I have a little experience having a big baby, this turkey sized human is mine, born at 38 weeks!  Typically, big babies are a result of Diabetes, Gestation Diabetes, a pregnant person gains an abnormal amount of weight during their pregnancy and good old genetics.  The above turkey/baby won the genetic prize.  I was a 9.5 baby, my husband an 11 pounder.  I wish I knew the facts that I now know.  I would have made much more informed choices.  Let me share this information with you.

Things to know if have you been told by your provider that they suspect you are carrying a large baby:

* Ultrasounds are notorious for poorly estimating a suspected big baby's weight, about half of the time they are right, and the other half they are wrong!
* Many studies have shown that the “suspicion” of a big baby increases the risk of having a Cesarean without improving the health of mother or baby. If  your doctor thinks you are having a big baby, they are more likely to diagnose your labor as stalled, or pressure you into a Cesarean, compared to a woman who has a big baby but that wasn’t suspected as such. About half of the time when they suspect a big baby, the prediction will have been wrong. 
evidencebasedbirth.com/wp-content/uploads/2018/01/Big-Babies-Handout.pdf
​* If you have Diabetes or Gestation Diabetes, having well controlled blood sugar levels throughout pregnancy means you are NOT at increased risk of having a big baby.
* A suspected big baby is not an indication for induction, even with well controlled GDM.  If you are have other risk factors related to GDM, an induction may make sense.  But not always.

So you might wonder about the dreaded factor that leaves providers shaking in their boots..... the dreaded shoulder dystocia.  Yes large babies have an increased risk of shoulder dystocia.  But since ultrasounds and providers are not great at predicting large babies, no provider actual KNOWS when this complication will arise.  It also happens all the time with smaller babies.  

Sound passionate about this issue? I am!  I want families to have all the facts, not fear-based bias when making informed choices.  Do your research, ask all the questions, know the stats and then advocate for the decisions you have made for yourself.  I will be doing the same for my clients.

So you've read a lot of books, maybe you've taken a prenatal education class, talked to family and friends, downloaded apps, taken a breastfeeding prep. class and of course Goggled eight million things about labour and birth.  In my experience, more families are concerned about having the "stuff" they need for their new baby, rather than preparing to care for their new baby and what that might be and feel like.

Some quick facts about new babies:
*they smell amazing
*they bring joy and excitement to your life
*you never realized how deep your love for them would be
*they are exhausting
*being a new parent will challenge your sanity
*they completely change the dynamic of your household 

Families need a postpartum plan, I have a blogged about this before.  But I want to focus on the ways a Postpartum Doula can help you deal with the new normal.  The day I brought my daughter home, it felt like bringing home an elephant!  This overwhelming sense of "what the hell do we do now?"  I couldn't wait to get home with her, but I was completely unprepared for the unsettling feelings that this monumental life shift brought.  A good Postpartum Doula is someone who sprinkles a  bit of magic. Someone who validates and normalizes your feelings, reminding you that every parent has felt this way.  Someone who cooks a meal and cares for your baby while you nap, shower or maybe just rest.  Someone who can help with breast/chest or formula feeding, prepares snacks, makes sure your fed, changes diapers, bath's baby, shows you how your breast pump works, folds your baby laundry and provides up to date infant care information. (No Nana, no more baby powder or cereal in a bottle of milk:) Someone to remind you that you are doing an amazing job during an extremely challenging time.  

We have never lived so far from our families and Covid has shed light on how little support there is for new parents.  Hiring a Postpartum Doula is definitely a luxury for some, I get that.  But this comes back to having a postpartum plan.  Prioritize the funds that you have.  You might find sacrificing $300 on baby gadgets that you likely won't need,  gets you three days of help in those early days when it's so needed.  Also, a fund for a Postpartum Doula makes a great shower gift instead of getting 20 fuzzy blankets.  We all need support, now more than ever!

Ah,  the membrane sweep.  What is it exactly?  Also referred to as a stretch and sweep or membrane stripping. It is a technique that involves gently lifting the amniotic sac away from the cervix and the lower part of the uterus. Your doctor or midwife inserts a gloved finger through the cervical canal and uses a sweeping motion to separate the membrane from the cervix. This intervention releases prostaglandins, which are the chemicals that help soften and open the cervix for labour.  Most providers will offer you a sweep in late pregnancy.  Remember, it is your choice and it should never be preformed without your explicit consent!

What are the risks and benefits of the sweep?
Risks 

• It can be uncomfortable, or downright painful for some
• May cause spotting and light bleeding
• Can cause cramping
• May take several tries 
• It often is not effective if preformed before 39 weeks
• On rare occasions your provider breaks your bag of waters by accident

Benefits

• It is a drug free option
• It is a generally safe option
• If your body is close to spontaneous labour, it may prevent a formal medical induction

So the take-away really is, getting an early sweep will likely just be uncomfortable and make you feel crampy without any real benefit.  After 39 weeks a sweep(s) can be helpful if you want to avoid a medical induction or get spontaneous labour kick-started.  Just remember, there are no guarantees.   

