I am so beyond excited to share this with you today! I was interviewed by the lovely Sarah Asay from The BirthCircle Podcast in November of 2019. My interview episode was just released, “Taking the Fear Out of Birth.”
Really this episode covers birth and postpartum support. I even share my journey through Postpartum Anxiety and Panic.
I hope you enjoy this episode. Thanks for the opportunity, Sarah. Can’t wait to do something like this again.
I’m Rickie Bryner, a Lamaze Certified Childbirth Educator and Certified Postpartum Doula. I have been supporting expecting and new families for 15 years. Click to learn more About Me.
Promoting Safe and Healthy Birth
There are essential principles (all evidence-based) that can lead to a SAFE, HEALTHY, and POSITIVE birth experience. We all want healthy outcomes as we bring our new little one(s) earth-side. Knowing what to ask your provider, what to look for in a birth facility is essential to a healthy, positive birth.
Lamaze International is committed to promoting healthy outcomes for families and has put together 6 Recommendations for a Safe and Health Birth Experience, all based on years of research and evidence-based care. While labor can throw the unexpected at you, these recommendations will stack the odds in your favor and can help reduce the need for un-needed interventions that can lead to un-wanted complications.
I want to share these SAFE Birth Principles with you AND I want to give you key questions you can ask your provider, or that you can ponder together with your birth team.
These essential questions will help you think about the birth experience you want, help you know what to ask your provider, and help you COLLABORATE for the most positive outcomes.
Let Labor Begin on its Own
Of course there will be times when an Induction (medically starting labor) is necessary for the health of mom or the health of baby. What a blessing it is to have the ability to start labor when needed! I needed to be induced with my first baby after showing signs of pre-eclampsia, which can be very dangerous for mom and baby if left untreated. However, it is important to let Labor begin on its own when an Induction is not Medically Necessary (Lamaze Healthy Birth Practice #1).
Some studies show an increased risk of Cesarean birth in first time mother’s that are induced when their body is not ready for labor to begin (i.e. a low Bishop’s Score). The bottom line, a body that is not ready for labor will not respond as well to Pitocin (the medication given to stimulate contractions in an Induction). Induction can also interfere with the hormones naturally designed to help labor progress and promote bonding and breastfeeding after baby is born. Here is a great Position Paper on letting labor begin on its own.
Here are some good questions to ask your provider and to consider when talking about an induction.
What is the reason for this induction? What is the benefit of starting labor now? What is the risk to mom or baby if we wait?
How ready is my body to begin labor? Is there anything I can do to ripen my cervix and help my body be more prepared to receive Pitocin if necessary? There are some options such as Cervical Ripening agents, Stripping the Membranes and possibly some other natural methods to help soften your Cervix.
What are the risks to mom and baby if we proceed with the Induction?
Do we have any alternatives we can try?
What does your gut tell you about doing this?
How much time do we have before we need to decide? Usually there is some time where you and partner can talk about the decision and decide what feels best.
What support and comfort techniques will be most helpful for this induction? You should be prepared for stronger, more intense contractions & more monitoring of you and your baby. You will need extra physical and emotional support from your support team.
When I was in labor, I honestly wanted to move. I dreaded arriving at the hospital and having them say “please lay down so we can check your cervix.” I loved walking, rocking, leaning forward and having my amazing husband, Mike, give me a deep lower back massage. At one point in labor with my 2nd baby, I was leaning over the back of the bed doing push ups! I probably looked funny to everyone else but it was helping me cope with the pain. Listen to your body and it will tell you what it needs.
Movement will help ease the pain of contractions as you seek positions that feel comfortable for YOU, not that are most convenient for those caring for you.
Movement and upright positions can help baby descend more effectively into your pelvis. Changing positions keeps labor moving along and helps contractions to be more effective. When you choose positions that feel right and most comfortable, they are usually the positions that will ease discomfort AND help labor progress most effectively.
The pain of labor has a purpose – to communicate with you – what both you and your baby need.
Here are some good questions to ask your provider or birth space (i.e. hospital, birth center) about positioning and movement during labor and birth.
