Zipadee Doula | Serving Portland, Oregon

Dou-la-la writes about lactivists, and issues that arise when asking and offering breastfeeding advice.

“When a woman is unwilling to breastfeed, but tells people she was unable, it inflates statistics and seeds fear in other women that breastfeeding is an unreachable ideal for most women.”

Yes.

Thank you.

There IS a flip side to that – and I can already feel the murmurs. In order for women to feel safe about publicly admitting that they were simply not willing to breastfeed, and that it was a choice, not some failure of their anatomy or – another frequent claim – “refusal” by their child*, we, as a breastfeeding advocacy community, need to be able to accept those choices and not condemn or harass these mothers who have made different choices.

Also, along the lines of breastfeeding, HERE is the info on the new law that provides pumping breaks for breastfeeding mothers.

Employers are required to provide “reasonable break time for an employee to express breast milk for her nursing child for 1 year after the child’s birth each time such employee has need to express the milk.”  Employers are also required to provide “a place, other than a bathroom, that is shielded from view and free from intrusion from coworkers and the public, which may be used by an employee to express breast milk.”

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Going along with my previous unassisted childbirth post, here are a couple more!

Preparing for an Unassisted Homebirth

Don’t Condemn Unassisted Births Because of 1 Tragedy by Rixa over at Stand and Deliver.

I’m not saying unassisted birth is perfectly safe, just think happy thoughts and nothing will ever go wrong, la la la. But condemning all unassisted birth–childbirth, after all, is a normal, inevitable physiological event, not a medical procedure–because of one tragic “dumpster baby” is way off the mark.

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Don’t Judge Pregnant Women Based on Junk Science

This is especially true when it comes to pregnant drug using women. For nearly two decades popular media claimed that any illegal drugs used by pregnant women would inevitably and significantly damage their babies.

The actual scientific research contradicts this assumption. Carefully constructed, unbiased scientific research has not found that prenatal exposure to any of the illegal drugs causes unique or even inevitable harm. This research is so clear that that courts and leading federal agencies have concluded that what most people heard was “essentially a myth.” As the National Institute for Drug Abuse explains, “babies born to mothers who used crack cocaine while pregnant, were at one time written off by many as a lost generation. . . .  It was later found that this was a gross exaggeration.”

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The Feminist Breeder writes “A Birth Plan is More Than a Wish List”:

The birth plan may not be a legal document, but mother’s desires during her birth are her legal right. Yes, a mother can Just Say No to anything she is uncomfortable with during her labor, and the Birth Plan is the first draft of that assertion.

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Finally, Placenta Encapsulation Instructions with Pictures!

Instead of always posting my favorite links up on Facebook all the time, I was thinking I should take some time and write more posts here, including them!

This video by Heather Cushman-Dowdee (AKA Hathor the Cow Goddess, also mama-is dot com, and author of one of the many books on my to-read list) is so right on about many hospital births. I’ve heard the stories, and even experienced it myself. Hilariously depressing.

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Outlaw Midwives vol. 1 is out and awesome. I think I need to re-read it later to fully absorb it. I was turning the online pages and just admiring the words and thinking about the work and love this took to create.

My favorite quote? “A community is only as empowered as its mothers.”

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Finally, a post by Gloria Lemay on retained placenta and some tricks that may help:

Molly, I am confident about your placenta coming out smoothly after the birth.
There will be no rush and no need to do anything except enjoy the amazing feeling of that slippery, soft, delicious newborn in your arms. It is the little (or big) sounds of the baby and the skin to skin contact that floods the body with oxytocin and clamps the uterus down around the placenta.”

Now, only because your busy mind needs to have some “things to do”, I’m going to give you some tricks to get the placenta out naturally that I have heard about over the years:
1. Sniff a little bit of pepper to make yourself sneeze. Sneezing will expel the placenta (same principle as when you pee a bit when you sneeze)
2. Blow hard into a narrow necked bottle. Blowing into a bottle uses those diaphragm muscles that make you bear down
3. Have someone stick two fingers down your throat to make you gag (this is something that was done in the Far North of Canada by an Inuit grandmother to help her grand daughter get her placenta birthed. I filed it in a corner of my mind but have never used it, sounds a bit harsh but was apparently effective).
4. Buy a bedpan. If the placenta doesn’t come out with you reclining and enjoying your baby, you could sit on the bedpan after the cord is cut and just bending your body forward in a safe space will probably give you the feeling of “needing to push” and out the placenta will plop.

