Cesarean – Doula Group of Evansville

After a Cesarean Birth

CBAC, HBAC, or VBAC?

April is Cesarean & VBAC Awareness month, and we know exactly how important it is to recognize both of these ways of giving birth. We know that nationally, around 1 in 3 births happen via cesarean section, and locally that holds fairly true according to the latest available data. While we don’t know the full extent as to WHY the planned hospital birth cesarean rate is so high, “It seems increasingly clear that anxiety and easy access to many medical procedures at hospital may lead to increased levels of intervention, which in turn may lead to further interventions and finally to unnecessary complications (Olsen & Clausen 2023).” All of that is big picture stuff though, and this post is really seeking to speak to the patient side of things. We celebrate ALL births, no matter how they happen. Let’s talk about 3 big areas where doulas can help after a cesarean birth.

Postpartum

The first 6 weeks after cesarean surgery can be challenging. Your body really needs to rest, but you have a newborn to take care of too. Maybe you’re still dealing with pain when you get home and timing medications, or your other kids really want to cuddle but you’re worried they might bust your incision. Lifting restrictions make moving baby, other kids, laundry baskets, etc challenging after a cesarean birth too. Hiring a postpartum doula, even when you didn’t plan to, can be a huge help to your family and your health in those first 6 weeks. Whether you get a doula or not, delegating should definitely be in your wheelhouse, because your body needs TIME to recover properly in this postpartum period at home.

Recovery

Physical recovery is what most people think about after a cesarean birth, and yes that is really important. After that initial 6 weeks, you may want to talk to your provider about physical therapy to work on scar mobilization and pelvic floor therapy too. Yes, even after having cesarean surgery your pelvic floor might need some work. Honestly, I don’t know why pelvic floor PT isn’t a standard referral after having a baby, but that is a blog for another day.

Mental recovery after a cesarean birth is something that we need to talk about more. I often find myself processing with my clients who’ve had cesarean surgery to talk about how things went, even if I wasn’t there for that birth. People react very differently to having cesarean surgery, and we truly believe all feelings are 100% valid. Mental recovery can be very easy for some and others struggle with it for a long time. Processing with a birth professional like a doula or with a therapist trained in birth trauma can be really validating and helpful for some people. This is a service we offer for clients all the time!

Next time

The big question that many people have after a cesarean birth is often, what should they do next time. Should you try for a VBAC (vaginal birth after cesarean), maybe an HBAC (home birth after cesarean), or maybe a planned CBAC (cesarean birth after cesarean) is for you. There is no one right answer that will work for everyone in this situation, and there are many many factors that go into making that decision. As doulas, we tend to nudge people to think about 4 things when they’re discussing what to do for their next birth:

What were the factors that lead to your cesarean surgery?
How do you feel about giving birth again?
Is there information or other support that would be helpful for you to know when making this decision?
How will you feel about your choice in 10 years?

Everyone answers those questions differently, and honestly there is no one right answer that will work for everyone. One thing we can say with the utmost certainty is that no matter what your choices are, our doulas will be there to support you 100% of the way. We’re working to try to help hospitals understand the value of having your doula in the operating room to support you during your surgical birth too, and will keep pushing for this here locally!

We’re very grateful that cesarean surgery exists, as we’ve seen it save lives. At the same time, we know that it is often over used. We LOVE that VBAC is a truly viable option here locally with many providers, and have seen some amazing HBAC births too. Birth is honestly just amazing in all the different ways it happens. If you’ve had a cesarean birth and want support in any of the above ways, don’t hesitate to reach out to us!

Our 2021 Local Statistics

Every year hospitals submit specific measurements to Leapfrog Group to see how the they are doing, and this year’s aren’t looking great. We like to check in on our local statistics to see how we are doing, and you can read last year’s local statistics if you’d like. In this table, the numbers in bold are from 2021 & those in parenthesis are from 2018.

