"From the beginning, I was very impressed with Tracy’s passion for being a doula. It was very evident after having seen her website, Facebook page and numerous testimonials. I knew I wanted to meet her and when we did, both my husband and I found her to be very warm and friendly, as well as very informed on numerous topics we had questions about. One thing I appreciated a lot about Tracy was the fact that she never pushed her own ideas or beliefs on me. She provided me with unbiased information and resources and let me come to my own conclusions about how I wanted the birth of my daughter to go. When my water broke a week early (and quite early that day), I was so relieved to have Tracy to call on who confirmed what was happening and what I could expect. She later came to the house to help me with various exercises and techniques to help move things along (which worked!) In the end, I had a very long labour (30 hours) that eventually ended up in a c-section. Tracy was there the entire time and my husband and I could not have imagined going through the whole experience without her. As the labour and birth were not going as we’d hoped, it was nice to have her there to ask questions as the doctors and nurses would want to change plans. She was also there for us postpartum, always willing to answer any questions we had or just checking in to see how we were doing. We would hire Tracy again in a heartbeat if we were to have another child and would wholeheartedly recommend her to others. Her support was absolutely priceless."

Christa, Mike & Gabrielle

I just received this testimonial from my last client of 2011.  The most memorable moment of the whole birth for me was seeing her husband holding his little baby girl for the first time, and watching his heart melt.  

Five Tips for Choosing a Childbirth Education Class
Contact: Berna Diehl
  202-591-4045
  Berna@JPA.com

For Release: September 13, 2011

Five Tips for Choosing a Childbirth Education Class-Best Courses Teach Evidence-Based Practices to Improve Chances of Having Safe, Healthy Birth-

WASHINGTON–A recent report from the World Health Organization set off alarm bells for many expectant parents.  The report showed that newborns in 40 countries, including Cuba, South Korea and Poland, have a lower risk of death than newborns in the United States. 

For expectant moms, one of the best, and often overlooked, ways of improving the odds of a safe and healthy birth is to take a good childbirth education class.  But how do moms know whether they are choosing a class that will make a difference? 

“A good childbirth education class can make the difference between feeling out of control and overwhelmed, and being able to handle the expected and unexpected on the day of your baby’s birth,” said Marilyn Curl, President of Lamaze International.  “A really good class will also help moms-to-be avoid routine interventions like inductions and being confined to bed, which can actually increase the risks around birth.”    

Here are some factors mothers-to-be should consider when selecting a childbirth education class:

1. Research the Class Curriculum
Ask to see the content covered in childbirth courses carefully before selecting one.  There are a variety of curriculums, and different approaches may work better for different people.  Some courses do little more than orient women to the procedures of the hospital, regardless of whether those protocols are backed by research findings.

Curl cautions that women should be wary of ‘patient obedience classes.’  “Any class that simply focuses on what women are or are not allowed to do according to the procedures of the institution is not going to equip them properly for labor and birth.” Curl said. 

Expectant parents should consider what they want to gain from taking the class and make sure those points are part of the curriculum.  Lamaze classes focus on educating parents about six safe and healthy birth practices that are based on extensive clinical research.  “Women rarely receive all of the best care practices, so it is critical for parents to educate themselves about their options,” Curl said.

Typical topics covered in Lamaze childbirth education classes include:

• Normal labor, birth and early postpartum
• Positioning for labor and birth
• Pain management techniques
• Labor support
• Communication skills
• Comfort measures, including breathing strategies, relaxation and massage techniques
• Risks and benefits of medical procedures
• Breastfeeding
• Healthy lifestyles 

If the instructor teaches the class in a hospital setting or in a doctor’s office, parents should ask whether the instructor feels she has the freedom to discuss controversial topics related to childbirth and whether the class will discuss strategies for broaching these subjects with their care providers.  This information can help parents evaluate whether the class will focus on teaching the safest birthing practices, rather than explaining hospital policies.

