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Parenting Mantras For Your Doula Clients

May 4, 2022

parenting mantrasAs doulas, we are quite familiar with using mantras for birth. However, what about parenting mantras? Part of our role as doulas is to ensure we build our clients’ confidence not just in birth but also parenthood.

Becoming a parent, or growing your family, can be quite intimidating and a vulnerable time. Building your client’s confidence can be a gift that keeps on giving.

Here are parenting mantras to help your doula clients:

“I am The Right Parent For My Baby”

In the early days, navigating a newborn can be exhausting and overwhelming. New parents see nurses and doulas handle their baby with confidence. However, when they take the baby, they may wonder how to navigate fussing, feeding, etc.

As a doula, you can remind them that there is no question they are the right parent for their baby. Remind them that you have experience as a doula, but you are not the parent.

I often let clients know that their babies know their parents. They know their scent, sound of their voice, etc. Even in the earliest of days you will notice newborns rooting and fussing more when their mother holds them versus a professional. This is often because the baby smells the milk and instinctively wants to latch and be close.

As time goes on, they recognize their parents and feel comfortable enough to let their emotions out. I remind my clients that my kids fuss more for me than anyone else even though I am a professional.

“My Baby Cries to Communicate”

There will be times parents will hear they are spoiling their baby or baby is getting them used to being held “too much.”

We know this is silly and that babies are incapable of manipulating parents. We also know that regardless of why a baby is crying, it can get frustrating. The unsolicited advice, along with frequent crying, can be draining for parents.

We may not always be able to fix the crying, but we can help them reframe their thinking. When they remember that babies cry to communicate, not manipulate, it can help them cope better. It also helps them remember they are working to comfort, and problem solve, not deal with a baby who is crying just to cry.

“True Self-Care Matters”

As caregivers, many new parents struggle to put themselves first. Yes, newborns are quite dependent. However, we cannot pour from any empty cup.

As a doula, it is important you “give permission” for your clients to put themselves first. Remind them that it is important they ensure they are fed, not just baby. Remind them it is okay to decline visitors, say no to outings, and do what they need to meet their own needs.

Self-care is more than showering. It is setting themselves up to meet their needs, even when it means potentially disappointing people who want to visit. Rest, nutrition, and mental wellness are vital when welcoming a new baby.

“I’m Not Alone”

New parenthood can feel incredibly isolating in our busy culture. Parents also often feel the need to keep up a façade that they have it together. This can lead to many parents thinking they are the only ones who are struggling.

In reality, all families welcoming a new baby experience a period of transition. When families are aware they are not alone in the struggles they are facing, it can help them feel better.

No, nothing is as wonderful as uninterrupted sleep, balanced hormones, and figuring out what your baby’s needs are. However, being aware that finding early transitions difficult is normal can help parents understand that they are not alone.

As a doula, you are also there to physically show them they are not alone. You are there to provide support as well as help them build up their support system. Our modern society normalizes parenting alone, but parenthood is not meant to be a solo practice.

Mantras are another tool you can stick in your doula bag to help support your clients. Ready to learn more about supporting clients? Be sure you are registered to train with IDI!

What is a Sibling Doula?

May 1, 2022

sibling doulaAt the International Doula Institute, we train and certify birth doulas and postpartum doulas. But what about sibling doulas? What is a sibling doula?

At IDI, did you know we also train sibling doulas? How? Well, sibling doulas are simply birth or postpartum doulas providing an additional service. Both our birth and postpartum trainings provide the information you need to offer sibling doula support.

Of course, to offer this service, you need to know what exactly it is.

What is a Sibling Doula?

Depending on where a family is planning to give birth, they might want their older child present. For those giving birth at a birth center or at home, it is advised there be a caregiver besides the parents to attend to the older sibling(s).

During birth, obviously the birthing person is busy. While they may enjoy and be fine caring for their child through much of labor, there will likely be times they cannot attend to their child. While the other parent could provide the care, it’s advised they be free to provide support to the birthing person.

This is where a sibling doula can come into play. A sibling doula is familiar with typical birth physiology and what to expect. They understand how to be on-call, how to explain the birth process, and how to support the family unit.

Not every birth or postpartum doula offers sibling doula care. It tends to involve general childcare which is not something everyone desires to provide.

If you are hired as a sibling doula, you are not typically in the birth doula role too. However, some families may request your role ebb and flow based on their needs. It is important you be clear with a family about their expectations and your services.

