 From the time you get two lines on your pregnancy test, you're faced with so many decisions! Where will baby sleep? How will you feed your baby? What car seat should you buy? Strollers? Bassinet or crib? Parents-to-be will spend hours scouring the internet to find the best choice for each of these decisions. Sometimes, though, the choice of your care provider and birth team isn't given as much attention, though this choice will make the most difference on your birthing day and how you feel as you bring your baby into the world. Sometimes we assume that all doctors have our best interests as their top priority, and that anything a nurse or OB recommends is the best choice. This perspective doesn't consider, though, the broken system in which care providers and nurses work. Doctors are often stretched for time, exhausted when working on call, and concerned about liability. Hospital administrators, who spend no time in the labor and delivery rooms, set hospital policies that affect your experience. Nurses work twelve-hour shifts, often when everyone else in their life is sleeping, day after day and week after week. They're not often thanked for their work, and sometimes are treated poorly by their patients or other hospital personnel. In the midst of all this hierarchical tangle, you arrive at the hospital to have your baby. For you, this day is momentous. You'll remember this day for the rest of your life, and the way you feel during the birth process will make a big impact in your story as a parent. So, how can you have a positive birth experience, even when it seems so much is stacked against you? Savvy Birth 101! This one-hour workshop is specifically designed for parents to navigate the systems surrounding birth. You'll learn about evidence-based care--what that really means--and how to get it. You'll learn about top-down care and how it contrasts with family-centered care. You'll learn what your "tickets out" of the top-down, hierarchical system of care are, and feel confident moving into your birth, knowing that you can be respected, your voice can be heard, and your birthing day will be one that you will fondly remember for the rest of your life. Savvy Birth 101 is not a typical birth class. In fact, we won't be discussing the stages of labor, contraction timing, or comfort measures for your birth. (If you want all that and more--and I highly suggest you do--take a comprehensive birth class. Check out the Evidence Based Birth® Childbirth Class or Navigating Your Unmedicated Hospital Birth!) Brielle Bernards and I will be teaching this one-hour class on Wednesday, March 29 from 7:30-8:30 PM in Provo, and is only $20 if you sign up by March 22! (After that, the price increases to $35.) You can read more about Savvy Birth 101 and register here! Questions? Drop them in the comments or send me an email (summitbirthutah@gmail.com) or text (385-309-0167). I hope to see you there! 
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 Since the day I became a doula, I've intended to add on childbirth education to the birth services I offer. Over the years, I've offered limited childbirth class options: private three-hour in-home customized birth classes, and the three-hour Birth Class Date Night I teach with my backup doula colleagues. I packed as much info as possible into these three-hour class offerings, but there is SO much to learn and share about birth, and during these three-hour classes, we can barely scratch the surface! So, in the fall of 2022, I finally added comprehensive, group birthing classes to the services I offer. I started with a class I specifically designed for those preparing to give birth in the hospital without pain medication, called Navigating Your Unmedicated Hospital Birth.  Why a class specifically for preparing for unmedicated hospital birth (which some call "natural hospital birth"?) While there are things you need to learn in any birth class--the standard progression of labor, what cervical dilation and fetal station mean, when to go to your birth place or call your care provider, and more--there's a specific set of knowledge and skills that can be particularly helpful if your goal is giving birth in the hospital without pain medication. As a doula, I have helped many families work towards and achieve this goal. I've seen the preparation necessary to have an unmedicated birth--mental, physical, and relational. And I've brought all of those experiences into the creation of this class.  So, while we will absolutely learn the birth "basics" of the stages of labor and the physiological process of birth, this class doesn't stop there. Let me give you a short tour of the topics we dive into in class! In the first session, we learn about basic terminology about your relevant anatomy and the process of labor and birth. We learn the basics of how your uterus contracts to open your cervix and move your baby down through your pelvis and out into your arms. We listen to what labor sounds like and practice making sounds that will encourage your body to open and release. We watch videos of labor and discuss what we see. We discuss your--and your partner's--anticipated needs during labor.  In the second session, we start to build your labor toolkit. We do a lot of practicing. We practice communication skills so that you and your partner can make sure you're on the same page. We practice discerning whether your care provider is truly supportive of your birth goals--and how to know if changing care providers will be beneficial. We practice relaxation and breathing strategies, learn how to break out of the fear-tension-pain cycle and give birth confidently, and we practice several other comfort measures for labor. We also practice a variety of positions for labor and birth and discuss when each might be helpful.  In the third session, we practice more strategies for communicating with your care provider about your birth goals and preferences. We learn counter pressure--an amazing way to maximize your comfort during contractions! We discuss the choices that are available to you during your birthing experience, and we learn about the dreaded "cascade of interventions" that can upend your plans for an unmedicated birth--and how to avoid it!  In session four, we begin by creating an internal birth plan--how will you cope and open and remain confident when the going gets tough? We practice making informed decisions by researching trustworthy sources. We learn some body balancing strategies that help get your baby in a good position before labor starts so that it can go as smoothly as possible. And you get some tools and work time for creating both a birth plan and a postpartum plan.