Why is it good to labour at home as long as possible?  So many reasons, early labour can be long, the hospital won't admit you until you are in active labour (sorry....no epidural yet!), you are comfortable, less anxious, you can eat, drink, be in your own bed and personal space.  

So what are the things that you can be doing at home so you get to the hospital in active labour?

• Ignore early labour contractions as much as possible.  They will be annoying and uncomfortable at times, but they might hang around for awhile.  Go about your day, if things pick up in intensity, you won't mistake it.  Just don't wander too far from home!
• Rest, rest, oh and did I say rest?  Sleep when you can, and if you can't, try and just relax and chill.  Everything is happening in it's own good time.
• Take a bath.  Hydrotherapy has long been used in early, active labour and birth as a form of pain management.  In early labour it can be relaxing and soothing.
• Don't worry about timing contractions, you will know when they get longer-stronger and closer together, there's no question about that.  Early labour can last days (sorry, unfun fact), and even if it doesn't, contractions will rarely be patterned for awhile.  It is super common for surges to start and stop repeatedly.  Try and expect and except that this is part of the process.
• Eat and drink normally, please, please do this.  You will need calories for labour and pushing.  This is often restricted in the hospital, so please, fuel up.
• Call your Doula!  I know I am happy to pop by, bring my TENS and give moral support and  a hip squeeze to two....or a thousand.

Having said all this, never hesitate to check with your provider or head into ELAU if you need to.  But know that your body and baby are doing their job and if you can labour at home if all is well until active labour, your time on the birth unit will be reduced and your progression might be faster.

Photo Copyright the VBAC Link

This is probably the most asked question from birth clients.  I am having cramping, is this labour?  I am pooping a lot, is this labour?  I think this is bloody show, has labour started?  I think I lost my mucous plug (please for the love of the universe, do not Goggle image mucous plug!!), this must be labour.  Most of these indicators are great signs that your body is preparing for labour, making the necessary changes for labour, that labour is getting close.  But that might mean tomorrow or in 10 days!  So my answer is typically.....maybe!

You've waited so long to meet your baby, you are anxious to know for SURE that this indicator is it.  And it might be, but it also might not.  I am a Doula, not a Midwife or an OB, I don't perform clinical tasks, I cannot check the position, softness or dilation of your cervix.  But all these indicators mean that labour is coming, sooner rather than later.  But here is what I know for sure.  When you are in active labour, you will KNOW it!  It will stop you in your tracks. Early labour contractions are annoying, but typically you will able to go with your day, eat, move, talk, etc.  Active labour contractions will be different, you will unquestionably know the difference, they will be longer, stronger and closer together.  You won't be able to concentration on other things when you have active labour contractions.  They will get increasingly more intense, and even more so with transition.

If you first time parents need a goal to focus on, try this...5-1-1.  Contractions that are five minutes apart, lasting for at least one minute and have been occurring for at least one hour.   This is a good time to call your provider for next steps.  Second + pregnant folx should probably head to the hospital or call your Midwife a little before the full hour as these labours tend to move faster.  

Trust your body, trust that you will know that this is the real deal, because you and your body will know!

So you've decided to hire a Doula to support your pregnancy, labour and birth,.....might I add, you've made an excellent choice!

While Doulas are becoming more mainstream, as the benefits become more widely solidified and known, there are a surprising number of us.  So choosing the right fit for you can be overwhelming.  I want to help you make this important decision.  Here are my top tips;

• Don't interview too many people. Faces will start to blend together and you might get lost in the weeds trying to decide.  My advice, interview 2 or 3 people.  Then interview more if you really don’t feel great about anyone you’ve met.
• Focus on the feel!  The feel is more important than how many births someone has supported or what organization they trained with.  A good connection is the foundation of the relationship you and your partner and your Doula will form.  The Doula's energy and presence should help you relax and instill confidence.
• What is the Doula's birth philosophy?  A Doula should be objective and not have an opinion on how you should labour or birth your baby.  A Doula provides current evidence-based information and helps parents build and support the birth plan that works for you!  A Doula cannot guarantee specific birth outcomes, but they should be doing their very best to help you achieve your birth goals,  and have the flexibility to help you adjust to any unforeseen changes.

Having a Doula improves outcomes and enhances your birth experience.  Don't overthink it, follow your intuition and you will find the right Doula for you!

I have heard many an expectant folk say, "why do I need a birth plan?" "It makes you sound demanding," or my personal favorite, "I don't need one, I'll be fine!"  Birth is better with a plan, or at least with clear wishes or preferences.  It's not that medical providers don't care about your wishes, but the reality is, when you get admitted to a hospital, you are now a patient and you will be offered medical choices!  Your providers won't know your wishes, unless you do.  My advice, write it down.