Having an unassisted birth can be a hard journey to take for many women. Often, if you discuss your plans with family and friends, you are bombarded by arguments trying to sway you into having an attended birth, talks of “what if”, or they may choose to avoid any contact with you for the duration of your pregnancy. There are very intense feelings regarding unassisted birth, and many do not want to listen to why you are going unassisted, and definitely do not want to support it in any way. “What if the baby dies?!”

Women who choose to have a UC sometimes want to have an extra support person there, just as they would want one there for an attended birth, but they are afraid to ask around. Most doulas do not feel comfortable serving women who are going unassisted. Some doulas do not believe that women should be able to have unassisted births at all. That, to me, is a sad thing to see in a community of birth workers who support women, yet deny and criticize those who choose a different way. We should giving unassisted birthers respect, just as we give respect to all other women who are giving birth. Isn’t it a bit hypocritical to say that you support women, yet only if they do it “the right way”? If you feel uncomfortable with someone else’s birth choices, you can still give them the respect that they deserve as a person.

How can a doula serve a women at an unassisted birth?

A doula can provide all the services she normally provides at any other birth. She can be there to offer support for you, a possibly nervous partner, and siblings. She can prepare food, help set up your birth space, and just be there, present and calm. She will understand when you want to be alone, especially during the birth. Having a doula at your UC means having someone there who truly believes in you and your decision, and is there to help you have the birth you want. Having that trust and relationship with another person can be a great thing at a UC, when often you are left alone to fend for yourself.

After birth, she can help clean up, make sure every one has what they need and help with settling in. She can be a person to look to for resources, advice and postpartum support. Having a doula on your side can ease the worries about not having anyone to turn to postpartum, because you are afraid of what they will think of your decisions. Women should not have to be afraid after their births, because they have no outside support.

Is it still unassisted?

Sure, you can talk semantics about what unassisted birth really is (some will even say that having your partner there means you did not really have a UC), but in the end, almost any UCer I have met online or in person is not really worried about having a UC just to say she had one. Personally, as a doula and someone that has had an unassisted birth, I believe that if a doula is there to serve you and your family at your UC, then yes, you can still say you had an unassisted birth. A doula is not providing any medical care. She is there as a support person, just as she would be at any other birth. A doula does not hold any responsibility for the outcome of your birth, you and your family do.

Wonderful post by Gloria yet again! Just love what she writes.

As cesarean and induction rates in hospital climb to astronomical levels many women are turning to homebirth. When interventions become excessively high, the risk/benefit ratio of being in a hospital swings more dramatically into the “riskier” zone, and even physicians and nurses begin choosing homebirth. Just removing your birth from a hospital setting doesn’t guarantee that it will proceed in a natural, flowing manner. Too many women learn the hard way that a midwife can bring a hospital mentality and interventions right into the home and negatively affect the course of the birth. How can you assess the type of midwifery practice that you are purchasing? Here are some tips to help you assess the care that will be provided by midwives:

1. Ask to see a video of some births your midwife has attended. This is the modern age. Many people videotape their births and an experienced midwife will have been given many copies of videos with permission to share them with other families. Videos tell you a lot more than photo albums. Be wary of the midwife who won’t give or show you videos. Watch the videos for things like: Is the father playing an active role in the birth? Are the attendants quiet when things are normal and healthy? Is the cord left to pulse until the placenta is born? Does the baby breathe spontaneously without routine suctioning? Are the baby and mother locked in eye contact with no disturbance? Is a water tub part of the birth?Watch the time clock on the video to see whether the birth of the placenta occurs in a leisurely way or whether the midwife wants it out in under 30 minutes.