Hospital	NSTV Cesarean Rate	Early Elective Deliveries	Episiotomies
The Women’s Hospital Newburgh, IN	27% (22.9%)	5.2% (1.7%)	11.9% (14.8%)
Ascension St. Vincent Evansville	23.5% (27.2%)	0% (.8%)	5.6%(6.8%)
Owensboro Health	declined to respond (29.7%)	declined to respond (1.4%)	declined to respond (12.7% )
Memorial Hospital & Healthcare Center Jasper, IN	17.5% (12.8%)	4.5% (0.0%)	7.4% (9.8%)
Daviess Community Hospital Washington, IN	15.7% (15.2%)	2.9% (1.9%)	6.9% (13.1%)
Good Samaritan Hospital Vincennes, IN	24.2% [20.7%]*	3.8% [4.0%]*	5.2% [14.2%]*
Deaconess Henderson Hospital	27.6% (26.1%)	2.5% (2.4%)	2.6% (2.4%)

*numbers are from 2020, as we did not record the data for Good Samaritan Hospital in 2o18

Let’s take a moment to congratulate Ascension St. Vincent’s in Evansville for their success in reducing their overall NSTV cesarean section rate. Yes, there is room for improvement, but they are also the only local hospital that reported data and reduced their cesarean rate, as well as early elective deliveries AND episiotomies. Way to go StV!

Why does it matter?

The NSTV rate tells us the likelihood of a 1st time parent walking into a hospital with one head-down baby at 38+weeks gestation and walking out after having had major abdominal surgery to deliver that baby. This statistic doesn’t count surgical births for breech delivery or repeat cesareans or even first cesarean surgeries for your 3rd baby. From a population standpoint, we should be aiming to get that rate to between 10-15%, and huzzah Davies Community hospital is hovering right on top of that target. These reported NSTV local statistics have all gone in the wrong direction, and that matters for birthing families.

It matters because having one cesarean section increases the risks to you with each subsequent pregnancy. Is VBAC an option for you? Maybe, but only around 20% of people who have had a previous cesarean section will even attempt a Vaginal Birth After Cesarean, and then only if they can find a provider who is actually supportive. After a cesarean, your risk of things like placental accreta, increta, and percreta increase too. Surgical birth carries risk, and according to the evidence, we are doing surgery too often.

How can we change?

Hold OBs to their own standards. Yes, I mean us as consumers, but also hospitals and insurance companies too. ACOG gave some great ideas here, California has some ideas we could bring to the Midwest here & Dr. Neel Shah has been a leader in the call to figure out how to reduce cesareans. I have also read about hospitals publishing their own data publicly and privately nudging physicians to change by keeping them informed of their own professional statistics. I promise you that physicians have access to their personal statistics, whether they access them or choose to share them publicly (or even with patients) is another story all together. There has to be that push and pull if we are going to create true lasting change.

How can you reduce your own risk?

Choose a place to give birth with a lower NSTV cesarean section rate. I know that insurance plays a huge factor in this, so that isn’t always an option for everyone. We do know that your greatest risk of needing cesarean surgery is the location of your delivery.
Inform yourself! Know your options & be ready for what is to come for labor and delivery. You can’t prepare for all of it, but you can at least know what to expect and how the system can sometimes set you up to fail. Know what to watch for!
Hire a doula! Having a doula on your team reduces the likelihood of needing cesarean surgery to birth your child. No, we can’t prevent all cesareans, especially because some of them are very necessary and honestly can be beautiful and healing too. We can promise that having a doula on your team will help you ask great questions of your care team and hopefully feel like the most important person in the room with all the decision-making power. (Because really, you are!)

5 Induction Truths

An induction is discussed with every pregnant person at some point, & these are 5 truths you may not hear anywhere else.

1. Sometimes Induction is Necessary.

High blood pressure, blood sugar control issues, protein in your urine, health concerns for the baby, and more can make it healthier for your baby to be better on the outside than on the inside. These are very valid medical reasons to be induced. Some providers prefer inductions to take place because of suspected big babies, low fluid, getting close or passing your due date, and other reasons. As we know from the evidence, these are NOT medical indications for induction.

2. You CAN Say No.

If everything is fine with you and the baby, then it is perfectly ok to say no to an induction. Even if you are in the hospital for an induction, you are STILL allowed to say no to anything that they offer, and you should be having a true informed consent and refusal discussion for each and every procedure. This includes breaking your water, starting medications, cervical exams, internal monitoring, the type of cervical ripening medication, and ANY TIME someone wants to touch you! Signing up for an induction does not mean you leave your autonomy at the front door. You’re still the boss applesauce!