What Does a Sibling Doula Do?

Sometimes, a postpartum doula will offer sibling doula support. While this is being on call in a different way than postpartum care, it is a service some add when they are not wanting to be a primary birth support.

A sibling doula’s role at a birth might look like:

  • Being on-call and arriving when parents request
  • Entertaining, playing with, and comforting a child(ren)
  • Explaining the birth process to the child
  • Helping parents involve their child in the birth process as much as they desire
  • Making sure the child gets food, hydration, and rest (nap or bed)
  • Creating special memories for the family unit
  • Practical support

Because every birth is unique, and every family is unique, your role can vary birth to birth. However, you can also be clear in your contracts about what you do and do not offer. Some sibling doulas are happy to provide light housekeeping support, while others do not offer that except what is related to the child.

Only you can decide what you are and are not comfortable providing. Clients can then decide if you are a good fit for their family.

Do I Need an Additional Certification to Offer Sibling Doula Support?

A sibling doula is not a separate or specific doula certification. The main reason doula is used in the title, verses just childcare, is the on-call and birth related nature of the support.

Typical childcare would not always have the birth knowledge to provide adequate support. It is important that anyone supporting a family during birth, especially an out of hospital birth, understand normal birth physiology.

For children, having a support person who can explain what is happening in a calm and reassuring way is important. Both birth and postpartum doulas are trained with the knowledge of how to support families during the perinatal period.

If you are interested in becoming a sibling doula, ensure you complete your birth and/or postpartum doula training. Upon completion of these certifications with IDI, you will have the skills to offer sibling doula support.

How to Help Doula Clients in Need

April 30, 2022

help doula clientsAs a doula, there will be times you may have a client experience a crisis around the time of birth. This may look like health complications, a NICU stay, loss of a loved one (baby or others), etc. Knowing how to help doula clients in need is an important part of your role.

This may look slightly different to how you support a non-client, such as your own friends and family. However, it is not completely different.

Here are ways to help a doula client in crisis:

#1: Offer True Empathy and Compassion

It can be hard to remove yourself from the situation to protect your own feelings. It is easy in some ways to offer sympathy or pity. However, those in crisis do not need sympathy, they often need empathy.

Empathy is an important skill for doulas. However, for doulas supporting clients in need, empathy is vital.

During your training with the International Doula Institute, you will learn about emotional intelligence. Beyond just training, emotional intelligence is an ongoing practice of awareness and empathy.

If you are unsure how to truly offer empathy to doula clients, this short clip from Brene Brown is helpful:

#2: To Help Doula Clients in Need, Make Sure They Eat

If you have a doula client healing from birth while navigating a NICU stay, a loss, etc., there is a good chance they will struggle with eating.

Stress, grief, and the practical weight of navigating a crisis often means not making eating a priority. As a doula, if you are hired in the home, make meal support a priority. If you are not actively in the home, help them with a meal plan whether that be a meal service, a meal train, etc.

#3: Help Clients Build and Rely on Their Support System

Everyone’s support system varies. However, as a doula, you can help clients sort through their available support. Encourage them to reach out to friends, family members, helpful coworkers, neighbors, community, or religious organizations, etc.

It can be difficult to ask for help, but it is vital they use the support they need. You can also take charge of this, with their blessing, and ask for help on their behalf. Be sure to have their consent before requesting help or sharing anything about their circumstances.

#4: During Scheduled Visits, Offer Practical Help

As doulas, our role can vary significantly. However, when a client is in crisis, if they hire us for support, think outside the box a bit in terms of how you can help. Their biggest need one day is help reorganizing the nursery for unexpected medical items following NICU discharge.

One shift looks like helping an older sibling get the attention they need as a parent is grieving. It is important to stay within your scope of practice, but there are many ways to help clients outside of how a typical visit might look like.

#5: Hold Space to Help Doula Clients in Need

When you are hired support, you can feel like you need to always be doing something. Even when sitting with a client, it is tempting to share information, ask questions, teach, etc. However, for clients facing a crisis, sometimes they simply need another human nearby.

What can be most helpful for some is simply having your presence. They may want to sit in silence. They want to debrief and share but do not want any responses to what they share. Use your emotional intelligence to try and read the scenario and provide the space they need.

At times, clients may need to share with the hope you can provide solutions. Other times, clients just need an empathetic ear.

