Doula Meet & Greet

TONIGHT! Starting at 6pm is our Doula Meet & Greet!

Whether you are an Embrace client or not, you are welcome to come Meet and Greet with the doulas! Learn the benefit of having a doula at your birth, and have the chance to meet several in one place.  Every doula is there to provide educational, emotional and physical support both during and after pregnancy. Some have backgrounds in physical therapy, others in yoga or massage, but they all share a passion for giving you the support you need!

Guide to Essential Oils in Pregnancy

It is safe to use some essential oils while you’re pregnant, as long as you’re healthy and you’re careful with them.  Essential oils are highly concentrated substances extracted from plants.  To give you an idea, 1 drop of peppermint oil is equal to 30 cups of peppermint tea! They are powerful, so it’s important to use them sparingly.  Be sure to buy high-quality oils from a reputable seller, like Mountain Rose Herbs, Aura Cacia, or Eden’s Garden. The MLM sellers of Young Living and DoTerra have good quality oils as well, but be prepared to pay 2-4 times the normal retail price.

Essential oils are used in aromatherapy, which is a complementary therapy.  The oils contain chemicals that can be absorbed into your body.  Essential oils can be diluted in a carrier oil for massage, or put in a vaporizer for you to breathe them in.

Once inside your body, essential oils work in the same way as drugs or medicines.  Because essential oil molecules are very small, there is a possibility that they may cross the placenta and reach your growing baby’s circulation.

We do not know exactly what effect essential oils may have on a developing baby.  Studies have only tested oils on animals, with varying results.

We do know that many mums-to-be find aromatherapy helpful in easy pregnancy niggles.  These include backache, nausea or swollen ankles.

If you want to use aromatherapy oils, it is best to take the following precautions:

• Only use one drop of essential oil at a time.
• Try not to use one particular oil for a long period of time, such as every day for serval weeks.
• Dilute the essential oil by mixing the drop with at least a teaspoon (5mL) of a base oil before you add it to a bath or smooth it over your skin.  Grape seed oil or sweet almond oil work well as base oils.
• You can add drops of the oil to a vaporizer, but don’t leave it on for longer than 10 minutes or 15 minutes in each hour.  If you leave it on for too long, the smell can be overpowering and make you feel nauseous.
• It is best to start using essential oils once you are past the first trimester.  If you use them in the first trimester, always consult an aromatherapist who’s trained in treating mums-to-be.

Oils that are safe for you to use

As long as your pregnancy is going well, it’s fine for you to use:

• Citrus oils, such as tangerine, neroli, and orange, which are said to make you feel calm and uplifted. Neroli also boosts skin cell regeneration so you will look and feel great!
• German chamomile
• Common lavender is said to bring serenity, relaxation, and balance (safe to use after 12 weeks).  It is also said to ease pregnancy aches and fluid retention.
• Ylang ylang can reduce blood pressure, comfort stressed or tense individuals and is an aphrodisiac (!).
• Eucalyptus is good if you're feeling congested.  It's a great anti-inflammatory, antiseptic and antiviral to ease respiratory ailments.
• Cypress is safe to use after 5 months and can help with varicose veins, swollen ankles, and hemorrhoids.
• Tea tree oil (not in labor) is a great anti-fungal and antiviral oil to ease the symptoms of thrush during pregnancy.
• Geranium boosts energy and promotes circulation.  Safe to use after 3 months, geranium can help relieve tired legs and help you feel refreshed.
• Sandalwood is amazing if you're having trouble sleeping or feeling relaxed.  It's a natural sedative and anti-depressant and eases cystitis during pregnancy. 
• Patchouli is good for those "baby-brain" days where it's hard to make a decision, this oil is said to alleviate apathy, indecision, and confusion.
• Frankincense 
• Bergamot
• Black Pepper
• Peppermint
• Ginger
• Rosewood
• Spearmint

Some of the last oils listed are considered emmenagogues (increases blood flow to pelvis) and therefore appear on both sides of the safe and unsafe lists, depending on the source.

Oils that are not safe for you to use

Don’t use the following essential oils while you are pregnant:

• Nutmeg, which may have hallucinogenic effects and react with pain-relieving drugs in labor.
• Rosemary, which is thought to increase blood pressure, and may cause contractions.
• Basil, which is thought to contribute to abnormal cell development.
• Jasmine and clary sage, which may trigger contractions.
• Sage and rose, which may cause bleeding in your uterus (womb).
• Juniper berry, which may affect your kidneys.
• Coriander
• Pine
• Fennel

Laurel, angelica, thyme, cumin, aniseed, citronella and cinnamon leaf should also be avoided as they could stimulate contractions.

