Doula at Inanna Birth Center in Denton, Texas

One of my favorite places to serve as a birth doula for pregnant families in the Dallas, Fort Worth area is at Inanna Birth Center in Denton!

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As you may know, in addition to my work as a birth doula, I am a midwife assistant at Inanna Birth Center. When I have a doula client birthing at Inanna, it has such a special feeling. It's always an extra special birth with our midwives and the midwife assistant that attends the birth since we all work together regularly and know each other so well. It really makes for a perfect, cohesive birth team! After a recent birth I was joking that it's kind of like a big birthday party, celebrating the new baby and the strong momma!

Inanna Birth Center is run by Jean Sala-Smith, CNM. It is staffed by Certified Nurse Midwives in Denton and the surrounding areas. In addition to the midwives on staff at the birth center the Midwives from Caring for Women that have offices in Denton, Flower Mound and Frisco also have privileges to practice at Inanna and if a client chooses to, they can deliver at Inanna. Caring for Women is the back up Midwives and OB physicians that Inanna uses if transfer is necessary. Presbyterian Hospital of Flower Mound is the hospital they work with for non-emergent transfers.

There are two birth rooms at Inanna. Both have tubs and one of the two bathrooms also has a shower. Water birth is an option at Inanna, of course you'll need to check with the midwife to make sure that you are a good candidate. Regardless of water birth or not, hydrotherapy is a great comfort measure in labor!

Inanna serves families from all over the greater Dallas, Fort Worth area. Families come for the compassionate quality care from as far as Witchita Falls, Gainesville, Fort Worth, Keller, Grapevine, Denton, Sanger, Decatur, Chico, Carrollton, Farmers Branch, Lewisville, Flower Mound - just to name a few!

If you're expecting and are in search of a doula I would love to chat! Consultations for doula services are always free of charge!

Sex After Childbirth - Things We Wish We Knew

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What we wish we knew about Sex after having a Baby

Sex after childbirth is something that not many women talk about. We will ask you endlessly about every pregnancy symptom. You may be pestered with questions about your birth plan and it seems that some women love to share their less-than-desirable birth stories with every pregnant woman they meet. What to expect in the bedroom after childbirth doesn't seem to be discussed often though. Just like you are learning a new life with a baby, you need to learn a new life as a partner.  I asked a group of Birth Boot Camp Doulas and Childbirth Education Instructors what they wish they knew about having Sex after having a baby and here is some great information and tips! 

 

Your Breasts may not be play things anymore

This can be an issue on more than one front. If you are breastfeeding you should be prepared that milk will spray upon orgasm. Milk will spray and leak other times too. Some women find this upsetting, messy or uncomfortable and choose to wear a bra or shirt in sex while they're still breastfeeding. One woman suggested keeping a hand towel near by to catch or clean up any milk spray. 

Since your breasts are feeding a small human, they may be rather sensitive or not sexualized for you in this season of life. Some women recommend wearing a shirt or bra to help manage these mixed feelings in the bedroom.

The hormones with breastfeeding can also complicate your libido. You might not have a lot of interest in sex for a while. Planning on sex so you're prepared mentally can help. Set the mood and keep your distractions minimal. Communication with your partner is key! Some people find that daily exercise is a great way to boost your libido, even something as simple as going for a daily walk. 

Breastfeeding is a beautiful and natural thing - all of these challenges can be overcome and you will find a new normal for your postpartum sex life!

 

You May be Dry... Desert Dry

Especially if you're breastfeeding, your body has reduced the level of Estrogen it produces which reduces how much natural lubricant you are producing. Lube is your friend! Many "crunchy" moms love using unrefined coconut oil - but be aware, if you're using condoms, it can damage them and make them ineffective. There are lots of great lubricants out there, don't be afraid to try different things! Being adequately lubricated can make or break postpartum sex! 

Try different types of lubes. Some may be uncomfortable or have an undesirable reaction. Buy a variety pack and go slow. Slow and lots of communication! 

 

Your Body Didn't Read the Calendar.

