The fourth trimester, or he immediate postpartum period, is something a lot of new parents are never really prepared for. They hear birth stories, get parenting advice, and fill a dresser with cute new baby clothes, but how to cope with the demands of an infant when you're sleep-deprived and healing from a birth is usually not a part of the conversation leading up to the birth of a baby.
This bothers me for a few reasons, but primarily because it persuades new moms to feel like they should be able to handle it all on their own without asking for help. "No one really talks about it, so it must not be hard for most people. I must be weak, a bad mother, or doing something wrong because I'm really struggling." Family and friends are usually so excited for your new baby, congratulating you on a job well done, but aren't paying much attention to how mom and dad are coping. It's hard. It's lonely. You may not feel like celebrating, and you may feel guilty for not feeling as excited as people think you should be.
If you haven't yet heard it, let me be the first to say that you are doing beautifully. You are strong. You are a great mother. You are not alone.
Postpartum Mood Disorders
What are postpartum mood disorders? Mayo Clinic defines a mood disorder in this way: "If you have a mood disorder, your general emotional state or mood is distorted or inconsistent with your circumstances and interferes with your ability to function." Most people have, at very least, heard of postpartum depression, but many people aren't sure of what exactly that looks like, or even that there are other postpartum mood disorders to be watchful of. There are a variety of other mood disorders associated with pregnancy, birth, and the postpartum period, including postpartum blues (the "baby blues"), postpartum depression, postpartum anxiety, and postpartum psychosis.
Common symptoms of postpartum mood disorders are: anger, irritability, guilt, anxiety, crying, restlessness, fatigue, mood swings, panic attacks, inability to concentrate, insomnia, and loss of interest or pleasure in things you normally enjoy.
Some quick stats for you (found here and here):
I Think I need Help, Now What?
If you suspect you or your spouse is dealing with a postpartum mood disorder, talking with your doctor or psychotherapist is a great start. Depending on your symptoms, and at the recommendation of a medical professional, you may consider medications to help alleviate the symptoms you're experiencing. Sometimes therapy is enough to reduce symptoms to a manageable level, and sometimes a combination of therapy and medications is going to be the right choice for you. If you feel like you need help, talk with your care provider as soon as you can.
For me, personally, I've experienced postpartum depression and/or anxiety after the birth of each of my four children. I had friends and family around for each birth, but the pervasive sentiment of, "If there's anything you need, just let me know. I'm happy to help!" was hard for me to handle. I knew I needed help, but I didn't know what help to ask for, and I certainly didn't want people to think I couldn't manage on my own. Most people do genuinely want to help, but it's hard for them to take the step to initiate support.
Here are some things you can ask for help with, or can help other new moms with:
Above all, remember that asking for help does not make you weak, it doesn't make you a bad mother, and it doesn't mean you aren't capable of caring for yourself and your baby. You are doing your best, and that is enough.
While birth work is a passion of mine, my first love was music. I started taking piano lessons at 7 years old and progressed at lightning speed, eventually picking up the flute and singing as well. I grew to realize that music is the universal language, the expression of life itself, and that everyone, no matter who they are or where they come from, is impacted by the power of it.
Take movies, for example. The music in movies shapes how you view the events that are unfolding before you. Do you ever wonder why you feel uneasy in certain parts? It's likely because of the music is low, filled out with string instruments that are playing an eerie repeated pattern. Why do you laugh when bad things happen to certain characters? Because maybe the music features a light-hearted saxophone playing a ridiculous melody in double time.
There's a YouTube video I found years ago that illustrates this point perfectly. It's a scene from Lord of the Rings where Legolas, Aragorn, and Gimli are doing some cross-country running near a cliff face that leads down to a ravine with a river flowing through it. The background music is a beautiful symphony of brass featuring a warm trumpet triumphantly expressing the melody. This clip is replayed several times, but the music is changed to something drastically different each time. Take a look and note how the music changes your perception of what is happening. (I'll wait.)
