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!

When I first learned about the children's book Nine Months by Miranda Paul and Jason Chin, I knew before even reading it that I wanted to add it to my bookshelf. Paul (author) and Chin (illustrator) collaborated on a family favorite picture book, Water is Water, that poetically teaches about the water cycle and water phases. That book is done so masterfully, with such beautiful illustrations, that I was giddy to discover that Paul and Chin had collaborated on a book about pregnancy!

As of right now, this is the only book in my Lending Library written for children. But I feel it's the perfect book for big sisters- and brothers-to-be. Each two-page shows what happens during a month of pregnancy: through poetry, simple facts about the growing baby, and beautiful life-size illustrations of the baby in-utero and a fictional family preparing to welcome the baby. The language and paintings appeal to the youngest children as well as older children and the adults reading the book. Here's a taste of the beauty of this book:

I love how the simple, rhyming words, paired with paintings of what's going on inside and outside the uterus, come together to tell the beginning of this incredible story of new life!

The side-by-side illustrations of the fetus growing and the family preparing help kids make sense of doctor's visits and mom's growing belly.

Aren't those illustrations beautiful?!

For especially curious young (or older!) minds, the book ends with four small-type pages of information of how a fertilized egg grows from embryo to fetus, detailing when each body system forms and develops. It gives additional information about fetal skills and abilities, compares human gestation to other mammals, and explains multiple gestation (twins and more), prematurity, and miscarriage.

Truly, if you're looking for an info-packed, thoughtfully-made, accessible, gorgeous book to help older siblings prepare for a new baby, Nine Months is it!

This is the sleep book I wish I'd had when my kids were babies.

Being a new parent is tough! Adjusting to a new sleep schedule and meeting the seemingly-constant needs of a new baby is exhausting. Worst of all, when you Google anything about baby sleep, you get experts on all sides disagreeing about the best way to teach kids to sleep! No matter how you proceed in trying to get some more sleep for you and your baby, someone out there will tell you that you're doing it wrong.

As a new parent, I also struggled with guilt when we resorted to cry-it-out methods, desperate to get more sleep for our babies (we started with twins) and ourselves. While one or both of my babies cried themselves to sleep in their room, I, myself, was crying in our room, wishing there was a better way to get everyone some more sleep!

I wish I'd heard then about The No-Cry Sleep Solution by Elizabeth Pantley. That's what I needed! No tears, for either of us.

The book begins with important information for getting started, like basic sleep facts for newborns through two years, and safe sleep practices for newborns. (If you're reading the first edition, which I have in my library, some of the safe sleep recommendations do need updating. I've annotated my copies with sticky notes.) Pantley then describes the in-depth process of creating sleep logs, then reviewing your sleep logs and choosing solutions to improve your baby's sleep patterns. Solutions are divided into those for newborn babies (up to four months) and those for older babies (four months to two years). Pantley cautions that, in order to have an impact, you have to try out new solutions for at least two or three weeks. This approach to a better night's sleep isn't a quick fix, and will require dedication and persistence.

Pantley recommends continuing to keep detailed sleep logs and analyzing them every ten days and making any necessary changes. Throughout the book, she gives examples of possible solutions, when they are likely to be effective, and alternatives to try if they are not. And she ends with a reminder that sleep patterns continue to change as children grow up, so keeping these tools and the book handy in coming months and years will continue to be helpful!

Although I can't vouch for the efficacy of this baby sleep approach from personal experience, I've heard this book highly recommended by a very experienced postpartum doula I trust. And, though I didn't get the chance to try out any No-Cry strategies on my newborns, I did use its wisdom to navigate a sleep problem with my four-year-old, who still slept with a pacifier.

I knew it was time for him to quit the pacifier habit, but all of my ideas of how to do it without lots of crying (from everyone!) were falling short. Then, using an idea from The No-Cry Sleep Solution, I wrote him a picture book--starring him, as the main character. It told the story of him growing up and saying goodbye to his pacifier (with compensation prizes to salve the hurt). When I read it to him, he did cry a bit about having to say goodbye to his pacifier, but only briefly. He didn't stormily protest (as he was in the habit of doing), and the whole transition went far, far better than I imagined it would.