3. Induction Increases Your Risk of Needing Cesarean Surgery.

Yes, there was ONE study that found that inducing everyone at 39 weeks reduces the cesarean rate, which actually was really problematic. I have discussed this previously along with a BUNCH of other scholars, however there is far more research that says the opposite. I really appreciate Dr. Sara Wickham’s resources on induction for help making informed decisions. This is something that needs to be discussed before you agree to any induction, no matter why it is being advised.

4. Induction Affects More Than Just When the Baby is Born.

Induction is forcing your baby and body to do something before they are ready to do it on their own. Most due dates are an estimate, and none are expiration dates, as babies keep developing even after they are born. Induction interrupts the hormonal physiology of birth, as Dr. Sarah Buckley has published on extensively. Interventions also affect breastfeeding, which can make feeding your baby more challenging after an induction. This needs to be part of the discussion when you are weighing the risks and benefits of whether to choose an induction.

5. Induction Can Take a LONG Time.

Especially for first time parents, induction can take a really long time. Locally most inductions start overnight with a cervical ripening medication and then proceed the next day. Will you be allowed to eat and/or drink during that time? Will you be allowed to take a shower? Will you be on the monitors the entire time? When are you allowed to get an epidural if you want one? Will your provider be there the whole time? What kind of time limits will they put on your progress? Will there be breaks? Can you bring your Fire Stick to keep watching your current favorite binge-worthy show? Ask questions to help yourself make the most informed decisions regarding your care!

The bottom line is this: If your provider is recommending induction, have an open and honest conversation with them using the BRAIN acronym:

Benefits–what are the benefits to this?
Risks–are there any?
Alternatives–what else could we try?
Intuition–what does your gut say?
Nothing–what happens if we wait?

Only YOU get to decide what is the right choice, and we want to make sure everyone goes into birth and parenting with their eyes wide open from the beginning. Want to do some more digging before making a decision about an induction? Asking for TIME can be the most empowering way to step away from what can be a high pressure feeling power imbalanced situation when you are sitting there with your pants off talking to your provider. We talk to clients about this all the time, so feel free to give us a call for a consult if you want a little help!

Measuring Change: Local 2020 Hospital Statistics

That numbers are out for 2020, and they might surprise you.

Statistics tell us part of the story of how a hospital cares for their patients and about the culture of a place. They do not tell us the entire story in any way shape or form, but they are a way to measure change and track goals. Leapfrog is a group that tracks statistics about hospitals around the country using a survey that 75% of hospitals participate in each year. Today was the day that they published this data for 2020.

You can find the 2018 Statistics in this post we wrote. I did not write a post for 2019’s statistics, but I think we all remember April 2020 right? You can look these statistics up for yourself here, because you really don’t have to just take my word for it.

Definitions & notes for you:

This Cesarean Section data is for NSTV (research speak for 1^st time parents, 38+ weeks pregnant, with a single head-down baby) cesarean rates and does not include repeat cesarean deliveries or 1st time cesarean deliveries in people who have had previous vaginal deliveries. This is an important distinction. Leapfrog Group uses the Healthy People 2020 goal of 23.9% for primary cesarean deliveries in this category. I want to note here that the WHO stated target NSTV cesarean rate is 10-15%, so that is something to also think about when looking at this data.
Early Elective Deliveries are defined as elective induction or cesarean sections before 39 weeks. This does not include medically indicated early deliveries, therefore the goal is for these to be less than 5%.
Episiotomies are a cut made to the perineum during the birth process. While sometimes necessary, routine episiotomies are not evidence-based practice, and Leapfrog sets their goal as less than 5%.
The numbers in (parentheses) are the previous numbers reported in 2018. I did not include numbers for Good Samaritan Hospital previously, so apologies to our friends in Vincennes for the lack of change comparison possible in this table.
New numbers that reach or exceed the Leapfrog goals are in blue.