Is intermittent (versus continuous) monitoring used for mothers and babies that are not considered high-risk, babies that are tolerating labor contractions well, or mothers that are not using pain medication? Intermittent monitoring will allow you to be free of monitors and wires and allow more movement. You can also ask about newer “wireless” or mobile monitoring that may be available at your birth space.
If I do need to be monitored more carefully, are the staff supportive of upright positions and other position changes I can do near the bed or monitoring equipment? Will they be helpful in suggesting ideas and encouraging this? You could also incorporate this language into your birth plan.
Are women allowed to move around during labor at this facility and are they encouraged to do this? For instance can I walk around, slow-dance with my partner, use a birth ball or get into the tub or shower?
Do you provide Birth Balls or Peanut Balls to facilitate position changes, movement, and comfort? If I would like to use these, do I need to bring my own? Do you have enough of these to accommodate the needs of mothers that use this birth space on a busy day?
Are there rocking chairs or chairs that do not have side arms that I can use for positioning, movement and comfort?
Can partner get into the shower or tub with me to provide additional support as needed? Some facilities have policies surrounding this so it is really important to ask.
Are your provider and birth space ok with squatting, side-lying or hands and knees position for pushing and/or delivery? Are there any times they do not encourage these positions? Is at least a semi-upright position encouraged for mom during the pushing phase of labor?
Continuous Labor Support
The environment in which a woman gives birth can directly impact not only her confidence and ability to give birth but can absolutely spill into her confidence and early bonding with her baby as a new mother.
I am reading a book about this very topic right now and it fascinates me how these two things are related yet often overlooked. I could go on for days about how much I loved my doula with Logan’s birth (my 2nd child). This is the birth I felt like I thrived the most postpartum, even with a NICU stay thrown in the mix for him. I felt loved, wholly supported, and cared for.
According to research (and thousands upon thousands of personal reports), doulas can reduce the risk of Cesarean birth, the use of pain medication, and decrease medical intervention use. Moms that have doula support are more satisfied and have more positive feelings about their birth experience. Lamaze Health Birth Practice #3
If you are not able to afford a doula, it is so important that your partner or support person is well-informed about how to best support you. A good childbirth class can really help you both feel prepared & partner feel equipped for this role. A continuous, reassuring presence can make a huge impact on your ability to relax during labor, cope with contractions, and can even decrease the length of your labor.
Here are some good questions to think about when hiring a professional doula for support.
Does your provider support a mother that has chosen to bring a doula for additional labor support? Is extra support encouraged? There are some providers/facilities that don’t like doulas and this could be a sign of impending conflict during labor. Make sure your provider and birth space are supportive of doula care. Doula support is evidence-based and a very good thing.
Has your doula been professionally trained? I personally recommend doulas that have been trained by a professional/reputable organization (ie CAPPA, DONA and others). This will ensure your doula meets professional standards and has been trained on the best evidence-based birth information available.
Does this doula have excellent collaboration skills – are they able to advocate for you as well as communicate professionally with staff and others supporting you.
I recommend interviewing a few doulas to find the right fit for you.
Cost can be difficult for some families. Many doulas offer services on a sliding scale so don’t be afraid to ask about this, or see if a doula can recommend a fellow doula that offers lower cost packages. Sometimes certifying doulas need to attend a certain number of births to obtain certification, and may be willing to support your birth at a lower cost.
The bottom line? You deserve an incredible birth experience. Do your research, ask questions and become involved in your care. This will ensure the best possible outcome for you, your baby and your family.
I’m Rickie Bryner, a Childbirth Educator and Postpartum Doula. I am passionate about helping expecting families prepare for baby & have been supporting families for 15 years. Click here to learn more about me: Rickie Bryner, BS, LCCE, Postpartum Doula
I get asked regularly, “How can I have the best Postpartum Experience possible?” “What do I need to plan for?” “How do I prepare for life after baby comes?” Postpartum Planning isn’t just for 1st time mamas. Sometimes even 2nd and 3rd time (and beyond) moms want their next experience to be smoother than the first.
Feel free to share this with anyone you know that is expecting. (Extra idea: for a baby shower, don’t give the usual card with your gift, instead give them this planning guide – you can tell I am extra passionate that every mom needs this – haha).
