Birth Plan

Blooma and HeathEast Early Labor Lounge – NOW OPEN!

Delaying admission to Labor and Delivery until a woman is in active labor can be challenging for families. Many women arrive for evaluation before they are in active labor.

Early labor management is a critical time to reduce the cesarean birth rate. When women are admitted to the hospital in early labor they are at increased risk for receiving interventions and having a cesarean section (Rahnama, et al, 2006). With the exceedingly high rate of cesarean sections in the United States (32% from 2013 census data), prevention of the first cesarean birth is important in reducing the overall cesarean rate (current rate of vaginal births after cesarean section – VBAC - is approximately 10%). When women present in early labor at a HealthEast hospital, we often recommend that they go home to labor in the comfort of their own environment. Some women are uneasy with this, feeling nervous to labor at home or are concerned they may birth at home or while in transit. At Woodwinds Health Campus, we want to provide our clients with a comfortable alternative to going home. An Early Labor Lounge has been shown to improve client satisfaction and decrease early admission, thereby lowering the rate of medical interventions and cesarean sections (Rahnama, et al, 2006).

The Blooma and HealthEast Early Labor Lounge offers a space for women and their support team to use until the onset of active labor. The Early Labor Lounge is a beautiful and relaxing space, with floor to ceiling windows looking out over the natural woodlands surrounding Woodwinds. It has supplies needed for the laboring team, such as birth balls, yoga mats, rocking chairs, snacks, hydration, relaxing lighting as well as inspirational messages of encouragement and empowerment to help women as they work through their labor.

Maternal anxiety and fear can lead to medical interventions and less optimal birth outcomes (Hodnett, 2008); promoting comfort and empowerment of the laboring woman can help her cope with the challenges of labor. It addition to staying relaxed and comfortable in early labor, some comfort measures can help a woman progress through labor. Some strategies and techniques include intimate support from a partner and/or doula, ambulation, position changes, utilizing a birth ball, rebozo use, therapeutic shower or bath, acupressure, massage, and nutritional support (Paul, 2017). Some of these supportive therapies are offered in the Blooma and HealthEast Early Labor Lounge.

By providing this space, Woodwinds families will have a comfortable alternative to going home if they arrive in early labor. We hope this will improve our patients’ happiness with their birth experience and improve outcomes. We hope the Blooma and HealthEast Early Labor Lounge makes a positive impact on the clients we serve and finds a permanent home at Woodwinds and other locations.

Written by Natalie Jacobson-Dunlop, MS, CNM, APRN, HealthEast Certified Nurse-Midwife

 

 

 

 

 

Hodnett, E. D., Stremler, R., Eston, J. A., et al. (2008). Effect on birth outcomes of a formalised approach to care in hospital labour assessment units: international, randomised controlled trial. BMJ, vol. 337, (Aug 28 1) 2008.

Paul, J. A., Yount, S. M, Blankstein Breman, R., et al (2017). Use of an early Labor Lounge to promote admission in active labor. Journal of Midwifery and Women’s Health 62 (2), 204-209.

Rahnama, P., Ziaei, S., Faghihzadeh, S. (2006). Impact of early admission in labor on method of delivery. International Journal of Gynecology and Obstetrics, 92 (3): 217-220.

Ask The Educators: What Should I Wear For My Birth?

Childbirth education at Blooma serves families no matter what type of birth they are planning. All classes present evidence-based information for normal and safe birth, influenced by the Lamaze 6 Healthy Birth Practices. Classes provide information to expectant families to reduce their fear or anxiety while building confidence and preparing them for birth.

We love hearing your questions, and helping you make informed decisions for your birth. Many mamas and partners want to know, What should I wear to my birth?

The short answer is, it’s totally up to you!  As a doula, I’ve seen birthing people wear a wide range of things.  

For some, yoga clothes scream comfort.  I’ve had many of my clients wear stretchy yoga pants throughout most of their labor. When they decide to get into a tub for comfort during active labor they either take all their clothes off, or leave just their bra on.  At most birthing places they have a stretchy piece of fabric that is placed over fetal monitors to keep them in place.  You could use this mesh fabric as a makeshift bra top, too.  It’s thin and doesn’t go over your shoulder like most bras, making it easy to maneuver.  