Having a birth plan, encourages you to think about what your options really are, and you do have options.  What if I told you that you don't need to have that icky IV port right away, you can have it later if you choose to have pain medication.  Or, that often you can have intermittent fetal monitoring rather than continuous monitoring.  That in fact, continuous fetal monitoring increases cesarean rates.  Also, pushing does not have to be the ever enjoyable counting to ten, three times per contraction.  Yes, some people giving birth will want/need some direction, especially if you've had an epidural.  But the fetal ejection reflex is pretty powerful, people in coma's have pushed out babies.  

Long story short, a birth plan, allows you to explore what is available to you during your labour and birth, discover the risks and benefits and make informed decisions that will enhance your birth experience.  You want your birth memories to be of you making decisions, not having them all made for you.​

Do you know about the hormones of labour and how you can help them along for a smoother labour?  Well, Doulas do! Childbirth Educators do.  So let me share some insider tips.  There are a multitude of hormones that play a key role in becoming pregnant, sustaining a pregnancy, birthing your baby and breast/chest feeding.  But for labour purposes, let's focus on the heavy hitters, and what you can do keep the wanted ones flowing and keep the unwanted ones at bay until they are needed.
Oxytocin- sometimes called the love hormone, it plays a super key role in labour.  Oxytocin is produced in the hypothalamus and released into the bloodstream by the posterior pituitary gland.  Oxytocin is what makes your uterus contract during labour.  This helps your uterus pull up the cervix to dilate and push your baby down towards the birth canal.  So pretty crucial right?  So, how can you influence the flow of oxytocin in labour?  

• Create a space for yourself during labour.  My best tip, stay at home as long as you can.  In your own space you are comfortable, more relaxed, can move around as you please, EAT, drink and be close with partners and loved ones.  All of this helps keep the oxytocin flowing.
• In the hospital environment, keep the space quiet, dimly lit, as calm as possible.  Wear your own clothes, bring your own scents and pillows if you want.  Ask that anyone who doesn't absolutely need to be in that room to stay out!  Make sure your birth team and providers are clear about your wishes.

Prostaglandins- so not technically a hormone, but work in tandem with your hormones to get your body ready for birth.  Prostaglandin's do all kinds of cool things, they help uterus be more accommodating to the influx of those oxytocin receptors, give you those awesome pre-labour poops and help relax the uterus for labour.  Most importantly, are responsible for softening the cervix so it can dilate. A tip for helping prostaglandins along?

• Semen is really high in prostaglandins, so if you have a male partner, after 37 weeks, having sex can really help your cervix along.  Don't feel like it?  Don't worry, you'll get their either way!
  

Catecholamines- these are your fight/flight/freeze hormones.  These are the ones you want to keep at bay until you reach the pushing phase.  During the second stage of labour, catecholamines will give you the needed surge of energy to push your baby out into the world.  Your baby will also produce these hormones as they get ready to be born, it helps them take their first real breath.  So, you are wondering, how do I stave these off?

• Broken record, but labour at home until you can't.  Being in your home environment (as long as it's a place of comfort for you) will help you stay more relaxed.  Transferring to the hospital too soon can activate your catecholamines, which can actually slow or stop contractions. 
• Having coping techniques ready (epidural or no epidural), a hospital environment can be very jarring for some people.  Having techniques to keep you breathing deep, slow and steady will help keep you in a good head space.

What a time to have a baby!  As the pandemic and our second wave rages on, expecting parents are awaiting the birth of their babies.  Talk about stressful.  Well let's talk about keeping life as simple as possible to help new parents keep their sanity.

We often think that babies require soooooo much stuff, and they definitely require plenty, but not as much as we sometimes think.  Parents look online at a million websites for what your baby will need, friends and family tell us all about the items that you "must" get.  But in reality babies needs are pretty basic, food, shelter, safety and love.  In these times when life is super complicated and we are swimming in what feels like time soup, don't make yourself crazy with stuff.  As a mother, a Birth and Postpartum Doula, here's the list I give clients as must haves for a newborn:
* Sleepers
* Change pad
* Diapers (cloth or disposable)
* Dye and perfume free laundry soap
* 4-5 Muslin blankets (can also double as burp cloths)
* Safe sleep surface (crib/bassinet or Moses basket)
* Safety approved car seat
* Stroller or carrier
* Feeding supplies (pump and bottles for breastfeeding) and (formula/bottles/nipples & brush for       formula feeding), breast pads and nipple cream
* Soothers (you might change your mind!)
* Swaddle blanket
* Sleep sack
* Barrier cream for baby's bum, scent free baby mositurizer
* Baby tub and gentle soap/shampoo, baby hair brush
* A higher end thermometer for accurate temperature taking
* A list of all important phone numbers, such as the IWK, Healthcare Provider, Public Health and Breastfeeding support if that's your intended method of feeding.

While this list seems long, it's really pretty basic.  Toys, books, bumbo chair, swings, playpen, highchair, play mats etc.  All these things you can borrow or purchase as your baby grows.  In those early days and weeks your baby just needs to be loved, fed, kept clean, warm and sleep in a safe place.  You can add more items as time goes on, but the early goals should be to take care of your needs and your baby's needs.  The "stuff" doesn't need to add to the already wild ride of bringing home your baby.  Sometimes less is more.