Power Points on Your Hands & Feet: Reflexology Eases All Aspects of Pregnancy | Marjorie Dickinson, LMT
During pregnancy, labor, and beyond, a mother's feet and hands hold powerful keys to her wellness and comfort.  Hand and Foot Reflexology is an ancient somatic therapy in which specific points on the hands and/or feet are stimulated to affect corresponding organs and glands in the body. Through Reflexology, like acupuncture and acupressure, the body's power to heal itself is stimulated and balance is re-established. 

Thanks to Reflexology, hormonal and structural shifts occurring in the body are more easily processed and assimilated. Deep relaxation arises, as stress is relieved, and the body is able to shift into a parasympathetic state (the ONLY state in which healing can occur). This peace is felt by not only mom but also baby. Fetal movements (jumps for joy and squirms of delight) can be felt as the little one is bathed in feel-good hormones like seratonin and dopamine, released by mom's brain during and after sessions.  Mama can rest assured that she will step into her new role happier and calmer, with decreased chances of postpartum depression. 

Maternity Reflexology relates to all aspects of a woman's child-bearing experience: a uterus primed for conception, a more balanced pregnancy (including decreased headaches, constipation, heartburn, swelling, high blood pressure, and nausea), a proven shorter labor, and even an easier time breastfeeding (lower rates of mastitis and sooner post-birth lactation occur in moms receiving Reflexology).  

Induction reflexology sessions are available to facilitate baby's arrival into the world. If the pregnancy has been carried to term, and baby is fully "cooked", a Reflexology session can be designed to help switch on the surges that will draw your newest addition forward. This drug-free modality of bodywork is so effective that during induction sessions, only when the baby has been ready (as baby has the ultimate say), I have witnessed water breaking on the treatment table. 

With all the swirling emotions and major life decisions that surround carrying and birthing a child, keep yourself centered and at optimal health with Reflexology. Remember, only get your treatment from a certified Hand and Foot Reflexologist.

For more information or to schedule your appointment in Jacksonville or Jacksonville Beach, FL with certified Hand and Foot Reflexologist, Marjorie Dickinson, please call (904) 945-4540 or mdickinsonlmt@gmail.com. Appointments can be booked online at www.marjorielmt.blogspot.com

For further reading about the benefits of receiving Reflexology before, during and after pregnancy, check out this great article: http://www.reflexology-research.com/expectant.htm 

and for more on Reflexology, please check out: http://marjorielmt.blogspot.com/2010/02/your-feet-are-talking.html

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By: Melissa Johnson, CD(DONA), HBCE

I was recently reading a blog which was explaining why men were ill-equipped to attend births and suggested that they should be “removed from the birth plan”…wow. I whole heartedly disagree. Do I think that some men/partners are better at supporting moms during labor than others, sure! But let’s not discount our spouses altogether! Geesh. Dads need support too...let's start here in providing informaion and what is expected of the partners. Below are some tips for dads to use during labor in hopes it will be a guide in preparing partners for this wonderful birthing day process.

“I’ve seen a man pull a line of boxcars with his teeth. I’ve watched a friend light his chest on fire and let another friend hop over his flaming torso on a skateboard. I’ve seen an actor on ”Deadwood” very convincingly pretend to pass kidney stones. None of this even comes close to the awesome experience of seeing my wife, Nicole, give birth.” – Josh Tyson: The Performance | Dads in the Delivery Room (great read for dads!)

Partners play an important role in pregnancy, labor and birth. Pregnancy is good practice but seeing mom in labor adds a totally different element. I feel that we should educate dads of the birth process and furthermore educate them on HOW to support the mom in labor.

We highly recommend dads / partners attend a childbirth class with the mom. Especially a class that includes the father…and most childbirth classes today include the partner. As a HypnoBirthing Childbirth class instructor in Jacksonville, of course I recommend that class. We really stress the involvement of the partner.  

It’s important to know the birth process, but all that reading and knowledge does very little if you have never seen a birth.  So...I have put together (based on what I have seen thus far as a Jacksonville Doula) some information for dads (please let us know your experiences and share in the comments at the end of this blog. We'd love to hear from you):

    * Educate yourself: read about labor stages and the hallmarks of labor (transition)
             - The Birth Partner is a GREAT book for the birth team!