Hospital	NSTV Cesarean Sections	Early Elective Deliveries	Episiotomies
The Women’s Hospital Newburgh, IN	26.2% (22.9%)	6.8% (1.7%)	11.5% (14.8%)
Ascension St. Vincent Evansville*	25.3% (27.2%)	0.0% (.8%)	5.9% (6.8%)
Owensboro Health	29.5% (29.7%)	.7% (1.4%)	5.7% (12.7% )
Deaconess Henderson Hospital**	25.5% (26.1%)	0.0% (2.4%)	2.8% (2.4%)
Memorial Hospital & Healthcare Center Jasper, IN	11.1% (12.8%)	5.9% (0.0%)	7.9% (9.8%)
Daviess Community Hospital Washington, IN	17.9% (15.2%)	0.0% 1.9%)	8.2% (13.1%)
Good Samaritan Hospital Vincennes, IN	20.7%	4.0%	14.2%

*Previously St. Vincent’s Medical Center of Evansville
**Previously Methodist Hospital of Henderson

What the Numbers Don’t Say

What these numbers don’t say is what an incredible strain 2o20 was on all hospitals, including in maternity care. While there were clearly jumps in early elective deliveries at Memorial in Jasper and The Women’s Hospital in Newburgh, we don’t know when those happened. Were those elective deliveries in March and April last year when everything was locking down due to the growing pandemic and people were truly scared for their lives? Conversely, maybe the pandemic was an easy excuse to push for early elective induction too. We can’t know that from the numbers. These statistics represent thousands of birth stories that we can’t know just by reading them.

These statistics are also not the only ones worth looking at when making decisions regarding your care. Other important factors such as VBAC success rates, availability of lactation help, availability of anesthesia, proximity to your home, provider access, insurance coverage etc. Sometimes that last one ends up being the deciding factor no matter what your preferences are on location.

How to Use These Numbers

First use them to think about where you want to deliver. You do have options and choices on where to go, and we would be happy to talk to you about our experiences at these places as well. Know that these are overall statistics that paint a generalized picture, and start there. Even if you don’t have a choice on where to go to birth, because we know that happens, these statistics can help you look at the norm where you will be delivering. They can help you know what to expect and watch for during your delivery.

Next use the numbers to start a conversation with your provider. Where do they deliver? What are their personal statistics compared to the facility? How do they feel about episiotomies?

We ALWAYS encourage everyone to have open, honest, and frank conversations with their providers. Don’t be intimidated by the white coats, they are people too. Keep it positive and be inquisitive, and go with your gut when it comes to making decisions regarding your provider and location for delivery.

We look forward to comparing 2020 with 2021 when those numbers come out!

What is the first question that comes to mind looking at this table?
Do any of these numbers surprise you?
Which of these statistics most line up with what you previously thought about these facilities?

Childbirth Education Improves Outcomes

A recent study found that taking a childbirth education class improves birth outcomes. People who took a childbirth education class in this study were three times more likely to have a vaginal birth. Taking a childbirth education class helps improve confidence and skills for coping with labor and delivery. Childbirth education is still important, no matter what kind of birth you are planning.

Group & Private Classes Available

Coping with Labor Naturally is a 3 hour group class that covers the basics you need. The next one will be Saturday February 8th, 9am-noon, and you can sign up here. I will also teach this class in April, July, & October in 2020, so stay tuned if you are interested but not quite ready to sign up yet. This is a great class to bring your partner so they can learn ways to help you in labor. You will also learn which tools to bring with you and which to request when you get to the hospital.

If group classes aren’t your thing, maybe a full private childbirth education class would be right for you. Full private childbirth education classes have 6 hours of private instruction in your home or at my office space. I am a Lamaze certified childbirth educator who only uses evidence-based information. Yes, we will talk about the hee-hee-hoo-hoo breathing, but I cover everything from pregnancy nutrition to birthing positions to postpartum healing. I’m also an experienced birth doula, so I know the ins and outs of the local birthing scene too. This 6 hour class comes with a 96 page spiral-bound book of handouts and articles packed full of information for parents too!

I also have the option of a private 3 hour birth planning only session. This class is easy to customize for your needs and specific situation. I’m happy to cover whichever topics you might be interested in learning about, and help you come up with a plan. This is a great option for people who might be shy or have a very specific situation that needs specific information. This is also a great option for those birthing at home, who might want all the comfort techniques and help writing a transfer birth plan. Contact us directly to schedule a class and get more information!

Online Options

Maybe you’re really busy and would prefer an online option? Lamaze has some great online courses that are inexpensive and evidence-based.

