Post Partum Care

Mamas on Bedrest: DOULAS SHOUL BE PRESENT AT ALL BIRTHS GLOBALLY!

April 6th, 2017

When people ask me what I think about doulas, I simply say,

“Doulas are an invaluable part of the birthing team and I wish I had had not one but two doulas when I was having my children, especially my daughter! We needed one doula for me and one for my husband!”

Doulas are birth attendants, typically women, who stay with a woman providing support, encouragement and non-medical pain relief and comfort measures to childbearing women during labor, delivery and in the early post partum. The World Health Organization has added their endorsement of birth attendants (doulas) by recommending that, “Birth Attendants be present at ALL BIRTHS GLOBALLY,” as part of the WHO Safe Childbirth Checklist Implementation Guide. This is huge, not only for those of us who are doulas and know the invaluable role we play in supporting mothers during pregnancy, labor and delivery and in the immediate post partum period, but also for mothers who may not know about doulas, or who may have been on the fence about getting a doula.

Research on the efficacy of doulas shows that when childbearing women have doulas attend their births they have:

  • Decreased overall cesarean rate (down 50%) and they are less likely to have a cesarean section delivery or other invasive interventions.
  • Shorter labors (decreased 25%)
  • Decreased use of oxytocin by (decreased 40%) a medication used to start or hasten labor.
  • Decreased requests for an epidural or other pain medications by 60%.

Doulas attend to mothers and/or couples primarily during childbirth and in the early post partum period. However, there are ante partum doulas (Mamas on Bedrest & Beyond for example) who attend to mothers who are experiencing complications prenatally and who need additional support. Prenatally doulas offer non-medical supportive care such as helping mothers on bed rest become more comfortable, attending to home duties, offering resources and tips for comfort and support, emotional support, family support, childbirth education, and lactation support and education.

Many people are under the mistaken impression that doulas are only for women having “natural” (vaginal) or home births. Doulas attend all types of births, in all types of settings; home births, hospital births or birthing centers. Additionally, doulas are as beneficial to women having cesarean sections as they are to women having vaginal births. Doulas are particularly under utilized by high risk pregnant women and yet this group stands to benefit the most from the support and emotional care.

Mamas on Bedrest, you can and should consider having a doula present at the delivery of your child-even if the father is present. This well trained, impartial birth professional can act as your advocate and as a bridge to the health care system and to providers when you are unable to advocate for yourself. They can help explain procedures, assist in getting you information on certain proposed procedures and treatments and can help be sure that you are giving informed consent when you sign forms. Doulas are present first and foremost for the mother and the needs of everyone else in the family or on the healthcare team are secondary. Doulas DO NOT MAKE MEDICAL DECISIONS for their clients, but rather hold a space so that a woman and her partner (if present) can determine the best course of treatment for them based on all the available information.

The doula model has been present historically as far back as Biblical times (Exodus 1:15-21) when women of a family or tribe attended to a birthing woman and made sure that her children and husband were fed and cared for. Doulas and Midwives nearly became extinct during the middle and latter part of the 20th century with the advent of hospital labor wards and the specialty of obstetrics. There has been a resurgence in doula use during the latter part of the 20th century and now in to the 21st century. Unfortunately, the use of Doulas has been limited to women of means as they have been the only ones able to pay for a doula as insurance companies have yet to agree to reimbursement.

But there is good news. There are many doula services that offer a sliding scale or are being reimbursed by Medicaid such that ALL women can receive this potentially lifesaving care. In Austin there are the following groups offering low or no cost doula services.

Austin

Giving Austin Labor Support (GALS)– A non-profit organization that supports women with limited or no resources for doula care so that “No woman gives birth alone.”

Mama Sana/Vibrant woman-a grassroots organization of low income women of color serving women in the community with prenatal, birth and post partum reproductive health support.

Outside of Austin, there are several programs around the country serving women from all income backgrounds:

Ancient Song Doula Services– A non-profit organization in Brooklyn New York serving low income women of color.

