Tag: Local

The Induction Discussion

Ask good questions & know your options!

Induction of labor has been a very hot topic in the birth world, most especially since a huge study published in August 2018 seemed to say that if we just induce everyone’s labor, it will help reduce the cesarean rate. If you are a super geek like me, you can read the actual study here, along with Henci Goer’s full critique and dissection here, and the California Maternal Quality Care Collaborative message about how to apply this study to medical practice here. Long story short: no, that is not actually what that study said and the circumstances that those included in the study had are NOT what most people are looking at when it comes to induction. I know academic discussions are not everyone’s cup of tea, and that is not the purpose of this post. I want to talk about ways that you can approach the induction discussion with your provider. 

I would be remiss if I didn’t start with a little information about induction. There are 2 basic reasons that people choose to be induced: Medical and Elective. A medical induction means that there is a medical reason that it would be better for your baby to be born instead of continuing your pregnancy. There are plenty of important reasons that induction exists for the safety of parents and babies including high blood pressure, high levels of protein in your urine, blood sugar issues due to gestational diabetes, and many more. Some people choose to be induced for all kinds of reasons like family flying in from out of town, pain from the end of pregnancy, a history of very fast labors, and many more. Induction is forcing your body and baby to get the process started before they are ready, so it isn’t always fast, ESPECIALLY the 1st time. There are all kinds of ways to induce labor medically, though providers typically have a way that they like to get things rolling depending on what is already going on with your body. 

What I really want everyone to do, is to have an informed discussion with their provider about induction. The old saying goes that if you don’t know your options, you don’t have any, and that is also true for induction. I always encourage everyone to have an open and honest conversation with your provider, ask great questions, know your options, and know the evidence for those options. 

Here are 6 questions that might help you start the induction discussion with your provider: 

  1. Why are you recommending induction? 

Some providers recommend everyone be induced at 39 weeks. Some providers only recommend induction for medical reasons. Asking why is a great way to start the conversation and communicate your preferences about whether or not you want to be induced.  

2. Can you tell me what my Bishop Score is? 

A Bishop Score is used to help rate the readiness of your cervix for induction of labor using five different measurements. How open is your cervix (dilation)? How soft is your cervix (consistency)? Is it pointed toward your back, middle, or front (position)? How thin is it (effacement)? How far down in your pelvis is baby right now (station)? All of this adds up to the score that will tell you how likely it is that you will deliver vaginally if induced. A score of 8 or more means you are favorable for induction. (Please note: this score is NOT a guarantee!!!) 

3. What is your recommendation for how this induction will start and proceed? 

Most inductions start with a medication to soften your cervix and get it ready. There are 2 medications that they use for this. Cervidil is essentially like a tiny tampon (with a string and all) that they place next to your cervix. Cytotec is a tiny pill that is cut into smaller portions and can be given three different ways: placed next to your cervix, swallowed, or allowed to dissolve under your tongue. You can read more about these drugs here and here if you would like. 

After your cervix is ripe there are different options to proceed, and you may want to discuss things like: a foley bulb for opening your cervix mechanically, your feelings about artificially breaking your water, pitocin for getting contractions going. These are all options that should be considered beforehand so you can be an active and informed participant in your care. 

4. Are there alternatives to what you are suggesting? 

As with most things, providers have a way that they normally do things, this is their job after all. Sometimes there are alternatives that are not always presented. For example, some people get their contractions going using nipple stimulation for a release of natural oxytocin. This is something that you will want to talk to your healthcare provider about before you just start trying to do it at home though. Not everyone wants to know all the options, so providers sometimes shorthand the discussion. By asking this question you show that you are curious and trying to have an open conversation with them.  

5. Will you be there? 

You spent 9 months getting to know your provider, and some people honestly choose to be induced to ensure that their provider will be the one who is present at delivery. I completely respect that. I think that part of the induction conversation always should include knowing who is going to be there and what their schedule looks like. (BTW: one of the nice things about having a doula is that no matter if you get induced or not, you will know and have spent time with at least one of the people in your birthing space.)

6. What kind of timeline are we looking at for this? 

Scheduling things is great, and managing expectations for induction is also important. What I see most often locally is people admitted to the hospital in the evening for cervical ripening and then the active portion of the induction starts in the morning. If you don’t need cervical ripening, then often you are asked to arrive in the morning to begin the process. Induction can be quick, but it isn’t always. You will want to know what happens if your provider goes home and who will be overseeing the induction and possibly the delivery then. If they break your water, do you have a deadline for delivery?   Will you be allowed to eat and drink at all during your induction? 