In the last session, we focus on everything that happens after baby comes. We discuss lactation and breastfeeding: reasons to do it, reasons people choose not to do it, how it works, and how to know if baby is getting enough milk. We practice several nursing positions with baby dolls so you can get the hang of each position. We learn about what to expect with diapering, and learn some strategies for soothing gassy babies. We also learn strategies for soothing hungry, tired, or uncomfortable babies! We discuss postpartum depression and other mood and anxiety disorders so that you can be on the lookout for them and know how to get help as soon as you need it if you think you may be developing postpartum depression, anxiety, or another mood disorder. And we finish the class by starting to build your community of support, because, whether this is your first baby or your fifth, you'll need people to lean on as you begin this next chapter of your life!  In every session of the class, I prioritize having activities that are interactive and engaging, so that you'll remember what you learn--no boring lectures here! I have two degrees in education, so effective teaching is something I care a lot about. Classes are enjoyable and memorable and will boost your confidence as you prepare for your birth!
Whew! Just writing all that out makes me so excited for the next session of Navigating Your Unmedicated Hospital Birth! I hope you'll join me!  At my initial doula training, another doula told me about Evidence Based Birth®: Rebecca Dekker, a nurse with her PhD, reads all of the academic studies about common birth practices and synthesizes them in a way that's accessible for the general public. She hosts a podcasts and writes articles on everything from natural induction methods to Group B Strep. Along the way, she often highlights the fact that many common, undesirable practices in hospitals (like restricting eating and drinking during labor and inducing for a suspected "big baby") aren't necessarily supported by the research evidence. I was quickly hooked on the Evidence Based Birth® Podcast. Much of the research felt validating, because I'd had a difficult first birth many interventions that I now saw as unnecessary. My second birth, in which I more carefully opted for a select few interventions that matched my birth circumstances, had felt entirely different. And I liked knowing the research was on my side. More than just knowing that research was on "my side," though, listening to the Evidence Based Birth® (EBB for short!) podcast continually affirmed a theory I was formulating: that when parents are informed about best practices for pregnancy and birth and make truly informed decisions, they feel whole and often empowered by their births, even when they take unexpected twists and turns. When Rebecca Dekker announced that Evidence Based Birth® was going to be hosting an in-person conference, I knew I wanted to be there. And when she send a call for workshop proposals to her birth professionals email list, I got brave and submitted a proposal. I was ecstatic when I heard back that my workshop, titled "Birth Words: Choosing Our Language to Positively Impact the Birth Space" was accepted as part of the conference! In this workshop, I drew on my background in applied linguistics and meshed it with my love of birth and created a memorable one-hour workshop for birth professionals about how to be intentional about using our words to make the birth experience the best it can be. (If you're interested in learning more about my work at the intersection of birth and linguistics, check out my podcast, Birth Words--you can find it on most major podcast platforms--and my website. You can even listen to the episode where I interviewed Rebecca Dekker on Birth Words!) Attending and presenting at the Evidence Based Birth® website was inspiring. I went out to dinner with Rebecca Dekker and the other conference presenters, she signed my copy of her book, Babies Are Not Pizzas (yes, this signed copy is the very one available in my lending library!), and I learned from many other wise birth workers.  Oh hey! It's a blurry picture of me and Rebecca Dekker at the Evidence Based Birth® Conference in September 2019! After the conference, I was firmly committed to my future goal of becoming an Evidence Based Birth® instructor. Since becoming a birth doula, I had planned to tack on being a childbirth educator--my college degrees are, after all, in education! And EBB instructors are able to teach not just childbirth classes, but also workshops for birth professionals and birthing parents (more on that below!) It took a few years for the timing to line up, but in fall of 2022, I finally applied to be an Evidence Based Birth® instructor. The application is rigorous and a bit nerve-wracking, requiring four letters of recommendation and thoughtful answers to many questions about teaching experience, commitment to evidence based care, commitment to birthing and social justice, and more. I was relieved and overjoyed when I received my acceptance email last October. I worked diligently on the training throughout the end of 2022 and early 2023, and finished my training in mid-January! I'm now currently offering two different Evidence Based Birth® classes for expectant parents: the multi-week, comprehensive Evidence Based Birth® Childbirth Class, and the power-packed one-hour Savvy Birth 101.  