~ William Coyle
"People tend to make really irrational decisions, that they later regret, when they're faced with a situation for which they haven't prepared."
When my wife first approached me about using a doula (Vonda Bartlett) for the birth of our child, I didn’t know what to think. At first I was skeptical and unsure why my wife would need someone besides me inside the delivery room. As far as I knew, I was a sensitive and compassionate husband that was ready and willing to stand by my wife’s side. However, after listening to my wife and trying to understand her reasoning behind using a doula, it all started to make sense. I soon realized that it wasn’t about me being an inadequate support system, or unable to deal with the stress. Actually, it wasn’t about me at all….it was about my wife, and what she needed. Sure, I’m a loving husband who will stand by her side, but that’s not what she was lacking. In addition, my wife needed someone who had been through the birthing experience before, and who could relate to what she was going through. Once I realized this, I was able to keep my ego in check and provide my wife with something that the doula couldn’t...the unconditional love and compassion that a husband has for his wife.
~ William Coyle
"People tend to make really irrational decisions, that they later regret, when they're faced with a situation for which they haven't prepared."
The following birth story was prepared by our very own doula, Nikomi Peltz. A special thanks goes to Brandi Steffan of Captured Photography that was present for baby Camden's sweet entrance to the world!
On the afternoon of September 3rd, I started feeling more intense contractions than what I had normally felt the last month or so. I began to wonder if "this was it," but I always seem to be in denial when I'm in early labor. The next day I was scheduled for my 41 week non-stress test for baby at the hospital. We showed up to that appointment around 11:30am. After being monitored for a short time in triage, I was told I would be admitted. My blood pressure was a little too high for comfort and Camden's fluid levels had begun to drop and were a little low.
I think it was anxiousness and excitement on my part because my blood pressure is always good. I was fine with staying because I felt I was already in early labor anyway -- even though my contractions were still inconsistent. Prior to this appointment, I knew I had already progressed to 3-4 cm and was 30% effaced before I was ever in labor.
I was admitted by 1:00 pm, and Chris and I were in our room. We began walking the halls together to encourage stronger contractions (thank goodness for wireless monitoring!). We weren't timing them at this point because they still felt pretty irregular even though they were becoming more intense. At 2:00 pm, I got checked and was 4 cm, 50% effaced and +1 station. So back to walking the halls we went!
Our birth photographer, Brandi, showed up around 3 pm. Then one of our Doulananda doulas, Vonda Bartlett, appeared shortly after. By around 5 pm Doulananda's owner, Zirah McGrath, came in. I was so happy to have the extra support there! Chris knows exactly what to do and what I need while in labor, but the additional support is always so nice! Who better to share the birth with than my husband, doula team, and for the first time for me - a birth photographer!
After a few hours of going between walking and just hanging out in the room, things were really picking up quickly and becoming very intense. I was beginning to lose my ability to carry on a conversation with everyone in the room. At 5:50 pm I asked to have my dilation checked and was 7 cm, 100% effaced. I was so relieved to be starting the transition phase because for me,it tends to go pretty quickly. In just a very short period of time, I could feel little Camden moving his way down.
With the next couple of contractions I felt my body involuntarily pushing. At 6:20 pm I was checked again and was dilated to 9 cm. The nurses were beginning to get the room set up for the birth. I believe with my next contraction, I said softly under my breath "he's coming." I'm not sure the staff heard me because no one seemed to move but Vonda, our doula, could tell something had changed with me. She took a quick peek and could see the baby's head was out. She told the nurses and they picked up their pace a bit. LOL! My nurse quickly threw on her gloves to catch the baby and called for my obstetrician. Next thing I knew, Camden was out! I think he practically fell out of me. I unknowingly breathed him down in a way that even surprised me because I didn't know how close he was to coming out. I really couldn't even warn anyone.
Our sweet Camden Jax Peltz was born 9/4 at 6:23 pm, 8.12 lbs and 21 inches.
I told Chris afterward that I'm so glad I had that non-stress test scheduled. The end of my labor went so quickly, that had I been able to labor at home longer I believe I would have waited too long to leave the house. Camden could have easily been a home or car birth unexpectedly. After all the stress I put on myself when Camden was breech so late in the pregnancy, I'm incredibly happy to have been able to have an unmedicated birth again.