2. Tell your midwife that you don’t wish to have any pelvic exams during your pregnancy. This avoids introducing bacteria and also avoids some routine interventions like membrane stripping (painful and ineffective). Making assessments of the readiness of the cervix to give birth at the end of pregnancy is inaccurate and largely discouraging to the mother. Remember that you were made to give birth—you’ve had menstrual periods, you conceived and you grew a baby; therefore you can have faith that your cervix will perform just fine. PAP smears can be done after the baby’s birth, if you so desire.

View the rest of the article here!

Andaluz Waterbirth Centers

“Our midwives provide prenatal, birth and postpartum care, specializing in waterbirth. We attend to you in your home or one of our birthing centers. We provide well baby newborn care up to 6 weeks, and have a naturopathic doctor to provide care after 6 weeks. We have a beautiful large classroom where we offer classes prenatally and postpartum. Andaluz has an extended community for continued support. ”

Contact:

http://www.waterbirth.net/birth-center/

info@waterbirth.net
503-885-0228

Portland Center
3323 SW Naito Pkwy
Portland, OR 97239

Tualatin Center
19255 SW 65th Ave. ste. 220
Tualatin, OR 97062

Alma Birth Center

“Our Birth Center is a warm, inviting space to give birth to your baby. We will treat you with respect and kindness throughout your pregnancy, birth and postpartum care. Our center

combines the privacy and comfort of a homelike setting, with the reassurance and safety of knowing that clinical care and equipment are nearby. We are located in a lovely three-story house centrally located in Portland, Oregon. Our Birth Center has two spacious birthing suites each with its own built-in birthing tub and bathroom. There are many other rooms for visiting family, prenatal care, well-woman gynecology, meeting space for childbirth education and other classes, and a full size kitchen. Our Birth Center is licensed by the State of Oregon.”

Contact:

http://www.almamidwifery.com/birthcenter.html

midwives@almamidwifery.com
503.233.3001
1608 SE Ankeny St.
Portland, OR. 97214

Natural Childbirth & Family Clinic

“Our state-licensed birthing room aims to provide all the comforts of home; and then some! We have a large jetted tub where you can labor as much as you choose, and you can give birth in the tub as well. The tub is large enough for two adults and has easy access for family and friends to be close by, offering additional support to the birthing Mom. There is a lovely view into our garden stocked with roses and a plum tree (stop by in August for some plums!), and the room feels very private and safe.”

Contact:

http://naturalchildbirthclinic.com/

http://naturalchildbirthclinic.com/contact.pl (click for email form)

Phone: 503.252.8125

10360 N.E. Wasco St.
Portland, OR 97220

Bella Vie Gentle Birth Center

“At Bella Vie, our rooms are uniquely different and gorgeous, offering your family luxury, comfort and safety. Each private and spacious suite includes a state-of-the art birthing tub, approved by Waterbirth International, and medical equipment mindfully tucked away.

Your room will also include a queen-sized bed, perfect for snuggling with your newly formed family. For your entertainment and comfort, we offer stereos, televisions and DVD players. Our desire is to make you feel like you are in the comfort of your own home including all of the extras like plush towels, a variety of candles, and delicious meals.”

Contact:

http://www.gentlebirthcenter.com/

info@gentlebirthcenter.com
503-315-BABY (2229)
13160 Jerusalem Hill Road NW
Salem, Oregon 97304

Alameda Clinic and Birth Center

503.282.9222
3351 NE Broadway St
Portland, OR 97232

Discovered and copied over from HERE. Makes wonderful soap! I currently offer making Mothering Soap for $50 for anyone looking to use up some of their frozen milk stashed away. It’s a wonderful keepsake to have for remembering those breastfeeding days that seem to go by too fast.

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Mother’s Milk Soap Recipe
32 (4-ounce) bars

Recipe:

3 lbs. vegetable shortening
17 ounces dark olive oil
18 ounces Safflower oil
6 cups thawed breast milk
(you can use any amount of breast milk you like and substitute the rest,
just make sure your total fluid volume reaches 6 cups).
12 ounces pure sodium hydroxide (lye – Red Devil brand works)
1 ounce Borax
2 TLBS honey
1 ounce Essential oil – optional
Ice Cubes

Tool List:
Stainless steel pans
Wooden or stainless steel spoons
Newspaper to cover counter tops
Candy thermometer
Measuring cup
Scale
Blender

***Wear Gloves and protective eye-wear when making soap…lye burns!!
****Use only stainless steel pans for making soap – DO NOT use aluminum!!

