10 Ways to Make a Hospital Birth More Comfortable

As a doula, I attend home, hospital, and birth center births.  One of the roles I try to facilitate in the hospital is creating a quiet, calm, soothing and comfortable environment in which the birthing woman can labor as uninhibited as possible.  When choosing a hospital birth, what are some ways you can make the hospital environment and room as comfortable as possible?

1) Have a support person to ease the transition from home to hospital.  When laboring at home, the transition from home to hospital can be a little bit stressful.  Be sure to pack a birth bag in the car at least 1-2 weeks prior to the expected onset of labor, and/or have a hospital bag by the door.  Have Dad, doula, or partner be prepared to grab this on the way out.  Once to the hospital, have a plan for who is going to park the car, walk in with Mom, grab the bag and camera, etc.  It's just easier not to have to do this in the heat of the moment, or to be scrambled, which takes the attention of Mom (usually in the middle of a contraction.)  No one wants to be doing decision-making at this time; a plan should be implemented then smoothly carried out.

2) Bring a personal item from home into the room, that can remain with you for the duration of labor.  This can be a pillow, robe, stuffed animal, picture frame, or focus object (pictures of other siblings, vacation picture, etc.)  Anything to maintain familiarity.  It serves as a comfort object.  When everything in the room feels unfamiliar and sterile having a pillow or object to hold onto with your scent can be very soothing.  If it is a pillow from home, make sure to bring an extra case, or one that you don't mind getting stained or possibly permanently soiled (i.e. blood, bodily fluids, iodine, etc.)

3) Pack food, drinks, and snacks for support partner.  Dads need to eat too, and sometimes in the rush of gathering Mom's belongings and getting to the hospital Dads forget to pack sustenance for themselves.  Dad gets a care package like Mom, and should include the following: a sandwich, drink, refillable water bottle, swim shorts (for shower or water birth,) change of clothes, pillow (hospital pillows don't always cut it,) small blanket (the room can get chilly,) slippers, reading material, and personal items (toiletries, etc.)  This eliminates the need for Dad or partner to leave the room, partake of the dreaded cafeteria food, or feel famished at one of the greatest highlights of his life!

4) Have extra copies of the birth plan.  These should be distributed to the doula, nurses, and OB on call.  It can also be handy to attach one to the door or place it in a well-visible area.  Ideally this will also be in your chart and will have been discussed with your provider at a prior prenatal visit.  Some people like to attach them to a gift basket or plate of cookies.

5) Dim lighting, minimize open doors, and pull the curtain.  After the initial check-in and traige, Mom should have all the privacy she needs.  Pull the curtain that divides the entry way from the room, quietly close the door, and switch off any lights that are too bright (fluorescents) or invasive.  If there is a window, adjust blinds to allow in or minimize natural light, or for privacy.  As a doula, I pack baby blankets and cloths in my birth bag to place over blinking lights and monitors.  This creates a more home-like and less medically "noisy" environment.  Too, if there are too many monitors Dad can get hooked on watching those instead of Mom.

6) If there is a tub or shower, use it.  Many hospitals and birthing centers offer the use of hydrotherapy for labor and sometimes birth, which can be very soothing.  Most nurses and providers are very good at adapting to Mom's wishes in this regard and taping up monitors, IV lines, saline locks, etc. and making everything "water proof" to enter the tub or shower.  If you are choosing intermittent monitoring, you may be able to remain in bed or on a birth ball for 15-20 minutes for a baseline reading, then remove the monitor and utilize the tub or shower for an hour at a time.  It is helpful for Dad or doula to get in the shower with Mom and aim the removable shower head at her back or abdomen.  Make sure to maintain a comfortable temperature (laboring women are often hot) and remember that hospitals have an on-demand water heater so it never runs out, refill away. :)