The standard six weeks or until bleeding has stopped is the usual green flag for sex to resume. Your body did not read the calendar. It may take more time for you to be ready to jump into the sack again, and that's okay! Beyond your physical readiness you may not be emotionally ready as quickly as you expected. Once you jump back in it still may take months for your "old favorites" to feel comfortable again. This is especially the case if you are dealing with scar tissue. This might be a great time to explore new things and find a new favorite! 

 

where did that air come from? 

Queefing - if you haven't heard of this term before this is when a trapped pocket of air comes out of your vagina. Your vagina has folds part of the way your body just made space for a baby to open up and exit your vagina! Air can get caught in one of these folds or wrinkles and it makes a sound as it passes. You might find that queefs happen more after birth in sex, or not during sex - this might happen in yoga or other workouts. 

 

Location

You have a baby now! If your baby is rooming in you might have to seek out a new location for your sexy time. Recommendations ranged from guest bedrooms, the nursery your child isn't using to bathroom floors. Use your imagination! 

There is more to a baseball field than just home plate... re-explore the other bases, go back to basics! 

 

Other Surprises

Birth can complicate sex postpartum no matter how you give birth. It may take longer to be ready for sex again after a cesarean than vaginal birth. Your body has a lot of healing to do after major abdominal surgery and you should give yourself plenty of time and grace. 

You might be "touched out" because you are being called on for so much of the day. Sometimes a break between mothering and time with your partner can help separate the two. 

 

The bright side

Don't be discouraged! I have heard several times that sex is actually more enjoyable after birth for both partners! Your tight pelvic floor may have loosened enough for you to enjoy in ways you never have before. You may be tuned in to your body in ways that you never have before, that hard to reach orgasm may be much more attainable! 

You just did amazing things bringing your child into this world and that my friend is sexy! Chances are your partner thinks so too and is more in love with you than ever! 

 

It's normal! 

You are not alone! There are challenges and differences, but everyone you know that has had a baby has worked through these things as well! 

The most important piece of advice offered was if a problem persists - seek help! It is not normal for sex to be painful for a long period of time after birth. If you feel like your challenges are greater than the average adjustment then please seek out a good Woman's Health Physical Therapist! If you need help, a local doula will likely have resources! 

 

Rebekah Lewis is a birth doula, professional belly binder and placenta encapsulator serving families in the North part of the Dallas Fort Worth area. She serves families in Denton, Cooke, Tarrant, Dallas, Wise and Collin counties.

 

 

 

2017 in Review

I planned on publishing this on the first, but instead I rang in the new year and supported a family in welcoming their beautiful child earthside. I think my New Years Day was the best yet and wins out over posting my statistics. 

2017 has been a year of much personal growth. I have learned so much from each family I have had the privilege and honor of serving this year! Thank you for trusting me to support you and join you in your sacred birthing space! I have walked alongside several long, hard labors this year. There have also been a couple of very quick labors, the fastest yet! I have held moms as they cried because it is so hard or because plan A or B wasn't working and we were looking at plan C. I have walked alongside inductions of every variety as my strong clients adapt and roll with changes so beautifully. I have cried with families as birth is unpredictable and sometimes emergency techniques are essential. I have held space and been in awe of such unimaginable strength over and over. This year brought more than just happy births and I have grieved as families have experienced immense grief at babies lost too soon. I have stood witness to beautiful redeeming births after hard past experiences with birth and pregnancy. 

Outside of learning directly from the births I attended, I have also taken on new trainings and education in the classroom. My advanced training has included TENS for labor and birth, acupressure for labor, advanced rebozo training and bereavement doula training. 

Last year (you can see my 2016 in review here) I said I expected 2017 to be slower, but I was wrong! 

This year I attended 50 births! What a nice round number! 

28 girls, 21 boys and I worked with 13 different providers. 

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Families I have served are all over the DFW area! It will be easier to just list the towns the hospitals and birth centers have been in. Denton, Fort Worth, Keller, Frisco, McKinney, Allen, Gainesville, Flower Mound, Decatur, and Grapevine.

I can't wait to see what 2018 has in store! I am working on training to add placenta encapsulation services for clients who would like this option and will be certified in February! I will also finish my bereavement training that I started in 2017. April will be a busy month with a doula training reboot and a retreat I have looked forward to since certifying in 2016! 