Whatever the situation your client is going through, do your best to provide care and support in an empathetic way.

Have not started your doula training yet? Be sure to register now and get started with the International Doula Institute where your training equips you to provide true support in a variety of circumstances.

Blogging For Doulas

April 29, 2022

blogging for doulas

For doulas who are working independently, part of your role is business. Blogging for doulas is a fantastic way to reach potential and current clients. At the International Doula Institute, we are committed to helping you be prepared to jump into doula work. This means understanding birth and the business.

Blogging for doulas can feel overwhelming if you are just starting out. However, with a few tips, you can easily get started.

Here are the most important tips to know about blogging for doulas:

Blogging For Doulas: Pay Attention to Word Count

One important aspect of blogging is understanding search engine optimization, known as SEO. While there is not a specific word count, search engines (like Google) are looking for quality. Articles under three hundred words are less likely to be seen as quality content.

When writing, ensure your articles are a minimum of three hundred words. Ideally, you would want 600-1200 words. You can draft much longer articles if you desire. However, it is important to note that current trends show people have a bit of a shorter attention span than we once had.

Keeping an eye to ensure your articles are not too short will help you rank well in searches.

Choose and Know Your Audience

When you are blogging for potential clients, know your audience. Think through:

  • What services you offer
  • Your target demographic
  • Your philosophies as a professional doula
  • How clients can reach you
  • Are you hoping to reach potential clients directly or through connecting with other professionals?

When you know who your audience is, you can better find your writing style. Your audience may change from blog post to blog post as well. Some doulas like to write towards potential clients to help them get to know more about their services, knowledge, etc.

Other doulas like to write to other professionals such as fellow doulas, midwives, chiropractors, OBs, etc. They use their blog as a form of advertising and networking in hopes others will refer clients to them.

Be a Source of Evidenced-Based Information

At the International Doula Institute, you know we value using truly evidenced-based information. As a professional doula, when you share information, it is important to use evidenced-based sources.

While not every blog post requires sources be cited, when you are sharing evidence, it is important to share from qualified sources.

To find appropriate sources look for:

  • Sites which are .edu as this indicates an academic website
  • Published medical journals, often found on the NIH website
  • Sources from NHS which is a UK equivalent of NIH
  • Websites ending in .org depending on the organization
  • .gov websites often have evidenced based sources

In addition to looking at the site source, it is important to check dates, who is funding the research, and any conflicts of interest. It is also important to watch the language you choose when presenting medical based information. Ensure you are not making any specific recommendations and you are always recommending readers to check with their healthcare providers.

Blogging For Doulas – Easy to Read Posts

Today, many people read blogs on their phones, tablets, etc., Contrary to the writing styles we are often taught in school, blogs use short paragraphs and sentences.

The layout for many blogs has just 1-3 sentences per ‘paragraph.’ This is much shorter than the 3-5 minimum we learned in school.

The shorter sentences and paragraphs make it easier for people to read on smaller screens.

People also find it easier to read when blogs contain:

  • Bulleted or numbered lists
  • Subheadings at least every three hundred words
  • Clear subheadings for those who might scroll for specific information

Take Advantage of Blogging Software

It can take time to learn how to blog efficiently. However, the good news is you do not need to learn on your own. In addition to classes, courses, books, and more, there are plenty of software options to help.

Many bloggers find the Yoast plugin for WordPress to be helpful. For those who use Wix, you might find Wix SEO Wiz useful. Both programs can help you check your posts for how well they might perform in search engine results.

For grammar support, the program Grammarly can be helpful. However, if you use the newest version of Microsoft Word, it has grammar software built in. It can also be used to check your writing for any similarities online. This ensures you have not used too much of someone else’s wording. It also helps with properly citing sources should you use excerpts from another site.

It can take time to learn about blogging. However, it is worth learning to help improve your business website.

What Is A Single Artery Umbilical (SUA) Cord?

April 13, 2022

single umbilical artery

The big scan – something every pregnant parent looks forward to. We know about the umbilical cord, but what is a single artery umbilical cord (SUA)?

Who has been growing for the last 18-20 weeks? Many cannot wait to see a clear profile shot and others are overjoyed to find out if they will be having a boy or a girl. Few think about potential umbilical cord issues.

While great pictures and finding out the sex are what come to mind for the big scan, the purpose of the scan is to check out fetal development and growth. Providers call this scan an anatomy scan.