Wearing a mid-thigh or knee length skirt can be a good choice for some, so your legs are free to move.  If you are birthing in the summer, a flowy maxi dress might also work! During your birthing time you may experience the release of bodily fluids like the mucus plug, vaginal discharge, blood, or amniotic fluid.  Wearing a pad with disposable mesh undies (a common garment kept stocked at every birth place) might be the best option for you if you prefer not to get your own undergarments messy. You may get blood or bodily fluids on anything you may wear.  Some people choose to wear hospital gowns for this reason.  At the end of the day, the gown is not your property and someone kindly takes it off your hands and deals with the washing.  If the sound of laboring in yoga clothes, a skirt, or flowy dress makes your skin itch you may prefer to be naked at your birth!  If you are in a safe place where you feel supported by those around you, undressing completely may feel most freeing.  When the intensity and frequency of your contractions require your full attention you likely will not care what you are wearing.  

Bottom line, simple is better.  I suggest finding one outfit you feel comfortable moving around in and is easily accessible for intermittent fetal monitoring, frequent bathroom trips, and easy to take off when you want.  After baby comes it’s best to have everything off your chest.  Keeping baby skin-to-skin with the mother or other primary caregivers during the first hour improves baby’s ability to breastfeed successfully and self-attach.  Skin-to-skin contact also helps maintain optimal temperature for baby and promotes the release of oxytocin, which can reduce the risk of hemorrhage.  Following the first two hours after birth some birthing people like to put on a robe or a nursing top that is accessible for nursing, easy to cover up with, and easy to take off if needed.  

Written by Amy Kelley, Doula, Childbirth Educator, Prenatal Yoga & Kids Yoga Instructor and mama-to-be.  You can find me on Instagram as @amykelleydoula.

 

Top Image by Meredith Westin Photography

Thank Goodness for the Prep Work! Margaret's Birth Story

“Giving birth can be the most empowering experience of a lifetime – an initiation into a new dimension of mind-body awareness.” ~Ina May Gaskin

As soon as I got pregnant I read everything related to pregnancy and childbirth. I wanted to know what to expect, and what I could do to ensure everything went smoothly.

I opted to take Hypnobirthing class through Blooma (shout out to Channing!).  

Hypnobirthing provided me with information about what to expect in the different stages of labor, and offered several techniques to help me cope with the sensations, thoughts, and emotions that pop up during childbirth.  It also provided a platform for my husband and I to talk about my wishes during labor and birth, and how he could best support me.  It helped him to know what to look for as I was going into labor and what he could expect.  Which, it turned out would be very helpful in my labor and birth.

As a part of Hypnobirthing you do daily work on affirmations and visualizations.  These were incredibly helpful for me on so many levels.  It not only helped me work through my own fears leading up to my labor and delivery, it helped me cope with the new experiences I was having in pregnancy empowering me as “labor-day” drew near. 

Doing this work helped me to honor and trust in my body and my son to birth safely.  These things that I practiced turned out to be critical, allowing me to have a labor experience that left me feeling happy and empowered.

I had measured “big” all along, and was so convinced my son would come early. I think every first-time mom thinks this - or is it just me?  I remember my midwives telling me that it’s normal for a first-time mom to go past her guess date.  I also remember thinking “yeah, okay – but that won’t be me”. The universe was laughing in my face.  It was a full eight days after my guess date that I went into labor. Nine days post-guess date my son, Crosby, joined us Earth-side. 

By labor started with a false-alarm water breaking (being that pregnant in the height of the summer – one never knows).  After this false alarm I was having inconsistent surges/contractions.  This went on for several days…

Finally, on Friday, August 3rd, I hit a mental break.  I had been having surges irregularly for at least 24 hours and I felt like I was not progressing AT ALL.  I remember thinking I was going to be in this in-between state forever.  As these surges continued, I utilized my breathing skills that I had been practicing and continued my affirmations.