7) Play music!  Bring an ipod or phone with your favorite playlist on it.  As circumstances allow, I carry in my portable Bose adapter and provide a playlist for my clients via a variety of stations on Pandora One (sans ads) for listening pleasure.  If played on a phone or personal device, it can be carried into the bathroom when Mom is in the shower or tub, or to other places around the hospital.  Sometimes Mom prefers earbuds so be sure to pack those in a birth bag too.  Whatever you do, make sure your streaming app does not contain ads!  I decided to pay the $8 a month to provide my clients with ad-free listening. :)

8) Use essential oils, atomizers, and battery-powered candles.   It's amazing how a couple drops on the bottom of Mom's feet, or into a palm-full of carrier oil used for massage can infuse the whole room and positively affect everyone who enters into it.  Different essential oils have soothing properties, and subsequently act as aromatherapy, and counteract the aromas of birth, sweat, stagnation, tension, and hospital equipment and concoctions.  Battery powered candles can be a nice alternative to the overhead lights in night time births, and can also be moved into the bathroom to create a nice ambiance if Mom labors there.

9) Bring as much food and drink from home as possible.  Often times the hospital staff will keep drinks and snacks in a refrigerator with your name on it for labor or after the birth.  Some hospitals may have an in-room mini fridge.  If you're not fond of hospital food or the midnight turkey sandwich, having your own meal packed eliminates the need for anyone to leave the hospital to bring you food of your choice.  In my birth bag I pack coconut water, vitamin water, spring water, gingerale, a caffeinated drink or two (for Dad,) honey sticks, granola bars, dried fruit, nuts, gum, hard candies, and mints.  You never know if you are going to be in that room for 24 hours or more and how far away the cafeteria is.  It's always a good idea to be prepared.

10) Relax!!  The hospital can be anxiety-provoking for some, but others receive it as a welcome break from younger siblings, household duties, and relish in the room service that is provided.  Try to make the most of your hospital stay and know that in no time you'll be back to the familiar as well as the grind.  Creating a cozy, even home-like environment, bringing a familiar object, being prepared, staying in the moment, and having the right support can give you a birth experience to remember.  You will probably grow very fond of the nurses and support people who helped you.  The hospital can be a wonderful environment if you just make a few tweaks to make it that way!  I would love to hear your comments and suggestions below. :)

"I'll Walk With You"

As your doula, I will walk with you.

There are lyrics to a young children's Primary song that go like this:

"If you don't walk as most people do,

Some people walk away from you,

But I won't! I won't

"I'll walk with you. I'll talk with you.

That's how I'll show my (doula) love for you."

As your doula, the moment you choose me to attend your birth, we make a connection.  By the time you are in labor (or sooner if you have taken my childbirth classes) that connection has been solidified.  

It's an energy field, and I believe it is catalyzed by oxytocin (the love hormone,) and spirit.  In fact I do believe one day they will make the connection between hormones and the spirit world, but that's another post for another day.

Believe it or not, when you nest, I nest.  If I get the call that your birth will be soon, I cook, clean, shop, and make preparations for my family.  

When you don't sleep, I don't sleep.  I may lie in bed but there is little rest to be had.  It's the "My water broke but I'm not having any contractions" text, or "I went to the hospital but I'm only 3 cm.," or, more commonly, when it's a first baby, "I'm having contractions but they're not very strong, or only 10 minutes apart."  It's going to be in the next 72 hours.  I may not be in your presence but my energy field is cast your way and I just *know.*  When that "go time" call or text comes through I am ready, I have been ready, anticipating where you are at every step of the way.

There is an African proverb, "Birth is like a narrow bridge; friends can escort you to the bridge, they can greet you on the other side, but you walk that bridge alone."  What I love about this is it alludes to the way a birthing woman goes inward, particularly during late active labor and transition.  No one can take that journey from you, but I am by your side, ever mindful, ever present.  A birthing woman is very attuned to her surroundings, and highly perceptive of the energy field of others.  My job is to stay with you in this space, regardless of what the nurses are doing, regardless of who may be coming or going, or even what your spouse is doing (when at that inopportune moment he decides to send a text, tell a joke, or leave for a coffee break.)  I am in-tune with your cues.  I am there, and we are connected.  You do not have to open your eyes to see me, to know that I am there.  A midwife holds the same space in a birth room when she sits in the corner and knits.  As your doula, whether I am holding your hand, breathing with you, or on the other side of the wall while you moan and sway in the shower, I am there.  I don't have to put my hands on you to "hold space."  

