved, Kimberly Sebeck, Knoxville Doula, 2016

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Comfort Measures Class in Knoxville

The next Comfort Measures Class is Saturday, May 7th at 9 – 12 pm at Knoxville Doula’s ofice — 1400 N 6th Avenue, Knoxville, TN 37917

Cost is $50.00 per couple. We discuss the stages and phases of birth and how to stay comfortable as well as how your partner and birth team can help.

 

Tickets available: http://www.eventbrite.com/e/comfort-measures-for-childbirthrefresher-course-may-2016-tickets-22819606056?aff=ehomecard

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Birth Disappointment

Let’s talk briefly about the births that don’t go as planned. The ones that don’t look like the photos we see of a goddess crouching to pull her baby to her chest with a look of triumphant bliss and power. The ones where a surgical birth is the best choice for the scenario, or a baby going to the NICU.

As a doula I tend to have clients who have some desires for their birth. Many want to go as natural as possible and have evidence based natural options, such as delayed cord clamping, immediate skin to skin (and undisturbed for the first hour), successful breastfeeding, etc. We prepare for this. Birth classes are attended, practice relaxation techniques are performed at home, birth plans/wishes are written. These are all beautiful and wonderful desires. After all, you want to provide the gentlest and “best” start in life for your baby.

And then it doesn’t happen.

The parents may wonder what went “wrong”. How could they hire a doula, a supportive ob/gyn or midwife, refuse unnecessary inductions or augmentation, attend classes, read about their options — only to have certain options stricken off due to unforeseen circumstances?

In the Comfort Measures Class I teach, I say that labor is being dealt a hand of cards. Some women will have the best cards to be played. Others will not. As I also remind everyone: If each woman and her partner could choose the 4 hour labor where you gloriously breathe through contractions, barely breaking a sweat, birth your baby without any interventions and settle into an immediately satisfying and rewarding skin to skin scenario, complete with breastfeeding — we would all choose that. Sadly, that is not how it always works and in those cases we are grateful for the medical interventions available to us.

Placentas can break down. Infections of various sorts can render antibiotics or medical intervention necessary. A home birth may result in a transfer. Long and difficult labors may result in an epidural, augmentation of labor, forceps or vacuum assistance, etc. A baby may struggle with entry into the world and require a NICU stay.

Again, this is not your fault.

We do the best with how labor plays out. We do the best with different scenarios and medical intervention. The game plan may change but the goal does not. The goal is to have a healthy mother and baby who also feel ultimately empowered. Disappointment is certainly normal. Questioning how the labor went or choices that were made is also normal. When you have done your best — you have done your best. Be proud of that.

You’re still a great mom. 

If your baby had to go to the NICU, if you had a cesarean because it was the best choice for a good outcome, if your baby didn’t get the delayed cord clamping — you are still a great mom. Sometimes being a great mom involves a change of plans, like pumping colostrum and milk for your baby in the NICU. Everything you do for yourself and your baby makes you a great mom.

You are still a warrior in your own right. It just looks a little different.

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Kimberly Sebeck, Knoxville Doula
All Rights Reserved, 2015