This Ultimate Postpartum Planning Guide contains all the questions I want expecting mothers and new families to think about BEFORE they are in the trenches – feeling exhausted with dropping hormones, recovering from giving birth, and adjusting to their new little one. Believe me, the first few weeks and months after baby arrives can feel like a blur, but if you have thought through these questions ahead of time, it will make your transition to motherhood easier. When you have a back-up plan for any bumps in the road, ideas for getting more rest, and where to turn for support, you will thrive even if things don’t go perfectly as planned.
Ideas for Self Care, a Postpartum Supply List & Postpartum Affirmations are included as well so you can have the best recovery possible. Here is the link to download this complete guide: Ultimate Postpartum Planning Guide
P.S. I have to give a shout-out to Michelle White with Rest Dress. She originally started working on this and then invited me to collaborate with her. I love the Rest Dress and her vision for helping new moms along their journey.
Have you wondered what you need to buy and have on hand to help get breastfeeding off to a good start? Here are my favorite tips and product information. I am not getting paid for any of this, these are simply my best helps after working with expecting and new mothers for over 14 years (and being a busy mom to 4 myself). All the best wishes on your breastfeeding journey.
Keep in mind that you don’t need to spend a lot of money to get breastfeeding off to a good start. Some of these are essentials & some are “would be nice-to-have’s.” Some of the extras could be added to a baby registry list or would make a nice gift if you are having a shower.
I think it is good to have at least two on hand for the first few weeks after delivery. You might wake up and leak milk in the middle of the night and leaks can happen at random times as your body is figuring all of this out – so an extra bra makes for less laundry.
You can always get fitted for the perfect bra once your milk has transitioned, any engorgement has stopped, and as your body returns to its non-pregnant self.
Avoid underwire nursing bras. I can’t emphasize this enough! Underwire bras are extremely difficult to place perfectly. They can put pressure on milk ducts leading to clogged ducts which might eventually turn into mastitis.
Look for soft cup or supportive, yet non-constrictive sport nursing bras. I have also seen some very cute camisole-type nursing bras. These might be uncomfortable, however in the event of a cesarean as they’ll put extra pressure on your surgery incision. But for a vaginal birth or once your incision has healed, some women really like these.
I suggest a nursing bra with a similar cup size as you became in pregnancy. Most women go up about 1 cup size in pregnancy, so stick with this size for your nursing bra. Most nursing bras allow for about 1 cup size in expansion which will be helpful in the first week as your milk supply may be abundant at first or if engorgement occurs. Once your milk starts to regulate better you will likely be closer to the cup size you became in pregnancy. Not always, but this is a good starting point.
If selecting a soft-cup bra, you may want to go down a band width size after a month or so as your rib cage area will get smaller after baby is born. If you want your nursing bra to last longer and not purchase a new one in a month, go down one band-width size when purchasing. For example, if you were a 34 before pregnancy and are now a 36, go with a 34 for your nursing bra.
I love the selection of nursing bras now. They used to be so hard to find. Now I seem to find cute ones at Target, Kohl’s, JC Penney online and more. I also really like Medela’s nursing products. Here is a link to learn more – Medela Nursing Clothing
If you will be returning to work and wish to pump breastmilk while away from your baby, a hospital-grade, dual electric breast pump is best. Check with your local hospital to see if rentals are available or check your local breastfeeding store.
If you are not able to rent a hospital-grade pump, a dual electric pump is your next best option. Dual means that you pump both breasts at the same time. Most insurance companies are covering a breast pump now, which is wonderful news! Check to see what they will cover. My favorite pumps are made by Medela. Here is a great one to use if returning to work – Medela Symphony Pump – I know a lot of moms really like the Spectra pumps, but I have heard and seen first-hand they are not as great at removing milk (a key ingredient to maintaining supply). I think both pumps are great overall, however. If you can’t afford those or your insurance won’t cover them, look for as high of quality dual electric breast pump as possible.
Pumping both sides at the same time releases more prolactin in your body and helps maintain milk supply.