The Pettaway Pursuit Foundation-Located in Pennsylvania, this non-profit organization specifically attends to high risk pregnant women on prescribed bed rest. A team of contracted doulas provide care and the organization has contracts with several managed care organizations for reimbursement.

Mamatoto Village– This organization also provides very high quality birth assistance and also has its own training program for its staff.

Uzazi Village – This non-profit organization provides doula services to low income women of color in the Greater Kansas City Missouri area, and has another location in St. Louis Missouri. They also provide doula training, childbirth education, reproductive health education and lactation services. They are also now beginning to train midwives.

These are just a few of the organizations that I know of providing doula services. There are others and I am sure many more that I don’t know about. The point I wish to make is that if you would like a doula to attend your birth with you, there is likely a doula organization or solo doula that can help. Mamas, don’t forgo this vital source of support. Doulas really do make births better!

Looking for a doula? e-mail info@mamasonbedrest.com and we’ll do our best to help match you with a doula.

Know of a doula that is excellent at what she does and serves women in need? Share her information here and we’ll start a running list of doulas that are serving low income.

Know of a doula organization that offers services at low or no cost? Let us know so we can share this information.

Did you have a doula at your birth? Please share your experience in the comments section below.

Mamas on Bedrest: Why there is a need for “Black Breastfeeding Week

August 18th, 2016

Hello Mamas,

Black Breastfeeding Week is August 25-31, 2016. Many may be asking, if August is Breastfeeding Awareness Month and August 1-6 was World Breastfeeding Week, why is there a need for a Black Breastfeeding Week???

According to organizers Kimberly Seals Allers, Kiddada Green and Anayah Sangodele-Ayoka,

Black Breastfeeding Week was created because for over 40 years there has been a gaping racial disparity in breastfeeding rates. The most recent CDC data show that 75% of white women have ever breastfed versus 58.9% of black women. The fact that racial disparity in initiation and an even bigger one for duration has lingered for so long is reason enough to take 7 days to focus on the issue.”

And the organizers cite 5 specific reasons a Black Breastfeeding week is essential:

  1. The High Black Infant Mortality Rate
  2. High Rates of Diet Related Disease in African Americans
  3. Lack of diversity in the lactation field
  4. Unique cultural barriers among black women
  5. Desert-like conditions in our communities

If you ask any black breastfeeding expert what are the top barriers to breastfeeding for black women, they will reply:

  1. The historical role of black women as “wet nurses” to white (slave owner’s) children
  2. The perception by many black people that breastfeeding is “dirty” or “nasty” (the result of #1)
  3. The aggressive campaign by formula companies who capitalized on the notion that “poorer women” breastfeed and modern women of means used formula.
  4. Hospitals that serve primarily black patients have been shown not to offer the same level of support and education for breastfeeding initiation to black women
  5. Few professional black lactation consultants
  6. The lack of support from family members for breastfeeding

It has to be recognized that breastfeeding has very different implications for black women than for white women and lactation consultants trying to counsel black women to breastfeed must be aware of the cultural history of breastfeeding for black women. They need to be aware of the fact that many black women have no breastfeeding role models as their mothers, grandmothers, sisters and aunts may not have breastfed their babies. Without the family tradition of breastfeeding, and the history of the “mammy” wet nurse, many black women lack breastfeeding support and encouragement from their families and are not eager to breastfeed themselves. Many black women work at jobs where they may not be able to take time to nurse or pump, nor do they have a private place to nurse or pump at work. For these reasons in particular and many others, it is imperative that more black women become trained as lactation consultants. Certification to become an Internationally Board Certified Lactation Consultant (IBCLC), the top credential for lactation consultants, is such a rigorous and expensive endeavor, and many black women who want to become certified state they cannot afford to undertake the process.

So while there are many challenges that face black women who choose to breastfeed and Sellers, Greene and Sangodele-Ayoka-like many other black women who are well versed in the benefits of breastfeeding for back women-have taken it upon themselves to create an organization that promotes breastfeeding and where they can provide information, education, support and resources for black women who want to breastfeed.  