    * Be familiar with the birth plan and be prepared to step-up and speak-up when needed    

    * Truly trust in your partners body’s ability to birth your baby

    * Release all fears before you enter the birth room (HypnoBirthing offers a great fear release exercise)
            - Sometimes this is accomplished by understanding the birth process – we are rarely fearful of things that we understand

    * Connect with other fathers: seek out other dads who have attended births and talk to them about their experience

    * Be responsible for the energy you bring into the birthing room
            - This is important of whomever is in the room
            - Mom is very sensitive to what is happening around her

    * Be the guardian of the space
            - If there are too many people in the room, ask them to leave
            - Take any intense conversations outside the birthing room
            - You may not be jiving with the nurse, ask for a new one

    * Ask questions: If there is a situation or a special circumstance that arises ask:
            - Is this an emergency? Do we have time to discuss this?
            - Ask for time alone to discuss what your desires are. It’s difficult to make a decision with a doctor and nurse staring your down – no pressure there! See "What Every Mom Should Know"

    * Have calm eyes 
            - Sometimes you have to "fake it til you make it"!
            - If you have never seen your wife / partner in labor, it is quite different! It's the most focused and purposeful you will ever see her...but internally focused and quiet doesn't always mean "trouble" or "pain". She may not need fixing or hovering over...just space to be where she is in the process. She will normally let you know one way or the other.

    * Be a quiet pillar of strength
            - Many times moms are sensitive to sounds and talking during the later stage of labor. Please try not to take offense to this.

    * Normal birth is quite uneventful: accept that there may not be much to do and that is okay! 
            - Sometimes your job is sitting quietly holding her hand, kiss her forhead or slowly stroke her arm

    * Be flexible: try not to judge if your partner changes her mind about the birth plan
            - I say a lot in my classes: “You don’t know what you don’t know” and things change. The entire birth team needs to remain flexible. Only SHE knows truly what she is feeling…and she has the right to make an empowered decision of change – and that’s okay

    * Rest or even sleep in the early stages of labor (this goes for mom and dad) 
            - Make sure this is okay with mom and that she doesn't need you during that time.

    * EAT! You will need this energy later! 
            - We see so many dads get excited in early labor and not take care of themselves and become exhausted near the end and right after birth, don’t be that guy!
            - Mom will need you after the birth – your rest and energy is important because as tired as YOU are – she is doubly + so

    * Make sure mom eats and drinks while you are laboring at home
            - Make some labor snacks (easily digestible foods with sustaining energy like pb&j, applesauce, nuts, cheese and crackers). Put the snacks into little bites for mom to nibble between contractions (surges).

    * Be present
        - Limit conversations with family and friends while at the birth. Set up a go to person who you text with and let them keep your list of friends and family updated (oh yeah, you have to make a list of friends and family you want notified)

    * Choose your words wisely and speak softly
            - Avoid “just relax” and “you are doing a great *job*” 
            - Try “you are amazing!” “you look so beautiful” “I am so proud of what you are doing”

    * Keep your attention on her – not the monitors. She is the best indicator of her progress and the monitors just refocus your attention. Ask for the monitor to be turned down so it is not distracting.

    * Stay by the head: especially if you are squeamish

    * Consider a birth doula
            - See our blog on “dads and doulas” (coming soon) to see what that looks like
            - The short of it is that the doula does a lot of the back-ground work (and a lot of the above) so that you can be present to just love, support and be there for the birth of your baby! 
            - The doula enhances the connection you already have and helps to support mom and YOU during the labor
            - In addition to the first paragraph of this blog: "Dads need support too": sometimes we are there just as much for the dads as we are for the moms!
            - Also see "What Makes a Doulas Fees"

Melissa Johnson is a Jacksonville Doula, Childbirth Educator and the owner of Doulananda Birth Services.

The Ramblings of a Jacksonville Doula

It seems that when most people think of a doula they think of “birth coach” and that the primary function is to attend the labor and the birth. We usually charge a flat rate for our services which is perceived mostly to cover our time during the labor. This has prompted me to take some time here to educate a little of what makes up a doulas fees.

When we tell people our price is $500, it’s not uncommon for us to hear an “oh no, we can’t afford that” and that is understandable since it is a lump sum…usually when we explain that we take half at the time of hire and half after the birth, families find it much more doable. (As a Jacksonville doula, this fee is pretty reasonable and price should consider experience and offerings as well).

I have thought about how to educate families on the importance of a doula and how it is worth the investment to the outcome of their births but the number $500 sometimes keeps getting the main attention. (I will be addressing ‘fair pricing for all’ in a later blog).

Why is it important to charge this amount or more for these services? I strongly believe (and if you ask any other doula or family who has hired a doula they will most likely agree) it is a valuable service – one that deserves protection. Protection? Yes, this is the first in a series of blogs I hope to write that speak to the protection of the doula profession.

Let me start by sharing a little bit about our Jacksonville/St. Augustine doula group. Not all doulas practice in the same manner. We are a group of 6 women who look forward to creating a bond with our clients. That means we are involved…we call after doctor appointments to check in, we email, text and (if there’s time or if it is appropriate) we have lunch. We also have tight bonds within our group and we feel like the bond that is forged with clients is just as important. It is, after all, the most intimate moments of the family’s life. We don’t just meet a client once and then wait for “I’m in labor” call. And many of our clients remain important in our lives (if they want to be – we aren’t pushy about the whole thing, it just organically happens that way J).