What kind of families have doulas at their births? Would you guess stay-at-home moms that are pros at researching family decisions, yoga practitioners that have meditation down to a science, and lovers of the environment that seek out "green" choices whenever possible? Yes! Would you say doctors, pilots, lawyers, and teachers? I hope you also said 'yes' because they also enjoy the help of a friendly birth sidekick. Believe it or not, more than half of Doulananda's clients are mainstream professionals that simply want to be sure they have a smooth birth experience. They know their business and we know ours!
Ironically in nearly EVERY childbirth class we hold, we have at least one doctor, nurse, or other medical professional taking the road of a natural birth. You would think having a mountain of medical data and experiences at your fingertips would make you MORE prone to take the medical route. Not always so! These professionals have often seen extremes and would prefer to leave their baby's arrival up to nature.
Just three years ago, the Jacksonville birth landscape was one lone birth center floating in a sea of hospitals. None of the hospitals had Baby-Friendly breastfeeding designations or were held to any metrics regarding elective induction or cesarean rates. Today, that has changed.
The last 12 months has been a particularly exciting time in the Jacksonville and St. Augustine birth communities! Doulananda has personally seen this sleepy little part of Florida experience a noticeable shift from the traditional birth scenario of obstetrician/hospital birth/high intervention rates to a broader range of choices for expectant mothers. The groundwork laid by the events above and mothers having access to more and better information is driving our community forward.
The impact of the c-section reduction initiative has yet to be felt here locally, but we firmly believe it is on the horizon. Some policy changes we have felt and hope to continue to be a part of are below.
Looking back on this past year, we could not be more thrilled at the direction Northeast Florida's birth community is heading! Cheers to another year of walking alongside families and colleagues that continue building Jacksonville up.
From the moment you walk into your OB or midwife's office for that first pregnancy appointment, it looms over you... those few little numbers that dictate everything going forward until baby arrives: YOUR ESTIMATED DUE DATE!
First things first, the due date is an estimate and has no magic powers over you. This date -- also known as "Due Time" in HypnoBirthing -- is calculated using Naegele's Rule and is simply a target of 40 weeks (280 days) from your last menstrual cycle. Just as many women have slight variations in their cycles, the 40-week target will move slightly to the left or right accordingly. Did you know, women allowed to go until baby decides their birthday typically begin labor around 41 weeks!
When Should You Worry
If your baby does not arrive at midnight sharp on the day you have circled on your calendar, there is no need to sound the alarms. All is well! It simply means your baby is not done cooking. As the days tick by, if no medical reason presents itself, there is still no hurry to jump-start baby's exit by way of an induction.
The American College of Obstetricians and Gynecologists (ACOG) revised medical terminally to do two things -- first, classify a post-term baby ("late") only at 42-weeks and beyond. This revision turns Naegele's Rule on its head and is a big deal! The second major revision classified what were formerly full-term babies as early. Prior to this update, 37-weeks was the date considered safe by doctors for baby to arrive. "Research over the past several years, however, shows that every week of gestation matters for the health of newborns... Planned deliveries before 39 weeks 0 days should occur only when there are significant health risks to a woman and/or the fetus in continuing pregnancy" (ACOG 2013).
So understanding that the official standard set by ACOG is very clear, the next time your medical provider hints at induction for reasons other than medical necessity, it is your turn to give them a prescription: TAKE A CHILL PILL! Baby will be here soon!
When I became pregnant, I didn’t know much about the services a doula provided but I kept hearing from friends just how much they had loved the care their doula provided so I knew I wanted to explore it. Nikomi Peltz was recommended and I reached out to her and had a great phone call that answered many of my questions. However, when I brought it up to my husband, he thought the idea of someone we didn’t know being beside us during delivery was weird. We agreed that we would meet with Nikomi together and see how we felt after that.
Nikomi came to our house and was so sweet and patient with us as we asked all about the services of a doula. Her knowledge, along with the support she would provide at labor started to sound very appealing but it was her faith that was the deciding factor for us. If we were going to have someone there during the very special and private moments of birth, it was very important to us that she share our beliefs. After that meeting, my husband immediately agreed that we wanted Nikomi there for our birth!
Nikomi continued to be available to answer any questions I had and assisted me in creating the birth plan that was right for me. I was hoping for a natural birth but I also did not want to feel judged should I decide on any medication and I felt Nikomi would support me regardless of the path our birth took.
