Birthing Choices in Portland

Portland is great, for a number of reasons, right?  It is a great place to bike, be close to nature, shop at farmer’s markets, go paddling, take the bus, run into your friends at the grocery store, AND give birth!  We have a lot of different options in the Portland area, which means all families get to chose what works best for them.

Portland is home to numerous hospitals, a couple free standing birth centers, and many midwives.  So, what is the difference between all these options and what does each options look like for your birth?

Hospital

Well, the first option is the standard one that most Americans still go to for giving birth, and the majority of Portlanders do too- the hospital.  We have some great hospitals and each one has its own flair.  You could go down the standard American route and see an OB doctor for all your prenatal appointments.  This is a good option for someone who has some high risk factors, like diabetes needing insulin treatment, among other risk factors.  Often the doctor works in a group practice and takes turns being on-call fonewborn in hospital r deliveries.  Some doctors have multiple hospitals they deliver at while other doctors only work at specific hospitals.  Make sure to get to know the doctors in your group practice as well as taking a tour at the hospital that they deliver at.

Another option in the hospital is to work with Certified Nurse-Midwives (CNMs).   Like an OB practice, CNMs work in a group and you get to see different CNMs in that practice during your pregnancy.  Whoever is on-call during your delivery is the one you’ll get!  CNMs practicing in the hospital setting work under different protocols than homebirth midwives, as they are under the direct supervision of the hospital OBs and their protocols.  Hospital based CNMs are perfect for low risk clients who are most comfortable delivering in a hospital but want a natural birth and/or trying for a lower intervention birth.  The Portland hospitals currently that have CNMs on staff are Providence Portland, OHSU and Legacy Emanuel.  Some of the hospitals allow for laboring in the birthing tubs with the midwives and provide telemetry units that allow movement while still being monitored.  Providence Portland also has a doula program that works with the families that are under the CNM care.

Birth Center

For families that are unsure where they want to give birth, but leaning towards out of hospital, a free standing birth center could be an option.  In Portland there are now 4 birth centers that are not in the hospitals and are staffed by a combination of midwives.   Most of the birth centers are staffed by midwives on rotation, like the hospital CNMs, so you don’t have continuity of care (like with home birth midwives), but many practice differently than the stricter protocols from the hospital.  There are CPMs/LDMs, CNMS, and ND midwives at the area birth centers.  The birth centers are made to resemble more of a home like setting than a sterile hospital environment.  All of them have birthing tubs that you can labor in and at least two of the centers you can stay and birth in them.  This middle ground is great for families that want a natural birth (no epidurals here!) but aren’t ready to commit to a home birth.

Homebirth

And then there are homebirths!  We, of course, love homebirths but completely acknowledge that it’s not the place for all families.  And that is OK!  It’s important to give birth where you are comfortable and where is the safest for your pregnancy, birth, baby, and set of risks.  Homebirths are not for women who are high risk.  But, if a woman is low risk and wanting a natural birth with her loved ones, pets, candles, pillows,  and kids around her then this is her best option!  A home birth is nice because you don’t have to leave your house in labor or get in the car with a tiny, new human being.  You have all your own things and can eat out of your own refrigerator (yes, we want you to eat in labor!).  There aren’t strangers coming into your room while you are in labor.  It also provides the best option for homebirth baby continuity of care and individualized care with midwives.  We bring all the emergency equipment to homebirths along with a whole bag of other supplies.  You also have the option to have an inflatable birthing tub which some women use just for laboring in and others give birth in it.  You have more options in your movement and birthing positions if you are at home.  We also come back to you three times in the first week postpartum, another great reason for a homebirth!  There are a lot of homebirth midwives in Portland so go ahead and interview a couple to find the right fit for you and your family if this is the option that best suits you.

It is important to know there are multiple birthing options and find the best match for you.  Just because your best friend had a homebirth doesn’t mean that’s right for you if you are worried to be out of the hospital.  Or just because your mother in law thinks all babies are born in the hospital doesn’t mean you shouldn’t look into a birth center or homebirth like you’ve been wanting to.  Go ahead, do some research, visit a couple places and talk to a couple providers and the right choice will present itself.

Happy birthing!

 

So, What’s the Difference between a Midwife and Doula?

