Birth Questions Answered

What's the difference between a doula, a midwife, and an obstetrician (OB)?

Doulas are non-medical support people who are trained to assist and comfort the pregnant person and family. They provide emotional, educational, and physical support throughout pregnancy and labor, but do not perform any medical duties.

Midwives and obstetricians are both medically trained care providers. They perform exams and any necessary testing throughout pregnancy, as well as catch babies.

Midwives are trained medical professionals who specialize in normal, physiological birth. They care for pregnant people in hospitals, birth centers, and home births. The midwifery model of care focuses on person-centered care, shared decision making, and holistic care. There are several types of midwives, including Certified Nurse Midwives (CNMs) who work mainly in a hospital setting, but also in birth centers and home births; and certified professional midwives (CPMs) that are licensed midwives by the state of Florida (LMs), who work in birth center and home birth settings.

Obstetricians (OBs) are trained surgeons who care for pregnant people in a hospital setting and can also perform cesarean sections and other procedures. Maternal-fetal medicine specialists (MFMs) are obstetricians who care for those with high-risk pregnancies.

What are my options for places to give birth in Tampa Bay?

If you choose to be under the care of a midwife, you can give birth at home, in a birth center, or at certain area hospitals, depending on your specific midwifery practice. If you choose to be under the care of an obstetrician, you can give birth at a hospital.

What's a VBAC?

While many people who have had previous c-sections deliver by cesarean in subsequent pregnancies, some people attempt to give birth vaginally, called a trial of labor after cesarean (TOLAC). If the TOLAC is successful, the person is said to have had a vaginal birth after cesarean, most commonly referred to as a VBAC.

How does a doula help during pregnancy and labor?

A doula provides emotional, educational, and physical support throughout pregnancy and labor. They provide continuous and non-judgemental support for both the pregnant person and partner. A doula acts like your personal birth encyclopedia and is also knowledgeable about local care providers, hospitals, and birth centers.

How is going to the chiropractor helpful in pregnancy?

Pregnancy is a very exciting time but often comes with unwanted discomforts such as heartburn, low back pain, headaches, neck pain, round ligament pain, pubic pain. Although these are common experiences, chiropractors who are specifically trained in the Webster technique can help lessen or resolve these issues. The Webster technique is a specific chiropractic practice where adjustments for the sacrum and pelvic region are made, getting the bones, muscles, and ligaments to be in alignment. This allows more space for the baby to get in the best possible position and alleviate any pain or discomfort. Prenatal chiropractic adjustments are gentle, safe, and effective for both the person carrying and the baby.. Pregnant people who have been under regular chiropractic care often report faster, easier labors without medical interventions. More information: http://www.happyhealthyspine.org/services.html (http://feathermama.com/chiropractic-care-and-pregnancy-by-dr-shannon-whitlock/)

Chiropractic research and pregnancy can be found here: http://icpa4kids.org/Chiropractic-Research/Pregnancy-and-Adjustments/

What are some holistically minded things I can do to increase my fertility?

You can be evaluated by a chiropractor, preferably one who is Webster certified. Chiropractors are experts in the nervous system as well as the musculoskeletal system. The brain connects to the spinal cord and the nerves that emerge from the cord control every muscle, tissue, organ, and cell in your body, including your reproductive organs. If there is a misalignment in the vertebrae, it can put pressure on the nerve and decrease the function of that nerve. A chiropractor will move the bones back into place, removing the pressure on the nerves allowing your body to function at its fullest potential.

Chiropractic research on infertility/inability to conceive at: http://icpa4kids.org/Chiropractic-Research/Infertility-/-Inability-to-Conceive/

You can also be evaluated by a doctor of Oriental Medicine (DOM), or an acupuncturist, who specializes in fertility. Stress and/or hormonal imbalances can play a role in infertility. Acupuncture can counteract stress by releasing endorphins and can increase blood flow to the reproductive organs, helping to increase fertility. Your DOM may also put you on a regimen of herbs to help you have a healthier menstrual cycle, leading to higher fertility.
More information on acupuncture and fertility can be found here: https://health.clevelandclinic.org/how-acupuncture-can-offer-you-natural-fertility-help/

I had my last child via cesarean, am I able to deliver vaginally with this pregnancy?

An evaluation by your provider should be done to determine whether you are a candidate to attempt a vaginal delivery. Many people are able to try and are successful!

Can I diffuse essential oils around my baby?

Some essential oils are safe to diffuse around babies. Consult with your care provider before use.

What’s in a doula’s bag?