As a doula, you are likely aware of the importance of the anatomy scan. While it is not a requirement for everyone to have ultrasounds during pregnancy, it is a standard of practice for most providers in the US.

Occasionally, a provider might find a fetal, umbilical, or placental abnormality. One of the possible abnormalities is a single artery umbilical (SUA) cord. Anytime you hear “abnormality” in relation to pregnancy, it can cause worry.

But what is a single artery umbilical cord? Does having an SUA mean your client or their baby are at risk for complications?

What Is A Single Artery Umbilical Cord?

The umbilical cord is the lifeline between you and baby. During typical development, an umbilical cord has three vessels. One vein brings oxygen and nutrients to the baby. Two arteries carry away waste from the baby.

A single artery umbilical cord has only two vessels. It has one vein, and instead of having two arteries it has just one. An SUA is the same as a two-vessel cord. Different sources use different terms.

Around 1% of singleton pregnancies have an SUA, and just under 5% of twin and multiple pregnancies have an SUA. It is the most common umbilical abnormality.

Is An SUA Dangerous For The Baby?

Anytime your client’s hear “abnormality” they are likely to develop concern for the wellbeing of baby. The good news, although an SUA is an abnormality, most cases are isolated and not related to any dangerous conditions for baby.

Occasionally, an SUA can be related to other abnormalities in baby’s cardiovascular, renal, or other systems, or related to a chromosomal issue. For this reason, your client’s provider may recommend further evaluations. Providers rarely suggest invasive testing for isolated SUA.

A more detailed ultrasound to check for any other abnormalities and ongoing growth monitoring is a common course of action. If providers find another abnormality, it might mean an increased risk of health concerns for baby. However, SUA alone is not the cause for concern.

Some studies have found a slight increased risk of Intrauterine Growth Restriction (IUGR), while others have concluded the risk of IUGR among babies with SUA is the same as the general population. If your client’s provider is concerned about IUGR, they will recommend routine growth monitoring.

Some cases of IUGR are attributed to placental function and blood flow, and the presence of an SUA might be a risk factor. However, as mentioned above, there are not studies which confirm an increased risk so it is something to be aware of but not something to expect to occur.

Will SUA Affect Labor And Birth?

Many experiencing SUA can still have a low risk, uncomplicated vaginal birth. Some studies, however, did find an increased risk of c-section due to small for gestational age (perhaps associated with IUGR) and fetal heartrate concerns showing signs of fetal distress.

One thing which is difficult to decipher with these increased risks is whether they are due to the SUA or are they due to managing labor with SUA. If a baby is measuring small for gestational age or experiencing IUGR, your client is more likely to be induced which increases the likelihood of fetal distress and c-section.

With a single artery, it does seem that baby is at an increased risk of fetal distress and thus anything that also increases the risk of fetal distress (e.g., induction of labor, epidural, etc.) could account for more c-sections or complications among babies with SUA due to combining risk factors.

As your client and their maternity care provider monitor their pregnancy, and plan for labor and birth, it is a good idea for them to discuss how to manage these risks. If there is not a medical indication for an induction, augmentation, or epidural, it’s likely planning a spontaneous birth with fetal monitoring could be ideal.

Anytime a client hears something which deviates from expected normal, especially during pregnancy, concerns can run wild. Hearing a baby having a single artery umbilical cord can be scary. The good news is that often, baby will be healthy and labor unaffected.

In the few situations where other conditions are present or where labor does not unfold as planned, discussing options with their maternity care provider before labor can help your client be prepared.

Skin-To-Skin After Birth – The Risk of Interruption

April 11, 2022

skin-to-skin

Over the years, we have seen understanding of the importance of immediate skin-to-skin after birth. We know for the birther and the baby there are significant benefits.

We know skin-to-skin assists with bonding, establishing breastfeeding, and more.

However, if there are benefits to skin-to-skin, are there risks associated with interrupting skin-to-skin?

As doulas, being familiar with normal physiological birth, including immediately after birth, helps you provide parents with information. Part of your role as a doula is to provide evidenced-based information so your clients can make fully informed decisions.

Skin-to-Skin Interruption

A 2015 study found birthers who did not have immediate skin-to-skin contact and breastfeeding attempts within the first 30 minutes after birth were twice as likely to experience one type of serious birth complication.