As midwives and doulas, we get this question asked a LOT!

  “What does a midwife do that’s different than a doula anyways?”  “Do I need both?” “Do I need either?!”

Midwives and Doulas are very different but both work with pregnant families.  It can be confusing, especially when you turn towards the dictionary…

Definition of doula  

: a person trained to provide advice, information, emotional support, and physical

comfort to a mother before, during, and just after childbirth

Definition of midwife 

: a person who assists women in childbirth

So, really, what’s the difference you still ask?  That definition didn’t help at all!  Well, doulas do an amazing job at supporting pregnant and laboring families through physical comfort measures as well as emotional support.  They provide emotional and physical tools (calming visualizations, massage, breathing reminders, a calm presence, etc) that can help laboring people through the intense contractions and have support for their birth plan.  PNB doulas are trained through different teachings and have years of experience attending births.  They bring a lot of skill and compassion to all their doula families.  Our Portland Natural Birth doulas meet families in their homes at the end of their pregnancy to get to know them and help understand what the families’ needs and desires are for their upcoming birth.  Then, the doula is on-call for whenever the birth happens and goes with the birthing family to their pre-chosen birth place (home, hospital, birthing center) to continue supporting them.  Doulas are not medical professionals and support the families while their medical providers do the rest of the stuff…

Which brings us to midwives!  Midwives are medical providers that support birthing families wanting a more natural birth.  At Portland Natural Birth, we provide all your medical care for pregnancy, birth, and postpartum (through 6 weeks) for families wanting a homebirth.  There are some midwives that work in the hospital as well.  Midwives are trained in everything pregnancy and birth related and understand what a normal birth looks like.  Homebirth midwives are trained for those normal vaginal births as well as any emergencies that may arise and are either trained to take care of it at home (manage a hemorrhage, resuscitate a baby, give IV fluids in labor, etc) or know when to transport to a hospital swiftly.  For low risk people who want a homebirth, midwives can be their only medical provider they see their whole pregnancy.

“So, do I need a doula if I have a midwife?”

Maybe!  Now that you know the different responsibilities and jobs that midwives and doulas do, you know that homebirth midwives provide the medical care for birthing families and because they only work with one birthing person at a time they give their undivided attention to them.  But, it can still be nice to have a support person that is just there for your physical and emotional comfort.  Doulas are awesome at being with laboring families in that early labor time before a midwife comes to their home.  PNB midwives love working with our doulas and vice versa!

 

 

Doulas and Partners

A partner’s participation during labor is both irreplaceable and indispensable; nothing can replace that emotional connection between the couple. Partners are also navigating their own transition into parenthood during childbirth and may need support for themselves during this time. To help support both people on their individual and connected  journies, a doula’s work enhances this experience for the couple by providing neutral information and support to both people.

A partner is there for the laboring mother every step of the way helping her with physical and emotional support and “a doula compliments and reinforces that unique partner support,” says Kelley Burke, owner and doula at Portland Natural Birth.

The doula’s training, experience, tools, and skills gives partners permission to experience the labor and birth without feeling like they are fully responsible for everything that happens once labor begins. “As a doula I wear many hats during the time I’m working with a family. I learn the family’s communication style and see where there are places I’m needed to support both people,” continues Kelley.

It is common for partners to be concerned that hiring a doula might force them out of the picture or like they won’t be needed as much. Really, a doula is trained to work in collaboration with partners and enhance their experience; childbirth isn’t about a doula, it’s always focused on the entire family. A doula’s presence will compliment the partner’s ability to be present and attentive to the laboring mother.  

 

Pillars of Doula Support

The role of a doula is to provide continuous labor support at home, in the hospital, birth center, or  in the operating room. A doula facilitates and promotes informed choice and helps the birthing parent and family advocate for their needs in any birth setting.

At Portland Natural Birth, our doulas offer physical support through:

~ Massage and Comfort Care
Our doulas is a licensed massage therapist and can provide a variety of bodywork techniques to promote relaxation in early labor, soothe areas of tension during active labor, and promote pelvic/baby alignment so your birth has the best possible chance of progressing smoothly.  Massage during labor can relax the birthing body and release pelvic ligaments, making for a faster and less painful birth.