Car adapters are an amazing thing!! Consider this feature if you think you may need to express milk in your car.
I think a small manual breast pump is also great to have on hand for those times you might be separated from baby briefly and don’t want to take your entire pump with you. I love Lansinoh’s Manual Pump the best but there are lots of great ones out there.
Breastmilk Storage Bags
They now have zip-loc storage bags for breastmilk. Back in my day, we used twist ties. I love these Lansinoh Storage Bags – you can usually find them at Wal Mart, Target in the Breastfeeding supply section.
I recommend storing smaller amounts of milk in each bag – perhaps in 2-3 oz increments (even though the bags will hold more).
You will find that breastmilk becomes a precious commodity. Once you thaw it, it is good for 24 hours in the refrigerator. If it is placed in a bottle for baby after thawing, it is only good for about 2 hours. So you won’t want to fill up a 4 oz bottle and have baby only take 2 oz. It would be better to start out with a small bottle and warm up more if baby is still hungry.
Never warm breastmilk in the microwave – it can kill the wonderful properties in the milk. Use a cup or bowl of warm water.
Medela Steam Bags
Ok I just love these Quick Clean Microwave Bags for quick, deep-cleaning of your breast pump, bottles and all the parts! You can use each bag up to 20 times. These were one of my favorite inventions.
Haaka Silicone Manual Pump
I had one mom tell me this made her life so much easier. Sometimes when you begin nursing on one side, your milk will simultaneously let down on the other breast. Rather than letting this precious milk go to waste into your nursing bra, you can place the Haaka hands-free silicone cup onto the breast you aren’t feeding from and capture some of that milk to store for later.
I recommend purchasing SMALL packages of a few different types of nursing pads. These will capture those small leaks that can occur if your milk randomly lets down when you are not feeding your baby.
Everyone has a different preference so go with what speaks to you. Some moms prefer washable/re-usable pads. Some like the disposable.
Change your nursing pads frequently, especially if they become wet. The wet, dark environment near your breast can easily lead to a yeast infection if moisture builds up combining with the sugars in your milk.
If your nipples are sore, the first thing you need to look at is your baby’s latch. That is the #1 cause of sore nipples – a poor latch.
However, if your nipples are dry/cracked you want to make sure they heal so that bacteria doesn’t get into the breast area and cause a breast infection.
Lansinoh hospital-grade lanolin can be applied after the feeding. A little goes a long way. Most if it will be absorbed by the time baby nurses again, however, it is safe for them to ingest if a small amount remained.
Cost-Saving Tip: Instead of Lansinoh, try expressing a few drops of breastmilk after baby nurses and then rub this into the nipple and areola. The breastmilk will naturally moisturize the breast and is also filled with antibodies to protect against infection.
The Rest Dress
I love this dress because it helps you rest and recover while still feeling beautiful after birth. Rest helps to increase your milk supply.
I also love this dress as it allows for skin-to-skin with your baby any time. Skin-to-skin promotes breastfeeding and boosts milk supply as well.
Boppy or Support Pillow
This can help baby be in a comfortable position while nursing.
If mom is relaxed, baby will relax more while latching on and during the feed. This is our goal.
You can use regular pillows but this is a nice extra to have if you can afford it or if someone gives it to you as a gift.
You can also use this pillow for tummy time as your baby gets a little older (supervised tummy time of course). It will elevate their chest and make tummy time more comfortable and enjoyable as they are first beginning to do floor tummy time (around 2 months of age).
A Few Other Recommendations:
Stool or ottoman to put your feet on while nursing.
Favorite water bottle – you will get so thirsty when baby latches on. You should be drinking lots of healthy fluids throughout the day to help your milk supply and stay hydrated.
Lots of easy to grab and healthy snacks. You will be hungrier when you breastfeed. You need about 500-600 extra calories/day than what you needed before you became pregnant.
A good support group or find your local La Leche League where you can call or attend support groups. La Leche League
The number for a great lactation consultant in your area!
Written By: Rickie Bryner, BS, LCCE, Postpartum Doula
I can’t tell you how many expecting mothers say they are nervous about giving birth. One mom even used the word “terrified.” It seems like once you become pregnant, people tell you all the dramatic labor and birth stories they know, not the stories where things go wonderfully well. Sound familiar?