Procedure
Melt the veg. shortening in a sauce pan (about 8 quart size)and add the oils. Bring temp up slowly until the shortening is all melted. Don’t over heat or scorch the oils.

Plug your kitchen sink. Fill half way with water and add about 3 dozen ice cubes.

Put thawed cold breast milk in a sauce pan (about 3 quart size). Place the sauce pan into the water. You *must* keep the milk cool when you add the lye to it or the lye will burn it and make it unusable, not to mention real stinky!

Slowly stir in the sodium hydroxide (lye) stirring constantly and occasionally circulating the outer ice water. The lye is going to heat the milk up as you stir it in. Avoid breathing the fumes by working in a well ventilated area.

Adding the lye should take at least 5 minutes, any faster and you will burnout your milk. If you accidentally splash any on yourself, rinse immediately!

Once combined, continue to stir the milk/lye mixture for just a few more minutes (3) and then remove from the water bath and set aside. You will notice that the milk/lye mixture steadily becomes yellowish in color. That is normal.

Add the honey and borax to your melted oil which should still be warm but not hot (115 degrees or so).

Now, slowly and carefully pour the milk/lye mixture into the pan of oil. Stir constantly until it is all mixed together.

This mixture must now be whipped in a blender (2/3′s full at a time for safety sake). Run the blender (with the lid on) at whip speed for 60 seconds each time. Pour off into a clean pan.

Repeat the blender process a second time. This is when you will add your essential oils.

Once the mixture has been blended twice, it will be ready to pour into a mold where it will saponify and be ready to cut after 24 hours.

**Make sure to set a few bars secretly aside for that someday when it could make a touching “Treasured Memory Gift” maybe when your child is all grown up. The soap will never go rancid (no matter what you may have read elsewhere), it will only improve with age. Mothering Soap has the unique potential of becoming something extra, special as the years roll by. But that’s just this mothers thought!

I have written briefly about unassisted childbirth before here. I have always meant to write more in depth, but hey, life gets in the way, doesn’t it?

Midwife Pamela Hines of Salem, OR has been a long-time supporter of women who choose to go unassisted, and she recently wrote a post including her own ‘Unattended Birth Contract’. She writes:

“A non-refundable midwifery care deposit of $500 ensures that Pamela Hines-Powell will be available to answer questions or concerns, order desired labs or ultrasound, collaborate with other healthcare providers during the course of pregnancy, birth and postpartum. This fee also ensures that she will be on call for the birth, whether or not she attends the birth.

Prenatal and postpartum care: Individual appointments are $75. The client decides how many, when and what type of appointment they need/desire.

I think it is a great option for those who want to open up their options when it comes to UC. Having an unassisted birth can be a long and lonely road, and I think that if a woman feels she needs some feedback/tests done/a midwife as a backup in case of an emergency or just as a line of support, then that is GREAT.

I do not think that having a midwife as a resource or as possible back up  means that you are abandoning your UC. Not all UCs are the same; some women have unassisted pregnancies, and some do not. Some women are completely alone, and some have doulas, friends, family, and/or their partners there. A wonderful midwife that supports UCs can be a great resource and partner on a woman’s road to going unassisted. There are many ways to have a UC!

Hosted with permission:

Wednesday morning(April 18th) I had contractions that were so strong they hurt, though they would come regularly and then disappear for a while before returning. The doctor’s office told me to head to labor and delivery anyway and see if I had made progress. We got there around 1:30pm; they checked me and I was 4cm dilated. The doctor showed up and examined the printout of my contractions. He almost sent me home, saying they weren’t strong enough, but he didn’t like the way the baby’s heartrate looked during the contractions and decided to admit me and augment mylabor.