This experience, plus recommendations from professionals I trust, gives me confidence that Elizabeth Pantley knows what she's talking about when she writes about no-cry (or low-cry) sleep solutions. Ready for your baby to sleep better? Or preparing to have a baby and wanting to get things right from the get-go? I'd love to lend you my copy of The No-Cry Sleep Solution in my Lending Library.

Penny Simkin writes, "How a woman gives birth matters--to her baby's long-term health, to her family (including her relationship with her partner), and to her mental and physical health and her self-confidence and self-esteem as a woman and a mother" (The Birth Partner, Fourth Edition, p. xi). Because this is true, Simkin also asserts that "How a woman is cared for and supported during birth is a major influence, not only in how she gives birth but also in how she feels about it" (p. xi). Quality support during birth is important. The way women are supported during birth affects how they birth, how they feel about it, and how the experience impacts their roles and relationships for a lifetime.

Given the importance of high-quality support during birth, wouldn't it be nice if support people (husbands, partners, family, and doulas) had a manual for how to give high-quality support? The Birth Partner answers this call. The book is a comprehensive go-to for support people during the last week's of pregnancy and birth. It's written by Penny Simkin, the co-founder of DONA International, the largest and oldest doula training and certifying organization.  

In The Birth Partner, Simkin writes to spouses and partners to help them prepare to be an active and supportive participant in the birth process. She describes in detail what to expect in the final weeks of pregnancy and through each stage of labor, and how birth partners can be helpful at each stage, while also caring for their own physical and emotional needs. Throughout the book, Simkin also briefly discusses the doula's role during labor and birth and how it complements the husband/partner's role.

She then describes some of the common tests, interventions, and procedures that may be recommended during pregnancy and labor and gives a framework for making informed decisions. In this section, Simkin does normalize some interventions that aren't necessary in many healthy pregnancies, but that's my biggest (and most nit-picky) complaint about the book. The book closes with a section on the first few days postpartum, and Simkin again shares helpful information and tips about how to be a supportive help at home in the days after birth.

In all, The Birth Partner is an info-packed and accessible guide for preparing to support someone through the experience of giving birth. I keep multiple copies of it in my Lending Library so that my clients can benefit from reading it! If you'd like to get a taste for an abridged version of ​The Birth Partner, Penny Simkin also published a pamphlet, "Comfort in Labor," that touches on many of the same topics covered in The Birth Partner. If, after reading "Comfort in Labor," you feel that you want more, then The Birth Partner is probably for you!

I've got good news, and I've got bad news. The bad news is that my previous partner, the fabulous Mary Caplin of Your Family Doula, is soon moving across the Atlantic to begin her family's next adventure. I have learned so much from collaborating with Mary over the last few years, and I'll miss her terribly!

The good news is that I have a wonderful new partner, Susie Hannig of Birth and Body Care with Susie Faye. Susie, Mary, and I have actually been working as a threesome for several months in anticipation of Mary's move, and I've already learned so much from collaborating with Susie! Susie has been a massage therapist for over twelve years, and I can tell you from personal experience that she is phenomenal at what she does. She's also an incredible doula, and we now back each other up in case of emergencies or other special circumstances. Susie gives so much to her clients and has a wide range of knowledge she draws on as she supports them. AND...

We're continuing to teach our Childbirth Class Date Nights, just as I did with Mary (with a couple of Susie-flavored tweaks, like a brief massage instruction portion!). To accommodate a few more couples, we've moved our classes to FLOW Chiropractic in Lehi. Dr. Steven Roushar has a very nice venue with plenty of space for us to spread out and practice techniques for working together during birth! We'll also add some nice date night-y touches with decor and refreshments for a cozy and intimate feel.

We've designed this two-hour class to help you strengthen your relationship and preparation for birth. Whether it's your first baby or your sixth, come learn how to make every stage of labor progress more smoothly. You will move beyond feelings of uncertainty to claim your power as life-giving agents. You'll learn and practice hands-on comfort measures so you can work together as a couple during labor. We customize the class based on the attendees and their birth plans and needs, and can adjust our curriculum to fit the needs of those planning to give birth at the hospital, home, or a birth center, and with or without an epidural. Throughout the class, we share lots of our favorite resources so that you can keep learning together after the class is over! AND... If you decide to hire Susie or me as your doula after attending the class, the cost of your Childbirth Class Date Night tickets goes towards your doula package fee.

