Doula Tea and Glucose Screening

26th Week of Development for Baby

Happy Earth Day! Well into my 26th week now, I have been growing at a much faster rate, mostly because our baby is going through a bit of a  growth spurt of his own. Robbie joined me for my appointment with the midwives today which he hasn't been able to do since my my very first appointment. It was good to have him there for support and also to be able to hear Mattimeo's heart rate, and how much stronger it is now. I got to meet with a new (new for me that is) midwife today, Jen. Like the others, she is really nice, knowledgeable and approachable. We talked about her opinion regarding doulas, circumcision, pediatricians, and my rate of weight gain. It turns out that she is using a pediatrician that is part of the same group of pediatricians that our pediatrician is in for her own children and had nothing but good things to say about their practice. That was very reassuring to hear. My weight gain is right on target; apparently the baby is going through a bit of a growth spurt right now which means I also am. I have gained about 15-20 pounds so far. He is now just under 2 pounds and his heart is beating at around 130 bpm. The midwife felt around my belly to get an idea of what kind of position the baby is in. She could feel his feet up high above my belly button, but couldn't quite make out where is head is. When she listened to his heart beat though, it was loudest way down low in my uterus, which means the baby is probably already in or nearly in an upside down position. This is great because gravity is already working to get him into a good birthing position. She said once he manages to get upside down, he will most likely stay that way. I was quite relieved about this because I was nervous about having a breach baby. I was breach when I was born, and my mom had a really difficult labor. Plus I know in most cases now, a breach birth will lead to a cesarean section, which I also do not want. So if my little boy is really on the right track, I am a very happy Mamma to be. Plus, that would explain the strange sensations I have been having very low in my uterus...like the baby is punching my vagina. Turns out, he basically is. His little tiny fists and feet have been busy dancing away in my belly, bumping anything within reach. It's such a wild sensation to feel him moving around inside me.

Part of my appointment, and the main reason I convinced Robbie to work from home so he could join me, was my glucose screening test. The purpose of this is to check for gestational diabetes, and they test this in every pregnant woman. The test involves finishing eating breakfast at least 2 hours before my appointment. Then, an hour before my appointment I had to drink this sugary orange drink within 5 minutes and record what time I finished at. Drinking this made me feel like a humming bird. Exactly an hour later they drew some of my blood. The will my blood into a lab to test for any signs of diabetes. If my sugar levels are off, I will have to go through further testing called a glucose tolerance test. I really hope everything comes back normal, I really don't like being poked with needles and would rather avoid any more needle encounters. They are also going to use my blood sample to check my iron levels again. At this stage of pregnancy, the woman's blood is at its most diluted point, and then want to make sure that the red blood cells are still able to hold adequate amounts of iron. If the iron levels are low, I'll just have to take an additional iron supplement. Hopefully my iron levels are fine too. As a vegetarian I have gotten pretty good at being able to tell if I am getting enough iron because when I don't I get more fatigued and tend to bruise very easily. I haven't noticed any of those symptoms, but being pregnant means I have a whole new body, so who knows. The reason why I wanted Robbie around for these tests is because I still get kind of queasy in the morning depending on what time I wake up and what types of food I eat. I was concerned that I would get really nauseous and not be able to drive myself. Fortunately I only got a little queasy and I was fine, but it was nice to have him there anyways.

I have mentioned the term "doula" in a couple posts now, but I'm not sure if everyone knows what that is. I certainly didn't know what a doula was before I was pregnant. A birth doula is a person who is trained and experience in supporting women and their partners during labor and birth. They are there to focus entirely on the woman, while the midwives and doctors need to also focus a lot of their attention on the baby. Doulas do a number of different things depending on what you need them to do. They can give you massages, help you find comfortable positions to labor in, advise your partner, make sure your birth plan is being followed, give encouragement, advice and any other sort of help you need. As one doula I met put it, "We are basically a physical form of google, so that when you are in the throws of labor and child birth, your partner can focus on you and not worry about trying to remember what he learned in class or read in books". According to Pregnancy Childbrith and the Newborn, a guide by Durham et al. (2010), studies show the following benefits from having a doula:

• Shorter labors, with less need for medication to speed up labor
• More spontaneous vaginal births (that is births that don't require forceps, vacuum extraction, or cesarean delivery.)
• Fewer requests for pain medications
• Less dissatisfaction with birth experiences

We have asked a couple of the midwives what they think about doulas. One midwife said that doulas are really fabulous to have around. She said sometimes there are a lot of births occurring at the same time, and the midwives and nurses might need to be in and out more often. In those circumstances, the doula would stay with us at all times and we would have constant support if we wanted it. She also pointed out that it can be very beneficial to the partner to have someone there to act as support, because no one really knows how they are going to feel seeing their loved one giving birth for the first time. The other midwife was also supportive of having a doula, although she said in her experience they have a great system at the birthplace where the midwives are usually around a lot and the nurses almost act as doulas. She said of course the nurses need to also pay attention/monitor the baby, but that they are very supportive and both midwife and nurse will be there to coach and support both partner and mother. She said that with regular doctors, a doula can be a really great idea, or even if we were having a birth in the hospital. But because we chose to have midwives who are more focused on the overall well-being of the mother than a doctor might be, and because we are giving birth at a birthplace that really cares about meeting the mothers needs as much as possible, we don't need to be so worried about finding a doula. She said while having a doula would be nice, we will be just fine without one.

This past Sunday, Robbie and I went to a doula tea at Birth Roots in Portland. Birth Roots is a great resource for expecting mothers and mothers who have babies. They offer lots of different classes, support groups, and generally act as a place where mothers can get together and bond as a community. The purpose of the doula tea is for doulas and pregnant women to get together over tea to discuss the roles and benefits of having a doula. It gives the pregnant woman a chance to learn about doulas, to ask questions, and to meet a bunch of different doulas from this area with a range of experience, expertise and personalities. The tea provides doulas with a chance to socialize with pregnant women and meet potential clients. When Robbie and I went this weekend there was only one other pregnant woman their, and she just happened to be a really awesome lady from my prenatal yoga class who is due just a week earlier than me. Their was a range of doulas there...some of them just finished their training and hadn't attended their first births yet; some have been doulas for 10 years and can't even count how many births they have been to. It was really awesome hearing from all of them and asking questions.

Robbie and I met a couple of them that really appealed to us (we felt like our personalities and ideals meshed nicely), and we have their contact information if we try to pursue them. Currently, we are on the fence about whether or not we want to hire a doula. First of all, they cost money. Their prices range from $300 to $1000. Some of the ones just getting out of training volunteer their services, but honestly neither Robbie or I were very keen on the idea of being our support persons first birth. While I'm sure they would do a fine job, it would be nice to have someone with more experience. Therefore, we need to figure out if we have the money to hire a doula. We also aren't even sure if a doula would be completely necessary for us. We are signed up to take hypnobirthing classes starting next month, and the main idea behind hypnobirthing is to be calm, relaxed, and really focus on what is happening in your own body. You are supposed to be really aware and focused on your birth, and may not necessarily need a lot of attention from more than just your partner. If we find after taking the hypnobirthing classes that it is something we are really comfortable with doing on our own, we might be fine without the support of a doula. But like I said, we are on the fence. I think it would be great to have a doula, but I'm not sure we can afford one or that it is completely necessary for our needs yet.