So let’s get started with what makes a doula’s fees starting with the usual suspects. There is the:

·         Initial consult
·         In-home prenatal visits (one or two) 
·         The birth attendance
·         Post-partum visit

I think everyone would agree that these are normal services and expectations of the doula. The services that I think get overlooked and could use some additional attention are:

·         Phone, Text and Email: Wow! These can really add up! I have had *at least* one client that I exchanged over 500 texts with (yes, five hundred). We generally have to change our phone carrier plans once we become doulas in order to keep up! It’s a welcome added expense since this is communication in the year 2011!

·         Client exclusivity: this topic has many facets. The most obvious is that in order to maintain that bond with clients, we don’t want to take on 10 clients a month. So we typically take between 1 and 4 per month and *try* to space it so that there aren’t birth collisions. This is a difficult task because babies come when they want to, not when it works best for our schedule. 

So if we are to take a client who requests more exclusivity, it can be tricky for the doula if she has committed to being a doula as a primary *career* (and not a hobby – or on the side). If we are to contribute to our family income reasonably, we need to take between 1 and 4 clients a month.

We plan our vacations and our lives around the client, their exclusivity and the on-call status…(see the next bullet). We generally like to book our clients far enough in advance so that we can plan vacations…and then inevitably a baby won’t get the memo and will be born early!

·         Being on – call: This is probably the most imposing part of being a doula (a job that I *love*). Imagine someone invites you last minute to a weekend away at the beach, your doula response, “Can’t, I’m on call for a momma”. You’re at dinner and everyone else is ordering wine, “no thanks, I’m on call”. A lot rides on the ‘on-call’ status. My typical on-call routine is “live life as usual” with a packed doula bag, clothes laid out in the bathroom (so I don’t wake my husband when I get up at 3AM), and go to bed about 30 minutes earlier than normal. I typically won’t do anything exhausting during the day (like going to the beach or running a marathon) while I’m on call…and may have more afternoon coffee than normal. My husband says that I really should go ahead and take 4 births a month because the procedure for being on call for one is the same for 10 (okay 4)!

And I am not the only person on-call…my family is on-call too! That means I may have to take a separate car to dinner or won’t be able to do the nighttime routine with my son. My mother may have to keep her phone on if my husband has a full day of work. It is a family effort.

·         Which brings up a great point! The family of doulas! I tell people often that I have an amazing husband who supports my career and my antics! But I also have an amazing mother who makes so much of this doula business a success! She makes it happen! Because when I am on-call, so is she. If I get called while my son is at school, then she drops her plans to pick him up. There have been times that she would have to be here at the house at 7AM so that my husband can get to work. When we get *the call* we have to plan to be gone for 5-40 hours.

·         The 24 hour + labor: Well this is a tricky one for the doula and for the doulas family. 24+ hours of constant physical and emotional support is wonderfully exhausting. It never feels like that long – and we don’t realize it until later. So the scenario is that we have been gone for 24 hours and now it is 8AM and we are home with a 3 year old who wants to play ;) it happens! We charge the same for a 2 hour labor as we do a 24+ hour labor since it seems to all even out in the end.

·         Experience Factor: As a doula and childbirth educator, we keep up-to-date on the latest studies, procedures, protocols, and policies surrounding birth and Jacksonville area hospitals and providers.  Every birth and every family teaches us something new and we bring that knowledge and the skills we learn to every birth.  This requires time and effort. 

 There are also many costs associated with being a certified doula; the initial training, the tons of books, the membership fees, and continuing education. Being an experienced and successful doula requires more than a weekend course and reading (as helpful as that is!). The experience makes the real impact. We have to maintain a certain amount of local knowledge, continuing education in order to remain certified, in order to increase our learning in order to gain more experience. Continuing education is costly in many ways.

 ·         Lastly, we are self-employed (independent contractors): The rule of thumb is that a self-employed professional's income is only half of what they earn, after deductions for vacation and sick time, self-employment taxes, insurance, travel and business expenses (and the others mentioned above).

It requires a specific formula for woman to take on the doula profession. It is something we have to take into consideration – sometimes before and sometimes we don’t realize the investment until we’ve been practicing a year or two. But it is an investment. Being a doula is an incredibly challenging, emotional, rewarding, amazing, stressful, exhausting, and joyful profession! One that should be respected and protected!

Melissa Johnson is the owner of Doulananda Birth Services in Jacksonville, FL. She is a birth doula, Midwife’s Assistant and HypnoBirthing Childbirth Class Instructor. Visit her doula profile.

The Ramblings of a Jacksonville Doula

It seems that when most people think of a doula they think of “birth coach” and that the primary function is to attend the labor and the birth. We usually charge a flat rate for our services which is perceived mostly to cover our time during the labor. This has prompted me to take some time here to educate a little of what makes up a doulas fees.

When we tell people our price is $500, it’s not uncommon for us to hear an “oh no, we can’t afford that” and that is understandable since it is a lump sum…usually when we explain that we take half at the time of hire and half after the birth, families find it much more doable. (As a Jacksonville doula, this fee is pretty reasonable and price should consider experience and offerings as well).