There is a lot of confusion over the safety of lavender essential oil in pregnancy.  That’s because lavender can be used to regulate periods.  Rest assured that this does not mean using it in pregnancy raises the risk of miscarriage.  However, for the ease of mind, you may want to wait until your second trimester before using it.

Clary sage can be a great way to get labor started if used by a trained midwife for a mum who is overdue.  However, don’t use this oil yourself, as overuse can make your contractions too powerful.

In some circumstances, it’s best to steer clear of essential oils altogether. Don’t use any oils if:

• You have a history of miscarriage.
• You have had any vaginal bleeding in this pregnancy.
• You have epilepsy.
• You have heart problems.
• You have diabetes, blood clotting problems, or have thyroid, liver or kidney disease.

It is always a good idea to talk to your midwife before using essential oils.

Adapted from the babycentre and bellybelly websites.

The Doctor, The Midwife, The Nurse & The Doula

Addressing the most common questions and concerns of many expecting parents, but often times, their extended family.  We have so many mothers who walk through our doors wanting to have a natural birth administered by a midwife, but are lacking support from their family members.  It is understandable for parents, grandparents, aunts and uncles to be concerned for the well-being of you and your new family, but ultimately it is not their birth.  We believe that good information and the best up to date research is a great tool to ease the minds of concerned parties when it comes to your pregnancy.  Starting with the fundamentals....

The Doctor, The Midwife, The Nurse & The Doula
From The Prenatal Yoga Center

I wanted to share some questions with you that I am asked on a regular basis: “What is the difference between a midwife and a doula? “; “Does my doctor work with my midwife?”; “Why would I choose a midwife over a doctor?”; “Isn’t the nurse like a doula?” I figured the best way to answer all of these questions would be to finally sit down and map it out.

First, let’s understand the definitions of those terms and the job of each of the people mentioned.

Obstetrician: A physician who delivers babies and is in the practice of obstetrics, the art and science of managing pregnancy, labor and the puerperium, the time immediately after delivery.

You will see your OB/GYN or members of his/her practice throughout your pregnancy, although who your care provider will be at delivery depends on who is on call during your labor. During the labor, the doctor will come in and out to check on your progress and, as the definition above states, “manage” your labor. Obstetrics is also a surgical field, so in the case of a cesarean, it would be your OB that would perform the procedure.

Midwife: A midwife is a trained professional with special expertise in supporting women to maintain a healthy pregnancy birth, offering expert individualized care, education, counseling and support to a woman and her newborn throughout the childbearing cycle.

A midwife works with each woman and her family to identify their unique physical, social and emotional needs. When the care required is outside the midwife’s scope of practice or expertise, the woman is referred to other health care providers for additional consultation or care.

Midwives operate from The Midwives Model of Care which emphasizes the fact that pregnancy and birth are normal life processes. Midwives statistically have lower rates of interventions and provide the mother with individualized education, counseling, prenatal care and postpartum support as well as continuous hands-on assistance during labor and delivery.

Midwives, like doctors, may work in a group that rotates who is on call and who will see you for your prenatal visits. Some midwives work alongside doctors in their practices, while some work individually or outside the hospital setting. There are different types of midwives: Direct Entry Midwifes, Certified Professional Midwives, and Certified Nurse Midwives. Depending on their credentials and training, some midwives work in hospitals while others solely attend home births.

Labor and Delivery Nurses: Nurses in this field provide care to women who are in labor or who have recently delivered, or for those who may be having complications with labor. They also work with doctors to develop a plan to aid in the safe delivery of healthy babies.

Labor Support Doula: A trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.

Unless the doula has additional training, she is NOT a medical professional and will not perform medical procedures on the laboring mothering or deliver the baby. However, she most likely will be one of the most consistent elements of the labor experience. She does not change shifts and only deals with one client at a time. The doula will also labor with you at home and come with you to the hospital or birth center.

Now that there is an understanding of what each professions offers, it may be clearer how they might or might not work together. So, back to the original questions:

What is the difference between a doula and a midwife?

As described above, the doula acts as an emotional, physical and informational support for the mother. While the midwife may offer many of those same qualities, it is the midwife that will deliver the baby and perform the necessary medical examinations throughout pregnancy, labor, delivery and postpartum. Midwives are also available to do “well woman” yearly exams throughout a woman’s life, not just working with her while pregnant.

Does my doctor work with my midwife?

Yes, sometimes a practice has both doctors and midwives. But if your current doctor does not work with midwives you cannot have both as care providers. If a midwifery practice does not have a doctor as part of the group, there will be a doctor that backs up that group. However, if you choose a home birth, you will have just a midwife; should you need further medical assistance, you would be transferred to a hospital. Some midwives have privileges at a hospital, while others just have a relationship with a doctor and will no longer be your care provider should you be admitted.