On the day my water broke, I checked in with Nikomi and she was so helpful in guiding me on the next steps. She met us at the hospital shortly after being admitted and from there, she was a gentle partner. She walked the halls with us many, many times but also had a way of knowing when we needed some time for just my husband and me. After 19 hours, I finally decided to get an epidural and she never judged. She was by our side, helping us work though everything. Twenty six hours later, I gave birth to our miracle boy! She was there capturing pictures for us that are so special to us.
Shortly after birth, I had to have an unexpected surgery to remove the placenta that would not come out. This is where Nikomi became the biggest answer to prayer. This surgery triggered some scary memories of some medical difficulties I’d had in the past and my husband was so concerned for me. She was there, even after 20+ hours already and stayed until I was back from surgery, almost two hours later. She held, comforted and loved our precious little boy while I was away. My husband later told me just how thankful he was that Nikomi was there because he wasn’t prepared to care for Carter while being so concerned for me.
Thank you, Nikomi, for being there that day to assist us with the labor and to care for our boy. It meant the world to us and we are so thankful God put you in our path.
~ Stacy Scott
Today I have the birth story that I’ve always wanted to be able to tell, thanks in a huge part to my doula, Vonda Bartlett. I first met Vonda at a "Meet The Doula's" event at Babies R Us for Doulananda. Personally, I felt like a big challenge during labor would be remaining calm and Vonda's voice alone was calming.
Since I was already 37 weeks when I hired my doula, I worried that we wouldn't have time for her be able to have a big part in my pregnancy. I was completely wrong! Vonda was extremely easy to connect with and share our anxieties and excitement. She made a home visit, attended my HypnoBirthing class, and a prenatal visit.
By the time I was in labor I felt as though she had been with me through my entire pregnancy. Vonda was extremely knowledgeable; I learned several things from her. She gave me some vital information that helped shape some of my decisions in my birth plan and she shared some of her personal experiences which put me at ease. As a first time mom I wasn’t sure what to expect out of labor, so when I started to experience surges for the first time I reached out to Vonda. She gave me some helpful tips to relax.
One goal was to labor at home for as long as possible. I kept Vonda updated of my progress and -- when I was ready -- asked her to come over to help me through the rest of labor. She kept me calm and reminded me to relax my shoulders, which helped relieve stress and pain. Vonda told me in the beginning that she would try to get me to the hospital around 7 cm dilated, thankfully she was right! I was 8 cm when they checked me. Vonda was most helpful during the pushing phase for me, reminding me of what I learned about breathing. One of the nurses commented on how well Vonda helped me get through the contractions and pushing the baby out. I couldn’t have asked for a better birthing experience or a better doula! Vonda, thanks so much for making a once in a lifetime experience an extremely positive one!
~ Tamir Schlosser
It was an honor and an absolute pleasure to work with Vonda Bartlett! I truly was blessed that after the Doula Meet and Greet in Growing Families Birth Center in St. Augustine, I had submitted an essay to qualify for a scholarship. At the end of the meet and greet, Vonda calls and tells me that she would love to work with me. I was astonished and overwhelmed, because prior to meeting her, I had read into the Doulananda program and Vonda was my number one choice. To have been chosen by her was incredible.
From the first day she became my doula, she started sending me videos and articles about the birthing process and breastfeeding. She filled my head with so much great information I was soaking it all in. I was glad to learn so much from her and the information she provided beforehand. She gave me her cell phone number to call or text her anytime I had any questions or concerns. She literally was available 24/7.
During the whole process she was so motherly and loving, which was great since my mother who lives in Chicago couldn't be there at the time of the pregnancy and birth. Vonda made me feel so comfortable and calm throughout the whole process. At the time of the birth, Vonda came to me ASAP and was prepped and ready to go in seconds. She brought such a calmness to me and helped me breath according to HypnoBirthing.
She helped me relax and would often remind me not to tense up. She also put cold wash cloths on my forehead to cool me down and when It came time to push, she held me up. She did above and beyond what I could have ever asked for or imagined! After my birth, she still keeps in touch with me and asks how the baby and I are doing. What an amazing experience it was to have a doula for the first time, but it was even more wonderful to have Vonda as my doula. The whole experience was well worth it.
Thank you Vonda! :)
~ Cynthia Wingfield
Turn, baby, turn! This is the mantra for pregnant moms everywhere that are told their babies are breech. Sadly, doulas are not immune. At 36 weeks, Doula Nikomi was told her baby was transverse (lying sideways across her belly), but she is not alone. At 32 weeks gestation, approximately 7% of babies are still breech (Dekker 2012). With a brain full of birth scenarios and correction options, Nikomi got to work!