I have thought about how to educate families on the importance of a doula and how it is worth the investment to the outcome of their births but the number $500 sometimes keeps getting the main attention. (I will be addressing ‘fair pricing for all’ in a later blog).

Why is it important to charge this amount or more for these services? I strongly believe (and if you ask any other doula or family who has hired a doula they will most likely agree) it is a valuable service – one that deserves protection. Protection? Yes, this is the first in a series of blogs I hope to write that speak to the protection of the doula profession.

Let me start by sharing a little bit about our Jacksonville/St. Augustine doula group. Not all doulas practice in the same manner. We are a group of 6 women who look forward to creating a bond with our clients. That means we are involved…we call after doctor appointments to check in, we email, text and (if there’s time or if it is appropriate) we have lunch. We also have tight bonds within our group and we feel like the bond that is forged with clients is just as important. It is, after all, the most intimate moments of the family’s life. We don’t just meet a client once and then wait for “I’m in labor” call. And many of our clients remain important in our lives (if they want to be – we aren’t pushy about the whole thing, it just organically happens that way J).

So let’s get started with what makes a doula’s fees starting with the usual suspects. There is the:

·         Initial consult

·         In-home prenatal visits (one or two)

·         The birth attendance

·         Post-partum visit

I think everyone would agree that these are normal services and expectations of the doula. The services that I think get overlooked and could use some additional attention are:

·         Phone, Text and Email: Wow! These can really add up! I have had *at least* one client that I exchanged over 500 texts with (yes, five hundred). We generally have to change our phone carrier plans once we become doulas in order to keep up! It’s a welcome added expense since this is communication in the year 2011!

·         Client exclusivity: this topic has many facets. The most obvious is that in order to maintain that bond with clients, we don’t want to take on 10 clients a month. So we typically take between 1 and 4 per month and *try* to space it so that there aren’t birth collisions. This is a difficult task because babies come when they want to, not when it works best for our schedule.

So if we are to take a client who requests more exclusivity, it can be tricky for the doula if she has committed to being a doula as a primary *career* (and not a hobby – or on the side). If we are to contribute to our family income reasonably, we need to take between 1 and 4 clients a month.

We plan our vacations and our lives around the client, their exclusivity and the on-call status…(see the next bullet). We generally like to book our clients far enough in advance so that we can plan vacations…and then inevitably a baby won’t get the memo and will be born early!

·         Being on – call: This is probably the most imposing part of being a doula (a job that I *love*). Imagine someone invites you last minute to a weekend away at the beach, your doula response, “Can’t, I’m on call for a momma”. You’re at dinner and everyone else is ordering wine, “no thanks, I’m on call”. A lot rides on the ‘on-call’ status. My typical on-call routine is “live life as usual” with a packed doula bag, clothes laid out in the bathroom (so I don’t wake my husband when I get up at 3AM), and go to bed about 30 minutes earlier than normal. I typically won’t do anything exhausting during the day (like going to the beach or running a marathon) while I’m on call…and may have more afternoon coffee than normal. My husband says that I really should go ahead and take 4 births a month because the procedure for being on call for one is the same for 10 (okay 4)!

And I am not the only person on-call…my family is on-call too! That means I may have to take a separate car to dinner or won’t be able to do the nighttime routine with my son. My mother may have to keep her phone on if my husband has a full day of work. It is a family effort.

·         Which brings up a great point! The family of doulas! I tell people often that I have an amazing husband who supports my career and my antics! But I also have an amazing mother who makes so much of this doula business a success! She makes it happen! Because when I am on-call, so is she. If I get called while my son is at school, then she drops her plans to pick him up. There have been times that she would have to be here at the house at 7AM so that my husband can get to work. When we get *the call* we have to plan to be gone for 5-40 hours.

·         The 24 hour + labor: Well this is a tricky one for the doula and for the doulas family. 24+ hours of constant physical and emotional support is wonderfully exhausting. It never feels like that long – and we don’t realize it until later. So the scenario is that we have been gone for 24 hours and now it is 8AM and we are home with a 3 year old who wants to play ;) it happens! We charge the same for a 2 hour labor as we do a 24+ hour labor since it seems to all even out in the end.

·         Experience Factor: As a doula and childbirth educator, we keep up-to-date on the latest studies, procedures, protocols, and policies surrounding birth and Jacksonville area hospitals and providers.  Every birth and every family teaches us something new and we bring that knowledge and the skills we learn to every birth.  This requires time and effort. 

 There are also many costs associated with being a certified doula; the initial training, the tons of books, the membership fees, and continuing education. Being an experienced and successful doula requires more than a weekend course and reading (as helpful as that is!). The experience makes the real impact. We have to maintain a certain amount of local knowledge, continuing education in order to remain certified, in order to increase our learning in order to gain more experience. Continuing education is costly in many ways.

