6 Guidelines for Aromatherapy in a Doula Practice.

Aromatherapy is an option many doula clients are requesting. In fact, it is on the list of must haves for some families who are shopping for a doula. Although there is some controversy around this, my doula practice is both happy to meet this need and feels comfortable doing so.

My doula practice carries oils to all births and to better serve our doula clients we have a few guidelines, as well as a few hard and fast rules we follow for the use of Essential Oils during labor and early postpartum. 

• We believe that due to their potentially strong smell and herbal properties use of essential oils in labor should be at the request of the person in labor.  For example we will not whip out a bottle of lavender, but will hand some over at your request.  This is because the person in labor is in a state of heightened sensitivity, and the person in labor is totally in charge of what is applied to their body in at all times. 
• We want the use of oils in labor to be self directed. We are not only happy to offer, but encourage clients to ask for a sample set of the oils we use during labor. Clients who want to use aromatherapy need to prepare and be aware of what different oils smell like and more importantly how the oils are going to effect them. If lavender reminds a client of their grandmothers house and causes them to feel sad it may not be the best choice, on the same note an oil can be associated with a happy memories and a sense of safety.  
• We will never recommend oils for a clinical condition during any stage of pregnancy or postpartum.  We are doulas not Midwifes, Doctors or Aromatherapist’s. We can’t recommend oils or any other substance to treat a clinical condition. 
• We recommend oils be placed on a wash cloth or if placed on the skin done so in small amounts.  This way the oil can be easily removed if your preferences change during labor. Oils applied to the body are harder to remove so bare that in mind.  Also if essential oils are placed in the water of a birth tub and the laboring person changes their mind about the fragrance or wants to avoid getting the smell on the baby they would need to drain and refill the tub. 
• We strongly recommend oils not be placed on baby or near mom’s breasts until nursing is well established. The breasts have glands that release a fluid that smells like the gestational parent’s amniotic fluid, helping baby find the breast. The smell of the infant is part of how a parent bonds with their new baby. So covering up these smells with oils, perfumes, or heavily scented soaps can negatively effect this new relationship. 
• We recommend clients who wish to use oils during pregnancy, labor, and postpartum seek out additional resources through books, online sources, or a trained aromatherapist. This way you can make an informed decision on the use of oils and how you wish to use them. There are many book resources and schools of thought about the uses of EO’s.

As doulas our place is to offer support, encouragement, and a sounding board for pregnant, laboring, and postpartum families. We will not tell you what to do and we respect your choices even if we disagree with them. We respect clients that choose to use oils in whatever way the parents desire and we attend many births where oils are not used at all. As doulas, we are all about choices.

Grace Burnham Doula and Massage therapist at AZ Family Massage 

To purchase oils, get discounts on oils and be added to a large Facebook group with more information about oils visit this site or contact us. 

Busting Diet and Bresstfeeding, Pumping and Dumping

There are many common myths about diet during breastfeeding. These myths lead to confusion for parents, they make breastfeeding seem so much more restrictive and complicated than it needs to be and can make life more difficult for breastfeeding parents. The first rule of breastfeeding for parents with healthy babies is " If someone, especially someone in the internet(*cough* Facebook parenting groups), is making a recommendation that A. seems overly complicated and/or B. requires lots of equipment. You need to do a double check and remember that it's just breastfeeding.

1. The Myth. You need to eat a super restrictive diet well breastfeeding.

The Truth. Eat what you want and ENJOY it while breastfeeding.

For the majority of parents, no dietary changes are required for breastfeeding(1). Eat what you normally eat. Any changes to your diet would be for your benefit and to role model healthy eating for your growing family as the nutrition content of you milk will not change, with two exceptions. You an change the type, not amount, of fat in your milk by changing the type of fat in your diet(2) and the vitamin D content of you milk by increasing your own vitamin D level(3), this is because vitamin D is not a true vitamin and is actually a substance produced by the body(4). The milk from a mother eating the worst diet is still the preferred choice over artificial baby milks  and better for supporting infant health.

It's common to hear that ALL parents must remove certain foods that could potentially upset an infant's stomach such as cruciferous vegetables, garlic, and spices. In the absence of known allergies, remember its just breastfeeding.

So, what is a parent to do ?