Recovery from a C-Section: Tips and Tricks

Recovery from birth can be tricky and you want to make sure you're taking care of yourself. Recovery from birth via cesarean section has an added level of challenge because it's surgery! I asked moms who have had cesareans what their best advice was for those first few days and weeks postpartum after a c-section and got some great responses! Several of these I would say apply to birth in general, but especially to recovery from surgical birth!

  • Dresses are great for going home and the first few days around the house. The incision line will be very sensitive!
  • You might consider packing a thick towel for the car ride home, fold it and put it over your belly to protect it from the seat belt.
  • If you are having a scheduled cesarean, make sure you have lots of food in the freezer! Trying to cook in addition to caring for yourself and baby is just too much in the first weeks postpartum! Don't forget to have quick easy snacks on hand!
  • You will be sore and maybe in pain, but don't put off walking in the hospital too long. The walking helps with recovery! Just a small bit of walking at first massively helps with recovery.
  • It will take a couple of weeks before you have full range of motion. Plan to have help during that time! Partner, family or a postpartum doula!
  • Your body has been through birth, your body has been through major abdominal surgery - you need time to recover!
  • Take stool softener while you're on pain meds
  • Take pain meds on schedule the first few days at least.
  • Drink lots of water!
  • Hire a postpartum doula!
  • Have extra large, high waisted cotton undies to wear at home for a while afterwards. You don't want anything that might dig into the incision.
  • wear a pad, soft side facing you, in front of your incision to protect it from rubbing
  • Bring baby to your height to nurse with nursing pillows or extra bed pillows, don't bend towards baby.
  • Your milk might come in an extra day or two later after a cesarean. Ask for the hospital lactation support and use that resource!
  • Ask for a belly binder in the hospital! It makes a world of difference in recovery! It allows you to feel better about getting up to walk and do daily things. It provides a secure feeling for your incision.
  • Don't over do it! When you start feeling better, only add things back to your day one at a time. Take it busy for a few days more so you don't have any set backs. It seems like if you don't over do it early on, recovery as a whole is so much easier and faster!
  • Keep a small hand towel folded in thirds by you to hold your incision when you cough/sneeze or go to the bathroom... #2 is tricky.
  • You might also like a pillow for the above reason...
  • When you get pain medication, ask the nurse when your next dose will be and remind them 30 minutes or so before so you don't lapse. Staying on that pain medication schedule for the first few days will help you to function more quickly and get those important first few walks in to speed recovery.
  • Try to time your first walk 30 minutes after you've had a pain pill, give it a chance to work!
  • Ask for 2 abdominal binders. One to wear when the other is in the wash. Use these for several weeks!
  • Use the bedrails and incline the bed up or down in the hospital so you're not trying to use your core muscles to sit up.
  • Before going into the hospital, set up a baby care station in your bedroom so you can be resting without walking all over the house for necessary baby stuff when you get home.
  • Make sure to plan who will be your driver for your doctors appointments and babys appointments you won't be driving or lifting baby in the carseat carrier for several weeks!
  • Laying down flat is pretty uncomfortable so I slept in a recliner the first few nights at home.
  • Yoga pants were the best when I was tired of wearing dresses. I lived in either a dress or yoga pants for several weeks!
  • You still bleed vaginally after a c-section!

My FAQs and Common Interview Questions

How Many Clients Do you take per month?

I take 1 to 3 clients per month. Never more than 3 and usually just 2. I want to give my clients the best care and attention and for me right now, that's the perfect balance! 

What Happens if you're at another birth when I go into labor? (Or you're sick, or *insert crazy event* that makes you need to miss our birth...)

First of all, I have never missed a birth because I was at another birth *knock on wood*! But it could *technically* happen though there's less than a 1% chance (3% chance of going into labor on any particular day, so the odds of 2 people with different due dates being in labor at the same time... not high!). Whoever I am with first keeps me, never fear - I have amazing back up doulas and you will know ahead of time who your back up doula is! I will send my back up to take amazing care of you until I am able to join you! By hiring me, you are guaranteed a birth doula for your Birth Day!
(if you were wondering, the one time I missed a birth was due to a totally unavoidable family crisis)

How do you work with my husband/partner?