 ·         Lastly, we are self-employed (independent contractors): The rule of thumb is that a self-employed professional's income is only half of what they earn, after deductions for vacation and sick time, self-employment taxes, insurance, travel and business expenses (and the others mentioned above).

It requires a specific formula for woman to take on the doula profession. It is something we have to take into consideration – sometimes before and sometimes we don’t realize the investment until we’ve been practicing a year or two. But it is an investment. Being a doula is an incredibly challenging, emotional, rewarding, amazing, stressful, exhausting, and joyful profession! One that should be respected and protected!

Melissa Johnson is the owner of Doulananda Birth Services in Jacksonville, FL. She is a birth doula, Midwife’s Assistant and HypnoBirthing Childbirth Class Instructor. Visit her doula profile.

I am trying hard not to call myself infertile until I no longer have oocytes in my ovaries or a uterus in my body. As a sub-fertile doula in Jacksonville I have found several similarities in the journeys of pregnant women and infertile women. 

The answers they seek are rarely answered definitively. Their experiences are completely unique and there are no two women with the same exact experience. The end of their journeys’ lead to change.

Expecting couples often engage their doulas (what is a doula?) in discussion that includes unanswerable questions. I don’t know of any doula in Jacksonville that can definitively predict what day and time your child will be born. When a birthing women’s partner wants the doula to give them an itinerary for exactly how labor will progress (so he/she can plan accordingly) the doula can share story after story and educate the couple on the stages of labor, but she has to explain that every birth is different and there is no way to predict exactly what will happen. I would LOVE to give my clients definitive answers to every question they ask, but I cannot tell a Mom that she will be one of the “lucky ones” who has a short 4 hour pain-free labor or that she WILL be completely dilated by lunch time. 

Couples struggling with fertility issues often ask their Reproductive Endocrinologists (RE) what it will take to get pregnant. RE’s are great at spouting off statistics and explaining the different test results, but they cannot tell a couple “you will get pregnant”. There isn’t a way to know if you will get pregnant with your first IUI or your fifth round of IVF. The question of “will we be able to parent our biological children” cannot be answered until you achieve pregnancy (and I know firsthand pregnancy does not equal getting to parent a living child).

The local (Jacksonville & St. Augustine) doulas I know have all shared many birth stories with me, and I have yet to hear of two births that were exactly the same. One of the benefits of being a doula is that our job is always different. We may only get to use our “doula bits” a few times a year. At some births our role might be to help dad support mom at another birth we way end up wearing the hat of “family peace keeper”, and at others we might be the primary support for mom. Our role (always within our DONA Scope of Practice, which is a whole other blog entry) is always different.

Every couple I have talked to that experienced sub-fertility has a different story. Most couples experienced similar testing, but once the results are in there are many different treatment options. Some women will become pregnant after swallowing a few Clomid pills and having timed intercourse, others try more advanced treatment cycles when the Clomid doesn’t work. Then you have me: I won’t bore you with our whole story today, but we went straight to injectable IUI cycles after I had surgery. The first IUI worked, but sadly we lost the baby (miscarriage). We had genetic testing done on the baby which led us down a crazy 6 month long side street. Now after trying several more IUI’s and an IVF cycle, we have started our adoption journey.

When a woman gives birth her entire life changes; she is now responsible for a living breathing little human. She sacrifices for her little bundle of joy and puts all her energy in to giving her little one the best life has to offer. 

Similarly when a woman comes to the end of her struggle to conceive she is changed. Not every journey ends with a pregnancy, or adoption. Some couples run out of money and or hope and end up living childless (not by choice). However their fertility journey ends, they no longer see the world the same. Many who end the journey harbor feelings of anger and jealousy towards “fertile Myrtles” and somehow feel like they are not “whole women”.

My heart goes out to those who can’t see past the hurt, jealousy and anger of infertility! (I had my days when those emotions raged within me, before my heart was healed.) I feel the need to educate the fertile Myrtles on how to tenderly and compassionately reach out to their infertile sisters. We are all women, we all have love with in us to give, we just don’t all end up with babies of our own to love. I sometimes wish we could go back to more simple time in history when all the women went off to the Red Tenttogether once a month and cared for each other through infertility, pregnancy, childbirth and child loss. In those days the women who didn’t have their own children spent their time loving on all the babies in their tent. I know this sub-fertile doula treasures every moment I share loving on other women's’ children.

Hillary Berger is a birth doula in Jacksonville, FL and is a part of the Doulananda Birth Services doula group. See Hillary’s Bio.

Home births are on the rise all over the country. If you take a look at our local birth center, Fruitful Vine in Jacksonville (with 3 midwives who births babies at home and at their center) website, you will see just how many babies are being born normally! As a birth doula in Jacksonville, I attend births in both hospitals, birth center's and at home. We see families taking more responsibility for their birth experiences and choosing care providers who share the family's trust in the birth process.