Due to the prevalence of this myth, if an infant is displaying "fussy" behavior some parents immediately jump to the last thing they ate, at times ending up on an incredibly restrictive diet without any real clinical indications(5). What is a parent to do if they are concerned about there infant? Check for upcoming developmental milestones(I recommend the "Wonder Weeks App") like new teeth/teething, and the gooey green "drool stool" which can frequently be mistaken for food allergies and it arrives at the same time infants are going through intense developmental changes, about 3-4 months. At this point the breastfeeding parents milk is also shifting. Your breasts may not feel so full starting around 3-4 months as a natural part of adjusting to breastfeeding. Talk to you breastfeeding friendly doctor, get your latch checked or trouble shoot with a lactation educator, lactation counselor or talk to an IBCLC to check for a clinical issues.

If you are concerned about a potential food sensitively, your infants is most likely sensitive to a protein and most common one being dairy and the good news is most infants grow out of this as their systems mature. For more information about food allergies you can check out THIS resource from La Leche League, talk to your local IBCLC or your doctor.

2. The Myth. You need to pump and dump if you choose to drink while breastfeeding.

The Truth.

Can we stop beating this dead horse please?  Yes you can still breastfeed and enjoy that glass of wine with dinner or that beer on a hot day. Even the most conservative recommendations from the American Academy of Pediatrics is to limit consumption to 2 oz of liquor, 8 oz of wine or 2 beers and wait 2 hours(6) that's it.

Pumping and dumping will not remove the small amount of alcohol from your milk any faster than doing nothing(7). 

If you choose to drink in excess, or binge drink, and want to be pumping to maintain supply and for comfort, that would be the only reason to pump. Remember pumping and dumping will not remove the alcohol from your milk any faster.

An additional real concern with drinking while breastfeeding is taking care of your infant. Co-sleeping or falling asleep on the couch or recliner with an infant and without full neurological awareness of your body.  

So drink up, safely, and parent safely. Choose a "designated parent" or get a sitter if you really want to hit the town.

Although a small amount of alcohol consumed while breastfeeding is OK regular, excessive, consumption of alcohol and breastfeeding can negatively affect infant health and development. Breastfeeding parents who are struggling to reduce their alcohol consumption should seek help from another source.

BONUS TIP! 3. No, you can not pass listeria or other bacteria to your infant if you eat lunch meat while breastfeeding. Go ahead and eat that turkey sandwich or sushi you have been craving for nine months. There is no magic mouth to nipple pathway, the food is broken down in your system and your mature gut will handle these potential contaminants without passing them onto your infant.

Grace Burnham CLEC

References
(1) http://www.breastfeedinginc.ca/content.php?pagename=doc-MB2

(2) http://www.llli.org/nb/nbmarapr04p44.html

(3) http://kellymom.com/nutrition/vitamins/vitamins/

(4) http://www.health.harvard.edu/mens-health/vitamin-d-and-your-health

(5) http://www.nbci.ca/index.php?option=com_content&view=article&id=27%3Amyths-of-breastfeeding&catid=5%3Ainformation&Itemid=17&limitstart=1

(6) http://pediatrics.aappublications.org/content/129/3/e827.full#sec-20

(7) http://www.infantrisk.com/content/alcohol-and-breastfeeding

More resrouces

http://www.llli.org/faq/alcohol.html

http://www.nbci.ca/index.php?option=com_content&view=article&id=27%3Amyths-of-breastfeeding&catid=5%3Ainformation&Itemid=17&limitstart=1

http://www.lalecheleague.org/nb/nbjulaug98p100.html

http://www.breastfeedinginc.ca/content.php?pagename=doc-MB2

5 Reasons You Want a CrossFit Doula

“I’m a doula and I do CrossFit, meaning, I like squats and snatches” Grace Burnham L.M.T.

When interviewing potential doulas, there may be one question you have forgotten. Did you ask your doula what WOD* she did last? Your doula has attended trainings in labor support. She knows birth like the back of her hand. She has hundreds of tricks for labor support from home birth to planed c-section. She knows how to use a peanut ball to support you with an epidural. She is grounded and 100% focuses on YOUR Birth. So, what makes your CrossFit doula extra special?

1. Stamina, She can be your rock during a 90 hour labor, after all she has done Angie* and Filthy Fifty* 
2. She really knows her squats. Squatting to push, what hospitals office squat bars for the bed, squatting with a robozo , reading Squat magazine or setting a PR* on her back squat. She’s kind of obsessed with squats. 
3. Strength, whether it’s carrying a birth pool up a flight of stairs, holding pelvic squeezes, hanging on tight to that robozo or moving a barbell, she’s been training for this, 4 births a month and in the Box* 5 days a week. 
4. She sees blood, sweat, and tears inside and outside the birth room. Don’t worry if you pee on your doula she has done double unders, and blood, whatever ask her how many callouses she's ripped open. 
5. She has a proven method for stress relief. She’s a professional and won’t go off on that L and D nurse that makes wise cracks about your birth plan. She will stay strong and support YOU then burn off that rage next time she does Fran*

CrossFit is what made your great doula into the bad ass birth supporting machine that she is, after all its functional training for the unknown and unknowable and I can’t think of anything more unpredictable than Birth.


