ACOG & SMFMDoulas! Just what the doctor recommended.

Did you know that this week the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) issued a joint statement: Safe Prevention of the Primary Cesarean Delivery recommending doulas?  See excerpts below:

Increasing women’s access to nonmedical interventions during labor, such as continuous labor and delivery support, also has been shown to reduce cesarean birth rates.”

Published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula.”

“…the presence of continuous one-on-one support during labor and delivery was associated with improved patient satisfaction and a statistically significant reduction in the rate of cesarean delivery.”

Given that there are no associated measurable harms, this resource is probably underutilized.”

You can read the full statement here.

This is something that doulas have known for years but it is wonderful to see that the medical world is noticing positive results from having us present.  Many area Obstetricians recommend their patients to our care and with this new statement I expect many more to follow.

When doulas and doctors work together towards improving maternal health outcomes incredible things can happen.

Who Are You Wearing?


OK, so maybe you aren’t going to the Oscars to accept an Academy Award.  Maybe you are just going to Target to have social interactions with other adults,  pick up some diapers, and look at all the pretty things.   So, why am I asking who you are wearing?  I’m not talking about what clothing designer you are wearing.  I’m talking about wearing your baby!

woven-wrap-1407192_1280Wearing your baby can make your life a lot easier (not to mention it also can reduce infant crying, create a healthier baby, and reduce postpartum depression.)  Imagine, two hands to push that red cart (or one hand on the cart, the other  holding a Starbucks cup.)  Sure, you could lug that infant carseat out of your vehicle and into the store.  You know the one that weighs 10 times as much as your actual baby?  It’s always great to work those biceps but the truth is that your baby would prefer to be snuggled close to you.  Especially in loud, bright, busy places.  You won’t have to worry as much about enthusiastic strangers leaning over to greet your baby in their car seat.  That can be really nice perk in the flu season.  Some seasoned parents can even pull of feeding their baby while wearing them and shopping or doing other tasks.  Don’t worry if that sounds overwhelming, you can start at the basics and decide if you want to level up your baby wearing skills.   So, what do I mean by baby wearing?  Well, there are many options available to parents today for how to wear their baby.

Carriers: The options come in a variety of price ranges from around $30 – over $200.  If you are crafty you can find DIY instructions online to make most types of carriers and then the key is just finding the right fabric.  If you are buying a used carrier be sure that the carrier meets the USA safety standards and hasn’t been recalled.

You have five types of carriers to choose from

  1. Wraps – Various lengths and fabrics, good for carrying infants – toddlers. You can carry your child on your hip, front, or back so it is very versatile but it does have a learning curve as the long length of fabric can be a bit overwhelming at first.  (This was my favorite option for my kids once I got the hang of it.)
  2. Ring Slings– Made of nylon or metal rings with a long fabric looping through. These are adjustable so as baby grows you won’t need a different size.   One end of the fabric is longer and called the tail and can be used to cover your baby, or an older child can hold the tail as you walk along.
  3. Pouch Slings- These are the easiest to DIY.  A simple loop of smooth fabric that you can pop on and off for quick use.  It isn’t as supportive to your body as other carriers and so your shoulder may get tired if you are wearing it for long periods of time. These are sized specific to your child and so they will be outgrown.
  4. Mei Tai- This consist of a panel of fabric with two shorter strips of fabric that tie around the waist and two longer straps that go over the shoulders.  Ideal for babies and toddlers, front or back carrying is most common with these.
  5. Buckle Carriers– These are a great option for family members who want to wear your baby but don’t want a lesson.  They snap on easily and provider support by going around the waist and shoulders much like the Mei Tai.  You can carry infants to toddlers depending on the brand.

Each has their own advantages and I highly recommend finding a local baby wearing group where you can test them out for yourself and get a lesson.  These meetings are usually free and a great way to meet other parents.

Most doulas are also a great help on figuring out how to use your carrier so be sure to ask them.  Practicing prenatally with a doll may be a lot less intimidating when you are first starting out.

Resources:  Babywearing International Eugene/Springfield Babywearing Network


Hunziker UA, Garr RG. (1986) Increased carrying reduces infant crying: A random-ized controlled trial. Pediatrics 77:641-648
“Current knowledge about skin-to-skin (kangaroo) care for pre-term infants”. J Perinatol. 1991 Sep;11(3):216-26.
Pelaez-Nogueras M, Field TM, Hossain Z, Pickens J. (1996). Depressed mothers’ touching increases infants’ positive affect and attention in still-face interactions. Child Development, 67, 1780-92.
Tessier R, M Cristo, S Velez, M Giron, JG Ruiz-Palaez, Y Charpak and N Charpak. (1998) Kangaroo mother care and the bonding hypothesis. Pediatrics 102:e17.

Shadows Covering Joy

anxietyAs an expecting parent you may have heard about the baby blues, the emotional roller coaster that comes in the immediate postpartum days.  There has also been more talk lately about postpartum depression.  Today, I want to shed light on something else.  What if you aren’t feeling sad,  but instead you are constantly on high alert, constantly worried that something bad will happen?  Maybe your heart races, you feel dizzy or nauseous. Sleep disruption and loss of appetite.  You can’t sit still as your mind races.  You could be part of the 6% of pregnant parents  or 10% of postpartum parents who suffer from anxiety.  Some have anxiety alone and others have it paired with depression.   This can occur during pregnancy, or even months after the birth of your child.

If you are expecting a child and wondering if you are at risk, risk factors include a family history of anxiety, previous depression or anxiety, or a thyroid imbalance.   If you know you are at risk you can be proactive and join support groups early or have family or friends help out and keep watch for symptoms as they may notice before you do.

For some parents, in addition to generalized anxiety, they may have more specific forms such as Postpartum Panic Disorder.  This is a form of anxiety where you may feel very nervous and have reoccurring panic attacks.  When a panic attack is happening people may experience shortness of breath, heart palpitations, chest pain, claustrophobia, numbness and tingling of extremities.   The attacks can come and go in waves and feel very scary but they can not hurt you.  This is of course something to talk to your doctor about, and  I highly recommend seeking out therapy for coping techniques and reduction of panic attacks.

Another form of postpartum anxiety is Postpartum Obsessive Compulsive Disorder.  It is estimated that 3%-5% of new parents will experience this.  It includes repetitive and intrusive thoughts or visions that are very frightening and disturbing and come to mind randomly. Often parents don’t mention the thoughts that go along with this disorder because they fear judgement from others.   Research has shown that these thoughts are anxious, not delusional and have a very low chance of being acted out.

The good news is that things do not have to stay this way.  Your entire parenting experience doesn’t have to continue down a worried and anxious path.  It is time to take it seriously and reach out for help.  Locally, in Oregon we have WellMama. They offer support groups and a warm line where a trained professional will call you back.  Therapy can also be extreamly helpful but be sure to go to someone who works with postpartum anxiety. Ann Tepperman, is someone in Lane County who has experience.  To find groups in other areas of the US and Canada you can visit Postpartum Progress.  If you are feeling overwhelmed you can send me an email with your location and I will help you find resources.

Just remember that these fearful thoughts, and even scary visions do not make you a bad parent and you won’t feel this way forever.