As with every decision regarding your care, you will want to use your B.R.A.I.N. as a starting point for any interventions. Talk about the Benefits, Risks, and Alternatives. Also check in to see what your Intuition is telling you, and don’t forget to ask what happens if we do Nothing! Induction doesn’t have to be scary and you also shouldn’t be afraid to say no if you don’t want to do it without it being medically necessary. Only you can decide what is right for your situation, and I promise that as your doula I only want you to have the best information to make an informed decision and I will support you unflinchingly and with all the encouragement you require. 

Meeting You Where You Are: Beacon Breastfeeding Support, LLC

Individualized feeding support now available in your tri-state home.

Today is the last day of World Breastfeeding Week 2019, and I could not let this week finish without highlighting one of the most amazing new resources we have here in the tri-state area. Holly Phillips has worked as a birth professional for the past 8 years, as a DONA certified birth doula, Lamaze certified childbirth educator, and La Leche League leader. Holly has a true passion for helping growing families, and is now branching out in a new business as this area’s only independent international board certified lactation consultant! I have known Holly for close to 6 years, and can tell you that she is fantastically warm and bubbly with an enormous heart for service, but I would be remiss if I didn’t mention how very INTELLIGENT and savvy she is too. Are you as curious about her new business as I was? Then read on to find out her answers to my top 5 questions:

1. Why are you passionate about helping new families
with breastfeeding? 

My passion for helping families with breastfeeding began with my own
difficulties nursing my first baby. We worked with numerous feeding
specialists in the hospital and once we were discharged. However, my
daughter was never able to breastfeed. I became an exclusive pumper and decided to educate myself so that my next attempts at breastfeeding
might be more successful. As a doula, and later as a La Leche League
leader I had the honor of assisting families with breastfeeding education, but I still wanted to do more. In January 2019, I became an International Board Certified Lactation Consultant because it allowed me to address
more complex breastfeeding situations, be more hands-on in assessing
and assisting dyads and offer comprehensive support. 

2. How are your services different than a hospital-based IBCLC? 

First of all, I want to clarify that I am extremely grateful for hospital-
based IBCLCs, they are often the first line of support in getting babies to
breastfeed successfully at the start. They work to improve hospital
protocols that impact feeding at their facilities. However, it can be
difficult for them to offer services that extend beyond the newborn
period. Because I have the ability to come to families where they are and where they breastfeed most often, I am able to create a truly
individualized plan of care utilizing the support network they have in
place. I try to look at all pieces of the puzzle when there are breastfeeding difficulties and because I set my own schedule, I can spend as much time as needed to help families work through the often multi-layered issues
that lead to problems with feeding. 

3. Are your services covered by insurance? 

I currently do not accept any insurance. I can provide a superbill for visits which families may utilize to seek reimbursement from their insurance
companies. I cannot guarantee reimbursement. 

4. What is your favorite part about being an independent IBCLC?

Working with families in their own home environment allows me to form a solid professional relationship that accounts for all the variables that
impact the breastfeeding relationship. I create plans based on these
variables and have more flexibility because I get to craft my own protocols for addressing concerns using evidence-based information. 
I get to know families on a more personal level, and there is frequent
follow up so that continuity of care is maintained. 

5. What is the biggest misconception about IBCLCs? 

I think the biggest misconception about IBCLCs is that we do not support mothers who bottlefeed or use formula to supplement babies. While my
goal is to help families provide breastmilk to their babies, I value any
amount of breastmilk babies receive and often work with families on
introducing a bottle safely. Every family deserves respect and compassion around their feeding goals. 

Holly is magnificent, and I sincerely hope that she is a HUGE success, as I know that more support for breastfeeding is a GREAT thing! You can find Holly at:

Little Ants & a Giveaway!!

As a doula, I get asked all the time about places to shop while preparing for the arrival of a new baby, and the first place I always like to send clients is Little Ants! Not only is the owner Katie Field an amazingly knowledgeable person about breastfeeding and baby wearing, but she also has some really awesome products that you can’t find anywhere else in the tri-state. I love to support local businesses whenever possible, and Katie makes it easy with all kinds of great products and excellent customer service professionals who know what they are talking about because they have actually used the products.

Are you thinking about baby wearing but worried about which carrier might work best for you?

Go to Little Ants and they will help you try on different carrier to find which one works for you, your baby, and your budget. You can even rent them for a trip, and if you decide to purchase it later, they will apply your rental payment toward your purchase. How cool is that??

Curious about cloth diapering, but don’t know where to start?

Little Ants has you and your baby’s butt covered! Can we mention that Katie also owns and operates the Happy Heiny cloth diaper company?? She might be magic you guys!