They way that music shapes your movie-watching experience is the same way that music can shape your birthing experience. What do you want your birthing experience to feel like? How do you want to view it when you look back on it years later? Here are some tips you can use when creating your labor playlist.
Create More Than ONe List
For me personally, I had two different labor playlists. One was for early labor, and it was filled with upbeat jams that made me want to get up and dance (Tonight, Tonight, by Hot Chelle Rae for example). I knew I had to stay busy so I wasn't focusing on timing contractions, how long it was going to take for baby to arrive, or a million other things that could put me in a sour mood. Going about my normal day while in early labor, but jamming out to my favorite songs was the best way to start labor. It feels so good to let your hair down and dance!
My other playlist was serious but encouraging. Gentle music that I connected with on a deeper level. For my third birth I had a lot of Enya on that playlist (don't judge--her voice is magical). When labor started picking up and I had to really focus on each contraction, I switched to this playlist. I needed something quiet but emotional, strong but gentle, in order to feel safe and in control. I needed to be able to reach down deep inside of myself to find the strength and power I possessed to birth my babies, and having a beautiful soundtrack playing helped shape that experience for me.
Don't Wait Till Labor to Use Your Playlist
One mistake a lot of people make is making their labor playlist and not touching it again until they're in labor. When I was pregnant with my third (first planned home birth), I spent weeks (nearly months) combing through music and selecting just the right songs for my playlists. Nearly every night before bed I would dim the lights, get comfortable, and practice relaxation techniques with my husband while listening to my calming playlist. I practiced getting "in the zone" so that when that music came on my body was trained to be relaxed.
It got to the point that as soon as the first song came on, my body was in instant relaxation mode. I didn't have to work to be relaxed, it just happened naturally because of the connections I'd formed between relaxation and those songs. When I went into labor I knew that I would be able to relax because I'd spent so much time practicing and forming positive associations with the music on that playlist, and it turned out to be the easiest birth of my four! (You can read that birth story here)
So the moral of the story is practice, practice, practice. Pump up your upbeat labor playlist while you're making dinner. Turn in on in the morning while you're getting ready for the day. Play your calming playlist while you're in the shower or getting ready for bed. But spend the time to form positive associations with your music so you can frame your labor and birth in a positive way.
Practice Your Tech Setup Ahead of Time
For some reason I get unusually irritated when technology doesn't work the way I expect it to, and because my husband is a tech geek I have lots of opportunities to practice patience. Make sure you have a simple setup that is easy for anyone to operate so that your doula, a nurse, or whatever other birth attendants you have can easily help with it. You don't want to have to worry about troubleshooting while you're laboring. A simple bluetooth speaker connected to one of our old phones was what we used for our last two births (pictured above), and before that we had a laptop playing music through Google Music (which isn't even a thing anymore). Whatever you choose, figure out how it's going to work ahead of time and practice with it that way so you're all set for labor day.
When I became pregnant with my first baby it never occurred to me to take a childbirth class. I had never known anyone who'd taken a class, and no one had ever suggested we take a one (except the nurse who was attending me while I was in labor). It wasn't until after our first child was born that I realized how unprepared we were and how much we still didn't know. To this day I still wish we had known to take a class because I know how different my first birth could have been.
Here are some of the most commonly asked questions about childbirth classes that I hear as a birth worker:
Do I need to Take a Class If I'm Not Having a Natural Birth?
Yes! Regardless of what options you choose for your birth, you need to know what those options are in the first place. Whether to have an epidural or not isn't the only choice you'll have to make, and taking a good, comprehensive childbirth class is a great way to learn what those options are. What happens when you arrive at the hospital ready for your epidural, and the anesthesiologist was pulled into an emergency surgery? What techniques will you use to manage your labor until he's available? Does your partner know what role he will play in the birth? Under what circumstances is a cesarean medically necessary? How many grams of protein should you be eating every day? We cover it ALL so that you can feel confident about your birth.