In counseling black women to breastfeed, highlighting the benefits of breastfeeding is a potent motivator. Breastfed babies are:

  • Less likely to have allergies and asthma
  • Less likely to have upper respiratory and ear infections
  • Less likely to have weight problems as adults
  • Less likely to develop Type 2 Diabetes
  • Able to self soothe/are less fussy
  • Have less stomach upset (and less incidence of Necrotizing Enterocolitis)
  • May have increased intelligence
  • Less likely to die from Sudden Infant Death Syndrome (SIDS)

And breastfeeding greatly benefits Mamas, Too!

  • Mamas who breastfeed tend to return to their pre-pregnancy weight sooner
  • Mamas who breastfeed experience decreased incidences of breast and ovarian cancers
  • Mamas who breastfeed experience decreased incidences of Type 2 diabetes

Before being brought to this country as slaves, black women successfully breastfed their babies. Unfortunately, the legacy of slavery and many current socioeconomic and cultural barriers have made breastfeeding a difficult process for many mamas. It is imperative that these barriers be eliminated and that the education, support and resources be made available so that black mamas and their babies can reap the many life enhancing benefits of breastfeeding.

My Breastfed babies then…..

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My kids just days after the birth of my son.

And Now!!

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References:

http://blackbreastfeedingweek.org/

https://historyengine.richmond.edu/epsiodes/view/2901

www.bbc.com/news/blogs-magazine-monitor-27744391

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6205a1.htm

http://www.webmd.com/women/news/20140821/racial-disparities-in-breast-feeding-may-start-with-hospitals-study-suggests

www.huffingtonpost.com/2014/08/27/black-mothers-breastfeedi_n_5721316.html

http://www.ncbi.nlm.nih.gov/books/NBK52688/

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6333a2.htm?s_cid=mm6333a2_w

http://womenshealth.gov/publications/our-publications/breastfeeding-guide/breastfeedingguide-africanamerican-english.pdf

http://www.womenshealth.gov/breastfeeding/breastfeeding-benefits.html

 

 

 

 

 

Mamas on Bedrest: It’s National Breastfeeding Awareness Month

August 4th, 2014

nursing infantGreetings Mamas!!

August kicks off National Breastfeeding Awareness Month here in the US. Officially designated on August 6, 2011 by the United States Breastfeeding Committee (USBC), the month of educational and promotional activities is designed to raise awareness of the benefits of breastfeeding-physiologically for mamas, developmentally for babies, emotionally for both and economically for families.  Here is the full proclamation. Breastfeeding has been reported to have the following benefits. In Babies

  • Breast milk is widely acknowledged as the most complete form of nutrition for infants, with a range of benefits for infants’ health, growth, immunity and development. (Healthy People 2010, Centers for Disease Control and Prevention, Atlanta, Georgia)
  • Breast-fed children are more resistant to disease and infection early in life than formula-fed children. Many studies show that breastfeeding strengthens the immune system. During nursing, the mother passes antibodies to the child, which help the child resist diseases and help improve the normal immune response to certain vaccines. Breast-fed children are less likely to contract a number of diseases later in life, including juvenile diabetes, multiple sclerosis, heart disease, and cancer before the age of 15
  • Breastfed babies are less likely to be obese as adults
  • Breastfeeding has been shown to reduce the likelihood of ear infections, and to prevent recurrent ear infections. Ear infections are a major reason that infants take multiple courses of antibiotics.
  • Researchers have observed a decrease in the probability of Sudden Infant Death Syndrome (SIDS) in breast-fed infants.
  • Another apparent benefit from breastfeeding may be protection from allergies. Eczema, an allergic reaction, is significantly rarer in breast-fed babies. A review of 132 studies on allergy and breastfeeding concluded that breastfeeding appears to help protect children from developing allergies, and that the effect seems to be particularly strong among children whose parents have allergies.