I feel like I am on a mission to help women restore trust in their bodies. Your body has unique wisdom and an innate ability to give birth. In fact, your body was designed for this very purpose! Trusting your body, that it knows what to do and that it will communicate with you during labor can remove some of the fear you have. It will help you feel confident and ready to embrace this life-changing experience.
Of course, things don’t always go according to plan during labor. Your care provider is there to not only support you as you give birth but to help in any situations where intervention is needed for the health of mom or baby. We are so lucky to have many life-saving tools and resources.
However, remember that usually labor and birth outcomes are positive. To illustrate this: think about how many stories you have heard on the news of mothers giving birth in the car. Most of the time, mom and baby are very healthy and there was no intervention. Her body knew what to do!
Here are a few interesting facts that may help you regain trust in your body.
Placenta: Your Body Grows an Entirely New Life-Sustaining Organ
I usually ask my classes, “How many of you had to lay there each night during pregnancy and tell your body to grow a placenta?” They all shake their heads. The placenta is a new organ that your body creates to sustain baby’s life during pregnancy. All of the nutrients and oxygen baby needs travel from mom to baby through the placenta. All waste products baby can’t process are given back to mom through the placenta. It is an incredible organ that YOUR BODY CREATES!
Relaxin: Your Joints Soften
During pregnancy, a hormone called Relaxin is released in your body (1). This helps to soften your joints. Your body knows that baby will need to travel through your pelvis in order to be born. Relaxin helps the pelvic joints soften to ease baby’s passage. It may lead to soreness for mom during pregnancy, and you will need to move more slowly as pregnancy progresses; however, it is your body’s way of preparing for birth.
Why You Dilate to 10 Cm
Did you know that as baby engages into the pelvis, their chin is usually tucked in towards their chest? If we were to measure the “bi-parietal” diameter of you newborn’s head at that point, it would average about 10 cm (Source 2). It is no wonder that your body dilates to 10 cm during labor in order to allow passage of baby into the birth canal. Your body and baby are designed to work together in order for baby to be born.
Pain of Labor
The Pain of Labor is actually very important. It can communicate what mom needs to do to birth her baby (3). For example, a mom may develop an intense backache during contractions. This could be because the baby is in a posterior position and having a hard time traveling through the pelvis. At this point mom will usually be uncomfortable lying down and want to find a different position (usually on her hands and knees). Finding a position that is most comfortable will often help the baby rotate and lessen moms pain during contractions.
Your body knows what to do…listen to what it is telling you during labor and birth and seek positions that are most comfortable for you.
Breastfeeding: Your Body is Already Preparing
Your breasts account for about 2 pounds of the total weight gain you will experience during pregnancy. This is because the milk-making glands and fat deposits are increasing in your breasts to naturally prepare your body to make breastmilk.
As early as 20 weeks of pregnancy and beyond, a pregnant mom may notice a yellowish substance at the nipple. This may even leak out when mom is relaxed or in the shower. It is called “Colostrum” and is actually the first type of breastmilk your body makes.
Your body is so wise and knows that it will need to sustain life after baby comes – it starts preparing early on in pregnancy.
Your Inner Wisdom Will Guide You Through Pregnancy, Labor, Birth and Beyond
This is one of my favorite Lamaze Fundamentals. I have seen the truth of this repeatedly as I have supported families over the years and watched parents make decisions that just “felt right” for them. There will be times that you may feel strongly about avoiding or needing a medical procedure. There will be times you will be guided to the place you give birth or the care provider you choose. There may be times you have a feeling about what your child needs. Listen to your gut; usually it is right. Your body knows what it needs and your body knows what to do.
I’m Rickie Bryner, a Lamaze Certified Childbirth Educator and a CAPPA trained Postpartum Doula. I have been teaching prenatal classes and supporting expecting families for over 14 years. I have a passion for helping moms and partners take the fear out of birthing, replacing it with confidence and all the tools they need for their journey. Click here to learn more about me About Me. Learn more about my classes here Childbirth Classes.