After I was taken to a delivery room they started the pitocin drip. I dilated to 10cm within about two hours and had really bad back labor. The anesthesiologist came and gave me my epidural. Eventually my doctor returned and they allowed me to start pushing. After about 2 hours of strong pushing and the baby coming down I still couldn’t get her out. She was turned slightly so that her forehead was against my pelvic bone, and she was stuck. Her heartrate dropped with every push and they finally decided to do a c-section. At around 7:20(I think?) I was taken to the operating room. I was pretty frightened and cried as they were wheeling me through the hall but I tried to suck it up and act like everything was fine. I didn’t want to be a wimp.

While they set everything up, the anesthesiologist held my hand and talked to me to put me at ease. He was so sweet. I was shaking like crazy from the epidural and fluids running through my body. They set up for surgery and then brought my husband in. He sat next to me and held my hand, and my eyes started to well up again. He wiped my tears and I squeezed his hand and felt better knowing he was right there. When it came time for the pinch test I could still feel it just enough that I was afraid I’d be in pain when they made the incision. I begged the anesthesiologist to turn up the epidural, and though he was hesitant because he wanted me to be alert enough to hold my baby, he finally gave me an additional medication in my IV that made me a bit foggy.

After the incision was made I could feel lots of tugging and pressure. It turns out baby was lodged quite firmly in my pelvis and they struggled a bit to get her out. After what seemed like an eternity I heard her cry- at 7:45 pm my daughter was born! They briefly brought her to my side of the curtain so I could see her… I remember thinking that she looked purple and that something was wrong, but the OR staff promised she was healthy and perfect! She had some bruising over her eye and cheek on the side of her face that was pressed into my pelvis, but this healed and faded away within the first week or two.

The recovery period from surgery was far from fun… I was incredibly sore between the normal post-birth cramping that occurs and the pain in my incision area. My husband had to help me shower the first two times because I seriously just wanted to curl up on the floor of the shower and cry.

Nursing was fine for the most part. My baby latched very well from the first time we tried to breastfeed, but my milk took a frustrating 5 days to fully come in and she was so ravenous and grumpy! When my milk did finally arrive it showed up in full force, and we were able to very successfully establish our nursing relationship. We battled a gnarly, painful thrush infection soon after going home because of the antibiotics from the surgery but it did eventually clear up. So nursing was initially a bit more of a challenge than with my firstborn (a vaginal birth) but we were able to get through it all just fine.

With regard to my hospital experience, I was (and still am) very disappointed that I ended up having a c-section but the hospital staff were wonderful and took fantastic care of me, my baby, and even my husband, who stayed overnight with us throughout our time there. Aside from my experience with my boneheaded doctor (a long story for another time), I felt like my family and I were in good hands during our stay at the hospital.

There are some local midwives planning on traveling to Haiti very soon to help out, and they are in need of funds, as well as supplies.

What is needed?

Everyday supplies
Clean Twin sized sheet sets (new/gently used)
Pillow cases
Washcloths
White cotton nightgowns
21 HP inkjet printer cartridges
Iron Supplements
Prenatal Vitamins (preferably with iron)
Ibuprofen & Tylenol (in sealed, new, non-expired packages)
Antacids
Newborn Onesies
Cloth diapers
Diaper Pins
Bars of Soap
Non-Sterile Gloves

Medical Supplies

Magnesium Sulphate
Pitocin
Misoprostol
Vitamin K
Novacaine
Umbilical Cord Tie and clamps
Sterile blades, stainless steel #10
Gloves
Soap, anti-bacterial
Povidone/Iodine prep solution
Headlamps
Alcohol Swabs BD 100
Doppler and ultrasound gel
Fetoscope
Blood pressure cuff (sphygmo)
Stethoscope
Headlamps
Tape Measure(60”)
Gestation wheel
Sterile gloves pair
Curved Kelly clamps
Blunt scissors pair
Episiotomy scissors (long/curved)
Needle holder
Ring forceps (sponge-holding)
Toothed (tissue) forceps
Metal box for instruments
Bulb syringe
Urinary catheter (disposable)

PayPal donations can be made through pamela.midwife@gmail.com and pcmidwife@gmail.com. Any amount can help.