Most doulas carry some basic tools for labor management, as well as some items for personal use. Some common items might be a rebozo, some type of massage tool, tennis balls for counter pressure, essential oils, massage oil, new lip balms, hair ties, a fan, or a rice sock. There will also be items for the doula’s own use, such as a change of clothes, snacks, a phone charger, and whatever else might be needed for an extended stay away from home. Doula bags likely vary as much as doulas themselves. But the most important tools a doula brings to a birth don’t fit in a bag...hands and heart!

Can my doula check how dilated my cervix is while I’m laboring at home?

Doulas do not perform medical tasks, including cervical checks. Your doula may be very experienced at reading other clues and have a good idea about your cervical dilation, but should not be physically assessing your cervix as it is out of the professional scope of a doula. You will need to wait for your medical provider to check your cervix.

I plan on getting an epidural. Why do I need a doula?

Doulas provide a wide range of support methods, which are appropriate for all types of births. Even with an epidural for pain management, there are still many aspects of labor for which a doula is helpful. A doula can assist with position changes while you are confined to the bed. This helps maximize the epidurals effect, and helps the cervix continue to dilate as efficiently as possible. If any unexpected situations arise, a doula will help you formulate appropriate questions and help you, or you and your partner to make informed decisions. Doulas do not make decisions for you but they can provide information and guide you on how to make the best choices for your family. A doula’s presence also allows your partner, if applicable, to take a break, tend to other important tasks, or run home if necessary. An epidural may reduce the options for movement and positions, but it does not reduce the need for a doula’s expert care and knowledge.

I’m giving birth in a hospital. Do I need a doula since I’ll have a nurse?

A hospital may be the birth site where you need a doula the most! There are various interventions available during a hospital birth, which you may or may not want or need. A doula will help you stick to your birth plan, help you formulate the right questions, and support you in all your choices. A doula is there just for you, or you and your partner, and will remain by your side until you are settled postpartum. Your doula has no responsibilities other than attending to your physical comfort and emotional well-being. Your nurse, on the other hand, will also have other laboring patients on the floor, and will leave at the end of the shift. Your nurse may not have experience or comfort with the type of birth you desire (unmedicated, natural pain relief, alternate pushing positions, intermittent monitoring, etc.). The nurse works for the hospital and is solely there to carry out your provider’s orders. Your nurse may be encouraging and comforting, but that is not their primary role. A great doula works alongside nurses in a way that enhances the nurse’s work.

How do I know when it’s time to go to the hospital and how long can I labor at home?

This can be a little tricky sometimes, especially for a first labor. Arriving too early may stall labor or be the first step in receiving unnecessary interventions “to speed things up”. If you arrive too late, it may make for an anxious birth experience, as the hospital staff and your care provider may not be prepared for a very rapid arrival-to-birth time. Most care providers will give you a guideline for gauging the right time to go to the hospital, but ultimately, it’s up to you. Many laboring people will instinctively know when it is the right time to be in their birthing space. If you have any additional medical issues, if your membranes have ruptured, or if you live far from the hospital, you may need to head to the hospital sooner than you otherwise would, under the advice of your care provider. An experienced doula may be able to make judgments about the speed of labor progress and may share those observations with you. Anything unusual should be reported to your care provider, who may recommend you go to the hospital for assessment or admittance.

Are my other children able to attend my birth?

Your choice of care provider and place of birth will be a key factor in determining whether your children can attend your birth. Individual hospitals vary in their policies regarding how many people can be with you and in the case of children, their ages. If you plan to give birth in a hospital, contact your care provider to discuss your wishes and any special requests that you may have regarding your other children. Birthing out of hospital, for example in a birth center or your own home, brings greater freedom of choice regarding those present at your birth.

What's the difference between a birth ball and a peanut ball?

Birth balls (aka regular exercise balls!) and peanut balls are simple, inflatable devices that can be used during pregnancy and birth. A birth ball is a round exercise ball, and a peanut ball is an exercise ball shaped like a large peanut that is used between your legs while reclining. They are available in different sizes and using the correct size for your height and weight is important for safety and the best results. Both birth and peanut balls have many positive benefits and uses during pregnancy and labor including promoting comfort, posture, rest, active change of position, pain relief, baby's optimal position, dilation, widening of the pelvic outlet and shortening the duration of labor. The peanut ball is particularly useful should you chose to have an epidural or special circumstances require you to labor and birth on the bed. Area hospitals and birth centers have birth and peanut balls available for you to use during your pregnancy, labor and birth. It’s also helpful to have a birth ball at home and/or work to sit. Eventually, it will be helpful while laboring at home before you get to your place of birth. See the links below to learn about the techniques and positions you can use with birth balls!

Is home birth safe?

The choice of where to give birth is a personal one which should be informed by accurate information regarding the benefits and risks of all options within your unique circumstances. Current research from studies within the USA and the UK indicate that planned home birth with skilled midwives is safe for healthy pregnant people and babies with low risk pregnancies.

