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"We must and will have women leaders among us. Native women are going to raise the roof and decry the dirty house which patriarchy and racism have built on our backs. But first we must see ourselves as women: powerful, sensuous beings in need of compassion and tenderness." -Lee Maracle

Tuesday, June 5, 2012

Doula Discourse: Labor and Birth Foods

Hi all. First, a few updates:

I attended two births since my last post! Both were valuable yet challenging experiences. I learn something new every time!

I'm happy to announce that my clients have had 100% breastfeeding success. Every client I have worked with has initiated breastfeeding during my stay with them at the hospital, or shortly after I left. Go moms!

Local hospitals in my area are making some great changes. One has implemented a birthing pool into their newly updated L&D suites! If all goes well, another pool will also be installed. Another hospital is working towards certification as a mother-baby friendly hospital, which means that their practices will encourage and support exclusive breastfeeding.

I have at least two births coming up in the next month. Both of the couples will be paying me which is the first time I've ever received a monetary payment. I'm a little nervous, I have to say. I've never charged because it is in my traditions to work for whatever a person can provide. Personally I have earned a Kitchen Aid Mixer and a lot of gratitude. I don't know what to ask for. I'm super lame and embarrassed when it comes to money. How do I decide what to charge for attending a birth?

I'm almost done with my Emergency Medical Responder training. I plan on becoming a licensed EMR in the state of MI. I start 24 hours of clinical rotations this weekend. Needless to say, I'm really hoping I can put my birth worker skills to use and attend a few births! This is an exciting opportunity for me because as an EMR I can act as a doula, but as a doula I cannot administer health care. I feel this is a great way to use all my skills and deliver one wonderful experience to my clients/patients.

Second, let's talk food:

Fact: Most women in labor need food and drink to keep them hydrated, healthy, and energized during the hard work of, well, labor. All the current evidence* supports women eating and drinking in labor as needed and desired. I've attended too many births where the moms weren't "allowed" to eat and drink because of old and outdated care practices that are not supported by evidence. At the very least, eating and drinking are discouraged by many nurses. Many women also do not wish to eat even if they are starving. Why? Because:

1. Fear. Fear of pooping, peeing, and throwing up. Women do not want to throw up in their labor. Nurses do not want to get thrown up on.

Keep in mind: Sphincter Law tells us that throwing up can actually be a good thing in labor, because it helps relax and dilate the muscles like the cervix. Nature's Law also tells us that pooping and peeing are a part of this normal, physiological process. Many women will indeed poop. Before she even realizes it the nurses or doctor will have cleaned it up and she will never even know IF no one tells her. Sometimes ignorance truly is bliss. Barf bags in the hospital (and for what it's worth, in the ambulance) are nifty little things. They're a small bag that fits right over the mouth and closes automatically when released, so literally no puke can spill from the bag. You just toss it right in the garbage when done. Ultimately the body knows what's best and will respond to and act within labor as it needs.

2. Fear. Fear of an emergency C-Section requiring general anesthesia. Some believe that women are in danger of vomiting and then choking while put under for surgery. Now, I'm no Nurse Anesthetist with an MSN, but I do keep up on current research. Current research* shows that modern technologies and the skills of NAs almost always prevent vomiting and choking during surgery.

Keep in mind: The patient has every right to her own dignity, respect, and competent care. If she wants to eat and drink in her labor, she has the right to. Period. Always. Forever.

Doulas and clients should expect that many staff still stick to a no eating and drinking policy. During the pregnancy, doulas should discuss this possibility with the clients and prepare for a situation where the client doesn't get what she wants. Practice ways of resolving the situation, which should always come from the client herself, including:

-Demanding the right to eat.
-Asking for another nurse.
-Eating anyway.

The client can prepare a defense of her concerns and preferences before the labor, so that she, her partners, and you the doula can be ready if something should come up. She can respectfully address the staff and try to resolve the dispute if she has the energy and motivation. Or she can swear at the nurse and have a tantrum like I did during my labor. Whoops. She can request another nurse who will better respect her needs. She can also ask to consult the OB. If all else fails, she can eat anyways.

The truth is, most women will not need or want an entire turkey dinner during labor. Here are some good foods that will give her energy and hope for a stronger delivery:

-Nuts, dried fruit, trail mix
-Tea of all kinds (What's her favorite? Find out before the delivery. Be a good doula and bring some with you to the hospital.)
-Yogurt with fruit, nuts, or just plain
-Soup, porridge, broth
-Fruit, raw or canned/jarred
-Granola bars
-One or two scrambled eggs
-Milk
-Oatmeal
-Nut butters with fruits or crackers

These are also good foods to have on hand for birth partners and doulas!

Happy labors, and may you eat and drink in peace. If not, eat anyways.

*Some may wonder why I do not provide hyperlinks to my research sources. Well, because I am a doula and a college graduate and soon to be Public Health scholar and also just a health nerd in general, so I spend my "free time" reading texts, following too many health blogs and websites, and talking to other health professionals. There's no way I am willing to keep track of all these sources for one little blog post. And chances are, most of the birth pros out there, at least the good ones!, are keeping track of much of the same research I am and reading the same material. I simply provide my interpretation of the research in my own words, and my site should never, ever be utilized a substitution for appropriate medical consultation. Consider that your run of the mill health blog disclaimer. :-)

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