From the Owner:

I was born and raised in Chicago and moved to Evansville via Urbana, IL in 2008.  I began Little Ants in 2000 six months after my oldest was born.  As I began raising my first child, I gained a deeper appreciation for the importance of mother baby togetherness.  The store grew out of that love.  I longed to create a work environment that allowed moms to work alongside their children all while emphasizing items that were made with just wages and dignity of the worker in mind.

Katie & 2 of her adorable kids!
  • What is your favorite thing about your job? 

I really love being able to help families in their journey through parenthood.  From the early days of helping finding the perfect baby carrier to later days of finding the perfect toy that inspires the child to learn and grow while preserving their creativity and maintaining interest through the childs growth.  I also love seeing how much my children have learned by being a part of this business from day 1. 

  • What do you wish people knew about your business? 

The importance of play in childhood is a major emphasis of our store.  I wish more people appreciated how developmentally important play is, how important open ended toys are to creativity, and how much further money stretches when you buy quality toys made to be played with for years.  That being a small local boutique doesn’t mean you pay premium prices, it means you get premium service at the same price as elsewhere.  We are here to serve our customers.

  • What is the most stressful thing about your job? 

The struggle to stay afloat.  In the day and age of tablets for two year olds and internet purchases for moms, it can be tough to keep paying the bills. 

  • What is your favorite thing about living in the tri-state area?

I love how welcome children are in Evansville.  It was the first thing that struck me when I moved here and I still appreciate it today.  This is becoming less true throughout many areas of country.  I love how many places my kids are treated with respect.

  • Where can people find you if they want to learn more about Little Ants?

Our address is 2820 Lincoln Ave Evansville, IN 47714 or online at www.littleants.com

Check out: #antfamilybusiness

I don’t do twitter but have both instagram (@LittleAntsInc) and facebook (https://www.facebook.com/LittleAntsInc/)

GIVEAWAY TIME!!!!!

Want to win a super cool basket of stuff from Little Ants??

Here’s what you could win:

Sweet Baby Callum (only 7 days old) & his boppy are not included in the giveaway, but everything else in this picture is!!!

Here’s what you can win: S’well bottle, the cuddliest pig ever from The Manhattan Toy Company, a hand-dyed swaddling blanket made from bamboo by the Austin tie-dye company, Earth Mama Angel Baby Pregnancy Pampering Kit, Sweet tooth baby teether shaped like an ice cream cone, and a beautiful chewable necklace…

And the BIG thing that will probably get most of you excited is a:

TULA FREE TO GROW!!!!

Thank you so much Ellen for allowing me to come take pictures of you only 1 week postpartum!!! You are so beautiful & such a wonderful advocate for birth, babywearing, and breastfeeding in our community!
You can read more about the TULA Free to Grow here at this link.

The Tula Free to Grow is an amazing carrier that is fully adjustable, ergonomic, and  has variable width and height settings to customize its fit to your growing baby. This innovative, no fuss design does not require an infant insert and can be used beginning at 7lbs, and it is soo very cool that I almost wish I was going to have another baby!!

This carrier is so versatile that she could have used it for her newborn OR her 2 year old OR her 4 year old!! The 6 year old might be a little big for it though.
(BTW: Ellen IS actually magical in case you were wondering!)

3 Steps to enter to win:


1. Like Doula Group of Evansville and Little Ants, Inc on Facebook
2. Like Little Ants, Inc and Doula Group of Evansville on Instagram. 3. Comment on this post with which item in the basket you are most excited to win!

I’ll put all the names in a bowl and have a live drawing on Sunday March 3rd on the Doula Group of Evansville Instagram page, so be on the lookout for the announcement. Don’t worry though, I will contact you via messenger if you win too. I promise I don’t need this stuff and am really excited to give it away!!

Rules:

-Basket full of stuff must be picked up in person by the winner, so you should probably be fairly local to the Evansville area or at least willing to drive here to Little Ants to pick it up from me. If you aren’t local, you can still shop at their online store!

-Must be 18 to enter & a Facebook user, as winner will be notified via Facebook.

-This giveaway is in no way sponsored by, associated with, or run by Facebook or Instagram or any other entity other than Little Ants & Doula Group of Evansville

-DEADLINE to enter is Saturday March 2nd by noon!

Can we also mention that starting tomorrow there is a SALE at Little Ants????

Seriously, go check out these deals!!

I am SOOO excited to give away this basket of hand-picked stuff! Special thanks also goes out to Chrystal Mehringer who helped me pick out all these lovely things that we both agreed we would want if we were expecting. She’s just one of the super knowledgeable staff members are Little Ants, and a friend of mine too.