Study Finds Double The Risk Of Postpartum Hemorrhage

Birthers who did not have skin-to-skin and breastfeeding initiation immediately after birth were found to be twice as likely to experience postpartum hemorrhage (PPH) compared to those who did have skin-to-skin and breastfeeding initiation.

As a doula, it is easy to see why skin-to-skin is an important part of physiological birth process.

We know that PPH is a serious birth complication. While all birthers experience some blood loss, a PPH is when 500mL or more is lost after birth. In some cases, this is the result of placental complications, previous anemia, or the result of interventions.

However, this 2015 study suggests some cases are the result of a lack of naturally release oxytocin. The hormone oxytocin is responsible for contractions during labor but also after birth. Oxytocin aids in the placenta expelling and the uterus clamping down.

Why Does Skin-To-Skin Reduce PPH Risk?

Birth is a complex hormonal process. Oxytocin is the most well-known hormone as it triggers the uterus to contract.

People release oxytocin when they feel good. This includes when we have skin-to-skin contact – such as breastfeeding. Latching triggers the body to release oxytocin to cause the letdown reflex. Therefore, early breastfeeding, and not only skin-to-skin, aids in reducing PPH.

Oxytocin plays a significant role after birth by:

  • Making the uterus contraction to cause the placenta to detach and be expelled
  • Causing contractions to help the uterus shrink and clamp down to reduce blood flow where the placenta was attached
  • Encourages bonding through feelings of euphoria
  • Triggers the milk letdown reflex

As doulas, we know that prolonged third stage can increase the risk of bleeding. We also know there is a risk of PPH during the entire postpartum period while healing. Helping clients understand the importance of immediate skin-to-skin can be an important part of preparing them for birth.

Why is This Study Important?

There are times when providers need to separate a birthing parent and baby. This can be for the health of either party – but this is often an exception and not the rule.

When we saw a cultural shift from birthing in the home to birthing in the hospital, we saw an increase in separation. Hospitals whisking away babies for weight checks and newborn exams became a norm. Babies spent most of the time in the nursery so birthing parents could rest and recover.

What providers thought would be beneficial – allowing extra rest after birth – turned out to interfere with a natural transition for both the birthing person and baby. Allowing rest IS important. However, it should not be done at the expense of immediate skin-to-skin contact.

We now know that interfering with the birth process, including the third stage, and immediately postpartum, comes with risks.

The body and our babies work together during the birth process. They provide each other with necessary hormones to make the transition safe.

When birthers and babies are not able to practice skin-to-skin we interfere with the natural release of oxytocin. While the birth itself might be finished, oxytocin still needs to flow to ensure the uterus clamps down. Oxytocin’s job is not complete just because baby is out.

The Significance

This study is significant because it could reduce the need for active management in low-risk births in low-risk settings. The study found immediate skin-to-skin had the greatest impact in low-risk women.

Active management does have a role in safe birth. It is when providers give synthetic oxytocin to aid in placenta expulsion and the uterus clamping down. Providers use active management to reduce the risk of PPH. This can be a routine practice in some facilities regardless of risk status. While active management is a great tool to reduce the risk of PPH, some birthers prefer to avoid unnecessary intervention.

Providing clients with information about the benefits of skin-to-skin to reduce PPH gives them the information to make informed decision when talking to care providers.

What If Separation Is Necessary?

In some situations, separation occurs because medical intervention is necessary. For example, in the case of premature birth. However, providers can safely delay routine exams and weight checks until after immediate skin-to-skin. Anything which a provider cannot safely delay they can do on or near the parent. This obviously excludes cases of serious medical complications.

Knowing the importance of oxytocin, when medically necessary separation occurs, providers will opt for active management. While not identical to natural oxytocin, synthetic oxytocin, known as Pitocin, will reduce the risk of PPH. When separation occurs, providers routinely give Pitocin.

Fortunately, we are seeing a rise in immediate skin-to-skin. As doulas, we hope this will continue to be an expected norm for routine birth. The more modern obstetrics learns about birth, the more we are seeing how interfering with birth is not without risk.

It is important we weight the benefits and risks of each birth option. As doulas, we equip our clients with the tools and support to make these decisions.

While we are seeing a rise in immediate skin-to-skin, perhaps it will become the expected norm for the safety of mothers and not only a social trend. The more we learn about birth the more we realize just how intricately designed the birth process is and interference is not without risk.

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