In Mamas

  • Breastfeeding helps a woman to lose weight after birth.
  • Breastfeeding releases a hormone in the mother (oxytocin) that causes the uterus to return to its normal size more quickly.
  • When a woman gives birth and proceeds to nurse her baby, she protects herself from becoming pregnant again too soon, a form of birth control found to be 98 percent effective — more effective than a diaphragm or condom. Scientists believe this process prevents more births worldwide than all forms of contraception combined. In Africa, breastfeeding prevents an estimated average of four births per woman, and in Bangladesh it prevents an estimated average of 6.5 births per woman.
  • Breastfeeding appears to reduce the mother’s risk of developing osteoporosis in later years. Although mothers experience bone-mineral loss during breastfeeding, their mineral density is replenished and even increased after lactation.
  • Diabetic women improve their health by breastfeeding. Not only do nursing infants have increased protection from juvenile diabetes, the amount of insulin that the mother requires postpartum goes down.
  • Women who lactate for a total of two or more years reduce their chances of developing breast cancer by 24 percent.
  • Women who breastfeed their children have been shown to be less likely to develop uterine, endometrial or ovarian cancer.
  • The emotional health of the mother may be enhanced by the relationship she develops with her infant during breastfeeding, resulting in fewer feelings of anxiety and a stronger sense of connection with her baby. Breastfeeding has also been shown to reduce the incidence of post partum depression in mamas. (See our posts on Breastfeeding and Post Partum Depression!)

August 1-7, 2014 is also World Breastfeeding Week. Coordinated by the World Alliance for Breastfeeding Action (WABA), the theme for this year’s week of awareness is to impress upon everyone importance of increasing and sustaining the protection, promotion and support of breastfeeding. Breastfeeding is one of the methods advocated in the Millennium Development Goals, developed in 1990 by the United Nations and affiliated governments to help fight poverty and promote healthy and sustainable development in a comprehensive way by 2015.

wbw2014-objectives According to the WABA breastfeeding and the Millennium Develoment Goals are intricately linked, “The Millennium Development Goals (MDGs) are meant to be achieved by 2015 – next year! Although much progress has taken place, there is still a lot of “unfinished business”. Here are some examples: Poverty has gone down, but 1 in 8 people still go to bed hungry. Undernutrition affects about a quarter of all children globally. Overweight, the other form of malnutrition is becoming more common too. In the last 2 decades, child mortality has decreased by about 40%, but still almost 7 million children under five die each year, mainly from preventable diseases. As the overall rate of under-five mortality has declined, the proportion of neonatal deaths (during the first month of life) comprises an increasing proportion of all child deaths. Globally, maternal mortality has declined from 400 per 100,000 live births in 1990 to 210 in 2010, but fewer than half of women deliver in baby-friendly maternities. By protecting, promoting and supporting breastfeeding, YOU can contribute to each of the MDGs in a substantial way. Exclusive breastfeeding and adequate complementary feeding are key interventions for improving child survival, potentially saving about 20% of children under five. Let’s review how the UN’s Scientific Committee on Nutrition illustrated how breastfeeding is linked to each of the Millennium Development Goals.” So breastfeeding can go a long way to not only benefitting the health of mamas and babies individually, but help reduce poverty, malnutrition and infant and child mortality globally. If you are considering breastfeeding and want more information, the links in this post are from some of the best resources globally, especially if you want to take on an advocacy role. If you want more specific personal information on breastfeeding, I suggest you contact your local La Leche League. These folks really know breastfeeding!! They offer a plethora of information on their website, have many books on breastfeeding available for purchase and do phone and often in person consultations. You can also check with your healthcare provider and local hospital for referrals to lactation consultants who can assist with breastfeeding.   Do you have more questions? Join Bedrest Coach Darline Turner for a one hour Q & A session during the Free Third Thursday Teleseminar, August 21, 2014, 1:00-2:00pm ET. She will field any and all questions relating to bedrest, pregnancy and post partum. You can join the conversation live or submit your questions up to 24 hours before via e-mail at info@mamasonbedrest.com. Join our interactive bed rest community on Facebook and chat with mamas globally on all things bed rest! Finally, Get your copy of the e-book From Mamas: The Essential Guide to Surviving Bedrest! This guide will help you not only survive bedrest, but THRIVE on bedrest! Order your copy now on Amazon.com   Other Resources: Natural Resources Defense Council 101 Reasons to Breastfeed Your Child