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!

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.