Address to ship or drop off supplies to:
Bella Vie Gentle Birth Center
13160 Jerusalem Hill Rd NW
Salem, OR 97304

Bella Vie Fundraiser information
Silent auction to help raise money for a group of midwives from Bella Vie Gentle Birth Center who are going to Haiti with the Midwives for Haiti organization. There will be great auction items, desserts, music, and a giving tree.

Sunday, January 31, 2010 from 2:00PM – 4:00PM
Praise Assembly Church
189 Monmouth Ave N.
Monmouth, OR

Also, HERE is some information about donating breastmilk for babies in Haiti.

Midwives for Haiti on Facebook.

We are so lucky in our country to have access to midwifery care and emergency obstetric services when needed. In some parts of this world, hundreds of thousands of women are unable seek help when it is needed. These women can labor for days and days, and many times in these terrible situations, their babies are born still. As a result of their traumatic labors, many of these women develop obstetric fistula.

What is a fistula?

“A fistula is a hole. An obstetric fistula of the kind that occurs in many developing countries is a hole between a woman’s birth passage and one or more of her internal organs. This hole develops over many days of obstructed labor, when the pressure of the baby’s head against the mother’s pelvis cuts off blood supply to delicate tissues in the region. The dead tissue falls away and the woman is left with a hole between her vagina and her bladder (called a vesicovaginal fistula or VVF) and sometimes between her vagina and rectum (rectovaginal fistula, RVF). This hole results in permanent incontinence of urine and/or feces. A majority of women who develop fistulas are abandoned by their husbands and ostracized by their communities because of their inability to have children and their foul smell. Traumatic fistula is the result of sexual violence. The injury can occur through rape or women being butchered from the inside with bayonets, wood or even rifles. The aim is to destroy the women and the community within which the sufferer lives. Once committed the survivor, her husband, children and extended family become traumatized and humiliated.” (Fistula Foundation)

• Fistula used to be present in the U.S. and Europe, but was largely eliminated in the latter part of the 19th century and early 20th century with improved obstetric care in general and the use of c-sections in particular to relieve obstructed labor.
• The World Health Organization estimates that approximately 2 million women have untreated fistula and that approximately 100,000 women develop fistula each year. Fistula is most prevalent in sub-Saharan Africa and Asia.
• There are an estimated 100,000 women suffering with untreated fistula, and another 9,000 women who develop fistula each year.
• Less than 6 in 10 women in developing countries give birth with any trained professional, such as a midwife or a doctor.When complications arise, as they do in approximately 15% of all births, there is no one available to treat the woman, leading to disabling injuries like fistula, and even death.
• The root causes of fistula are grinding poverty and the low status of women and girls. In developing countries, the poverty and malnutrition in children contributes to the condition of stunting, where the girl skeleton, and therefore pelvis as well, do not fully mature. This stunted condition can contribute to obstructed labor, and therefore fistula.
• But, fistula is both preventable and treatable. For instance, the Addis Ababa Fistula Hospital has treated over 30,000 women over 33 years. Their cure rate is over 90%. Fistula can be prevented if laboring women are provided with adequate emergency obstetric care when complications arise. (Fistula Foundation)

The Addis Adaba Fistula Hospital provides these surgeries for women in need with donations. For $450, they can provide one woman with a fistula repair operation, high-quality post-operative care, a new dress and bus fare home. What they are giving these women is their life back, and that is an incredibly amazing gift for such a low cost.

How can you help?

You can help by donating any amount to the Fistula Foundation. You can also join their Love-a-Sister program, and donate $450 (either the full amount or 12 monthly installments of $37.50) to ensure that one woman will get the help that she so desperately needs and deserves. If you are unable to donate yourself, please take the time to pass on this information to others. By educating ourselves, we can all work together to support these women, and change the lives of those who are not so different from ourselves.

Also, please take the time to view “A Walk to Beautiful” – this amazing documentary on obstetric fistulas filmed in Ethiopia. The Addis Adaba Fistula Hospital is featured, and you can see the amazing work that they do, as well as witness the incredible transformation these women go through once they are cured.

For more information:

Campaign to End Fistula

The Worldwide Fistula Fund

Source:

Fistula Foundation