After two phone calls to the midwife, an increasing pressure and discomfort low in my pelvis, and continued inconsistent surges, I was convinced I was in very early labor or prodromal labor. I consciously welcomed the sensations that I was feeling and let them flow.  In fact, I remember wanting to feel more of it – because I knew that would mean we were getting somewhere!

Eventually, I felt like I needed to use the restroom, so I tried, and tried, and tried.  I didn’t need to go to the bathroom - it was a head, my sons head. In the moment I was confused. Listening to my body I thought I was progressing, but because of my irregular surges and after my conversations with the midwife I was convinced I wasn’t even close to birthing this baby. (Side note: my husband was NOT confused – he knew what was up.  But remained a steadfast observer and supporter.)

Before I knew it, my body sprang into action.  I felt a surge coming and my whole stomach bore down! After a conversation with my husband, and a call to the midwife, we were on our way to the birth center!

These pushing surges continued and about 30 minutes later we arrived at the birth center.  My midwife checked baby, I got in the water, I was checked, and he was on his way out!

This is where things got good! The water was AMAZING.

This was a happy phase for me – it felt good that my baby was coming, that I was in a comfortable space surrounded by the support team I trusted.  I worked with my body and breathed through the pushing phase. This is really where I feel the techniques that I had learned and practiced paid off!  About 2 hours after arriving at the birth center, we had our baby boy.  It was the most crazy and surreal experience.  I wouldn’t change a moment of it.

In the moment, I couldn’t tell you what stage of labor I was experiencing, but I knew to use my breath. I knew how to build support around me that allowed me to get through the moments of fear. The months prior to my birth, I had been learning and practicing so that I could put these lessons into action. It felt so good to work with my body as I brought my dear boy into this world.  My experience would not have been the same if I did not put in the work.  By preparing and practicing coping skills I set myself up for success.

Doing the work, taking time to educate yourself (and your partner), preparing your mind and body, and sharing your wishes with your support team are amazing steps you can take to create an amazing and empowering birth experience.

Written by Margaret Achu – Certified Health Coach, Occupational Therapist, Mama You can follow me on Instagram @coach_margaret_achu or check out my website margaretachu.com

To schedule a Health Coach appointment with Margaret, you can contact her at coach@margaretachu.com,  or you may schedule an introductory session through Blooma’s Wellness page.

Value Systems & Birth Choices

A birth plan is important as a decision-making tool in the prenatal period and as a guide for providers at the time of birth. Now, the vast majority of nurses, doctors, and midwives know (and often expect) that a family will enter birth with a piece of paper that details their specific hopes during the different stages of labor and delivery including newborn care. Many hospitals even offer families an easy to use, and hospital specific, birth plan that goes straight into their file before birth. 

This all is wonderful news for birthing families. It means that providers are interested in what families want and need during one of the most vulnerable and intimate times in life. Providers that listen to families needs are able to provide more specific and supportive care.

While I encourage everyone to write a birth plan, it can sometimes create expectations that come with any give "plan". For example, a mother’s highest priority may be to have a vaginal birth. In her Birth Plan she may write that she does not want an epidural, but at the time of labor an epidural may be what she needs to allow a vaginal birth. Both items are important in her plan, but what holds the most value?

I encourage you to take a different approach to writing your Birth Plan by creating another important document, your Birth Values. By writing your Birth Values, you can allow your personal values to play the biggest role in your birth decision-making process.  The Birth Values approach allows a birthing family to ditch a Black and White Birth Plan and the sense of the "right and wrong", "good and bad" and "success and failure" that it can sometimes bring. Exploring your values goes deeper into the internal needs of the birthing woman, her partner, and the evolving family, rather than only looking at the choices available at the time of birth. 

An Example - A mother may have in her Birth Plan “something” that will help her remain calm and in control. This could be a birthing tub, nitrous oxide, or an epidural. But, it isn’t so much the item on her birth plan that is important, but the underlying value- feeling calm and in control during birth.