FREE Labor Confidence with Lamaze Course here
Safe & Healthy Birth: Six Simple Steps here
Labor Pain Management: Techniques for Comfort and Coping here
Breastfeeding Basics: From Birth to Back to Work here
Bringing Home Baby here
Vaginal Birth After Cesarean (VBAC): Informed and Ready here

There are other online courses as well that I like, but I will say that most people benefit from some in-person, hands-on learning too. No matter how you choose to learn, taking the time to prepare for childbirth is a GOOD thing to do. Refreshing your knowledge and skills, even if this isn’t your first birth, are also good uses of your time and energy. I’m always happy to recommend books to read too! Childbirth education is important. Childbirth education is helpful. Childbirth education is worth your time.

Families Deserve Support

The continuous support of a doula is supported by science!

The continuous support of a doula is an evidence-based approach to improve outcomes, decrease intervention, & increase satisfaction. Multiple scientific studies and committee opinions have concluded that doulas make a difference! This is an easy to read summary of the evidence if reading academic text isn’t your thing. As a birth doula, I believe that all birthing families deserve support, and not just on the big day.

These are the kinds of support that I have been able to provide for my clients in the past:

Prenatal

Knowing what all the local options are for prenatal care and planning for birth. Calming fears is another thing I do to support my clients in the prenatal period, and this comes in many forms, but most often through education. I also find myself supporting clients prenatally by connecting them with trusted professionals. This can be for all kinds of things including prenatal massage, chiropractic, and more. I also am happy to share my shopping tips when clients are looking for specific things!

Birth

As a doula, during birth I am giving physical support by helping my clients move around. I give hand massages and help keep their gown closed as we walk the halls. I also like to say that I help clients ask more questions about their care. This is part of helping them know what all their options are as well. I like to say that sometimes I help them order off the secret menu of options that aren’t necessarily the norm, but are perfectly fine to request.

One area that I wish I could support birthing families better here is during cesarean surgeries. All families deserve support, and it can be so hard for families when their plans go sideways. In many other places in the United States, they allow doulas in the operating room as a second support person. Doulas are even trained in how to behave inside an operating room, and how to support clients having a cesarean. Doulas are not currently allowed in operating room of all our local hospitals, but maybe we can change that in the future.

Postpartum: direction to proper resources & support!!

The most important thing that I can do for birth doula clients is to direct them to the people who are actual experts in the things that they are dealing with in the moment. If they have questions about breastfeeding, I make sure I send them to an International Board Certified Lactation Consultant. That is just one example, but knowing WHO to ask questions is really important. Breastfeeding is a great example because so many people don’t really understand how little training most physicians have in breastfeeding science, and they end up getting non-evidence-based advice despite best intentions by everyone involved. Part of my job as a doula is helping clients connect to the right people for whatever questions they might have. I don’t always have the answers, but I do make it my business to know who to send you to.

I have not had the capacity to serve postpartum clients this year, but VERY soon, I am going to have an announcement coming, so be on the lookout for that in early 2020!

All families deserve the support of a doula. Part of my job is helping insure you get the right support at the right time from the right people. I’m constantly learning, so I can continue to know the best local and online resources for my clients.

What was the most helpful resource you found to help you after you brought your new baby home?

Things Doulas Know

Unsolicited advice is not my style

I have stopped giving random advice to pregnant people that do not ask for it, essentially for two reasons. The first reason has to do with other people and the second because of me.

Everyone seems to feel entitled to give pregnant people advice, and I do not want to add to the mostly annoying cacophony.

I do not know what it is about pregnancy that makes everyone feel like they need to give you advice and tell you what to do. I know that most everyone really means well, but holy moly it can be really exhausting to be constantly bombarded by people who think they know better than you about what you should do. I won’t even get started on the horror stories that people feel obligated to tell you like they can’t stop the flow of awfulness spewing from their mouths. I have a strict no spreading trauma policy when it comes to speaking to pregnant people, and I highly encourage all clients to tune out any and all negative messages surrounding birth and parenthood, especially while you are extra vulnerable and pumped up full of hormones!

2. I know way more than most people about pregnancy, birth, babies, etc than most people, and I have a tendency to go on and on about it.

