PDX Birth Magazine!

Well, if you haven’t seen this beautiful magazine in our office or in other providers’ offices, you really need to! Jen Berryman, photographer extraordinaire, has produced one of the loveliest magazines for all things related to birth. She combines her doula work with photography and wanted to give the Portland community something that not only looked amazing but really captured all different families’ stories surrounding their birth. She includes articles from new parents as well as a couple other providers. And, yours truly, is in there! Jen was the photographer for a past client’s birth last year so we were able to use some stunning pics from that homebirth mixed with me doing what I do so often… answering all the questions folks want to know!

So, head over to her website to check out my article. And if you need some photos of your family, you have an amazing photographer to reach out to! Stay tuned for her next issue with some more answers from Portland Natural Birth.

Condoms in my birth bag?!

I’ve been asked many times what’s the weirdest thing in my homebirth bag… Well, I’d have to say condoms now!  Yes, you read that correctly.  I’m now carrying latex-free condoms.  Yes, they work well for preventing pregnancies and STIs, so why would a midwife, delivering babies, be carrying them?

Well, I recently attended a great workshop put on by the Oregon Midwifery Council who brought in a local OB-GYN from the area.  I had been hearing about this interesting method for controlling postpartum hemorrhage but hadn’t yet been taught how to use it (or even seen it used).

In Oregon, as a Licensed Midwife, I carry specific medications in case of a postpartum hemorrhage (when the birthing person heavily bleeds after the birth).  I sometimes start with certain anti-hemorrhagic herbs such as Shepherd’s Purse, Angelica, or cinnamon.  It really depends on the situation and how the birthing person is handling the bleeding.  Sometimes the herbs work wonderfully well and we can all focus back on the normal immediate postpartum (you know, cooing over the cute baby, helping mama nurse, doing a full newborn exam on the baby, cleaning up our supplies…).  But sometimes, we need more help.  Occasionally I’ll go right for the pharmaceutical medication if that’s what indicated instead of herbs and other times, I’ll try the herbs first and then use the meds.  I carry Pitocin, Methergine, and Misoprostol- all have their specific indications for use.  All but rarely, these medications stop the bleeding and we can, again focus on the more-normal parts of the immediate postpartum and replenish the mama as needed (an IV can really help in this situation and then iron building supplements soon after).

So what happens in those rare cases that all our herbs and medications don’t work and bleeding continues?  This is an instance where, as midwives, we go into emergency mode, place our hands on the mama in specific positions (it’s called bimanual compression) to limit anymore bleeding and transport to a hospital immediately for more tools.

But wait, here come the condoms!  So, a devise had first been described in 1951 as a balloon tamponade and then in 1999 a more specific uterine balloon tamponade came in to play.  The FDA approved this devise, called the Bakri balloon in 2006. It’s basically a balloon that you inflate in the uterus to put pressure from the inside to stop uterine bleeding.  Great, right?!  Well, it gets better… that devise is very expensive BUT you can use a condom and some supplies from our own homebirth kits to make a homemade uterine tamponade! And, according to studies it works just as well as the expensive Bakri balloon.  With the insertion of this devise, it gives us time and breathing room to get to a hospital safely for further help without the birthing person losing more blood.  It’s also amazing to have for rural home births or in other countries where hospitals are far away and transporting to the hospital with someone bleeding could be a very scary situation.

I’ve dealt with my fair share of bleeding as a midwife, but I’m excited to have learned a new method for those more intense bleeding situations.  It’s cheap and easy to make and now I get to say I carry not only cool instruments, lots of gauze, some herbs and meds, but also condoms now!   Honestly, I’d be OK with not having the need for this devise but I’m ready if we do need it!

Here’s to continually learning, updating our midwifery practices and condoms for the win!

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!