2. Consider the Instructor’s Training
Check what kind of experience and background the prospective teacher has and ask about the instructor’s certification.  Lamaze offers the only internationally recognized childbirth educator certification program that is accredited by the National Commission for Certifying Agencies (NCCA).  Lamaze Certified Childbirth Educators must pass a rigorous examination to show they meet the highest professional standards and have the necessary knowledge and skills to teach courses.  To find a local Lamaze Certified Childbirth Educator (LCCE), visit www.lamaze.org. 

3. Invest Some Time
Between work schedules, family obligations and setting up the nursery, expectant parents may feel pressed for time.  But parents-to-be need to make certain they devote plenty of time and attention to preparing for labor and birth.  A one-day crash course might sound like the quickest way to get up to speed, but parents may not retain as much information from a course taught in this format.  Online forums and TV shows focusing on birth do not offer personalized or in-depth information that’s found in a class.
Lamaze classes typically provide 12 hours of instruction and discussion.  The classes are spread across six weeks to ensure parents have time to absorb the lessons and consider priorities as the big day draws closer.  “It may seem like a big time commitment, but nothing is more important than preparing for a safe and healthy birth and a good start for the baby,” Curl said.

4. Plan Ahead
Classes fill up quickly, so start researching courses early.  Try to sign up for a Lamaze class six to eight weeks ahead of time – around the first week of the second trimester. 

5. Check Class Size
For first-time parents, in particular, having personalized attention from the instructor is an important part of a childbirth education class.  Ask about the size of the class.  Ideally, there should be a maximum of 12 couples enrolled to ensure each has a chance to interact with the instructor and ask questions. 

Choosing a class with an informative curriculum, a knowledgeable instructor and personalized attention are crucial for ensuring expectant parents have their questions and concerns addressed before the baby’s birth.  More information on childbirth education courses is available at www.lamaze.org.

About Lamaze International
Lamaze International promotes a natural, healthy and safe approach to pregnancy, childbirth and early parenting practices.  Knowing that pregnancy and childbirth can be demanding on a woman’s body and mind, Lamaze serves as a resource for information about what to expect and what choices are available during the childbearing years.  Lamaze education and practices are based on the best and most current medical evidence available.  Working closely with their families, health care providers and Lamaze educators, millions of pregnant women have achieved their desired childbirth outcomes using Lamaze practices.  The best way to learn about Lamaze’s steps to a safe and healthy birth is to take a class with a Lamaze certified instructor.  To find classes in your area, or for more information visitwww.lamaze.org.

http://lamaze01.prod.web.sba.com/IntheNews/NewsReleases/FiveTipsforChoosingaChildbirthEducationClas/tabid/957/Default.aspx

I hosted a prenatal class reunion yesterday at the YMCA in which I was privileged to meet these six sweet babies.   Not only did I get to hold each one (can't help but grab them!) but I got to hear their birth stories.  One looong birth, two really short ones and the rest somewhere in between.  All unique, and all so important.  I know these women were transformed by their experiences, and I could see each one had grown as a result.  This reunion made me pause to remember the change we go through from a couple to a family, and how amazingly awesome and difficult it can be.  Talking about our experiences helps us to make sense of our journey and can give us the strength to go forward, stronger, and ready to meet the next challenge.    Keep on growin'!

This was a wonderful group of expectant parents.  They were funny, intelligent, and asked lots of insightful questions.  Can't wait to meet their babies!  

Dr. Sarah Buckley  does a fantastic job explaining the interplay of hormones that helps us to birth our babies naturally, much like our cats and dogs.  With inductions becoming more common, women don't have the benefits of the natural endorphins of labour and birth.  It's no surprise that pain relief becomes more necessary as more artificial means of starting and continuing labour are introduced.

Pain in labour - your hormones are your helpers
Dr Sarah Buckley

Imagine this. Your cat is pregnant, due to give birth around the same time as you are. You have your bags packed for hospital, and are awaiting the first signs of labour with excitement and a little nervousness.

Meanwhile your cat has been hunting for an out-of-the way place - your socks drawer or laundry basket - where she in unlikely to be disturbed. When you notice, you open the wardrobe door, but she moves again. Intrigued, you notice that your observation - even your presence - seems to disturb the whole process. And, wish as you might to get a glimpse into the mysteries of birth before it is your turn, you wake up the next morning to find her washing her four newborn kittens in the linen cupboard.