I never want to take the place of your husband or partner! I want to support the two of you working together to bring your baby into the world! It looks different for each couple and I want to be flexible and meet your needs.
Do you mostly want suggestions on how to best support her? I can do that! Do you want me to handle the physical support while you see to her emotional needs? Perfect, that works! Are you queasy around medical situations and unsure of how labor will affect you? I have experience working in many of these situations and we can work together!

How are doulas different than our nurse or Midwife Assistant?

I am non medical support, so I am there with you the whole time meeting your needs whatever they may be, physical support, emotional, information on what's going on. Both nurses in the hospital and birth or midwife assistants out of hospital will come in and out of the room until it's time to push. As long as you and baby are doing well health wise they do not stay and offer support. In out of hospital situations, many times the assistant doesn't come until around transition and they are just there for birth and postpartum. Nurses and assistants are awesome and have their place but a doula and nurses jobs do not really over lap.

What if I have a planned induction/cesarean?

I have experience supporting both! A lot goes into supporting inductions and there are so many options and avenues that I can help you navigate. Each induction is different and I tailor my support to what the situation needs. For planned cesareans I help you to plan and have the best family centered cesarean possible meeting both your desires and the policies of your hospital. If I am allowed, I will support you and your partner in the operating room and provide snapshot pictures of your birth and postpartum if you do not already have a birth photographer). My postpartum support is focused on working to make the most of the golden first hour after birth and establishing breastfeeding post operative and helping you to get settled into your postpartum room.

What if I just want you to take pictures and video?

That's just fine! Let's chat and see what we can work out together!

Do Doulas only work with women planning an unmedicated/natural birth? I know I want an epidural...

That is just fine! I have worked with clients who know they want an epidural before transition or at various points in labor and I am happy to support that! I will support you just like any other client and birth plan and help you meet your goals!

What if I go into labor outside the on-call time frame of 38-42 weeks?

You will still get a doula! I have had clients have babies outside this window of time and it works out just fine! You just give me a call and if I can I will be there. I might be a little further away than my usual on-call distance and there's a chance since I wasn't on call that I may be out of town but I will send one of my amazing back up doulas to you! You will still get awesome support for your birth, no matter when that may be!

What if my unmedicated birth plan changes? What if I decide I want to have pain medication? 

That is a-okay by me! I often say I am team whatever you want! We will have a game plan in place but when that doesn't go as planned it's time to use the tools we have available to us and I am happy to help you navigate that and support your birth.

At what point in pregnancy should I hire a doula?

I have been hired as soon as the test says "positive" and I have been hired in the last days of pregnancy. There isn't a right or wrong time. The earlier you hire me, the more time you get with me in pregnancy to answer any questions that may pop up, help you understand tests and procedures that happen during pregnancy and to build a relationship together so I can best support you and your desires in labor.

Will you labor with me at home?

Yes! I am happy to labor with you at home and help you decide when it's time to head to your birth place. We can talk more about the logistics at our consultation and prenatal visits!

Do you serve my area?

Probably! I serve the northern part of the Dallas Fort Worth Metroplex. If you live outside one of these areas, still feel free to reach out! I may be able to make an exception or if you're birthing in one of the areas I serve we can do your prenatals while you are in this area!

I doula any of Denton County, so Denton, Lewisville, Flower Mound, Argyle and all the surrounding smaller towns and communities. I will serve up I-35 E to the 121 intersection - occasionally I take clients in Carrolton or Farmers Branch so don't hesitate to ask! It usually depends on what my calendar looks like for that month and if I can add that drive time to my schedule. I will serve Collin County, Prosper, McKinney and Plano. I will sometimes serve in Frisco (if you live in another town and plan to birth in Frisco, that's no issue!) again, it just depends on the month. I will serve north all the way to the Oklahoma Boarder, so Sanger, Valley View, Gainesville (pretty much all of Cooke County) with Munester being my north western boarder and Callisburg being my North eastern boarder. I am happy to doula for all of Wise County, so Decatur, Bridgeport and Slidell and any other towns or communities there. I serve some of Montague county, depending on where you are specifically - if you're birthing in Denton, feel free to contact me! I'm sure we can work that out. I serve as a doula south into Tarrant County to downtown Fort Worth with the hospital district. This includes Keller, Haslet, Grapevine, Colleyville, Southlake, and Northlake.