Why would I choose a midwife over a doctor?

Choosing your care provider is a very personal choice. It requires a long, hard look at the model of care you would like for your pregnancy and delivery. While both professions try to offer the best care they can to women, the path in which that support is offered differs. The Model of Care that midwives subscribe to reflects the idea that pregnancy and birth is a natural physiological process that should be inherently trusted, while the medical model focuses on the pathologic potential of pregnancy and birth. They both have the same desired outcome, but use different routes to get there.

You should also consider the style of care you personally prefer. Midwives will tend to be more present during labor; moreover, they will be more holistically based and allow more space for the labor to unfold naturally before moving to medical interventions. Doctors are not as likely to give you as much personal care and time and may move to medical interventions more quickly.

Isn’t the nurse like a doula?

Many of the Labor and Delivery nurses (L & D nurses) I have worked with are wonderful and can offer a lot of helpful advice for the laboring mom. However, I would not advise depending on your L & D nurse to provide the same comfort and assistance as a labor support doula. The L & D nurse often has several women they are monitoring at the same time and cannot offer consistent support since they work in shifts and breaks. You may also find it appealing to choose your labor support doula and have the opportunity to previously discuss you birthing preferences with this person.

Now that the cast of characters has been laid out, I hope this makes it easier to make decisions about the model of support you will receive and who you would like at your birth.

To Push or Not To Push? Only you can answer that question!

The more research that goes into birth, the more we find out how instincts and natural intuition plays a role in successful birthing.  As a western culture we have grown accustom to doctors telling us how to care for our bodies as if it were separate from ourselves.  Ultimately, if we are in tune with our bodies, we can decide the right steps to take as long as we have access to good information!  That is our ultimate goal at Embrace Midwifery & Birth Center, to equip you with good information for you to make the best decision for yourself!  We believe all birth is beautiful and agree with Dr. Rachel Reed, the author of this wonderful article that, "a powerful, primal, loud and ‘out of control’ birth is just as amazing and valid as a gentle, quiet ‘in control’ birth."

Pushing: leave it to the experts
By Dr. Rachel Reed

A birthing woman is the expert regarding when and how she pushes. Providing directions implies she needs our guidance and we are the experts. Of course each woman and birth situation is different and in some circumstances guidance may be helpful for a woman. This post will examine the implications of telling women when to push, how to push and not to push during birth.

This post is based on part of a literature review I carried out for my PhD. You can find more information and the reference list in my Phd thesis (p.19 to 24) or on a research poster you can download here.

Telling women to push

There is overwhelming evidence that directed pushing results in increased morbidity for both mother and baby, and amongst other things is associated with: Mother – altering body fluid pH resulting in inefficient uterine contractions; maternal fatigue; and metabolic acidosis. Baby – interferes with the gradual descent and rotation and increases risk of hypoxia.

In addition directed pushing does not reduce the duration of the ‘second stage’. However it does result in the common scenario of: Woman is directed to push = baby becomes hypoxic and fetal heart rate abnormalities are heard… woman is shouted at to push harder to get her stressed baby out quickly… woman pushes harder… baby becomes more hypoxic and stressed… obstetrician is called in to rescue the baby and pull it out.

Telling women not to push

The cervical lip

The most common reason for telling a women not to push is that her cervix is not fully dilated. Often when a baby is in an occipito posterior position the woman will feel the urge to push before the cervix is completely open. She is then told not to push because the lip will swell up (and/or tear) and prevent the baby from descending. Not pushing is an almost impossible task and many women in this situation opt for, or are encouraged to have an epidural so they can stop pushing. The baby is then less likely to rotate into an anterior position because the pelvic floor tone is reduced and the woman is unable to move.

There is no evidence to support his notion of a swelling cervix and I am yet to encounter the situation as a result of  ‘premature pushing’. In some cultures it is tradition for the woman to push with each and every contraction from the beginning of labour. Surely these cultures would have died out if the outcome had been swollen/torn cervices and stuck babies. Studies (Borrelli, Locatelli & Nespoli 2013; Downe et al. 2008) have found that the incidence of ‘early pushing urge’ EPU (as it is referred to in the literature) is between 20% to 40% and is not associated with complications.

When we tell a woman not to push the message is ‘your body is not working correctly and is sending you the wrong messages – you need to fight against it’. Fighting her body until she is ‘allowed’ to push may result in difficulty switching into trusting and following her body once given the ‘go ahead’ (Bergstrom 1997). For more information about pushing and cervical lips see this post.