Lucky for her, 36 weeks left time to take action. Her boy was still moving between transverse and breech which is good news (sort of) because that meant there was still room TO move. Want to know what a doula does when HER baby is mal-positioned and she wants to correct alignment naturally? Read on!
Call the Doctor
If you have gotten to this point in the process, it's because easy and mid-level tricks have not encouraged baby to turn. Not to worry... hope is not lost! Doctors can perform a procedure called External Cephalic Version (sometimes known as just "Version" or "ECV") in which they manually turn breech and transverse babies from the outside.
While Nikomi was scheduled for an ECV at week 37, she chose not to go forward. Her amniotic fluid levels were good which made the procedure favorable. It could have been successful, but Nikomi had a few weeks remaining and preferred nature and baby to take their course. We should note, this was a risky decision on her part. The further a pregnancy progresses, the bigger baby gets, and less fluid available to lubricate the turn.
SPOILER ALERT: After trying all of the tricks above, her sweet baby cooperated and turned head down. No need for the Version! Now rather than prayers to turn baby, her prayers are for him to stay put and settle in. As the days tick by, Nikomi continues her home remedies and stays hydrated so fluid levels remain good in the event she needs to take advantage of a Version.
8/25/14 UPDATE: As of today -- 3 short days away from Nikomi's estimated due date -- her sweet baby boy remains head down. Our fingers are crossed, and we are just counting down the days until we get to see his perfect face! Stop back in soon to see if this doula's birth goes as planned.
Please note that the techniques mentioned in this post are not treatment recommendations. This is a summary of one individual's experience to correct her baby's birth position. While the actions are not invasive, they should still not be considered a prescription. If you have concerns about ways to correct your breech or transverse baby, please contact your medical provider.
The role of a doula is tough to describe... even for us! Sometimes seeing is believing. Doulas are experts at support and guidance, but what exactly does that mean? In the Doulananda world, it means you will never be alone. That -- from the moment you connect with a birth doula -- you can expect information and resources appropriate for the stage of pregnancy or birth you are in. This info is delivered to your family by way of a sweet woman familiar with the birth process and environment. And on the day your beautiful babe decides to enter the world, this kind lady helps ensure your experience is calm and smooth.
Your Birth: What to Expect
Upon arrival to your birth location, you will be assessed. If the hospital or birth center decides you are progressing favorably, you will be admitted and settled into your space. For some, this can be a nerve-wracking time. Sights, sounds, and smells unlike home can cause some anxiety. Doulas can help interpret the initial assessment by medical staff then facilitate gearing up for GO-time.
For those that desire an unmedicated or natural birth, as labor progresses a large part of the doula's role will be ensuring mom's comfort. This can take many forms: hand-holding, helping mom maintain regular breathing patterns, rubbing her back, encouraging position changes, performing rebozo techniques, and more! However the responsibility for mom's comfort does not fall on doula alone. Doula's job -- and this is just as important as the rest -- is including and encouraging dad or partner and teaching them techniques to make mom comfortable. It is such an AMAZING team... really beautiful to be a part of!
For those families choosing or requiring medical interventions, the doula role changes to focus on keeping mom -- whose movements are now limited -- moving or and being a sounding board for questions about next steps. As much as medical personnel would like to, sadly they don't remain with the family the duration of labor to perform these functions (which surprises many first time moms!). The doula continues to work with the family however is needed. No shift changes for her!
Dads and Doulas
On the other hand, some of the most special moments for a doula are simply stepping back and bearing witness to the magical moments in a couple's journey of becoming a new family. There are times of such joy, intimacy, and power that really all you can do is bask in it. There are no words to describe it.
Working with a doula in no way excludes dad or partner from the birth experience. It means dad has the option to breathe... to step back and live the moment without fear of doing the "wrong" thing or leaving his wife unattended. He can really press into the experience knowing he has a knowledgeable resource at his fingertips who will show him the way. Doula's presence means he can plug in as much or little as he is comfortable, giving him more confidence than he would have alone. This is no small thing.
Trying to describe this delicate exchange of knowledge and emotion that happens with a couple that is in the midst of a life-changing moment is nearly impossible. We hope this little window into the births of one of our clients has been helpful. Looking upon these images remind us of the tremendous blessing it is to do the work that we do. Thank you for the gift.