The research shows that for those birthing at home with low risk pregnancies, the outcomes for home birth versus hospital births provide equal if not better outcomes. Home births provide high rates of vaginal birth, low rates of interventions (such as induction, epidurals, vacuum/forceps or episiotomies), high APGAR scores, high breastfeeding rates, and no significant increase in absolute risk or adverse outcomes for mother or baby. For those birthing their first baby, research shows that the likelihood of transferring from home to hospital either during or after labor/birth is higher than for pregnant people who have given birth before. In the case of a high risk pregnancy (for example a multiple birth, VBAC, breech presentation or specific medical conditions) current research is less clear regarding risk, therefore shared decision making with your chosen care provider is important to discuss the benefits & risks of a planned home birth for you and your baby. In the State of Florida, home birth midwives, when required, work in consultation with an obstetrician which enables greater flexibility for pregnant people and babies who aren't low risk to have their pregnancy and birth safely managed at home. Speak to a licensed home birth midwife (link to directory) about any specific concerns you may have- they are super knowledgeable!

I’ve heard that vaginal tearing can occur during the pushing stage, how can I prevent that?

Around two thirds of those giving birth vaginally will experience some degree of perineal tearing and/or grazing during the second stage (pushing phase) of labor. The likelihood of tearing is influenced by many factors including the position you give birth in, forceful pushing, the position and weight of your baby, birthing vaginally for the first time, and whether your birth was assisted by an episiotomy, forceps, or vacuum. Perineal massage can increase muscle and tissue elasticity and may reduce the risk of tearing requiring stitches. For first timers giving birth vaginally, you can massage your perineum daily from 34 weeks of pregnancy. Other strategies that can help reduce the likelihood of tearing include birthing on your side, in a forward leaning position, or on your hands and knees (lying on your back or squatting can increase the chance of tearing), birthing in water, following your body's instincts during the pushing phase (avoiding forced, coached pushing) and having a warm compress against your perineum as your baby's head crowns.

What is delayed cord clamping?

Immediately after birth, baby's umbilical cord pulsates as the placenta continues to provide essential oxygen, nutrients, and blood back to baby. This transfer of blood from the placenta to baby is part of the physiology of birth and delayed cord clamping enables this important transfer of blood to occur. The World Health Organisation (WHO) recommends that the optimal time to clamp baby's umbilical cord (for all babies irrespective of gestational age, weight or condition at birth) is when the blood circulation in the cord has ceased and the cord is flat and no longer pulsating. This may occur approximately 3 or more minutes after birth, but as it is a physiological process, the time is different for each baby. Research has shown that when cord clamping is delayed, baby will receive up to 30% more blood volume than it would have with immediate cord clamping and with this, the benefits of red blood cells, immune cells and stem cells. If you chose to birth your baby in hospital, check with your care provider regarding their delayed cord clamping policy, as practices vary widely. Delayed cord clamping is more likely to be part of the physiology of your birth should you chose to birth with midwives out of hospital, at a birth center or in your own home.

What birth centers are in the Tampa Bay area?

We are fortunate to have some great out of hospital options for birth in the Tampa Bay area!

* The Birth Center of St. Pete - http://bcofstpete.com/ - (727) 895-2300
* Breath of Life Birth Center - http://breathoflife.cc/ - (727) 216-1420
* Labor of Love Birth Center - http://laboroflovetampa.com/ - (813) 949-1185
* Sweet Child O' Mine - http://sweetchildbirth.com/ - (813) 685-8404

*TBBN members

Is there any evidence on the benefits or risks of placenta encapsulation?

There have been limited formal studies conducted and research is still emerging on placenta encapsulation. Neither the benefits nor the risks have been officially confirmed but some existing research shows modest benefits of placenta encapsulation. Many people who have used placenta capsules report positive experiences and that they would consume their placentas again following subsequent pregnancies.

For more information see link below:

https://evidencebasedbirth.com/evidence-on-placenta-encapsulation/

I'm GBS positive. Can I still encapsulate my placenta?

Consult your care provider. If there is in an infection occurring in the infant or mother following birth, the placenta may not be safe to encapsulate. Properly trained encapsulators will inform their clients about any and all contradictions to placenta consumption.

What does a postpartum doula do?

A postpartum doula provides evidenced based information on things such as infant feeding, emotional and physical recovery from birth, parent-baby bonding, infant soothing, and basic newborn care. A postpartum doula is available to help a new family in the first days and weeks after birth wherever help is needed which can include:

Feeding support
Help with the emotional and physical recovery after birth
Light housekeeping
Running errands
Assistance with newborn care such as diapering, bathing, feeding and comforting
Light meal preparation
Baby soothing techniques
Sibling care
Referrals to local resources such as parenting classes, pediatricians, lactation and other support groups
Helping the family transition more smoothly into the challenges of night time parenting

When does my milk come in?