 

I would love to schedule a free consultation with you to see if we're a good fit!

 

 

 

Birth Affirmations

Birth affirmations can be a great help and emotional boost in labor. I recommend my clients prepare birth affirmations before labor and display them around the house where they can be a focal point in the last days of pregnancy. For some moms, taking the time to actually hand write the affirmations can be a nice way to focus, meditate, pray and really take heart in the affirmation, plans and hopes you have for birth.

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These were my personal birth affirmations for my second daughters labor and birth. I had them hanging in the bathroom and next to my bed to read over and focus on in the last few weeks of pregnancy. When I was in early labor I grabbed them to bring to the birth center with me. I also had a few cards packed with affirmations for my husband to read to me after I was in active labor and knew my eyes would be closed most of the time.

Clients who prepare birth affirmations are encouraged to pack them & I'm happy to hang them up around your birth space so your partner and I know exactly what you would like to hear most in the trenches of labor.

There isn't a right or a wrong when it comes to birth affirmations. A couple of unique affirmations of choice I've heard throughout my years as a doula; "I'm going to kick labors butt!" and "This baby is going to slide out like 'buttah'"! I have a pinterest board dedicated to birth affimations, check it out and see what resonates with you!

 

Rebekah Lewis is a birth doula, professional belly binder and placenta encapsulator serving families in the North part of the Dallas Fort Worth area. She serves families in Denton, Cooke, Tarrant, Dallas, Wise and Collin counties.

Doula Interview Questions

A doula is a professional support person that provides continuous emotional, physical and informational support to the birthing person or couple. A doulas presence has proven to improve birth outcomes for both mom and baby! Finding a doula that is the right fit for your family can seem like a daunting project. Most doulas offer a complementary interview in person or over the phone. Here are some questions you can ask to see if she is the doula for you!

How has your training prepared you to support me in my labor and birth? (Hospital, birth center, home birth? VBAC? Planned water birth? Twins/Multiples? etc)

Are you Certified? With who? 

Do you have to recertify yearly?

Tell me about your training?

Are you a member of any doula organizations?

Are you obtaining any continuing education? What additional education and skills have you obtained since training?

What are your doula fees? What do they include?

Do we meet before birth? How many times?

How do I communicate with you before birth? Are you available for questions?

What types of births have you attended? What unique or challenging experiences have you faced as you have supported clients?

Do you have reliable childcare?

How do I get in touch with you when I am in labor? Are you always on call?

What if I go into labor outside of your on-call time frame?

At what point in labor do you join me? Will you come to my house or meet me at the hospital/birth center?

How long will it take you to get to me when I am in labor?

How do you support the laboring mom?

How do you work with my husband/partner?

Have you worked with my provider/hospital?

I am planning a ______ birth. What questions would you suggest I ask my care provider to see if he/she will support my wishes.

Do you have any "black out dates" around my due date?

How many clients do you take a month?

Do you have a back up doula? Can I meet her?

How did you pick your back up doula?

Do you have an hourly clause in your contract?

Do you have any experience/training in breastfeeding instruction? Will you help me get baby latched after birth?

How long do you stay after the birth?

Do you make a postpartum visit? How many? Do you offer additional postpartum support?

These are just a few questions you might consider asking in a doula interview. At the end of the day, I believe that it matters most how you personally connect with the doula. If you feel on edge, or like you're being judged by the person you are interviewing - she isn't the doula for you! It should be a pretty easy connection and someone you look forward to seeing.

Check out this post for explanations on why some of these questions are important and how to get the most out of your doula interview!

 

Rebekah Lewis is a birth doula, professional belly binder and placenta encapsulator serving families in the North part of the Dallas Fort Worth area. She serves families in Denton, Cooke, Tarrant, Dallas, Wise and Collin counties.

Interviewing Doulas: Why some questions matter!

Congratulations on your pregnancy and decision to hire a doula! It can be a daunting project to decide what to ask when interviewing doulas and finding the right one for you. Here is a peek behind the doula curtain to see why certain interview questions matter!