Does Everyone Need to Take a Class?
Yes! And no. But mostly yes. We see couples come through our classes from a variety of backgrounds and circumstances. First time parents with no experience, second time parents who had a disastrous first birth and want to know how to make the next one better, a wife who's had children previously but her husband hasn't, couples who've had a cesarean and want a vaginal birth after cesarean (VBAC), couples who had an epidural but want a natural birth, and everything in between. If you've never taken a class, even if you've given birth before, there are a lot of valuable things to be learned from coming to class taught by a certified instructor.
When is the Best Time to Take a Childbirth Class?
There really is no best time. Want to get a jumpstart on preparation and have lots of time to practice before birth? Start a class at the end of your first trimester or beginning of your second trimester. Want to have the class end right before you give birth so everything is fresh in your mind? Start a class at 29-33 weeks. There's nothing that says you have to look pregnant in order to take a childbirth class! It's really just a matter of personal preference.
Does my partner Come to Class With Me?
Yes! Partners are an integral part of our classes! We're not only talking about what's happening to your body and how to cope, but we're teaching partners all the ways they can support you during the process. We teach your partner how to recognize the different stages of labor and what things he can be doing during each one. We have a "Top 10 Tools for Partners" section with helpful suggestions of things to try when you need to mix things up in labor. We teach them what positions they can support you in, how to help you relax, ways to verbally praise and support you, and what questions to ask when you feel like you can't anymore.
What is the Birth Boot Camp Method or Philosophy?
Simply put, Birth Boot Camp isn't a method. It's a toolbox. We don't focus on one singular technique, but instead fill your toolbox with a wide variety of tools to utilize in any given scenario. Every birth is so unique, and it's almost impossible to tell which labor management techniques will work for you. If you have a long, drawn out labor that spans multiple days, you'll use different techniques than if you have a short, fast labor. Or you may find that some relaxation techniques you connect with better than others. Our goal as childbirth educators is to give you a comprehensive study of the physiology of pregnancy and birth, the management of labor and the postpartum period, breastfeeding, and of newborn care, so that you leave feeling prepared and confident for any scenario.
Will a doula be my advocate?
The answer to this is no. And sort of yes. (But mostly no.) A doula should never speak to your care provider or the medical staff of your behalf or interfere when a provider is caring for you (i.e. "She doesn't want you to do that!"). Our job is to support you in your birth wishes. A doula will never tell you what decision to make or how to handle a situation. We will help you remember what the evidence says in a given situation and help you remember what questions to ask, but it is not in our scope of practice to make any kind of decisions for you. We will ask the nurse to bring your more ice chips, or let her know when you're feeling the urge to push, but it is not our job to communicate your wishes to the medical staff.
Can my mom or sister be my doula?
Yes, but also no. As with your partner, your mom and/or sister will have a more intimate relationship with you than your doula will. They will know you, but it's not very often that we have a mom or a sister who is also a trained doula. Doulas go through months of study and training and have hours and hours of hands-on experience in the birth space. This training provides us with a set of professional skills that are hard to replicate without training. And while we are more than happy to help your mom or sister support you during your birth, there really is no substitute for a trained labor doula.
How do i become a doula?
There are a variety of training programs available for aspiring doulas, but understand that not all training programs are create equal! Birth Boot Camp offers an all-inclusive training program that teaches you more than just how to support couples in labor, but provides doula mentorship, marketing materials and guidance, training in communication skills, and so much more. Having trained with a different organization first (before Birth Boot Camp was even around!), I am amazed at the difference and all that Birth Boot Camp has to offer. To learn more about the Birth Boot Camp training program and to find out where your closest training is happening, visit https://birthbootcamp.com/doulas/ .
What is a doula? Is that like a midwife?