So, now that I'm an Evidence Based Birth® instructor, what classes will I be teaching? I'm so glad you asked. ;) Evidence Based Birth® Childbirth Class The Evidence Based Birth® Childbirth Class is a comprehensive birth class in which you'll learn everything from the stages of labor, to your birthing rights and how to advocate for evidence-based care, to comfort measures, to lactation basics and newborn care. This class can be taught either fully online or with a hybrid model, where the first and last class are held in person. Either way, it consists of 4-6 (depending on length) meetings of everyone in the class, plus some videos you'll watch on your own in between classes. To start, I'll be offering the hybrid model, though I may open entirely virtual options in the future! Check out my current offerings here! Whether you're preparing to give birth at home, a birth center, in the hospital, or need help deciding, this class will confidently prepare you for birth. You can also read more about the Evidence Based Birth® Childbirth Class on the Evidence Based Birth website. Savvy Birth Workshop for Parents Unlike the Evidence Based Birth® Childbirth Class, The Savvy Birth workshop for parents is not a comprehensive childbirth class. Rather than a multi-week series of classes, it's a one-night-three hour class focused on giving you the skills you need to communicate with your care provider to get evidence-based, family-centered care. As EBB describes it, "The Savvy Birth Workshop for parents was developed by Evidence Based Birth® to give you and your partner the confidence and know-how you need to have a more positive, empowering experience in the birthing room." In the Savvy Birth Workshop, you'll learn what evidence-based care is, discuss local birth options and their pros and cons, learn communication skills for discussing your preferences with your care team, learn how to have optimal support from your labor team, and learn about your legal rights in birth. I don't currently have a Savvy Birth Workshop scheduled, but I plan to in the future, so check back here! And I AM currently offering the one-hour, condensed version of this workshop: Savvy Birth 101! Keep reading for details on that! Savvy Birth 101 for Parents Like the Savvy Birth Workshop for Parents, Savvy Birth 101 is not a comprehensive birth class. We won't be learning about the stages of labor, how to push your baby out, or how to stay comfortable during labor (remember, you'll want to go to the Evidence Based Birth® Childbirth Class for that!) We will be packing that hour full of info on how you can advocate for evidence-based care (and what that even means!) in a way that builds bridges, not walls. I'm teaching a Savvy Birth 101 workshop on March 29 with Brielle Bernards (The Calming Doula). Check out the details here! Private Coaching The last resource I'm able to offer parents as an EBB Instructor is private coaching. If you'd like a one-on-one session with me about how to best get evidence-based care, what your birthing rights are, how to build a great birth team, and more, please reach out on my Contact page, or send me an email (summitbirthutah@gmail.com) or a text (385-309-0167). I'm thrilled to be offering this content to Utah! Which class are you most excited about?   I'm thrilled to welcome a guest author for this blog post, Dr. Betty DeLass. Betty is the founder, owner, and CEO of Reborn Pelvic Health and Wellness, and a phenomenal pelvic floor physical therapist. I'm also fortunate to be able to call her a friend and fellow change agent. You're going to want to give her a follow on Facebook and Instagram as well. :) Thank you, Betty, for writing this post! Birth Through A Pelvic Physical Therapist PerspectiveDr. Betty DeLass, PT, DPT  Birth is a physically demanding activity. Period. You need to mentally, emotionally, spiritually and physically train for it. It is one of the most taxing athletic events of your life…and many of us do it multiple times! Personally, I have completed marathons and ironmans and let me tell you, giving birth is just as hard, if not harder, than doing these things! (This statement is not meant to scare or frighten, but rather put into perspective the demand that labor and delivery has on the body). As a pelvic PT, I went into pregnancy and labor/delivery with an intentional mindset. I was training for another athletic event. I read up on all the books. I took childbirth education classes (actually every single one that was offered…yes, nerd alert!) I learned how to do a perineal massage on myself. I practiced deep squats and breathing. I exercised, stretched and did prenatal yoga. I practiced mindfulness and coping strategies. I was training for pregnancy, birth and postpartum recovery. Let me tell you…whoa, that quite the event when it actually decided to happen! (With my first I was a week and a day overdue! And it felt like I was waiting forever to go into labor). I remember waking up in the middle of the night thinking…hmmm….pretty sure these are contractions, woke my husband up, got up and started laboring at home on my exercise ball and turned on my Jesus music. A few minutes later, I told my husband that I think we should go to the hospital, things were kinda getting intense… and then, I immediately threw up… Yep, definitely time to go! We arrived at the hospital after the longest car ride of my life as contractions increased in intensity with shorter intervals in between. I was thrilled to find out that I was 7 cm dilated. Sweet! I can do this! So I thought… Then another hour went by… And another… And another… Until I was exhausted… This is so hard. This is the hardest thing I have ever done. I am so tired. NO I AM BEYOND EXHAUSTED. I can’t do this anymore. I quit. Then…. Finally… After 