Posterior Positioning

Before birth, the positioning of your baby is something that can cause a lot of confusion and potential anxiety. As a doula, it is my job to educate the mother on ways to promote the optimal position for their baby before labor and more importantly, educate myself on the different positions, as well as pain coping techniques that the mother can use before and during labor. The more I am learning about OP (occiput posterior fetal position) babies, the more I am discovering about what you can do to prepare for a posterior labor and what one can do during posterior labor.

The OP position is when the back of baby’s head is up against the mother’s back as opposed to the more optimal OA position, in which the baby’s head faces the mother’s back. A posterior baby doesn’t fit as well through the pelvis as the anterior baby, since the posterior baby’s head seems larger due to the angle it has when in the pelvis. However, it is good to keep in mind that most posterior babies rotate to the anterior position during labor.

Some things the mother can do to encourage the baby to rotate into the OA position include using the rebozo, abdominal release, pelvic tilts, hands and knees position, the lunge position, the inversion position and using the birth ball, to name a few. It is important to choose a few techniques that work best for you and stick to them daily up until labor and throughout early labor as well.

During labor it is important to do activities that encourage your body to be balanced. This can include using the rebozo, doing the belly lift, or trying the forward leaning inversion. Being vertical as much as possible can be very beneficial as well. When you feel the need to rest, using the birth ball to sit on or a birthing stool, encourages good maternal positioning and in turn, create space for the baby to rotate. You can also use the birth ball to create some movement during contractions, by making circles with your hips.

There are also several comfort measures that either your partner or doula can use for the laboring mother. Massage of the lower back can be very helpful in releasing tension during back labor. Counterpressure can be done by firmly gripping the front of the mother’s hip while pressing into her back. This can be done during contractions and can feel quite nice with a considerable amount of pressure. The double hip squeeze is another great method to be done with either your partner or doula (if either are accessible). From behind, someone presses on both sides of the mother’s hips with the palms of their hands. The pressure should be applied towards the center, pressing her hips together. This can also be done during contractions. Rolling pressure over the low back either using a rolling pin or tennis balls can be soothing during or in between contractions as well. Cold or hot compresses, the shower or tub, and electric massagers are all useful tools to use for back labor as well.

Overall, as daunting as posterior labor may be, there are many things that a mother, partner, or doula can do the make her experience one that is more enjoyable. As the incidence of posterior labor increases, it is great for me to remain informed as a doula and continue to educate myself on the different situations that I might be presented with before, during and after childbirth.

I hope this information is as helpful to all of you as it has been for me. If you have any questions or would like more details on the information I have presented, please don’t hesitate to contact me directly. Talk to you all soon and happy birthing!

What is a doula?

The more I promote myself as a doula, the more I come across the question, “What is a doula and why should I hire one?”. Since the tradition of having a doula has just started to become revived, there are many misconceptions out there about the role of a doula and what they actually do. Part of being a birth doula is educating people on what my job is and promoting awareness about the different birth options that women have. There is no wrong way to give birth, but there is no harm in knowing what is available, in terms of making your birth experience one that is unique to who you are and addresses the specific needs that you have.

Doula is a Greek word that means, “women who serves” and in many ways, that is just what we do. A doula’s role is to provide emotional, physical and educational support before, during and after labor. Not only is a doula a consistent familiar face during this process, but having the continuous care of a skilled professional can be a tremendous source of comfort to a laboring mother.

Before labor, doulas will develop a relationship with their client, where the mother feels comfortable asking any and all questions related to her experiences and can freely express her fears and concerns. Doulas can also help with making a birth plan and educating the mother on different positions one can use during labor, relaxation and pain coping techniques, and what to expect during labor. A doula will make herself available by phone or email, so that the mother can continue to ask questions and develop a stronger relationship with her doula.

During delivery, doulas can help with pain coping techniques including massage, breathing techniques, laboring positions and a consistent voice of encouragement. Doulas are also there to encourage partner participation and provide support to the couple during labor. This can be done by reminding the partner of things that might be helpful to the laboring mother or stepping in so that the partner can take a break. A doula is not there to replace the partner, but only to enhance their experience and take the pressure off of them, if necessary. A doula can also act as an advocate for the mother and help her to make informed decisions.

After birth, doulas can provide support in breastfeeding and make wonderful referrals to lactation consultants if necessary. They also screen for postpartum depression and can make referrals for this as well. It is also an opportunity for the mother to process her birth experience with someone who was there alongside her.

My goal as a doula, is to provide mothers with women centered care that views birth as a natural process. I hope to meet a mother’s needs coming from a place of strength and empowerment. When people ask me what my role is, I typically tell them that it can range from things as simple as getting water for the mother so that she and her partner can remain together, to actively supporting the mother with breathing techniques, suggesting positions, acupressure and massage. It is always up to the mother as to what my role will be and I continue to let her lead the way in regards to where I fit it.

Many studies have demonstrated the benefits of having a doula present during labor. In fact, it is shown that, “having a doula as a member of the birth team decreases the overall cesarean rate by 50%, the length of labor by 25%, the use of oxytocin by 40% and requests for an epidural by 60%”. Having a doula at your birth can dramatically enhance your birthing experience, regardless of what type of birth you have.

If you have any more questions about what a doula is and how one can enhance your birthing experience, please don’t hesitate to contact me directly. Until then, happy birthing!

Sources:

Klaus, M., Kennell, J., Klaus, P. Mothering the Mother.: Addison-Wesley Publishing Company, 1993.

Tips to Start Labor

So far in my doula training, several mothers have asked me how to start labor naturally. There are many reasons why a mom might want to start labor on or around the time of her estimated due date (EDD) and there are options out there to try!

When reading this material, it is important to keep in mind that babies come when they want. There is a very specific combination of hormones, gestation time, and timing that dictate when a baby is ready to enter the world. However, if you would like to get labor going and it has been advised by your health care professional, here are some techniques to try.

It is important that you don’t overwhelm yourself by trying every technique, but instead, use techniques that appeal most to you. Remember, no amount of tips or techniques will replace the “right” time for your baby to enter this world.

Tips:

  • Raspberry leaf tincture can be used to bring on labor and cause contractions of the uterus, whereas red raspberry leaf tea can be used as uterine tonic throughout pregnancy.
  • Evening primrose oil can be taken as an oral supplement, 500 mg daily for the last 3 weeks of pregnancy which can soften and efface the cervix
  • Spicy food can cause contractions of the uterus
  • Both intercourse and orgasm help bring on labor. Intercourse causes the cervix to release prostaglandins which naturally effaces the cervix and semen contains prostaglandins as well. Orgasms can also cause uterine contractions.
  • Nipple stimulation can cause the body to produce oxytocin which can lead to uterine contractions.
  • Another technique to try is walking for 30 minutes and then resting for 30 minutes, in order to help move fluid throughout the body and increase awareness of the body to the pelvic pressure that presently exists.
  • Eating well and staying hydrated is essential.
  • Talking to the baby, using hypnosis, and/or visualizations can help calm both mother and baby.
  • Getting things ready for the baby (i.e. setting up the nursery) are great ways to reduce anxiety and create space for your baby’s arrival.
  • Minimizing distractions.
  • Doing pre-natal yoga can help prepare the body both physically and mentally for labor

If you have any questions or would like more details on the options I presented, please don’t hesitate to contact me directly. Talk to you all soon and happy birthing!