I know a ton of really specific and sometimes seemingly random things that can really help people who are navigating pregnancy, planning for their upcoming birth, and getting prepared to take care of a new tiny human too. I am happy to talk about all these things all day long, and I do quite a bit, BUT not everyone wants to hear that. I respect people’s wishes and only expose my super birth geek side when requested.

As a doula and childbirth educator, I have extensively studied pregnancy, birth, and postpartum. I know where to find great evidence-based and unbiased information. I know different comfort techniques to get through labor and delivery. I make sure to keep up on all the local resources for new families in our area including great breastfeeding support services, chiropractors who specialize in the Webster technique, prenatal yoga classes, which physicians will provide parallel care for home birth, support for victims of abuse, stores that sell green baby products, and more. I am seriously committed to life-long learning and I want to help everyone be better connected with the resources and information that they need.

I never want people to feel afraid to ask me questions. I would rather my clients ask me anything rather than sit around worrying or wondering. I make an effort to not overshare or overwhelm people. I am always happy to answer questions, especially for my clients. BUT, I can’t send you answers that you don’t ask for, and I won’t, not because I’m protecting the information, rather because I know it is really hard to sip from a fire hose and it has taken me YEARS to gather all this information that you are trying to digest in 40-ish weeks.

What was the worst unsolicited advice you ever received about birth?

My Goals as Your Doula

As a doula, I listen and follow your lead.

Support you and your family how you want to be supported.

End of list.

Yes, seriously.

As a doula, I listen and follow your lead. If you want information about anything pregnancy or birth related, I am happy to help you find great and unbiased information about all your options. I love answering pregnancy and birth questions, but make a big effort not to inject my opinion into any of it. That is because my opinion about what you should do is pretty much irrelevant. I do not tell people what to do, and completely understand that there is no one right way that works for every birthing family and every situation.

Most people only think of the physical support a doula can offer, and that is certainly part of the job description, but it definitely is not all of it. I hold space for my clients to give them room to think things through and listen to their gut without an audience. I talk through tough decisions and help you get to the root of your desires for your birth. I am an empathetic ear when you are frustrated, excited, anxious, worried, elated, exhausted, etc. I also don’t have ALL the answers, but I am really great at helping people wade through the sea of information out there to find excellent sources and resources too.

In my 5+ years as a doula, my practice has certainly changed, but my #1 goal has always been steadfast, and I don’t ever imagine it will change! I have no agenda for your birth; I only want your family to feel fully supported as you would like to be. I truly strive to check any bias I might carry and leave it outside of the space of your blossoming family.

Would you like to have an extremely knowledgeable, experienced, and compassionate person in your contact list and at your birth? If you said yes, then I would love to talk to you about birth doula services!

Doula? A do what now?

Midwives and doulas have very different jobs!

One of the most common misconceptions that I run into as a doula is that people think that we are the same as midwives. While I have worked with some really great midwives in my time as a doula, and LOVED having midwives catch my own 2 babies, I do not want to be a midwife or be confused for one. Doula care can compliment midwifery care very well, but we certainly do not replace a midwife.

As a doula, I do a whole lot of things that can improve your pregnancy, labor, delivery, and immediate postpartum. I help you ask more (and sometimes better or more specific) questions prenatally and think through all those decisions about what you want for your delivery before it is actually the big day. I help you practice different comfort techniques and even help you know exactly what things you actually need to have for your birth and immediate postpartum period either at the hospital or home. I hold hands and help people move around, sometimes with all kinds of wires attached to them. I push on your lower back, squeeze your hips, and massage your hands during labor. I help you to the bathroom and comfort you through the challenges of labor and deliver with all kinds of affirming words. I will let you squeeze my hand and listen to the changes in your voice and demeanor for clues on how I can better help you. I do not doula the same for any two births, as each one presents its own unique set of circumstances.

Midwives provide care for healthy pregnant people prenatally, during labor and delivery, and postpartum. They approach birth differently than an Obstetrician, but essentially do all the medical things an OB can do other than surgery. Midwives view birth as a normal process and often practice watchful waiting while expecting everything to be perfectly normal and fine instead of trying to prevent things from going wrong through action. It can seem a very subtle difference in philosophy, and not all midwives take this approach, but this is the midwifery approach generally to pregnancy and birth.