Home birth and birth center births are most successful when families educate themselves through childbirth classes (such as HypnoBirthing), read books and medical studies, choose a care provider who meets their needs, have a doula for labor support and advocacy, are free of fear and trust their bodies!

If you live in Jacksonville or St. Augustine and you are seeking a normal and peaceful birth...check out our Resources page for a list of care providers that will support you. See the article from the Washington Post.
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Despite skeptical medical establishment, more women choosing natural birth at home
By Associated Press, Published: July 5

NEW YORK —

One mother chose home birth because it was cheaper than going to a hospital. Another gave birth at home because she has multiple sclerosis and feared unnecessary medical intervention. And some choose home births after cesarean sections with their first babies.

Whatever their motivation, all are among a striking trend: Home births increased 20 percent from 2004 to 2008, accounting for 28,357 of 4.2 million U.S. births, according to a study from the Centers for Disease Control and Prevention released in May.

( Paul Beaty / Associated Press ) - Chicago blogger Gina Crosley-Corcoran holds her two-month-old daughter Jolene while her husband John Crosley-Corcoran puts shoes on son Jules 3, in Lombard Ill., Sunday, July 3, 2011. Crosley-Corcoran is a pre-law student who chronicled nightmarish pressure from nurses and doctors to abandon a vaginal birth with her second after a C-section with her first. She followed up with a third child born at home in April.

White women led the drive, with 1 in 98 having babies at home in 2008, compared to 1 in 357 black women and 1 in 500 Hispanic women.

Sherry Hopkins, a Las Vegas midwife, said the women whose home births she’s attended include a pediatrician, an emergency room doctor and nurses. “We’re definitely seeing well-educated and well-informed people who want to give birth at home,” she said.

Robbie Davis-Floyd, a medical anthropologist at the University of Texas at Austin and researcher on global trends in childbirth, obstetrics and midwifery, said “at first, in the 1970s, it was largely a hippie, countercultural thing to give birth outside of the hospital. Over the years, as the formerly ‘lay’ midwives have become far more sophisticated, so has their clientele.”

The American College of Obstetricians and Gynecologists, which certifies OB-GYNs, warns that home births can be unsafe, especially if the mother has high-risk conditions, if a birth attendant is inadequately trained and if there’s no nearby hospital in case of emergency. Some doctors also question whether a “feminist machoism” is at play in wanting to give birth at home.

But home birthers say they want to be free of drugs, fetal monitors, IVs and pressure to hurry their labor at the behest of doctors and hospitals. They prefer to labor in tubs of water or on hands and knees, walk around their living rooms or take comfort in their own beds, surrounded by loved ones as they listen to music or hypnosis recordings with the support of midwives and doulas. Some even go without midwives and rely on husbands or other non-professionals for support.

Julie Jacobs, 38, of Baltimore, who has multiple sclerosis, said she “chose midwives and hypnosis because I wanted to surround myself with people who would support me as a birthing mother, rather than view me as an MS patient who would be a liability in need of interventions at every turn.”

Her first two children were born in a freestanding birth center operated by midwives. After the center closed, her third child was born at home in 2007. “If I had been in a hospital I probably would have had C-sections for all three,” she said. “With the first, I would have been terrified to try a home birth. After the second one I was like, hey, I can’t necessarily walk in a straight line, but I can do this.”

Some home birthers cite concerns over cesarean sections. The U.S. rate of C-sections in hospitals hovers around 32 percent, soaring up to 60 percent in some areas. In some cases, there’s a “too posh to push” mentality of scheduled inductions for convenience sake (Victoria Beckham had three).

Below are some suggested interview questions to consider before hiring a doula.

Interviewing your potential doula should be like interviewing your care provider. You will find many different types of doulas in Jacksonville and St. Augustine. Most of us come to birthing from our own personal experiences which can contribute to our 'doula style'. We suggest one or two initial interviews to determine if a doula is right for you. She will be with you in this most sacred moment of your lives. Most of us are doulas because our heart leads us down this path; we tend to be natural nurturers and advocates. It is important to choose a doula whose personality you can see at your birth. Consider if she will be a good fit with your existing birth team (father/partner/family, doctor or midwife). When asking these questions below, you should get a feel for the doula's style, personality and whether or not she will be a good addition to your birth team. Sometimes it is not as important "how many births" she has attended or about her own births (many GREAT doulas have not yet had their own babies), and can be more about her *passion* regarding supportining families.

The role of a doula is that of emotional and physical support along with advocacy...ask yourself: "Can I see this person supporting me unconditionally? Is this person caring? Will this person advocate for our birth choices?"

Take what you like from the questions b, and maybe you will develop your own. If you think of something to add or a different way of asking, email us and let us know your thoughts.

These are great questions to bring to our monthly meet the doula events held in Jacksonville and St. Augustine!

Interview Questions for Doulas

1.      Why did you become a doula?

2.      What are your core beliefs surrounding birth?
            a.  Do you believe it is best for all women to go un-medicated or that home births are for everyone?
            b.  What are your thoughts on interventions? 
            c.  How many of the births you have attended  been in a hospital or homebirth setting?