So, pick the date that works best for you, and head on over to ​www.utahcountydoulas.com/childbirthclasses to register! We can't wait to see you tehre!

This is the seventh post in a series of blog posts based on interviews I’m doing with midwives who serve Utah County.

In this post, I’ll introduce you to the wonderful Melissa Chappell, owner of Songbird Maternity and co-owner of Utah Birth Suites, alongside Seasons Warner. She attends births at their beautiful new birth center in Provo, as well as home births in Utah County.

Twenty-six years ago, when Melissa was pregnant with her first child, she took a Bradley Method birth class and had a great first birth experience, even though her labor was very long. After that birth, she wanted to teach others to help them prepare for awesome birth experiences, so she became a childbirth educator. Later, she became a doula, then a doula trainer, and then a midwife, which she has been doing since 2015! She attended The Community School of Midwifery and completed the North American Registry of Midwives (NARM) Portfolio Evaluation Process and earned her CPM and Utah State Licensure (LDEM) credentials in 2018. Now, she also enjoys teaching potential midwives! Over the 25 years she’s served the birth community, she has touched the lives of hundreds of birthing families.

During our interview, I asked Melissa if she would talk with me about pushing, or the second stage of labor. If you’ve ever watched a TV birth scene, you likely imagine many people standing around, chanting, “Push! Push!” or counting from 1 to 10 as the mother bears down, purple-faced and out of breath. But, as Melissa can attest, birthing your baby doesn’t have to be this way!

In fact, that’s not how it goes at all at the births that Melissa attends. “Most of the time, if you just let a mom follow her body, she’s going to be able to push on her own,” she says. Melissa mentions that some people say they’ve given birth to multiple babies and never really felt the urge to push. “A lot of times that comes from people not really being given the time for their bodies to get to that point where they’re ready to push,” Melissa explains. “I mean, no one’s just going to sit there with a baby inside them forever! Their bodies are eventually going to help them know how to push the babies out.”

Sometimes, you may reach full dilation (10 cm), and still not feel, instinctually, that it’s time to push. Your contractions may even slow down for a while and give you a little break. When that happens, Melissa calls it the “rest and be thankful” stage. As you take some time for a little break before birthing your baby, your baby descends further into your pelvis, until you may notice that you’re grunting a little at the top of each contraction. When Melissa hears that little grunt, she gets excited—the baby is almost here!

Once the second stage of labor (pushing phase) starts, the length of time until baby is born varies greatly. On average, Melissa’s clients push for under an hour, but some push for a couple of hours, and every now and then, up to four hours! Recent research indicates that this is safe as long as both the mother and her baby’s vital signs look good and she is making progress in moving the baby down.

In a first birth, Melissa will sometimes offer gentle coaching or direction if her clients would like more guidance about how to push. One way she may do this is by gently placing her finger inside the bottom of the vagina (in the perineal space) to offer direction about where to push. Of course, Melissa never does this without the explicit consent or request of her clients!
For many clients, though, Melissa doesn’t give any direction or coaching. She just gives them time and space to listen to their bodies.

And what about cervical exams? Melissa says she rarely does them. (Although with first time moms, she does them a little more frequently, to help them assess where they are in their labor progression when they first arrive at the birth center.) “As a midwife, after doing this for years and years, you get to a point where you can tell without doing a cervical check, if someone is almost ready to push.” She listens to the sounds her clients are making (like that little grunt at the top of each contraction), and she watches the pattern of their labor: the length, frequency, and intensity of their contractions. By closely watching and listening, Melissa says that cervical exams to ensure complete dilation before pushing begins are rarely needed. Melissa further explains, “If you’re really, really empowering a laboring person to listen to their body and not push unless she feels that overwhelming urge, you’re not going to have people pushing on cervixes that are not ready to be pushed on.”
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Melissa is not alone in the way she empowers and encourages her clients to listen to their bodies and instinctively push during labor—there are many other fabulous midwives across Utah County who offer that same sort of care! I’m grateful that Melissa took the time to discuss this important topic with me, and for the individualized and empowering care she gives to her clients. She has a vibrant personality and lots of enthusiasm for the incredible work she does. Head on over to her website to learn more!