No, a doula and a midwife are not the same thing! A midwife is a care provider, like an OBGYN, who sees to a woman's clinical needs (tests, procedures, labs, measurements...etc) during pregnancy and delivery. A doula, on the other hand, is a trained labor support person who sees to your physical, emotional, and educational needs throughout pregnancy and birth. Doulas meet with you before the birth to discuss your birth preferences and practice comfort measures techniques, and are present throughout labor and delivery with the sole focus of taking care of you (and your partner).
What do doulas do?
A doula is sort of like a jack of all trades in the birth space. She might support you physically by providing counter pressure on your hips, massage on your head, or make sure you're staying hydrated by regularly offering water. She might suggest you change positions, get up and walk for a bit, or rest on the birth ball. She might spoon ice chips in your mouth, or ask the nurse for a popsicle for you to suck on. When you're feeling emotionally spent, she might take the time to reassure you of your strength, recite birth affirmations to you, or lead you in a relaxation script. She might whisper to your partner ways he can better support you, or leave the birth space altogether for a little while to give the two of you time to intimately connect. When you're unsure of what to do next, she might remind you of the things you learned in class, what the informed consent questions are when a new procedure is suggested, or help you find information about a topic you don't know much about. I think the better question in this case is, "What doesn't a doula do?"
Does a doula replace my partner?
No! We work together to make sure you have all your needs met so that you can focus solely on birthing that baby. While doulas have specific support training that we utilize, one of the most important aspects of support comes from your partners who has established intimacy with you. We know the technical stuff, but your partner knows you. With our combined unique expertise, you'll have all your bases covered! In fact, doulas love helping partners look like the rockstars they are! Any chance we get to encourage your partner to get in there and support you, we take it.
do i need a doula if i'm not having a natural birth?
I may be slightly biased, but most doulas will tell you with resounding excitement that, yes, you need a doula no matter what kind of birth you're having! As detailed above, a doula does so much more than just pat you on the back and say, "There, there! You'll be fine." We support you in all aspects of labor and delivery. You're not going to have an epidural the second you walk into the hospital, right? A doula helps while you're waiting for the anesthesiologist to arrive. Your body still needs to be in an optimal position for baby to descend, right? A doula can help with position changes. What about immediately postpartum when you're cold, hungry, or need help breastfeeding? Having a doula there is essential! If you're having a cesarean, who is going to stay with you while your partner goes with baby? Doulas have a variety of skills that can be utilized in every birthing scenario.
Stay tuned for part 2!
So you’re going on a hospital tour. Maybe your care provider recommended this, maybe your doula, maybe your bff. Maybe you’re going because you like being prepared or maybe you’re just really excited and looking for yet another fun baby thing to do over the weekend. Maybe you are planning an unmedicated birth or maybe you just scheduled your c-section. Whatever the reason you’re taking the tour and whatever birth you’re planning, knowing what questions to ask on your tour can be overwhelming. Here are our top ten favorite questions to ask when touring hospitals, questions that, no matter what kind of amazing birth you are working towards, will give you a sense of what your hospitals policies and procedures are and if they will be supportive of your wishes.
Where do we go if we come in after hours?
People don’t always think about this, but if you show up to the hospital at 2am, the door you enter through or your check-in process might be different than if you show up for a scheduled induction at 7am. Normally your tour guide will talk about this, but sometimes they don’t. Make sure to bring it up if no one mentions it.
Where is your drink area?
This is a favorite for a few reasons. First it allows the person leading the tour to show off a bit (Check out our slushie machines), second it gives you a chance to be a bit nosey and look in cupboards and drawers at their snacks. And third it also leads perfectly into the next question.
Am I allowed to have more than just ice chips when I’m in labor?
This answer will differ from area to area and hospital to hospital. Some hospitals will say “If your care provider is alright with it you can have whatever you like.” Some will say clear liquids only, and others will say stick with the ice chips. It's an important question to ask because it can drastically affect the outcome of your birth. If you're wanting more freedom to eat and drink during labor, you may consider switching birthing locations if that's not their policy.
Who’s allowed/how many people are in the room before, during, and after the birth?