*Official CrossFit to English translator

WOD: Work out of the day.

Angie: 100 reps each of pull ups, pushups, sit ups, and squats.

Filthy 50: 50 box jumps, 50 jumping pull ups, 50 kettlebell swings, 50 walking lunges, 50 knees to elbows, 50 push press , 50 back extensions, 50 wall ball shots , 50 burpees, 50 double unders.

PR: Personal record. AKA, I rocked today a little more then Yesterday.

Box: A room, a garage, warehouse or whatever in which people do CrossFit. It’s not a gym. Did I just hear your call it a gym? It’s not a gym.

Fran: 21-15-9 reps of pull ups and thrusters

CrossFitters reading this may be asking if they can hire a Doula for emotional support next time a hero WOD pops up on the board and the answer is YES!  Enchanted Desert Doula is happy to support you and both Amanda and Grace have set aside Memorial Day 2016 to provide emotional and physical support to those doing Murpf.

Above : Doula extraordinaire Amanda, who really knows squat, and Massage Therapist/Doula Grace, who uses her CrossFit induced arms of steel for some killer deep tissue treatments at their new favorite CrossFit box Made in CrossFit

Binding After Birth

Wrapping the belly is an effective and important part of a woman’s recovery that aids the body to shrink and recover in a shorter time period, normally six to eight weeks. A sacred belly wrap provides a woman’s postpartum body with 360 support to assist the abdominal wall muscle retraction, improve posture, stabilize loosened ligaments, and provide support to the torso while vital organs return to their pre-pregnancy position.

During pregnancy your body retains water, fat, and air which causes your body to swell and expand, including the organs in the womb area such as the cervix and vagina. The water retained by cells supported the amniotic fluid; and the purpose of the air was to cushion the baby, your internal organs and bones, as your center of gravity shifted and the baby grew larger and larger. This is why a woman gets more swollen during the last months of pregnancy. When a baby is born the excess water, fat and flatulence are no longer needed and the cells will naturally release and shrink. However, the purpose of a belly wrap is to speed up this process with constant pressure on the abdomen and torso area. The design of the belly wrap provides holistic support to all of the abdominal and pelvic organs, including the muscles, in the pelvic area. Support to the pelvic area is very important in the immediate weeks after birth as your cervix dilated to 10cm(or more) to make way for the birth of your baby. Therefore the pressure of a longer wrap on the hip area helps the cervix shrink and allows the pelvic muscles to heal without being further stretched.

Steady, pressure and support on the hips allows the body to “close” more easily than if just left in its expanded state. The bengkung style of binding is known to help heal diastasis recti with the constant supportive pressure on the abdomen area. During pregnancy, musculoskeletal changes are stimulated by hormone secretions and the continuous expansion of the uterus. Some of these changes include:

1. Abdominal Wall Expansion and Separation
The growing fetus and the increasing weight of the baby puts pressure on the muscles and can stretch
the abdomen as much as 50%. The abdominal muscles on either side are joined by a narrow fibrous strip that thins as it stretches. Hormonal changes which happen during pregnancy also cause connective tissue to soften. When the muscles separate, their strength is reduced and this can lead to back pain. The condition is more likely to occur where the abdominal muscles were weak prior to pregnancy. It is vital that the abdominal wall returns to its normal location to protect internal organs and properly support the torso.

2. Spine and Posture Realignment
Posture is greatly affected as a baby grows larger in the womb. The pelvis tips forward to counterbalance the baby’s weight, which causes the pubic bones and tailbone to move backward, increasing the arch in the lower spine and creating a lordotic posture.

The upper spine simultaneously responds to this structural change by increasing its curvature, which rounds the shoulders forward, collapses the chest inward, and slides the head forward, creating a kyphotic posture. The combination of the kyphotic/lordotic posture results in the classic “S” shaped spine of a pregnant woman and is a direct result of a shifting center of gravity. This shifting of a woman’s center of gravity and spine can affect the nervous system and cause aching, weakness, and numbness in the body from poor circulation which can also cause swelling.

