The Need For Extra Care After Your Cesarean Birth

By Judy Eastman  PCD  BA

Your pregnancy came off with out a hitch!  You felt great, were able to continue exercising, and accomplished your goals prior to going into labor.  Your OB sent you off with your baby in good position, you were rested, with no foreseeable complications.   You had your birth plan, you stuck to it, and you still ended up having a Cesarean Section!

You understand that some times this is simply how it happens. You and your baby are doing well. I know when I had my C-Section I was grateful.  My nearly 9 lb baby was butt breach.  He would have never been able to make it through the birth canal.  After 20 hours of induced labor I had a C Section.  I was exhausted, sore, and emotionally spent. Yet, we were both healthy and alive!

I had not even considered the possibility of surgery. This was my fifth delivery, all previous had been natural and easy.  Now I was faced with four little ones running around the house, a newborn, and my recovery from major surgery.  It was overwhelming!!!

Those at the hospital are trained to serve you through your labor and delivery.  They are not in the mindset of helping you make decisions about after you leave their care.  There is an entire industry prepared to serve you now.  Postpartum Doulas are trained in individual needs and care.  They will spend time talking with you about the importance of healing, what services you will need during this time, nutrition, breastfeeding and a myriad of other issues.

More than anything, a postpartum doula will walk you through this unplanned situation with experience and grace.  It is important to realize where you are.  You just finished nine months of building a little person. You are experiencing the overwhelming wash of hormones and physical changes involved.  You have a new baby who needs you for everything.  Your body is preparing to feed this little one.  On top of all this you have just experienced major surgery.  You were under general or local anesthesia; your body is trying to stabilize, you may be having problems doing so.

1. Getting your head right:

At this point it is important to assess your situation. What is the best path for your health, healing, self care, and long term success?  Taking stock will help you put together a plan.  Someone who has worked with mothers in your situation will have valuable information for you.  She will share her thoughts and suggestions.  She will come to understand where you are in all this.  She will assist you in gaining a vision of what the next few months will require.  Her goal will be to help you choose your best route to success.  There are many things you will want to discuss with your doula.  If you are experiencing emotional trauma due to your unexpected delivery she will help you process your feelings.  If necessary, she will refer you to professional assistance.  If she feels you are experiencing  postpartum depression she will help you find the help you need.  Finding an experienced well trained postpartum doula will relieve you of having to walk this path on your own.  This will provide you wonderful peace.

2. Selecting what help you will need in your process:

What are the best services available to you?  There a many different options.  Your doula will offer suggestions helping you decide what you believe will be of use.  She will provide referrals, and more.  Certified doulas have created their own referral resources.  This will be very helpful to you as you evaluate your needs. Will you want someone to come in and clean your home while you recover?  Will you need help with grocery shopping and meal preparation? Do you have family and friends who would like to help?

3. Physical services provided by doulas:

A doula is trained on how to facilitate your recover.  She will talk over your diet, water intake, and sleep.  She will make suggestions for you in each of these areas, helping you come up with a plan that best meets your needs.  She will discuss any issues you foresee and provide referrals when necessary.  Doulas are trained to educate you in the best way to care for your baby.  She will assist in breastfeeding, infant care of all kinds, bathing, dressing, soothing, nursery organization, pacifiers, diapering, and more.

4. Assisting you with baby care:

A night doula will stay in your home with the express purpose of caring for your baby and allowing you to sleep.  She will bring baby to you when it is time to breastfeed, taking care of diaper changes, burping, and settling.  This will allow you to heal more quickly and return to feeling normally.  She will assist with specific tasks you request.  These will be decided when you interview her.

5.  Your doula will pay specific attention to your self care:

Are you hydrating, resting, recuperating?  Does your diet support healing and encourage your milk supply?  Are you taking time each day to enjoy a bit of  ‘me time’?  Are you recovering physically as well as emotionally and psychologically?  I encourage my clients to spend time each day doing something they truly enjoy.  Maybe enjoying a good book, a walk around the block, a phone call with a good friend…. This helps make since of life.  It provides something to look forward to each day when breastfeeding and exhaustion are the norm.  A little something to look forward to feeds the soul and enables hope.

