#1: A Doula

What is a doula?

I had a successful natural birth with few complications (though it hurt like crazy) but I tried to stay flexible. While I was able to “go all the way” and was fortunate to not have had any complications my main goals were as few interventions as possible no matter what method I ended up taking. A doula was a life saver at those crucial 8-10cm for me. The great thing is that a doula is more than a natural birth coach, they are your advocate in the room for your best birth outcome. They have seen numerous births of all kinds and are typically up to date on evidence based practices for everything from pain to stress reduction. They can help you think in moments that are hard to think in and help your birth partners be able to best help you in your time of need and maintain the atmosphere that you need for this task ahead of you. This means you have someone in your corner whether you get an epidural or even a c-section. Oftentimes they are knowledge about lactation and can help keep your birth preferences (and health) at the forefront if and when your birth plan does change. When getting an epidural, a doula can be key to helping you progress your labor and wait for the best timing - without waiting too long. Doulas can help the physical progression of labor, the mental difficulties, they can help you process quick decisions, give your labor coach or significant others ideas on how to be a better helper, they can even help handle tricky family drama during the action. All of this is to keep you in the right headspace for your best delivery, regardless of your method. At my delivery hospital the hospital doulas can even accompany you in for c-sections. They help advocate for your voice when the hours and the pain may have stifled it.

As a process improvement professional in the healthcare industry, I’ve learned handoffs mid-delivery between shifts and staff can lead to breakdowns in communication and are something hospitals need to actively work towards improving. However, this isn’t easy or guaranteed but your doula is your advocate for your entire delivery, two hours or 42, helping to bridge gaps in your care.

My first baby ended up being a “compound presentation” with other challenges such as meconium being present. She has a low Apgar score and required the NICU team standing by to attend to her. This meant several aspects of our birth preferences not happening including immediate skin to skin, delayed cord clamping, and my partner cutting the cord. This was very sudden and confusing in the moment but my doula quickly stepped in as our advocate to keep us apprised of what was happening and focused on what we could do in the moment. I believe this would have been a very traumatic part of our birth had our doula not been there for us - a benefit I would never have imagined when I signed up for a doula!

#2: Pelvic Floor Therapy

This mother’s day I saw a sign that said “your mom pees when she laughs because of you - buy her some flowers!” and while this sentiment seems very commonplace, this doesn’t have to be the case!

Pelvic Floor Therapy is physical therapy meant to teach your body how to strengthen and correctly engage your pelvic floor. I’d recommend this to anyone who has carried a baby, regardless of how you had your baby (as well as anyone else who might be facing symptoms that this can address - including men!). The most common symptoms are urinary leakage when jumping or laughing, pain with sex, diastasis recti, tight scar tissue, and pelvic “heaviness.” This can even be helpful post c-section for scars and regaining core function. I was convinced by reading an article during the final days of my pregnancy.

In other countries pelvic floor therapy is standard postpartum care. Throughout my pregnancy numerous healthcare providers and lots of internet sources recommend kegels - lots and lots of kegels. This may be the US “catching up” on pelvic floor health with these recommendations. However, this therapy taught me how to correctly do a kegel and helped me learn that I had not been fully relaxing my pelvic floor. This relaxing allows it to work as my body’s “suspension system” keeping unwelcome pee in and protecting my body from sudden movements (like coughing or jumping). Trying just a one-visit assessment to see if pelvic floor therapy could help, I think, is worth it since even with a perfect delivery a body undergoes stress that could impact your pelvic floor not to mention the months of pregnancy strain on the body.

Considering the usual circumstances of birth that may involve extended pushing, labor interventions like episiotomies, tearing, and the possibility of diastasis recti, every woman I’ve met could likely have benefited from pelvic floor therapy. For me, I treated it as my postpartum “me time” to help me focus on healing and feel confident about getting back to my pre-pregnancy life of working out and intimacy. I felt “good as new (or better!)” 19 weeks postpartum from my first birth. As an added bonus, I learned a lot about breathing and posture that I use every day. Here’s a website I used to find my therapist.

For my subsequent pregnancy and birth I completed pelvic floor therapy both before for my pregnancy symptoms and preparation for labor, and after delivery. Turns out for my second labor I had a much easier time pushing as I was able to understand how to relax my pelvic floor and fully “bare down.” I didn’t have this mind muscle connection during my first delivery and it made me feel more confident through my second. This proved especially important for me as my second was a shoulder dystocia that required significant labor effort and a quick-thinking team to help us avoid significant intervention or injury.

For both of my births, my doulas and my pelvic floor therapy were key aspects that helped me feel more in control of my birth stories, even when problems came up. I believe these made a world of difference to my family and my health, and maybe they could for yours too.

*These may seem like benefits restricted to those who have funds to pay for these services but in many areas in the United States these services may be offered to families based on need. Ask about options for you.