14.5 hours of laboring…SHE WAS HERE!! In the blink of an eye, all the sweat, tears, pain, perseverance and hard work…my exhausted body forgot it all the second she was placed on my chest. Similar to crossing the finish line of a marathon or ironman. Joy, and sheer exhaustion raged through me. Thankfully, my second daughter was a tad bit faster with a 3.5 hour labor. So, I wasn’t quite as exhausted, however my pelvic floor was not as happy the second time around with how fast she came out! Let’s just say my second left a bigger mark on my pelvic floor from a rehab perspective. Postpartum recovery was hard. Where is my body in space… Abs…what are those? Oh no..I have a mom-butt (pancake buns)… Did I just pee myself…??? Am I ever going to sleep again…??? I cannot believe we just let moms go home and tell them at 6 weeks they are “cleared.” I need to change the world…we can do so much better, we can prepare better, we can birth better, we can recover and rehab better. I am going to change the world one vagina at a time. Going through two unmedicated vaginal deliveries myself was the catalyst to Reborn Pelvic Health & Wellness changing the standard of care before, during, after and beyond birth. A pelvic revolution has started. Let’s dive in a little more…  Being pregnant and giving birth (regardless of medication, no medication, vaginal delivery, or c-section, hospital, birth center or home birth) is one of the biggest changes that will ever happen to a person’s body. Your rib cage expands. Your abdominal muscles get stretched. Your hips widen. Your pelvic floor supports a bowling ball of a human GROWING INSIDE OF YOUR UTERUS!!! Any underlying sub-clinical dysfunction that may have been going on gets exposed with a magnifying glass while pregnant. You get stripped down to skin and bones postpartum and have to rebuild strength, coordination and endurance. Recovery after delivery takes time. Period. It’s THE NUMBER ONE BIGGEST change in your body. BIGGER than SURGERY! During a vaginal delivery, the muscles in your pelvic floor stretch 3.5 times their length. There are no other muscles in the body that do that. During a c-section there are more than 7 layers that are surgically cut and sewn back together. These are both major musculoskeletal events. Meanwhile, you still have to pee and poop, take care of the baby and many other tasks all while recovering. For all other major musculoskeletal surgeries or injuries like knee surgery or shoulder surgery you start rehab immediately and continue for months and months. Additionally, you can use crutches or a sling to let it recover. With birth your bowels and bladder still work daily and don’t get a true ‘rest.’ Most people after giving birth do nothing. They wait until 6 weeks postpartum to be “cleared.” Then, try to resume activity, running, lifting and intercourse. THIS IS NOT OK! THIS IS NOT THE STANDARD OF CARE! THIS IS GARBAGE CARE! How have we at Reborn Pelvic Health & Wellness changed the standard of care?  We see our patients before, during and after pregnancy. We set you up for success from the get go. We teach you how to stay strong and mobile during pregnancy. We keep the common (but not normal) aches and pains away. We help you prepare for birth so that you can have the best chance of success at a smooth and safe labor and delivery. We teach you how to use your hips and pelvis to your advantage during labor. We teach you how to do perineal stretching. We teach you how to get your pelvic floor to lengthen and get out of the way. We optimize the pelvis to allow for a vaginal delivery or a VBAC (vaginal delivery after c-section) by addressing limitations in your body. Planning for a c-section, no worries, we help with that too! Then postpartum, we help you get your rib cage and pelvis back into position. We get your core and pelvic floor back ‘on-line’ and activating properly to support your body’s movements. We retrain movement patterns so you can lift a car seat and give your kids a bath without low back pain. We make sure your pants stay dry even when you cough, sneeze, jump or run. We address any scar tissue sensitivity, pain, adhesions or restrictions. We make sure you can have intercourse without pain. We fundamentally and progressively load and exercise so that you can return to the activity that you love to do without pain, fear, or embarrassment. We provide true pre-hab, prep, and rehab during the biggest musculoskeletal change of your life. This is the pelvic revolution. This is standard of care. This is becoming Reborn. We love to set our patients up for success throughout this process by teaching them about their bodies. We want you to be the experts of your own body from the inside out. If you are interested in optimizing your pregnancy, birth and/or postpartum journey be sure to reach out. Remember it is never too late to start! There is always room to improve and optimize :) You can find us and contact us at www.rebornphw.com or call us at 801-216-3117. Connect with Betty and her team at Reborn Pelvic Health and Wellness: Want more Betty? Check out my interview of her in this podcast episode of Birth Words!
 What are the benefits of using a pacifier?
 What are the drawbacks of pacifier use?
Pacifier Safety
 I first heard about doulas when I was pregnant with my third child. My husband was in graduate school and I was working random side-jobs. A friend who had just had a baby enthusiastically shared about her birth experience and the invaluable support she received from her doula. It sounded incredible, but it simply wasn't in the budget for us at that time.