6.  Be sure you are communicating with postpartum doulas:

Postpartum doulas are trained to evaluate your situation and help you find answers to the million and one questions running through your mind.  Be sure you are communicating with postpartum doulas.  Birth doulas understand pregnancy and birth.  Personally, I highly recommend having a birth doula present at your birth whether you deliver at home or in a hospital.  Her expertise as your advocate will be an invaluable asset during your labor and delivery.  Postpartum doulas are educated specifically to help you after the birth of your baby.  There are doulas certified in both areas, but they are few and far between.  DONA, the Doula Organization of North America, provides referrals for doulas specializing in each field.

Best wishes to you as the delivery of your precious baby arrives.  You are entering the greatest adventure in life: becoming a Mother!  Whether you are doing this in the traditional way, through adoption or surrogacy, your life will never be the same.  No one can explain to you what you will feel and think.  It is a road you must travel to understand.  Congratulations!!!  Have so much fun!

JUDY

 

‘The Middle Wife’ a birth story as told by a second grade sister

Within the infant support industry there are innumerable hilarious stories about what happens during and after birth.  This is one of the funniest I have seen.  It was shared on this blog several years ago.  Many of you may not have seen it.  I literally laugh until I  cry each time I read it.  A good laugh is always a wonderful thing!!!

Also, children do not see and understand situations as we do.  One of my life goals has been to keep this in mind when supporting siblings as a doula.  They come to life experience from a completely different place than we, as adults, do.  It is very important to remember this in helping them acclimate and cope!

 

“The Middle Wife’   (Mid-wife)

by an Anonymous 2nd grade teacher

I’ve been teaching now for about fifteen years. I have two kids myself, but the best “birth” story I know is the one I saw in my own second grade classroom a few years back.

When I was a kid, I loved show-and-tell.  So I always have a few sessions with my students.  I believe it helps them get over shyness and usually, show-and-tell is pretty tame.  Kids bring in pet turtles, model airplanes, pictures of fish they catch, stuff like that.  And I never, ever place any boundaries or limitations on them. If they want to lug it in to school and talk about it, they’re welcome.

Well, one day this little girl, Erica, a very bright, very outgoing kid, takes her turn and waddles up to the front of the class with a pillow stuffed under her sweater. She holds up a snapshot of an infant. ‘This is Luke, my baby brother, and I’m going to tell you about his birthday. “First, Mom and Dad made him as a symbol of their love, and then Dad put a seed in my Mom’s stomach, and Luke grew in there. He ate for nine months through an umbrella cord.  ” She’s standing there with her hands on the pillow, and I’m trying not to laugh and wishing I had my camcorder with me. The kids are watching her in amazement.

“Then, about two Saturdays ago, my Mom starts saying and going, ‘Oh, Oh, Oh, Oh!’ Erica puts a hand behind her back and groans. “She walked around the house for, like an hour, “Oh, oh, oh!’ (Now this kid is doing a hysterical duck walk and groaning.) “My Dad called the middle wife.  She delivers babies, but she doesn’t have a sign on the car like the Domino’s man.  They got my Mom to lie down in bed like this.’ (Then Erica lies down with her back against the wall) “And then, pop! My Mom had this bag of water she kept in there in case he got thirsty, and it just blew up and spilled all over the bed, like psshhheew!” (This kid has her legs spread with her little hands miming water flowing away.  It was too much!)

“Then the middle wife starts saying “Push, push” and. “Breathe, breathe’,” They started counting, but never even got past ten.  Then, all of a sudden, out comes my brother. He was covered in yucky stuff that they all said it was from Mom’s play-center, (placenta) so there must be a lot of toys inside there. When he got out, the middle wife spanked him for crawling up in there.”  He started crying really loud.  He thought they were mad at him!  She wrapped him up in a blanket and I got to hold him.

Then Erica stood up, took a big theatrical bow and returned to her seat.  I’m sure I applauded the loudest. Ever since then, when it’s show-and-tell day, I bring my camcorder, just in case another ‘Middle Wife’ comes along.

 

 

Suggestions for Calming Your Baby With Infant Massage

Provided by Eastman Doula Services

There are many sources of information regarding infant massage.  Some are more technical, however the main goal in massaging your very young baby is bonding, connection, and calming.  You want to prepare yourself and the environment for the most beneficial session possible.  When you first begin, massage may seem stiff and awkward.  As you practice and become more acquainted with what your baby likes, the process will be come more natural and easy.  This is a great way to relax before nap or bed time.  It is also a helpful step in calming an upset baby.  Here are a few ideas…..