A short and completely non-comprehensive list of things a midwife can do that I do not as a doula:
Check your vital signs like blood pressure and temperature
Order labs
See you for in-office prenatal visits (monthly, biweekly, then weekly)
Check your cervix
Catch your baby
Give you stitches
Check your fundal height after delivery
Order and administer medication

If you want to learn more about midwives, this link is a good place to start.

If you would like to learn more about doulas, you can read about us here. I would also LOVE to talk to you about my services! You can contact me through this website, via email, phone, or message me on social media–whatever you are comfortable with is fine with me. You can read reviews from previous clients and check my availability at this link as well if you would like.

I love helping my clients navigate pregnancy, birth, and postpartum, and have more than five years of experience as a doula at both hospital and home births. I have worked with some amazing midwives and OBs too. I have been to 8 different hospitals as a doula and learned all about their policies and who has which equipment. I know which cabinets have the towels and where to find the emesis basins. More than that though, I support my clients however they want to be supported, because each one is different and each situation demands different techniques and approaches.

Someone once asked me what the #1 most important quality is for a good doula. That was easy for me to answer: EMPATHY! What I may lack in midwifery clinical skills, I make up for in compassion and listening skills. Midwives and doulas can work really well together and there is definitely room for both in your chosen birthing space!

Cesarean Awareness Month

I took that picture above at Indiana University many years after I graduated and I was walking around campus with my family, and I saw the statue with new eyes–with my doula eyes. I had never seen the low-transverse incision mark on her abdomen before that day. It made me smile in admiration and wonder if it was intentional. I’ll probably never know for sure, but I like to think that it is.

April is Cesarean Awareness Month. This was started by
ICAN (International Cesarean Awareness Network) to direct attention to the fact that the cesarean rate in the United States is too high.
32% of American babies in 2017 were born via cesarean section according to the CDC. That number actually hides quite a bit though. That is the number for TOTAL cesarean births, as Jill Arnold explains on cesareanrates.org, and looking at the low risk first time cesarean data gives us a more accurate picture of what we should be targeting to change, especially given the lack of access to and support of VBAC in many places in the country. There are some amazing people working to try to reduce that first cesarean, including the American College of Obstetricians and Gynecologists with this statement originally published in 2014, and Neel Shah and his team at Ariadne Labs who are working to reduce medically unnecessary cesarean surgeries. Shah says that as many as HALF of all cesareans may actually medically unnecessary, and he is not the only one working to reduce that number!

Sometimes cesarean surgery IS necessary. Sometimes surgery saves lives. NOBODY is suggesting that there should be ZERO cesarean surgeries! I join the chorus of people saying that perhaps we should question the efficacy and long-term health consequences for individuals all the way up to the population level.

I’ve never had a cesarean section surgery personally, but I have been in the operating room as a doula for some. Cesarean surgery can be scary, especially if you don’t know what to expect and your support person doesn’t either. Many times you weren’t expecting to be in that operating room, or are questioning whether you should be there right then. Learning about what to expect before you go into the operating room is one of the things I talk about in my childbirth classes. In my first prenatal visit with my clients, we talk about birth preferences, and I always make sure to talk about cesarean birth preferences with every single client no matter what their plans are. Plans sometimes go awry, and knowing what your options are if everything else is going sideways is a great way to mitigate fear as well.

Cesarean birth IS birth, and great medical staff can make a world of difference. There are even some hospitals that will allow a doula into the operating room as a second support person, which can be extremely beneficial for parents who can often feel like strangers in a strange surgery land. I know I have learned so much each time I have been in the operating room, including how best to support a person undergoing surgery, what is normal and expected, what exactly happens in that surgery, which staff is in charge of what action, where to stand, what not to say, and soo much more.

I sincerely hope that more doulas will be allowed in the operating room as a second support person for people undergoing cesarean surgery! I hope that it becomes just one more way that doulas can support the rest of the 32% of births in this country!

Photo by Chris Ensey on Unsplash

Birth is amazing, no matter how it happens. I seriously believe that! The bravery of having your body literally sliced open to bring a child into this world is not lost on me at all. I honor and respect all cesarean parents, and know the sacrifice you have made for those tiny humans.