Fortunately, we were able to invest in a high-quality comprehensive birth class and felt thoroughly prepared for my birth. We lucked out with a smooth, uncomplicated labor, and I had the incredible birth experience that fueled my desire to become a birth worker. But the conversation with my friend and our inability to hire a doula sparked something in me. I feel strongly that financial barriers shouldn't stand in between you and the education and support that you need to have a positive, empowering pregnancy, birth, and postpartum experience. That's why I offer grants for families with financial constraints. Grants are available in a variety of sizes and can be applied towards birth classes, birth doula services, or postpartum doula services. Although grants are somewhat limited, I'm usually able to offer a grant of some size to those with a need! So if limited finances are stopping you from signing up for a birth class, hiring a birth doula, or moving forward with postpartum doula support, head on over to the grant application page to apply!  All of the pregnancy books recommend swimming as an excellent exercise during pregnancy. The water's buoyancy helps support your belly while minimizing swelling and supporting your joints. And it's a great workout! It always sounded so good in the pregnancy books, and I tried it out a few times... Only to remember why I've never loved lap swimming. Something about inhaling a face full of splashy water just erases the charm for me. Enter prenatal water aerobics! I first heard about this class when a doula client, who was taking the class, mentioned that she'd been attending it. It sounded like a great class and something I wanted to check out for myself and tell my clients about. I finally got around to attending class a couple of weeks ago, and really enjoyed myself. The other class members were welcoming and friendly, even to me in my non-pregnant state. :) As we got into the water, we got to know each other a bit, and then we started with some gentle warm-up exercises in the water. I was surprised by how much difference water resistance made in doing simple exercises like kicks and steps. I could feel that my muscles were engaging, yet the workout was gentle on my joints. Later in the class, we used pool noodles for added resistance, and I was again surprised to find that a super-lightweight pool noodle acted like a light dumb bell in the water! They also made fun flotation devices for other exercises. In pregnancy, water fitness classes have many benefits. It reduces swelling, is low-impact, carries little risk of falling, alleviates spinal and pelvic pressure, and helps to improve mobility and range of motion. It also encourages increased amniotic fluid production--so discuss this exercise option with your care provider if you have low fluid levels! This class is adaptable for people with all fitness levels and can be done throughout your entire pregnancy--from first trimester through the end of third trimester! Non-pregnant participants who are looking for a gentle workout are also welcome.  The class is taught by Aimee Sanders-Krause. She's a lovely, warm person and a clear, yet flexible, instructor. Aimee is a mom of three and has a bachelor's degree in exercise science. In addition to teaching this class, she teaches other fitness classes at Orem Family Fitness Center and is also a personal trainer.
Interested? Class is held on Fridays from 11:00 a.m. - 12:00 noon. It's free with a membership to Orem Family Fitness Center, or non-members can pay a $5 day pass fee. Childcare is offered on-site! For more info, visit the Orem Family Fitness Center website. Information is at your fingertips. You can Google anything from round ligament pain to pushing positions. Your favorite pregnancy/birth influencers post mind-blowing new information daily. Many childbirth classes are offered online, and you can watch them from the comfort of your home on your own time. Why take an in-person childbirth class? In class, you'll build a community of support. There's nothing like face-to-face connection with other people. Pregnancy is a unique time in life, and it feels good to connect with other expecting parents who get it. Yes, there are zillions of online pregnancy groups and forums you can join, but the familiarity and connection that happen in person exceed what a virtual group can offer. Summit Birth Utah's Comprehensive Childbirth Class runs for 8 weeks, so there's ample time to form friendships. They say it takes a village to raise a child--maybe you'll meet your village in your birth class! You can have a say in the class's agenda! I've planned eight classes' worth of material about labor, birth, and postpartum, but it doesn't have to be set in stone! During the first class session, I will ask each class attendee what they're hoping to get out of the class, and will tailor the class series to meet the needs of the class participants. So start thinking about topics and tools that you want to learn, and come ready to share them. I can't wait to personalize the class to fit your needs! When you're invested and accountable, you'll learn more.
I'm passionate about evidence-based care and I've thoroughly vetted everything I'll share in class. Rest easy knowing your sources are trustworthy.
You'll have a private space to ask your personal questions.
We'll practice labor and birth positions with props like those you'll have at home and in the hospital.
You will really practice labor comfort measures. There are so many ways to cope and optimize your comfort during labor and birth. In class, you'll have hands-on practice with a wide range of them. Fill your toolbox with comfort measures so that you know what you can draw on during labor and birth! We'll practice guided meditation, using a TENS unit, counter pressure, aromatherapy, breathing techniques, sounding out your labor, and more! By handling models of a pelvis (both bones and muscles), baby, amniotic sac, uterus and ligaments, you'll learn how Baby will move through your pelvis and how your body positions can help Baby on the journey!
At each class, feel free to check out books from my lending library. I have an always-expanding lending library of books about fertility, sexuality, pregnancy, birth, postpartum, breastfeeding, and baby care. I'll bring books from my lending library to each class, and you'll have the chance to check out or exchange books each week. If you're interested in getting a taste for some of the books in my library, give this blog post series a read! We'll discuss and practice hypothetical situations as a group.