5 Infant Massage Techniques for Calming Your Baby

Since massage can provide relief from stress and relax your baby, you should consider using different infant massage techniques to keep your baby calm. In many cultures, parents also massage their infants to promote bonding between the baby and the parents.

Benefits of Massage

Active skin-on skin contact between parent and infant has positive physical, emotional and developmental advantages that are often observed when the baby reaches adulthood. Regular massage makes a baby calmer, helps the child sleep better and promotes alertness during waking hours. Babies prone to constipation and colic also benefit through regular massage. Studies have shown that regularly massaged infants gain weight faster, reach mental and motor skill milestones more quickly and become more sociable and pleasant.

Preparing the Room for the Massage

It’s best to massage your baby before a bath. You should ensure that the room is warm and that the atmosphere is conducive to relaxation. Music can provide a soothing a soothing background. You may choose to use oil when you massage your baby. However, be sure to select oil that’s specially formulated for infants as babies are likely to put their fingers into their mouth. A light olive oil or almond oil is ideal for this purpose.  Coconut oil has also been found to work well.  The amount of oil needed for a new born is very small.  Rub your finger on the source.  You shouldn’t be able to see the material on your hands.  If more is needed use it.  Otherwise, this is one of those ‘less is more” scenarios.

Original notes for this article were found at WHAM.com.

Process:

Place a mat on the floor and sit on the mat with your legs stretched out in front of you. Place your baby on your legs so that his legs are near your torso and his head is closer to your knees. Your baby should initially be placed on his back.  Lightly rub your fingers on your old course then rub it with long, slow and rhythmic strokes into your baby’s skin. The pressure of your palms should be firm and stimulating but not painful. Gentle talking while you massage can help strengthen the parent-baby bond and create a safe space.

Technique 1

When you massage your baby’s head and face, hold the head with both hands and massage the scalp with your fingertips. Massage behind the ears using the thumb and forefinger. You should stroke gently with your thumbs. Areas that should be covered include the eyelids, the cheeks, and the area between the eyebrows and the bridge of the nose.

Technique 2

Hold both your baby’s knees close together and lift them towards his abdomen a few times. Then, place your hand on his stomach and gently massage from one side to the other. All the movements should be in the direction of the heart and never away from the heart.

Technique 3

Hold your baby’s wrist and massage his arm moving upwards towards his shoulder. Also massage the palms by moving your thumb down his fingers.

Technique 4

Hold your baby’s ankles and massage his legs by using upward movements towards his thighs. Use circular movements of your thumb and fingers to stimulate the legs.

Technique 5

Turn your baby over and use the heel of your palm to massage his back, starting from his buttocks.

You should take at least 20 minutes to complete the massage and once the massage is over, bathe him by which time he will be pleasantly tired and ready for his nap. There are several books and videos available that teach you proper techniques for infant massage. You can also visit your local baby center or hospital to learn a few massage tips and techniques.

These are a few of my favorite things….

Secret tips from an experienced doula!!!!!!

Disclaimer:  These are my ideas and suggestions.  If you find something you like better in any category please use it and pass on the information to me!  My feelings will not be hurt!  This is a growing living industry.  I am always happy for new suggestions. 

Caldesene Medicated Powder

CVS produces their own generic brand of this magical mix.  It is great for any kind of rash, yes even that kind, diaper, anything!  The CVS brand has the same active ingredient.

Aquaphor Healing Ointment

This comes in many sizes.  It is expensive.  See if you like it.  It comes in a large tub container, Costco or Sam’s Pharmacy for the best price.   It is high end petroleum ointment, use for dry skin, etc.  Coconut oil works too

Gerber Cloth Diapers 

The best burp clothes ever made!   ALWAYS, ALWAYS, ALWAYS THROW ONE OVER YOUR SHOULDER WHEN YOU PICK UP A BABY.  Make it a habit.  I promise you, you will not regret it!!!

Also, if you have a baby boy, ALWAYS have one close by when you are changing his diaper!   Another item you will be very happy to have!

MAM light weight pacifiers for newborns  

These are my favorite pacifiers for newbies.  They can hold on to them.  The others, the straight ones, shoot out when they suck!  You will see.  Find the ones you like best and keep putting them in until baby can hold on.  It takes a little while. You will gain hours, yes hours, of sleep once your baby can hold on! It is a learned behavior.  DO NOT GIVE UP!!!!  YOU ARE THE PARENT AND YOU DESERVE ALL THE SLEEP YOU CAN COME BY!!!!!