Our hearts are knit together in unity.

When you've made it to the other side, we can look each other in the eyes and say, "You did it."  You may recognize me from the beginning of the journey, but now I look different, and you look different, because you are a mother, and you are viewing me through a lense of one who has "been there."  You have joined to the side of millions of women who have gone before.  I did it, and you did it, and we did it together.  I am so proud for you I am beaming inside and it is hard to not let it show.  Inevitably Dad is crying, and we all shed tears together.  *You* did it.  Everyone stands back and retracts their energy fields into their own bodies (because you know we were all pushing with you,) so that Mom, Dad, and baby can bond as a new family.  Mothers are, and ever will be, amazing.  I am honored to walk this journey with each and every one of you. <3 

*As a birth doula, I support all births, natural, medicated, cesarean, home, hospital, and birthing center births.  For more information or to schedule a consultation, contact Lisa Hart CD(DONA) 530-919-0034 or www.facebook.com/lisahartbirthdoula.

Getting to the Top of Hard Things

The other day I embarked on a hike with my children, ages 5, 6, and 8, to the waterfall at the back side of Sly Park Lake.  4.5 miles to be exact.  It was hard, the day was getting late, we had little water and snacks to suffice us, and at one point they all started getting tired.  "Do I keep going?"  I asked myself, "What if they can't make it to the waterfall, or if they do, what if they can't make it back?  What if it gets dark on us and we are without flashlight?"  It was a decision I had to make as a sole parent of 3 young children on that hike (Dad was at home and the older 3 had other activities.)  Yet as they made it a good 2/3rds of the way in and began to complain of achy feet, tired legs, fatigue, and lack of energy, I found myself promising, "Just wait until we get the the waterfall.  You'll be able to put your feet in, which will feel so nice, and it will be so pretty.  I know it's hot and dusty now, and you're tired, but I promise it will be worth it."  I couldn't bring myself to turn them around 2/3rds of the way there without getting them to the waterfall, lest their efforts be in vain.

There are many hard things we do in life.  I am a runner.  Training for a half marathon is hard work, but the mental, emotional, and physical benefits propel me.  I know if I get to the top of a hill and achieve an aerial view, or catch a beautiful sunset, it will be worth it.  Sometimes we are called to do something in life, and the path is clear, but once we get going the path is rocky, and we stumble, or falter, and begin to question why we started in the first place.  I have experienced this in many callings in life, from motherhood, to birth work, to my church callings.  "What is it that thou would have me do, and will it be worth it?"  These instances, and many others, got me thinking of an analogy for birth.

Many women who come to me are wanting a natural birth.  They know they want something that they can do for themselves, or maybe can't do for themselves, and all they need is someone who believes in them.  Unfortunately, for some women, there is not one who believes in them.  "Why would you want to do that?" or "Just have the epidural, I loved mine and it worked great" or "natural childbirth is 'risky.'"  But something in them says no; or "more," or "better."  These women of whom I speak intuitively know that their bodies are designed to give birth, and they choose not to succumb to modern medical interventions or the belief that their bodies "can't" give birth on their own.  Some of these women were marketed a lie, that birth needs to be a medically managed event, a disaster "waiting" to happen, that they are putting themselves or their baby at risk, but they didn't buy it.  This isn't to say that birth always goes according to plan, but most women, at least, start with a plan.  Thoughts are after all seeds of action, and what happens in the mind will often manifest in the body.  It is important to start with a plan, or as I say in running, "Train the mind, and the body will follow."