3.      What is your style as a doula? Do you have a style? Give me an idea of what you "do" during labor.

4.      What are your own birth experiences?

5.      How many births have you attended?

6.      How many clients do you take each month?

7.      Do you have a back-up?  Will I be able to meet or at least speak by phone with this person? Have you ever had to utilize your back-up? What was the circumstance?

8.      Will you be able to support our family unconditionally even if we make decisions about our birth that you don’t agree with?

9.       Are you certified through an organization (like DONA or CAPPA) or actively working towards certification? If not, why?

10.     Do you have additional certifications?

11.     How do you actively continue your education?

12.     What birth methods are you familiar with? Are you able to support us in our chosen method?

13.     Have you attended a birth with my provider before? At this birth location?

14.     Do you get along with my care provider?

15.     What happens if I end up being scheduled in advance for a c-section – are there changes to the process or your fee? Is there an option to cancel services? Refund policy?

16.     Do you have a client-doula agreement? Can I look over it?

17.     Do you have referrals?

18.     When do you do post-partum visits?

Pregnant in Jacksonville or St. Augustine? Looking for a birth locaiton? The following are the most current birth by cesarean section (c-section) rates for local hospitals in Jacksonville and St. Augustine (October 2009 - September 2010). Information taken from Florida Health Finder.

Jacksonville Hospitals
44%    Memorial Hospital
39%    Baptist Medical Center Downtown
38%    St. Vincents
37%    St. Lukes: Family Place
36%    Baptist Medical Center South
24%    Shands / UF

Orange Park Hospital
32%  Orange Park Medical Center

Jacksonville Beach Hospital
34%    Baptist Medical Center Beaches

St. Augustine Hospital
31%   Flagler Hospital

 Your Best Birth: Planning and Checklist

If you’re married, take a moment to think about your wedding (or the process of choosing a college or the last car you bought) think about all the preparation, planning and research you did for those events. It takes most brides a year to plan that perfect day right? Now think about what people say about the birth of their first child, “this is the best day of my life besides my wedding day” and many would probably say it trumps their wedding day. So why wouldn’t we put as much effort into the planning of the birth? One reason might be that it there is so much information and EVERYONE has an opinion on this topic that the “overwhelmed wall” (when you’re so overwhelmed that you get frozen and can’t proceed) is placed. Another reason might be that we don’t necessarily connect choosing a provider with “choice”. Most families find someone in their network and in their neighborhood. We generally assume that all physicians are created equal and stick with that person not matter what. A recent study revealed that 70% of Americans do not seek a second opinion…what does that tell you?

Jacksonville is becoming more open minded as women begin to voice their requests and work with their providers as a team (just take a look at the volume of the home birth midwives in Jacksonville and you will see a different trend!). Your care provider (OBGYN or Midwife) and location of birth are very important elements in determining how the birth will go. If you are hoping for an unmedicated, minimally invasive birth, there are care providers and hospitals that may not be a good fit for your family. But how do you know this as an expecting mother? Top two: 1. Ask questions! 2. Research. We hope to provide the tools you need within this blog and the Doulananda website to empower your family to make the best decisions!

How does one go about making these birth decisions and researching what is available in their city? Below is a checklist of sorts to help guide families in the many decisions regarding their births. Take what you like from it…all of the information may not pertain to you, your family or your “birth plan” (we’ll get to that too).

I’m Pregnant, Now What? Checklist for Expectant Moms in Jacksonville and beyond

·         What is my ideal birth? If you don’t know the answer to this question yet, take some time to think about this. Have you thought about a natural / unmedicated birth? Do you want to be in a hospital? Do you know about home births? Would you feel better in a birth center? Do you know you want an epidural or maybe you have special circumstances that require a c-section? What information do you need regarding birth location? You have choices with all of the previous scenarios (yes, even for a c-section) Take a look at online birth plans and read some birth stories. A great place to start is Ina Mays Guide to Childbirth and our generic birth plan template. Print this out and highlight items that you aren’t familiar with and start the research. If you are considered “high-risk” ask why and what the risks are and if there are alternatives…a second opinion is always an option.

·         What elements of the birth are important to me? (the above might help you with this). You might decide that movement during labor, immediate skin to skin with baby or delayed cord clamping are “deal breakers”…these decisions will help guide you to the best provider and birth location. Interview and research care providers in your area. Here is a link to 10 questions to ask your provider and What Every Mom Should Know.