Onsies 

Your baby will not need to wear anything else for the first three months!!  Ha!  Ha!  (Well, he will need diapers.)  These are comfortable, easy to use, bleachable.  White is best because you will need to bleach the heck out of them!!!    When swaddled, baby will be plenty warm!!!

Swaddles 

These will make your life so much easier!!!  The family I just worked with in Newport Beach swaddled baby in the flannel hospital blanket, then put one of these on to hold everything in place.  MIRACULOUS IDEA!  I had never seen it before!!!  I swear by this now!

Hospital Flannel Blankets     Order on line from:  carelinemedical.com

While in the hospital figure out your favorite swaddle with the large blankets. Every nurse will have her way to do this.  Watch and learn, choose the way you like best.  I can only make it happen with the flannel blankets.  The gauze blankets are beautiful, soft, comfortable, but they do not swaddle worth a darn!  I cannot make them work!  And I have really tried!!  The reason using the blanket with in the swaddle is so great is because the swaddle does not hold those precious little legs in place.  Baby kicks around and wakes himself up! Babies are jampacked into the uterus during pregnancy.  The snug secure swaddle allows them to sleep as they are accustomed to doing.  It makes life so much easier!!  You will be grateful for every moment you can sleep!  Ha!

Wisdom

1. Everyone you meet will have suggestions for how you can improve.  Smile, say thank you, and go home and do what you think is best.  Even if what they say is crazy, give them the benefit of the doubt.  Assume it comes from a well          meaning place. Don’t argue with them.  Seek peace.
2. Decide, before you start taking baby out, what your position is on strangers touching your baby.  Everyone will want to, you just need to be prepared to direct them as to your desires.
3. Bathing babies, as needed. You don’t need a bathtub.  A large bowl in the kitchen sink works great.  Until the belly button stump falls off, lay a thick towel next to the sink.  Lay baby down, wash with wash cloth diaper on, remove diaper to wash bottom.  Keep it simple!  No soap necessary.

Enjoy your time with your newborn.  It will pass by so much faster than you ever thought possible.  A year from now you will not believe your baby was ever this small.

JUDY

 

Why Should You Hire a Certified Doula?

Currently I am in the midst of my recertification process.  The Doula Association of North America, DONA, is the organization through which I am certified.  This organization has recently received international status in that it is reaching numerous nations world wide with services and education beginning here in the US.

So why is it important for you to look for a certified doula when you find you want help with your newborn?  There are many night nurses, nannies, and non-certified doulas out there.  Why does it benefit you and your baby to search out doulas who have studied, trained, and are accountable to certification?

My original training through DONA was an eighteen month process.  It required nearly 30 hours of face to face education and training with an experienced professional postpartum doula.  I was trained with thirty other women over a three day period.  They were long days, but we jelled.  Our desire to be the very best doulas we could be caused us to grow together in our training.  Not all of us completed the certification process.  It is rigorous.

After our in-class training we were required to complete a reading list compiled of ten different areas of education in doula services.  Reports were written on each of the books read.  We had to receive written assessments from three different families served through our work.  We each were required to receive an evaluation from a Pediatrician with whom we worked in addition to a referral from an experienced certified doula.

As we continue to work under DONA’s leadership we are required to maintain records, submit confidentiality agreements from each of our clients, and keep our training up to date.  Every three years we must provide documentation that we have completed educational classes, served in the community, and promoted our industry.

How does all this benefit you, as a client?  Locally, most of the the doula agencies you find on line charge the same hourly fee for all the doulas in their registry.  In general, they do not discern between the doulas who take the extra time to advance their skill set and those who do not.  For your needs, having a doula who is active in keeping her training current, connected with the community of doulas in your area, and accountable to an overseeing agency is a plus.  It insures you will be served at the highest standards.  DONA doulas are encouraged to carry business insurance, keep their CPR/First Aid certifications current, and maintain their own inoculations.  All of these are plusses for you.

If you have questions about my training or certification standards, please do not hesitate to ask.  I am excited to share with you the new information I am learning.  In addition, my desire is to offer you the highest quality in infant care.  I keep my training current in order to serve you in the very best ways possible.

JUDY