Breathe don’t push***

I need to breathe before I write this next bit as I am sure it will offend many – some of them my friends. So please feel free to comment and share your alternative views. Here goes… there seems to be a growing trend of telling women to resist their instinctive urge to push. The idea is to ‘breathe’ the baby down gently, and it does sound lovely. However, I have spoken to a number of women whose birth stories conveyed a sense of failure because they were unable to achieve this gentle ‘birth breathing’. I have also seen women attempting this during birth – struggling to breath upwards lightly to avoid the guttural downward pull of their body.

Hypnobirthing – the Mongan method seems to be one of the key advocates of this no-push technique and I recently read the book in an attempt to understand the approach. Overall the book has many positive messages for women about their innate ability to birth. However, I have concerns regarding some of the concepts (which I will blog about in the future) in particular ‘birth breathing’ . I agree that staff directed pushing is not good (see above) but I disagree with the following quote: “Often women speak of an overwhelming urge to push taking over. If this is felt it is also because of conditioning… our animal sisters elect to gently expel their babies” (Mongan 2005, p.129)

Pushing is physiological and instinctive, and a feature of all mammalian births. To tell a woman that if she pushes she has given in to external programming and her baby will not enjoy a gentle birth is disempowering – especially for those who fail to override their ‘conditioning’. A powerful, primal, loud and ‘out of control’ birth is just as amazing and valid as a gentle, quiet ‘in control’ birth.

***We strongly believe in choice, and while we are strong advocates of Hypnobirthing, we don't believe in edited or convenient information.  We have had an amazing success rate with our Hypno-mamas, and while we don't practice telling mothers when to push, we have too many amazing births and testimonies to reject its effectiveness and find that it does facilitate calmer births.

Suggestions for Midwives

Antenatally

• Find out what the woman’s expectations are about this part of labour.
• Reinforce her belief in her own innate ability to birth and explain that this is the reason you will not be telling her how and when to push. This is important as some women will interpret a lack of instructions as a lack of support if they are expecting to be told what to do (Anderson 2010; Parnell et al. 1993).
• Encourage first time mothers to talk to other women and read birth stories written by birthing women. This will give her some idea about what it may feel like, and how different it is for each woman.
• Show her ways to connect with her body and relax her pelvic tissues so that she can use this in labour if needed. 
• If the woman is planning a hospital birth she will need to be prepared for hospital practices including directed pushing – a Doula and a birth plan can help. The Maternity Coalition have a good info sheet aimed at parents.

During birth

• Avoid interfering with the physiological process ie. only do or say something if it is really necessary.
• If the woman tells you she feels the urge to push, reassure her that this is good. Don’t tell her to push. There will come a point when she is pushing rather than feeling an urge to. Gloria Lemay has recorded an audio ‘pushing for first time mothers’ explaining why this is so important, especially for first time mothers.
• If she is extremely tense and the baby is not descending encourage her to use the techniques she learned antenatally to relax her pelvic tissues and open.

In essence – telling women when to push, how to push or not to push contradicts the notion that women are the experts in their own births.

Pushing with an epidural

The information above is about physiological birth i.e. a woman birthing without intervention. An epidural can alter the ‘urge to push’ and prolong the descent of the baby once the cervix is open. An evidence based approach to pushing with an epidural is to wait until the baby’s head is visible i.e. is almost birthed. Then, if required, actively push to birth the baby… it should only take a few pushes. This approach reduces the chance of an instrumental delivery and decreases pushing time (Brancato et al. 2008). I have worked in a hospital where this was the standard approach and there was a lot less fetal distress and perineal trauma for women with epidurals.

It is also beneficial to help women with epidurals to get off their sacrum to increase pelvic space. So, semi-supine is perhaps the worst possible position. Many women can move and kneel or squat with an epidural – if not a side lying position allows the sacrum and coccyx to shift backwards.


For more great information and to read this article, visit MidwifeThinking.com

Beginning the Birth Journey...A Community Class at Ellwood Thompson's

Corina Hossle will be speaking at The Beet Cafe community classroom at Ellwood Thompson's on Wednesday, August 3rd at 6:30pm for an educational hour about beginning the beautiful birth journey!

Join us as we Begin the Birth Journey…

From Conscious Conception through the First Trimester, the emotional, physical and spiritual well-being of both Mothers and Fathers impact their baby’s development and future…the cells that will create your baby are being nourished now!   Corina Hossle, Midwife and Birth Center Founder, will lead you through an informative and inspiring evening, giving you the tools you need to create an optimal pregnancy and birth.

While discussing the importance of preconception nutrition, we’ll cover simple and effective ways to increase your health.  Learn natural tricks to help you thrive— and not just survive, the physical changes and challenges of the first trimester.  Take away accurate and up-to-date information on the safety of herbs, homeopathics and essential oils during these critical first weeks of fetal development.

Partners are welcome!

This class is FREE!