Why does birth seem so easy to our animal friends when it is so difficult for us?

One obvious difference is the altered shape of the pelvis and birth outlet that is caused by our upright stance; our babies need to twist and turn to navigate these unique bends. Even our nearest cousins, the great apes, have a near-straight birth canal.

However, in every other way, human birth is like that of other mammals - those animals that suckle their young - and involves the same hormones - the body's chemical messengers. These hormones, which originate in the deepest and oldest parts of our brain, cause the physical processes of labour and birth, as well as exerting a powerful influence on our emotions and behaviour.

Researchers such as French surgeon and natural birth pioneer Michel Odent believe that if we can be more respectful of our mammalian roots, and the hormones that we share, we can have more chance of a straightforward birth ourselves.

Labour and birth involve peak levels of the hormones oxytocin, sometimes called the hormone of love, and prolactin - the mothering hormone. These two hormones are perhaps best known for their role in breastfeeding. As well as these, beta-endorphin, the body's natural pain-killer, and the fight-or-flight hormones adrenaline and noradrenaline play an important part in the birth process. There are many more hormonal influences on birth that are not well understood.

All mammals seek a safe place to give birth. This "nesting" instinct may be due to an increase in levels of prolactin, which is sometimes referred to as the nesting hormone. At this stage, as you may have observed with your cat, interference which the nest - or more importantly with the feeling of safety - will stall the beginning of labour.

Even after labour has started, there are certain conditions that will slow, or even stop the process. If the fight-or-flight hormones are activated by feelings of fear or danger, contractions will slow down. Our mammalian bodies are designed to give birth in the wilds, where it is an advantage to postpone labour when there is danger, and to seek safety.

Many women have had the experience of their labour stopping when they entered the unfamiliar surroundings of a hospital, and some women can be as sensitive as a cat to the presence of an observer. Giving birth away from our natural environment can cause the sorts of difficulties for us that captive animals experience when giving birth in a zoo.

Michel Odent cautions that even hunger, which also causes the body to release fight-or-flight hormones, can stop labour from progressing. He advises women to eat- if they are hungry- in the earliest stages of labour; many hospitals, though, have a policy which prevents labouring women from eating once they are admitted.

Oxytocin is the hormone that causes the uterus to contract during labour. Levels of oxytocin gradually increase throughout labour, and are highest around the time of birth, when it contributes to the euphoria and receptiveness to her baby that a mother usually feels after an unmedicated birth. This peak, which is triggered by sensations of stretching of the birth canal as the baby is born, does not occur when an epidural is in place. Administration of an epidural has been found to interfere with bonding between ewes and their newborn lambs.

Synthetic oxytocin is often given by drip - that is, directly into the bloodstream - when labour contractions are inefficient. Oxytocin given in this way does not enter the brain, and so does not contribute to the post-birth "high", and in fact can lead to a reduction in a mothers own oxytocin production. Nipple stimulation is sometimes used to stimulate contractions because, like breastfeeding, this causes oxytocin levels to increase.

Oxytocin has another crucial role to play after the birth. Oxytocin causes the contractions that lead to separation of the placenta from the uterus, and its release as the "after-birth". When oxytocin levels are high, strong contractions occur that reduce the chance of bleeding, or post-partum haemorrhage.

Putting your newborn baby to your breast is the easiest way to increase oxytocin levels, but Michel Odent also emphasises the importance of privacy during the hour following birth. This gives the opportunity for uninterrupted skin-to-skin and eye-to-eye contact between mother and baby - conditions that optimise oxytocin release.

Oxytocin helps us in our emotional, as well as our physical, transition to motherhood. From the first weeks of pregnancy, oxytocin helps us to be more emotionally open and more receptive to social contact and support. As the hormone of orgasm, labour and breastfeeding, oxytocin encourages us to "forget ourselves", either through altruism - service to others - or through feelings of love.