Some hospitals have a strict limit on how many people are in the room during labor and delivery. Some say “invite the whole family.” Depending on their answer you have some things to consider. First, if your hospital has a room limit of 2 support people in the room and you want your mom, your partner, AND you’ve hired a doula, you might have some hard choices to make (and one of those choices can always be to change birth locations). However, if your hospital’s policy is “you can have as many people at the birth as will fit in the room”, you still need to decide if having a room full of family and friends waiting and watching is going to be supportive or distracting.
What are my fetal monitoring options?
Fetal monitoring refers to monitoring the baby’s heart rate during labor. Standard practice in most hospitals is to do continuous fetal monitoring, or watching the baby’s heart rate throughout the whole labor. This is normally done by fixing a heart rate monitor in place with a big elastic band and will require you to stay in bed during your labor. However, intermittent fetal monitoring, or listening to the baby’s heart every 30 minutes or so, would allow you movement during labor and is shown to be a safe alternative.
Can I labor in the water? Can I see your tubs and showers?
Water is sometimes called the midwife’s epidural. More and more people are asking for tubs and showers to be an option during their labor and more and more hospitals are rising to the request. However, just because a hospital says they have tubs and showers for you to labor in that doesn’t always mean they’re accessible. I have seen gorgeous tubs and showers in hospitals that made me want to go home and redesign my bathroom. I have also seen Labor and Delivery wards with only 1 tub for the whole floor and it was being used for storage. Different hospitals might have different policies for when you can use these tubs and showers. Some might say that once your water breaks you can no longer be in the tub, others might say you can labor but not push in water, and others (on a very very blue moon) might even be ok with you delivering in the water. If being in the water is important to you, make sure you ask this question!
In the event of a cesarean, who is allowed in the OR with me? And while we’re at it, what are your caesarean rates?
Different hospitals have different policies about who can be present for a cesarean birth. Most (in my area at least) will allow 1 support person (normally the partner) into the OR. However, some are totally fine with your partner AND another support person such as your mother or doula. But the thing that you really should pay attention to (and that most people don’t think to ask) is what their caesarean rate is, or how often that hospital performs cesareans. In some areas of the country it can be hard to find a hospital with a cesarean rate below 30%, however the World Health Organization considers the ideal c-section rate for a community to be between 10%-15% and all hospitals should be aiming to be below 30%.
How do you handle delayed cord clamping?
Most hospitals (in my experience) will say something like “whatever your care provider is ok with we’re ok with”, but sometimes some hospitals have policies that are different than what you and your provider talked about. Check and double check. Delayed cord clamping has many proven benefits, so make sure you talk to both your provider and hospital to find out what what their policies are.
Does the baby have to go to the nursery?
How many doulas do you see here?
As more couples become aware of what a doula is and the benefits of having a doula at your birth doulas are slowly but surely becoming more common at hospitals. However, at some birth locations doulas are still a rarity. Worst yet, some nurses, doctors, and hospitals don’t fully understand what a doula is or might even expect a combative relationship with them. Asking how familiar a hospital is with doulas is a good way to judge how they will feel about having one at your birth.
No matter what kind of birth you’re planning, knowing your hospital’s policies and procedures is one of the best things you can do to make sure your wants and needs are going to be met. By taking a tour of your birth location and asking the right questions you are setting yourself up for success.
How many times have you heard someone talk about their experience taking a childbirth class and thought, "Yeah, I don't need that. It's not for me. I'll just show up and do what my doctor tells me and everything will be fine." ? If you're anything like me before I had children, you probably felt that way almost every time the subject came up. How hard can it be? Show up, get the epidural, push the baby out, and go home in a couple of days already looking like my pre-pregnant self. Right? I definitely don't need a childbirth class for that. What else could I need to know? Here are 5 reasons you should not take a childbirth class:
We are Birth Boot Camp certified doulas and childbirth educators. we are passionate about birth, education, and a couple's right to be informed about their options.