3. Pelvic Floor Relaxation
The pelvic floor provides balance, body stabilization, and vital organ support. The pelvic floor is the base of the core muscle system, attaching to the abdominal muscles and the sacroiliac joints. During pregnancy, hormones cause ligaments to stretch, which loosens the pelvic floor structure. This natural realignment allows the pelvic bones to open for the baby’s birth and makes a woman feel a bit wobbly on her feet. After birth the pelvic floor can remain loose and unstable for up to five months. Because the pelvic floor acts as the support system for the lower intestines, colon and bladder, these vital organs may be less supported for a few months immediately postpartum. This lack of organ support is the primary reason why women suffer incontinence when coughing, sneezing, or laughing after giving birth.

4.Back Support
Due to the design of the wrap, binding supports a woman’s back and so relieves the back pain associated with the immediate postpartum period. This also helps to reduce the strain involved in lifting and carrying a baby as well as provides back support when breastfeeding as most women don’t realize they are slouching and develop what's commonly referred to as "nursing back".

Sacred Cesarean Incision Support
One of the major benefits of a self-wrapping belly wrap is that it supports the muscles around the incision site, protecting the incision and therefore helps to reduce pain. The garment also props-up the stretched skin above the incision so it doesn't lie against the incision allowing the body to be able to heal better. This garment allows a woman to be more mobile and active while recovering during the first few weeks.

For the best results begin tummy binding as soon as you can after giving birth, ideally around day 5 but we have loosely bound a woman a few hours after delivery at her request, and then continue to wear it each day for at least 40 days and even longer if you are not satisfied with your healing. For the most benefits we recommend wearing your bind for 6-12 hours per day or even overnight.

I'm honored to be your Doula, but..

Isn't it everyone's goal in life to be happy in their career as well as be successful and earn a living off of the job that makes us happy?

This week is World Doula Week, it runs from the 22nd to the 28th of March every year. The purpose of World Doula Week is to empower all doulas all over the world to improve the health of birthing and postpartum women and newborns through support! As well as to me it's a bringing together of doulas to empower each other in their businesses. In honor of that I'm writing about the value of the doula.

When I attend a birth it is always an honor for me to be there, for a family to choose me to be part of this intimate moment. I always say thank you for letting me be there and tell them how great it is to have been a part of that moment with them. There have been times where I have provided my information to someone searching for a doula and told them I'd be honored to serve them. Later down the road I've had families ask, and heard from other doulas that they've been asked the same thing in some way, "If it's such an honor and a privilege I am giving you, why am I paying you?"

As a doula I am an extensively trained professional with a set of valuable skills that are helpful to you. Take any profession where one person has a set of skills you don't have yourself, you're going to pay that professional to do or use those skills for you whether they hate their job or love it. Just because I am passionate about what I do, doesn't mean I don't deserve to get paid.

The doula profession sometimes gets undervalued because people don't see the behind the scenes work.  When I am contacted by a client I then have to, if I haven't already, make up a folder for our consultation with all my information, contracts and helpful tidbits and referrals. I get a babysitter and plan a consultation and drive out to meet them. They hire me, insert little internal yay moment, I go home and make a schedule based on mom's needs and desires and what we discussed. I have to plan babysitters, contact my back up doula, inform my family and all that jazz. Informing my family is the hard part, especially when we discuss my on call period. I go officially on call for a mom 2 weeks before her due date and stay on call until she delivers. This includes holidays and birthdays, oh the pouts I get when I miss those times or they hear I'm on call over their birthday or certain holidays. In reality as soon as I have a client I make sure my birth bug out bag is packed and I am prepared to be called, which basically means 24/7 365. When I am officially on call every time we go out to dinner, the movies, the grocery store even, I have a plan of OK I have a mom due soon if he were to call and say she needs me what is the most efficient way for me to get to her in a timely manner. This, at times, means two vehicles, if I go to a play date relying on my great friend to watch my little one until daddy can come get her(no lie, it's happened!) I also take time out to go have a birth plan discussion and get to know the families needs, prepare them for their birth with however many prenatal appointments they've decided they want. Constantly updating myself on new techniques, I devote time and money every year into taking new training and continuing my education to be a better doula, taking the time to get to know the local care providers, hospital policies, state laws etc. Child care during all of this, gas, mileage and maintenance because of how brutal my profession is on my poor car. It's hard work!

Doulas have a high burnout rate, especially in areas where they're undervalued and they think as a new doula the only way I'm going to get work is to work for free, and that just isn't fair when they've paid for their training and have so many other expenses along the way even before they get their first client.

Their is a mutual honor and respect. We, as in the doula and the family, need to be honored to be together. It's a privilege for the doula to choose the family just as much as the family to choose the doula. I am proud to be a doula and I an proud of the families I've served.

How did I get so lucky to be the successful doula I am today and be doing what I love? I'm not lucky, I worked hard. I am a professional doula.