·         Choosing a childbirth education method. Sometimes taking a childbirth education class early on can lead you to making better decisions regarding your birth and help answer a lot of questions. This is an important part of your education and research regarding your birth. You wouldn’t go in to sit for a test without studying right? Education regarding the birth process helps moms trust her body and nature’s way of birthing. And in HypnoBirthing© we believe that when healthy moms carrying healthy babies are educated, supported, trust their bodies, are free of fear, birth can occur without peril. When do you start taking a childbirth education class? In HypnoBirthing, we encourage parents to take class early (anytime during pregnancy 8-12 weeks on) but for other methods you might wait till 30 weeks or more. There are many childbirth education classes in Jacksonville to choose from: HypnoBirthing©, Bradley Classes, Lamaze, Hypnobabies all are based on the Fear-Tension-Pain concept and all prepare parents for normal birth. Of course, as a certified HypnoBirthing© instructor I highly recommend that method but families must make the best decisions for them! Make sure to save time for a Breastfeeding class! Did you know that some insurance companies reimburse for childirth education classes and doula services? Click here to read more.

·         What are the birth statistics at the local hospitals? Consider the cesarean rate at the local hospitals in conjunction with choosing your provider since you OBGYN/Midwife will have privileges at most likely 1 to 2 hospitals. I am quoting a colleague in saying; “You don’t go to an Italian Restaurant and order sushi.” In other words you wouldn’t go into a high intervention hospital with a corresponding provider and ask for a “natural birth.” It just may not be on the menu and they would have a difficult time preparing that since they are used to serving a different dish all day. It’s not that they are necessarily opposed to making your sushi, they just don’t know what it looks like or how to prepare it. **I will be presenting the cesarean rates of hospitals for Jacksonville and St. Augustine in the next post**

·         What is my OBGYN GROUP’s stance on labor and birth? I am highlighting “GROUP” since in most situations there are several physician’s in a practice and what one care provider’s plan for care  is could most likely be different from the others within the group. This might mean that you go over your birth preferences with one and he/she is on board with your choices, but on the day of your birth he/she may not be on call. It is important when asking the 10 Questions for your Care Provider that you ask what is the stance of the entire group.

·         Choose your birth location. Hospital, home or birth center? Once you decide this, it is a good idea to take the hospital tour and bring with you the birth preferences (see below). You have natural options in Jacksonville: Fruitful Vine Midwifery (home and birth center births) is one and a few other home birth midwives that even support home birth VBAC’s (Vaginal Birth after Cesarean). See the Childbirth Connection's evidence based research on choosing a birth location

·         Choose your birth team. Will you be using an OBGYN or Midwife? Will you be hiring a doula? There are many amazing doulas in Jacksonville…see our page “what is a doula” and “our doulas” for more information (tip: if cost is a factor for hiring a doula – ask for donations as a part of your registry! and some insurance companies reimburse for professional labor support). Who else will be a part of the birth team? Do you feel your birth team will be able to work together? Remember that *you* should be an active participant in your care. Your body is your vessel to steer and you are best able to do that with information! Risks to benefits…evidence based information. You can find evidence based information at the Childbirth Connection website.

·         Create your birth “preferences.” We try to stay away from the word “plan” since we want to remain flexible. You don’t know what you don’t know and in some birth situations, you might change your mind. You just won’t know that until that scenario presents itself. I feel like the main goal of any birth plan should be simply allowing the birthing body to do what it inherently knows how to do *first* then if assistance is needed, by all means, bring in the medical Calvary! Interventions save births! Save lives! But we also know from our ranking of 44 in infant mortality and 50 in maternal mortality (of developed countries) that more technology isn’t always the answer in the case of a normal birth. Accepting that birth can be a windy road versus a linear path and that all births don’t fit into Ferguson’s box is difficult for some practices. In so many scenarios if you go off that road you end up on the intervention highway.

·         Will you be breastfeeding? Do you plan to take a breastfeeding class? It’s better to read and learn ‘before’ you are faced with the reality. Have you researched lactation consultants in Jacksonville? (see below for more on resources).

·         Choose your post-partum team and plan. Who will be helping or supporting you after the birth?  What is your plan for meals? Check out: Take Them a Meal for ideas for your family support system. Do you need a post-partum doula?

·         Prepare your body, your mind and your emotions. This preparation should be going on all throughout your pregnancy and may be an organic process. Whereas for some, a little extra effort might be required. You will receive a lot of tips for preparing the body in your childbirth education and your prenatal yoga classes but preparing the mind and emotions? Maybe…In HypnoBirthing we do a fear and anxiety inventory and then go through a hypnosis script that allows families to release those fears, anxieties and concerns regarding birthing. This can be huge for the family since fear plays a leading role in how your birth will progress. If your childbirth education class does not offer this element, call around and see what your options are…consult with a local hypnotherapist in Jacksonville (or your city) to see if they will do a fear release exercise with you.

·         Check your resources. Do you have a place to easily locate resources you might need after the birth? Your doula, midwife and OBGYN should be able to provide you with references for breastfeeding support, post-partum depression, pediatricians, etc. See our local resources for birth professionals in Jacksonville, FL.

·         Relax and enjoy! Count yourself as one of the few expecting parents in Jacksonville who went the extra mile in preparing for birth! :)