Childbirth education is so important in my practice.  I find that the more a woman reads, studies, absorbs, watches, and "picks up" positive cultural stories and influences surrounding birth, and engrains that in her mind, truly believing it, the better her birth experience will be.  "An ounce of prevention is worth a pound of cure" they say and I definitely find this true in preparing for childbirth in terms of study, meditation, training of the mind and body, and preparation leading up to birth.  It usually becomes pretty evident in labor what a woman was or wasn't prepared for, so a little bit of prenatal education goes a long ways.  

Now, to get to the waterfall analogy.  I kept pushing my kids because I knew once they got there, it would be worth it.  To let them come so far and not see the waterfall would be an injustice at best and a huge disappointment at least.  True, we could turn back, and they'd never know what they'd be missing, but I knew, and the prospect of their satisfaction is what kept me going, through mosquito bites, tears, and a good amount of whining and complaining.  That's not to say I didn't throw them on my back for a piggyback every so often, but for the most part, they were doing it themselves, and they were going to get the reward.  If I had a dollar for every time a woman came to me and said, "If only someone had told me (in my last birth) how close I was to pushing, or complete dilation, I don't think I would have done... (A, B, or C,) usually it's get the epidural or succumb to some intervention.  If only that nurse would have told me how close I was before offering the epidural, or medication, I don't think I would've taken it.  Unfortunately, for most first-time moms, this epiphany doesn't come until in hindsight.  I like to say there are no regrets in birth, only taking what we learn from it and moving forward.  There are two main categories of moms who come to me: 1st time moms, and moms who have given birth before but want something "different."  Often the case is healing from past birth trauma by creating a new experience.  Those are the moms whom I am passionate about supporting.  

I like to tell moms birthing for the first time, "When you think you can't take anymore in labor, there's no more to take.  When you feel like you couldn't possibly handle anymore, pushing is right around the corner."  The difference between a mom who achieves a natural birth and a woman who receives the epidural at 9 centimeters is this bit of knowledge.  Despite the best of intentions, many women want to throw in the towel at 8-9 centimeters, and the most staunch of natural birthers may be asking for meds at this time.  I know I always did with my 7 natural births, even if only in my head, which is how I came to recognize when I was in transition.  Birth takes you to the edge of your limits then takes you over them.  That is what makes birth so empowering; it proves our strength to ourselves, for natural childbirth gives a woman a reward that no one else can give her.  No woman walks out of birth the same person; she is a mother, a gentle warrior, and forever changed.  The physically demanding limits of childbirth prove our own strength to ourselves, giving us the strength and capacity to become strong, capable mothers.  The newfound strength of a birthing mother will sustain her through those child-rearing years.

 

There's a reason why I don't go to women too early in labor: part of it is I don't choose to be on births for 24-48 hrs., but a large reason is I know my clients will want me alert, ready, and attentive when they need me most, and that is late active labor, transition and pushing.  I feel my most valuable role as a doula, in terms of labor support, comes in at those last couple of centimeters, the time when a woman truly feels she cannot take anymore or that she is going to break, lose control, or worse that she is "never going to make it."  We have talked about this in detail in a prenatal visit, and for the duration of pregnancy, and I am well aware of what her wishes are, and how to support her.  I don't need her birth plan because it is engrained in *my* mind.  "On a scale of 1 to 10, what is your desire for a natural birth" is one of the first questions I ask at a consultation, and her answer enables me to know how to best support her, for no one ever really has a natural birth "by coincidence."  I am there to remind her of how close she is, to keep going, to get to the waterfall; her place of bliss.  She has hired me for this.  For I know that holding a newborn baby on your chest for the first time is a happiness unsurpassed by anything in this world, and no matter how many times I see it, it never gets tiring.  There is nothing more rewarding than watching a woman become a mother, and as a mother, to watch that newfound strength and transformation unfold in another.  It is a miracle, every single time.  

*As a birth doula, I support all births, natural, medicated, cesarean, home, hospital, and birthing center births.  For more information or to schedule a consultation, contact Lisa Hart CD(DONA) 530-919-0034 or www.facebook.com/lisahartbirthdoula.