You'll watch and participate in meaningful, memorable role plays. Discussing hypothetical scenarios, though helpful, isn't quite as effective as participating in role plays. To really help prepare for birth and make concepts stick, we'll do some role playing. Think of it as a dress rehearsal for your birth! You'll feel more at ease during labor and birth if it doesn't feel like the first time you've encountered anything like this. I've specifically chosen birth videos to coordinate with class content. Watching birth videos can be a great way to prepare for your birth. They can help you visualize a variety of ways that birth can go. And watching an empowering birth helps your mind create that expectation for your own experience! I find that birth videos are most helpful if you watch them with a specific purpose in mind, so I'll be weaving them into the class curriculum with prompts to maximize your learning. You can practice breastfeeding positions with doll models. It can be tricky to get the hang of breastfeeding! We'll go over the basics of lactation and preparing to breastfeed, and we'll practice several different ways to hold Baby. I'll explain the benefits of each of the positions, and give you a doll to practice each position with. When you have a baby in your arms, you won't be experimenting with different holds and positions for the first time! This familiarity can ease some first-latch nerves. I hope you'll join me!Have I convinced you yet that in-person birth classes are the way to go? I hope you'll join me at an upcoming series of my Comprehensive Childbirth Class. The next series starts in just two days, on October 15! It runs through December 10, so this is a great class to take if your estimated due date is in early 2023. My next class series will begin in January 2023. I hope to see you in an upcoming class!
 Last week, I polled my Instagram followers. Did you give birth without pain medication? Are you planning to? Tell me why!
The reasons came rolling in, and they were as different and varied as my followers themselves. So let's consider the question: Why unmedicated birth? Some choose unmedicated birth (sometimes called natural birth) because they feel it will best connect them with their bodies. They feel confident that their body is powerful and capable, and feel that birthing without pain medication will enable them to best tap into that power. Others choose unmedicated birth because it helps them feel more in control of their body. Without pain medication, you're able to move around freely and choose the positions you labor and birth in. You aren't restricted to a bed and can walk, dance, sit, stand, kneel, squat, shower, bathe, use the bathroom... In short, you can move as you'd like! Some want to give birth without pain medication as a way to connect with their ancestors and the generations of people for whom anesthesia wasn't an option. Many believe that it is safest for them and their babies to avoid interventions in the birth process. Some are grateful for the option of medical intervention in birth when necessary, but want to avoid it--including pain medication--unless it becomes necessary. Others trust that birth will unfold in the way it is meant to only if the body has the opportunity to orchestrate its own hormonal symphony, without interruption from medication. For others, unmedicated birth isn't a choice. One follower shared her experience with me: Went into labor really fast, baby was born 20 minutes after we pulled into the hospital... Spent most of that 20 minutes yelling at the nurse that this was not my birth plan. This birth experience highlights the emotional strain of having an unmedicated birth without feeling prepared for it. For this mom, the right choice for her second and third births was to birth with pain medication, and those births were peaceful and empowering for her. Others who have had an unmedicated birth that caught them off guard choose to double down in their preparation for future unmedicated births. Whatever your reason for unmedicated birth, it will go most smoothly if you prepare both your mind and your body for the experience. There are many different approaches to preparing for unmedicated birth, oftentimes adopting a method such as Hypnobirthing or the Bradley Method. As a doula, I've found that most of my clients prefer a "toolbox" approach. Rather than learning a specific method, they learn about lots of different tools that they can use to be as comfortable as possible and manage pain during labor. These tools range from learning as much as possible about what happens during birth, to deep breathing and meditation, to using a TENS unit, to aromatherapy ... and much more! After five years of working as a doula specializing in unmedicated birth, I'm adding a comprehensive birth class series to the services I offer. This class is the toolbox. We'll begin by building a deep understanding of labor and birth. (Knowledge is power! ... And it helps provide pain relief.) Then, we'll learn about alllllll of the tools that will help you be confident, calm, and open during your labor. We'll spend a while learning about communication and decision-making, giving you the skills and practice you need to make informed decisions you feel good about and to advocate for yourself in the birth space. We'll finish out the series by exploring the postpartum phase, newborn care, lactation, and building a community of support. Are you preparing for to birth without pain medication? If you'd like to learn about all of the tools and skills I've honed as a doula over the last five years, come join my Comprehensive 8-Week Childbirth Class. This class is interactive, engaging, memorable, and ... Dare I say it? ... Fun! Watch for next week's blog post that will give a sneak peek into some of the activities we'll be doing in class. I hope to see you there!  