~  Water therapy
Doulas understand when to utilize certain tools like a warm shower or tub soak to provide the pain relief and rest a laboring parent needs from contractions.

~ Calming Effect
Doulas work with the entire family to understand their communication styles and needs during the birth. This familiarity not only has a calming effect on everyone in the room, it also allows the doula to make sure a mother’s laboring environment is supporting her birth.

At Portland Natural Birth, our doulas offer emotional support through:

~ Continuous presence
Our doulas support you at home, helping you decide when to leave for the hospital, and throughout your labor in the hospital or birth center.

~ Emotional clarity
Labor can be a tiring and emotionally-draining event for birthing parent and family. Doulas provide emotional clarity, allowing the family the space they need to process their experience, and trained know-how to help a family through the emotional hard spots of labor.

~ Reassurance
Nothing may be more valuable than the reassurance a doula can offer based on decades of attending births.  Our doula has attended over 500 births as both a midwife and doula.  Bridging clinical knowledge and comfort care skills is her specialty.   

At Portland Natural Birth, our doulas offer informational support through:

~ Evidence-based information
Our doulas are current on the latest information about pregnancy, labor, childbirth, and postpartum. Most importantly, we are trained in how to break the academic studies down into sizable and understandable chunks of information, allowing you to make informed decisions.

~ Labor techniques
Doulas will help with various labor positions to speed or slow down labor and ways to breath through the contractions and while pushing.  

~Medical procedures
Doulas are able to distill and explain medical procedures so families understand what will happen beforehand.

My Commitment to you as your Doula:

As your doula, I will use my skills and knowledge of anatomy, the birth process, bodywork and my training as a midwife to guide and inform you. We will work together to support pelvic alignment and baby positioning so your birth has the best opportunity of progressing smoothly while also honoring your emotional journey both individually and as well as a family unit. I will provide perspective and guidance to you and your partner, make suggestions to support labor progress, assist with relaxation, positioning and bodywork techniques to aid your comfort. As your doula, I am working for you, not your care provider, hospital or birth center.  My only agenda is for you have the information you need to make informed decisions and the support you deserve to give you the strength to get through it.  

Preparing for the Holidays – Doula Advice

If you’re due anytime during the holiday season (even as early as November), it will be so much less stressful if you’re able to check things off your holiday to-do list early. Here’s a list to help you manage your time while waiting to meet your baby.

Hire a Doula
Your doula will help ease you into the reality of having a baby during the holidays. She’ll help you activate your postpartum support network now, before baby, so that everyone is ready to help as soon as your baby is born. And yes, doulas work during the holidays!

Be Flexible
Your baby will change everything; your schedule, getting out the door, driving around, your energy! The more you’re able to do now (even if baby is due way before the new year), the more you’ll be able to let go of what can’t get done.

Shop Online
As a local Portland business we love supporting other small establishments. As a well-mama-well-baby business we know that you can’t do it all (nor should you). If you’re tired, stressed from driving, and want to stay in your cozy maternity pants all day long, then shop online. And not just for presents, think about grocery shopping online and meal delivery services. Bonus – most doulas visit you in your home rather than an office setting.

Be a Guest
If you usually host holiday gatherings, let everyone know that you’ll be skipping this year. See what family members or friends wants to host the big dinners, cookie exchanges, and holiday festivities.

Minimize Decorations
Go easy and light this year. It may be fun to decorate your home in your traditional way, but keep in mind that you’ll also have to take down those decorations and then store them, all while caring for a new baby. It’s a lot of work.  

Prepare for your Birth
Pack a hospital bag, write down important numbers, install the car seat. Spend cozy hours nesting, cleaning, and preparing for your baby. Your doula can help you with suggestions and resources for welcoming baby.

Rest
Doulas love telling their clients how important it is to rest. And we understand that the bustle of the holiday season makes it difficult to do so. But try. Labor is hard work. Birth is hard work. Rest well.

ASK
Consider asking for gift certificates of self care and support for YOU this season.  If your needs are met for maternity and baby things, let your loved ones know to consider gifts of helpful, healing experiences. Massage, pelvic floor care, postpartum doula support, acupuncture, house cleaning, meal prep delivery can all support your need for self-care.