Colostrum starts being produced at about 16-22 weeks of pregnancy. Colostrum is the first milk your baby will ingest and is concentrated with nutrients and disease-fighting antibodies. It provides everything your baby needs in the days after they are born. As your baby's stomach grows and your "milk comes in" colostrum gradually transitions to mature milk. This typically occurs 2-3 days after birth but may take longer that 3 days in as many as 25% of those breastfeeding or chestfeeding . For more information see the links below.

https://kellymom.com/ages/newborn/when-will-my-milk-come-in/

https://kellymom.com/bf/normal/newborn-nursing/

How do I find help with breastfeeding or chestfeeding?

The Tampa Bay area has many great Certified Lactation Consultants (CLCs) and Internationally Board Certified Lactation Consultants (IBCLCs). You can search for one in your area via our member directory or contact us at info@tampabaybirthnetwork.org for more information.

What is a tongue tie and how can it impact breastfeeding and chestfeeding?

If your baby has a tongue tie, it mean that the attachment from the underside of the tongue to the floor of the mouth is short. In some cases, this can cause your baby to have problems latching, reducing their ability to feed efficiently. Your baby may not be able to open wide enough to latch properly or may try to latch at a less effective angle. If you suspect your baby is having trouble feeding, a lactation consultant will be able to help you! Upon evaluation, your consultant may refer you to a pediatric dentist for a tongue tie consultation. For more information on tongue ties, see the following link: https://tonguetie.net/breastfeeding/

How long should I breastfeed/chestfeed my child?

The World Health Organization (WHO) recommends exclusively breastfeeding or chestfeeding for the first 6 months, until you start introducing the appropriate foods. After that, the WHO recommends continuing breastfeeding/chestfeeding until 2 years of age.

http://www.who.int/topics/breastfeeding/en/

What is baby led weaning?

Baby led weaning (BLW) is a method to begin introducing your baby to solid foods. BLW works by allowing and encouraging your baby to feed themselves solid finger foods instead of spoonfuls of purée. Rather than weaning babies off of breastmilk, the idea is to wean them onto solid foods. There are some classes available at local parenting stores throughout the year. For more info, see the following link: https://www.mamanatural.com/baby-led-weaning/

What should I pack in my birth bag?

Less is more when packing for your birth. Pack like you’re going to a hotel for the weekend with basic toiletries and comfort items. Some basic items that we recommend are healthy snacks, hydrating drinks, nursing shirts and bra, PJs, no-slip socks and flip flops that can get wet, lip balm, hair brush and hair ties, travel mirror, sleeping mask, camera, chargers, one your own comfy pillows (avoid white pillowcases), diffuser and essential oils, sleepers, baby blanket and a going home outfit for you and baby.

How do I safely co-sleep with my baby?

Sleeping with your baby comes with lots of wonderful benefits when done properly! Whether you plan to sleep with your baby or not, it's still good to know the safety tips of co-sleeping. We recommend doing your research when it comes to safe co-sleeping. Here is a link to help get you started. Some of the most important things to keep in mind when co-sleeping are to keep the room cool, dress baby properly for the season, sleep on a firm mattress with no pillows near or under baby, and no heavy blankets or any covers near baby's face. Never sleep with baby if either parent is taking sedatives, smoking, or is under the influence of drugs or alcohol.

Is cloth diapering hard?

It definitely doesn’t have to be!

From a local doula: I cloth diapered two of my three children and I wish I would have done it with my first born. Some tips I have are buying a little variety of different brands and styles. Don't skimp on detergent when washing your diapers! The sun is your friend when drying and removing stains. Follow the best washing routine for your kind of water and washing machine. A lot of people ask me if having dirty cloth diapers around stinks up the house. Truth is, I found having disposables around smellier. When I cloth diapered, I washed every other day and when I introduced solids, the poop was flushed down the toilet. Here is a link to more information on cloth diapers. There are parenting stores around the area where cloth diapering classes are held. Email us at info@tampabaybirthnetwork.org for more information on where to find a class near you.

What does a birth photographer take photos of?

Birth photographers capture the moments and memories that are often lost or not noticed by the one in labor. They document all the sweet moments of the birth team providing loving encouragement and support to the laboring person, the first moments after the birth, such as the family meeting the new baby for the first time, as well as the first feed. The photographer may also photograph the newborn exam and some of your first newborn snuggles! Photography is a art and birth photographers are unique in style. Check out our birth photography members here.