My path to becoming a birth worker started with Clomid. Clomid is an ovulation-stimulating drug. After a year of trying for a baby, normal test results, and a diagnosis of “unexplained infertility,” my OB prescribed Clomid to increase our chance of becoming pregnant. The good news? It worked! The second month of taking Clomid, I conceived two babies—my wonderful twin daughters. My husband and I were ecstatic that our dream of becoming parents was coming true! I love these sweet girls and their twin bond and am so grateful they came to our family when they did. The bad news? This approach to fertility treatment did nothing to help my confidence or trust in my body. After a few blood tests that ultimately didn’t turn up any real reasons for infertility, my doctors stop trying to find a “why” and just moved ahead with a “Band-Aid” approach. I was already regularly ovulating each month, but my OBs figured that if I ovulated more eggs, there’d be a higher chance of me getting pregnant each cycle. They weren’t wrong. But I started my pregnancy feeling broken and confused. And I’m confident this affected the choices I made during their birth. After my twins were born and we were ready to start trying for another baby, I really wanted to figure out why it had been so hard for us to conceive. Turns out, trying to get pregnant the second time wasn’t really any easier. But I had a thirst to try to figure out why. One day, I was reading an email newsletter and saw that a local fertility educator was hosting a free one-hour workshop on fertility awareness. I really had no idea what that meant, but I knew I wanted to be more aware of my fertility, so I went to the workshop. It was eye-opening. The teacher talked about all of the signs our bodies give us to indicate how fertile we are at different phases of the menstrual cycle. I had heard about temperature charting—and had it dismissed offhand in a doctor’s appointment as something that didn’t actually work! But I had no clue about the other cues she was talking about: cervical position, firmness, openness, fluid, vaginal wetness, and more! I got my hands on a copy of Toni Weschler’s Taking Charge of Your Fertility and dove in. TAKING CHARGE OF YOUR FERTILITY: AN OVERVIEW Taking Charge of Your Fertility is a comprehensive book that describes fertility signs, how to identify them in your own body, and how to use this knowledge to either avoid or achieve pregnancy and be informed and empowered about your own body. The book begins with a review of the current common options for birth control and bodily awareness that are offered for women: the long list of birth control options and their accompanying side effects do nothing to help us take charge of our own fertility, and they leave us with a long list of negative side effects!  The Menstrual Cycle Weschler then offers a detailed overview of female and male internal and external reproductive anatomy. With that groundwork laid, she describes the menstrual cycle in detail, including the hormones that trigger each phase. In the first portion of the menstrual cycle, Follicle Stimulating Hormone encourages the maturation of 15 to 20 eggs in each ovary. The follicles that hold each egg produce estrogen as the eggs continue to mature. Eventually, when your body reaches an estrogen threshold, the most dominant follicle that cycle releases an egg, and the others disintegrate. This can happen anywhere from day 8 to day 21 or later in your cycle. As your estrogen levels peak, this also triggers a surge of Luteinizing Hormone (LH), which causes the mature egg to pass through the ovarian wall. This is called ovulation. After ovulation, fimbria (little fingers at the end of the fallopian tubes) gather the egg and carry it from the pelvic cavity into the fallopian tubes. The follicle that released the egg becomes the corpus luteum and releases progesterone for 12-16 days. This hormone stops the other follicles from releasing their eggs, induces thickening of the endometrium (inner lining of the uterus), and triggers a shift in basal body temperature, cervical fluid, and cervical position. If the egg becomes fertilized and burrows into the endometrium (lining of the uterus), your body starts producing HCG, which signals for the corpus luteum to continuing releasing progesterone so that the uterine lining doesn’t disintegrate and shed itself during menstruation, as it does in cycles that don’t result in pregnancy. If you’re like me, after getting to this point in the book, you’ve probably learned 10 times what you’ve ever been taught about anatomy, fertility, and menstruation. And we’ve only covered the first tenth of the content of Taking Charge of Your Fertility! (I won’t go into as much detail about the content of the rest of the book in this blog post.) The Three Primary Fertility Signs After gaining a firm understanding of your anatomy and menstrual cycle, you’re ready to learn about how you can take charge of your fertility, by learning about, identifying, and charting the three primary fertility signs: cervical fluid, basal body temperature (or waking temperature), and cervical position. There’s so much more detail for each of these signs than I’ll be able to give here (which is why Toni Weschler wrote a 400 + page book about it!), but let me give you a quick overview.  Cervical Fluid: Your cervical fluid, which presents itself to you as vaginal discharge, changes consistency throughout your cycle. The consistency of your cervical fluid is a big clue as to whether you’re in the fertile portion of your cycle. Everyone’s fluid is slightly different, and it may take you a while to identify your pattern at what influences it, but here’s the general pattern: at the beginning of your cycle, you have menstrual discharge. When that ends, you may have a few days of vaginal dryness, and then you’ll likely start to have some secretions that are sticky. With this type of discharge, you’re potentially fertile, but it’s unlikely that sperm would survive in this type of fluid. After a few days (it’s different for everyone and can vary from cycle to cycle), your cervical fluid will likely become more wet and creamy or slippery. You’re more fertile when your cervical fluid is creamy. Then, your cervical fluid starts to resemble eggwhites: it stretches and is clear, and creates a lubricative vaginal sensation. This eggwhite-quality cervical fluid indicates that you’re in the most fertile part of your cycle. If you’re hoping to get pregnant, take advantage of this time! If you’d rather not, use barrier method birth control or abstain from intercourse during any pre-ovulatory days with cervical fluid of any consistency. After ovulation, as estrogen levels drop, cervical fluid tends to dry up quickly, and progesterone kicks in as the primary hormone of your menstrual cycle.  Basal Body Temperature (Waking Temperature): As hormones rise and fall during your cycle, your basal body temperature shifts in response. During the first part of your cycle, pre-ovulation, your temperature will be lower, around 97.0 to 97.7 degrees Fahrenheit. After you ovulate and progesterone is the primary hormone of your cycle, your temperatures will shift and remain higher throughout your cycle, with an average basal body temperature of about 97.8 degrees.