At the time of her birth to remain calm and in control, that “something” may change. A mama that planned to be in a birthing tub may now prefer the epidural. Or, a mama planning to have nitrous oxide wants to get into a birthing tub.  The item on her Birth Plan may have changed, but it still aligns with her Birth Values of being calm and in control. Her Birth Plan may only point to one of these things, but at the time of birth, another makes her feel calm and in control. Changing something on the Birth Plan shouldn’t make a mama feel like she has failed because she is still making decisions that align with her Birth Values.

Values do not start and end at the hospital. They are at the center of our very being, and they are at the heart of the new and challenging path new mothers embark on. Values are what matter.

So sweet mamas, and dear birthing partners, please do not ditch the Birth Plan. It is important, and it can act as a wonderful source for essential conversation in the prenatal period. It helps guide the mama, partner, and birth team  - keeping them on the same page before labor and delivery. But, I encourage you to dig even deeper and look at your values as you bring forth new life. Write these values down and share them with your birth team, this way you can move through labor and delivery fully wrapped in those values. 

By doing so, you will feel more fully heard, held, supported, honored, empowered and understood. It can also allow you to be super gentle on any decision made during birth. If there is any one thing I want for a birthing mother, it is that she feels held and supported, and that starts with first understanding her most intimate values before she ever steps foot into her place of birth.   

Best to each of you on your birthing journey, 

Brook Holmberg - full-time Birth Doula, a Childbirth Educator, a Lactation Counselor, co-founder of Birth Doula Centering and above all else, a value-drive mother. 

borealbirth.com 

Birth Doula Centering  - Twin Cities

 

Birth Story: "Go With The Flow"

Thank you for sharing the beautiful story of Hudson's Birth.

The moment I found out I was pregnant I had an Amazon Prime order in for the top pregnancy books so I could prepare for pregnancy and birth.  I’m a Project Manager by profession, so needless to say I’m a meticulous planner.  We took the Blooma Birth Class, did classes with our midwives, and I constantly read blogs and birth stories. I had, what I thought was, the perfect detailed birth plan.  I wanted a natural water birth with the midwives at my hospital.  Little did I know, my sweet baby boy had a different plan for me.

My due date came and went, and I wanted to avoid induction if at all possible.  We had friends and family constantly reaching out, asking for updates and wondering why the heck I hadn’t been induced yet.  It was the longest two weeks of our lives. After trying every natural way to induce labor I learned that baby will come when baby is ready!  I also learned that maybe we shouldn't have shouted our due date from the rooftops to family and friends - post due date was such an emotional time to get through.

Had it been my choice, I would have waited even longer. I simply didn’t want to go through the cascade of interventions that can oftentimes lead to a c-section.  But, at 42 weeks, we went in to the hospital for induction and I was only 1 cm dilated.  My midwife was supportive of my birth plan, and tried to stay true to it as much as possible following the induction. Thanks to our classes and preparation, we felt educated to make decisions as things progressed forward.

After 36 hours of labor, I was exhausted and, in my mind, “gave in” to the the epidural.  Within 2 hours of the epidural I went from 6 cm, to fully dilated and ready to push.  After 3 hours of pushing, the OB came in to check the positioning of our baby.  He was face up and after a flip and 3 additional hours of pushing, it was determined that he was stuck.  I was devastated to find out that a c-section was my only option after 40 hours of labor.  

In a blink of an eye, Hudson was here, and I completely forgot about all of the exhaustion and pain.  Along the way, I listened to my body and the excellent health care professionals surrounding me.  Do what you can to prepare for your birth, but be ready to adjust your plan based on what is actually happening.  Go with the flow, and listen to your support team, this will be the key in getting through it all.  Be your own advocate and surround yourself with people you trust.  Labor and delivery is a beautiful experience - even if it doesn’t follow “the plan”.

Written by A Blooma Mama.

Share your birth story with us here.