The fight or flight hormones- also called catecholamines (pronounced cat-e-kol-a-meens), or CAs- can interfere with oxytocin release during labour and after the birth. However they do have an important role to play in the second stage of labour, which is when birth actually occurs.

Early in second stage, when the cervix is fully open but the urge to push is not yet strong, a woman can feel the need to rest for some time. This is known as 'transition'- or the 'rest and be thankful' time. After this, she may quite suddenly experience the dry mouth, dilated pupils and sudden burst of energy that are all characteristic of high levels of CAs.

This burst of CA's gives a mother the energy to push her baby out, and Michel Odent observes that, when unmedicated, women usually want to be upright at this time. Some traditional cultures have used this fight-or-flight effect to help women having difficulty with the delivery by surprising or shouting out at this stage. It makes sense, at this point-of-no-return, for fear or danger to speed up the birth, so that a mother can gather up her newborn baby and run for safety.

CA levels drop quickly after the birth, which can make a mother may feel cold or shaky. At this stage a very warm atmosphere is essential, according to Michel Odent, to keep CA levels low and to allow oxytocin to work effectively to prevent bleeding.

The other major birthing hormone, prolactin is most noteworthy for its effects after the birth. Prolactin is the major hormone of breast milk synthesis. Suckling by the newborn baby increases prolactin levels; early and frequent suckling from the first days makes the breast more responsive to prolactin, which in turn helps to ensure a good long-term supply of milk.

Like the other hormones, prolactin has effects on emotion and behaviour. Prolactin stimulates 'aggressively defensive' behaviour in breastfeeding mothers- what I call the 'tiger mother' effect. As well as this, prolactin helps us to put our babies needs first in all situations by increasing submissiveness, anxiety and vigilance.

When prolactin is combined with oxytocin, as it is soon after birth and during breastfeeding, it encourages a relaxed and selfless devotion to the baby that contributes to a mother's satisfaction and her baby's physical and emotional health.

Beta endorphin (pronounced beet-a en-door-fin) is one of the endorphin hormones which are released by the brain in times of stress or pain, and is a natural equivalent to painkilling drugs like pethidine.

During labour, beta-endorphin helps to relieve pain, and contributes to the "on another planet" feeling that women may experience when they labour without drugs. Levels of beta-endorphin are reduced when drugs are used for pain relief.

Very high levels of beta-endorphin can slow labour by reducing oxytocin levels, which may help to 'ration' the intensity of labour according to our ability to deal with it. Moderate levels of beta-endorphin help us to deal with pain in labour, as well as encouraging us to follow our instincts. As part of the hormonal cocktail after birth, beta-endorphin plays a role in bonding between mother and baby, who is also primed with endorphins from the birth process.

Beta-endorphin also switches on learning and memory, perhaps explaining why we remember our labour and birth in such amazing detail. Like oxytocin, endorphin hormones can induce a euphoria and are also released during lovemaking and breastfeeding. In fact endorphins are actually present in breast milk, which explains the natural high that babies can get after a breast-feed. Beta-endorphin helps the body to release prolactin, underlining the elaborate interplay between these hormones of labour, birth and breastfeeding.

So there you are, at the door, with your bag in your hand and a strong contraction. You remember the oxytocin and endorphins, which you also carry with you, and with your next relaxed breath, you breathe out all of your fear and tension. You've packed your new nursing bra, and you know that prolactin will come to your aid as well. As you take a last look around the house, you notice your cat.

She's lying down as her kittens attach to her nipples, and as you catch her eye, she winks at you.

The author can be contacted @ sarahjbuckley@uqconnect.net

Two of the moms in the local hood (Panorama/Sullivan) have started a great site called "Not Quite South Surrey".  They blog about local events, stores and services and give their personal recommendations.  I check their site at least once a week, and have found lots of great resources and things to do with my kids.  Jen, one of the creators of the site, knows me through our mom's group and wanted to learn a little more about doulas, so she interviewed me for an article on the site.  Click here to read more...

I'm searching for what to teach in my childbirth classes...you know, beyond all of the regular "stuff".  What do the first time bellies really want to know?  What is it that will make a difference?  I came across this article and wanted to share it, so here's my first post :)