Tracking basal body temperature is pretty easy, but there are a few things that make it even easier—nearly effortless! In order to ensure that your temperature is accurate, you’ll need to use a thermometer that is accurate to the tenths place. Choosing one that is specifically marketed as a “basal body thermometer” will ensure this accuracy. Typically, you must also take your temperature at about the same time every day, before getting out of bed, and after three hours of uninterrupted sleep. As a mom and doula, I know that regularly aligning those three requirements can be tricky! Personally, I’ve opted to use TempDrop, a wearable thermometer that has uses an algorithm to account for sleep disturbances or inconsistencies. I just put on the armband when I go to bed, take it off when I wake up, and sync it to the app on my phone, which uploads my temperature data to a graph on the app and makes it easy to see when I’ve ovulated and my temperature has risen! If you opt for a different thermometer, there are several other apps that will chart your temperatures for you, such as Femometer, CycleProGo, and many others. They also offer places to write notes and keep track of your cervical fluid quality and cervix position, firmness, and openness, as well as any other notes that may impact your fertility (illness, stress, etc.). I started charting my cycle years ago with pen and paper, and let me tell you, these apps are game changers! Cervical Position: Weschler describes cervical position as an optional sign gives more information about how fertile you are at different signs of your cycle. To remember the cervix’s position during fertile times, Weschler introduces the acronym SHOW. When you’re in a fertile phase of your cycle, your cervix becomes Soft, High, Open, and Wet. (You can imagine that this would create an ideal environment for sperm to pass through to achieve pregnancy!) Applying Your Fertility Knowledge After describing each of these signs, Weschler gives detailed instructions on how to observe each of them within your own body, and how to chart or keep track of them. As you put these principles into practice, you’ll be able to gain valuable information about your own body and use this information to help you achieve or avoid pregnancy. Throughout the rest of the book, Weschler describes various circumstances during which you may not ovulate (adolescence, breastfeeding, PCOS, etc.). She gives information about how to use fertility awareness to avoid pregnancy and to help become pregnant. Beyond avoiding or achieving pregnancy, she discusses how an increased awareness of your fertility is helpful in staying informed about your gynecological health, appreciating your sexuality, navigating PMS and menopause, and enhancing your sense of self-esteem and self-efficacy. In short, fertility awareness is useful throughout your life! After the primary content of the book, Toni closes with tons of helpful appendices, ranging in topic from using fertility awareness while breastfeeding, troubleshooting hard-to-read basal body temp charts, how to research fertility clinics, and much more! Last Thoughts This blog post has been a (comparatively) brief overview of how to better understand your body’s fertility cues, which you can use to avoid or achieve pregnancy. But it’s not comprehensive! I hope you feel empowered by the information you’ve read here, and that you’re motivated to go and learn more! Especially if you’re using fertility awareness to avoid pregnancy, I highly recommend that you get your hands on a copy of Taking Charge of Your Fertility and get familiar with all of the details that I didn’t go into here! (I have multiple copies in my Lending Library!) I also recommend that you take several months, off of hormonal birth control, to get familiar with your body and your fertility signs. If it’s not something you’ve been used to paying attention to, it can take some time to read your body’s cues. So use a barrier method of birth control while you’re learning! If you’re using this information to become pregnant, you’ll still learn a lot from reading Taking Charge of Your Fertility. The things you’ll learn will help you navigate fertility challenges, time your pregnancy, and be confident in your estimated due date based on your unique cycle and day of ovulation. Whatever your circumstance, I can’t wait for you to learn more! |
AuthorHi, I'm Sara. I'm a childbirth educator and birth + postpartum doula serving Utah county. I'm a twin mom (plus one!), natural VBACer, and birth lover! 
Photo by Julie Francom Birth Stories
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