A Birth Story - Baby Fritz

Seven weeks. It’s been seven weeks since Fritz decided to grace our lives with his presence outside of the womb. I truly do not know where the month of May went – it seems to have flashed by in a snap. However, the seven weeks leading up to Fritz’s arrival dragged slowly on.

My pregnancy with him, my third, carried along relatively fine and uneventful. But, as anyone who has been pregnant before will tell you, the last handful of weeks tick by at a snails pace. As our family approached his due date, there was a flurry of family events, and we wondered if you would be a part of them – our daughter’s birthday, Easter, and a few baptisms of his cousins. Nope. He decided he wanted an entrance and celebration that was completely his own.

At my 40 week appointment, two days after my guess date, I was completely fed up with being pregnant, and so dearly wanted labor to be over and our baby to be on the outside of my body. I spoke with my midwife about stripping my membranes – something I hadn’t done with our other two babies. She told me that with stripping my membranes, I may or may not go into labor, I could cramp, I could spot, etc.

About an hour after my appointment, I had consistent cramps that felt worse than the Braxton-Hicks I’d been feeling for weeks. But, I still wasn’t sure it was actually labor. I called my husband home from work and a friend to come over to watch our napping kids. Even though I wasn’t sure this was IT, my second labor and delivery was four hours start to finish and I didn’t want to take any chances.  With a flurry of last minute packing and spewing out instructions about our other kids, we went to the hospital, only to see the look in the nurse and midwives’ eyes that I was not in ‘real’ labor. We stayed for observation for a few hours and were sent home. I was so disappointed, and frankly, embarrassed that I didn’t know what my body was doing. Retrospectively, I am glad that we went, even if just to know that everything was healthy and moving along.

The next morning came with cranky kids who seemed to know that something was going to rock their world later that evening. To get out of the house, I put together a list of errands that I had been putting off – like going to the DMV, Costco, and the bank. Waddling in and out of each store, I would have random contractions at no regularity. And, due to the ‘false alarm’ the night before, I wasn’t even sure that they were contractions. After getting the kids home for lunch and down for naps, I finally sat down to time my ‘random’ contractions. Twenty minutes apart. “Oh,” I thought. Maybe this would actually turn into something.

An hour or so later my husband came home, got the kids up for naps and outside to play. Thirty minutes (and two contractions later), I decided we should go on a family walk ‘around the block.’ My contractions were now coming about every five to ten minutes, and soon I needed to stop and breathe through them. My husband called his dad to come over and watch the kids while we went to the hospital. As we got home from the walk, I labored in the living room while my husband tried to make the kids a quick dinner and we waited for my father-in-law to get there. Within ten minutes, my contractions (and back labor) were increasing in intensity and length. Something really felt like it was changing quickly and my husband sent me outside to wait by the car. I kissed my older two babies as I walked out the door, now truly realizing that our family was changing right before my eyes. Within one minute of his dad showing up, my husband was in the car and pulling out of the driveway. Running three red lights with me laboring in the front seat, is how we pulled into the hospital and were raced up to our delivery room.

The nurse who brought us to our room introduced herself and quickly helped me into bed, letting me know my midwife was on her way. My husband happened to tell this nurse that our favorite nurse, who had been a part of both of our previous births had her same name. “Oh, she’s here today too!” said that nurse who brought us to our room. As my contractions were coming right on top of each other, and full of back labor, I was only able to burst into tears, when our favorite nurse walked into our room, ready to be a part of another Olson baby birth.  Her presence, words of encouragement, strength, and gentle touch always seem to be exactly what I need to get through a natural labor. With a team of two nurses and our wonderful midwife, a little baby boy was born into this world not 40 minutes later. He was put on to my chest immediately, stuck his thumb in his mouth and looked up at me with the bluest of eyes.

From the time that I starting timing my contractions to the time that our babe was in my arms was four and a half hours of the most intense labor I have experienced yet. It was so deeply worth the bundle of true joy and easygoing nature which has been given our family. Frederick ‘Fritz’ Simon is a gem and a delightful addition to our little family.

Written by Shea Olson- Wife & Mama Trying to Make it All Work