You can find lists of questions to ask when interviewing doulas all over the internet and one of the first questions they recommend is how many births have you attended? A better question to ask is: How has your training prepared you to support me in my labor and birth? You might even ask a bit more about what their training was like and what it involved! Everyone has to attend their first few births, I have to say, I did an amazing job supporting my very first client! It is about so much more than numbers. A good training will have your doula ready to support you whether it is her first birth to attend or her twentieth! Your connection with your doula honestly matters more than the number of births she has attended. Do you feel comfortable and supported with her? That's what you should ask yourself!

Speaking of a good training - ask her if she is Certified? If so, with what organization? There are many doula training organizations out there! Some people pick a big name company or a smaller one that they connect with their ideology and philosophys. Sometimes you will have an uncertified doula tell you that she has decided to remain uncertified although she trained with xyz organization because she found their "scope of practice limiting". Honestly, if they found it limiting, they needed to find another organization that has a broader scope or one they agree with more and certify with them. Ask them what about that scope was limiting? Was it that they can't use essential oils? Is it because they aren't allowed to do cervical exams? (if your doula says she will do cervical exams RUN! that is not her job!)
You can be a great doula without being certified but here's why I advocate for certification - it holds the doula to a higher standard! If I was running around doing things I shouldn't (catching babies, acting unprofessional, not showing up to births etc) my clients can contact the 3 (yes 3!) organizations I hold certifications with and I would have someone to answer to. I get resources and materials from these organizations, I don't want to do something to ruin that relationship with my cert org because that's part of me staying in business! Doulas are not regulated (like midwives or doctors) so working with someone who has taken the time, expense and effort to maintain a certification is an indicator that you have found a professional, not someone doing this as a hobby.

Some other certification/training questions: Do you have to recertify yearly? (or did they get a lifetime stamp of approval regardless of how they practice?) Tell me about your training? (was it an in person hands on training or was it all distance education and books or a combination of both? There isn't a good or a bad here, just what fits their learning style best. If they've only attended a handful of births, is it important to you if they had hands on training?)

Ask about continuing education. A professional doula should always be working towards learning and growing, if her certification organization requires yearly recertification she will be working on something. This is also great for you! Continuing Education is when doulas pick up skills beyond the basics they learn at training. Accupressure, TENS, Massage, advanced situation training (ie bereavement doula), rebozo, spinning babies etc. These are just an example of things a doula can add to her tool belt to help you have a supported birth!

What unique or challenging experiences have you faced as you have supported clients? This is where the number of births comes into play, you can have a doula that has been to 50 births, but they all happen to be uncomplicated vaginal births. You can have a doula who has attended three and all three had a complication arise that has afforded the doula unique and invaluable experiences.

Some people ask how many children a doula has. That might be important to you, but I know doulas that do not have children and they are awesome at their job! Instead ask, Do you have reliable childcare? How long will it take you to get to me when I am in labor? Doulas who do this professionally have some awesome on call childcare options! When I take on a client I have a game plan of where my children can be dropped off at a moments notice for the 5 week on-call window, 24/7!

What is your birth philosophy? is a common interview question -  it isn't a bad question, but a better question would be if she can support you in your desired birth? (water birth, hospital birth, birth center birth, home birth, vbac, unique complication, c-section whether planned or emergent)

How do you work with my husband/partner? Doulas and dads should complement each other. A doula should not take a partners place (unless that's what the birthing person and partner want!). Sometimes I'm at an interview and a pregnant mother wants me to convince her husband that a doula is a good idea. Doulas love to talk about what we do and how we can help you have an awesome birth but please understand we can't make him do anything. I don't know the dynamics of your relationship and if he doesn't really want me there and it has been forced on him, it probably won't be the greatest birth environment when half of the birthing couple doesn't want the doula present. Hopefully after meeting a doula your partner is on board with a supported birthing experience!

Another frequent question is whether or not a doula has worked at your particular birth place or with that provider. I am in the Dallas Fort Worth metroplex, we have hundreds of care providers! While there are some providers I have worked with more than once, chances are I won't ever work with all of them! It still might be nice to know if the doula has worked with them, but don't put a lot of stock in that response! You should ask the doula instead, I am planning a ______ birth. What questions would you suggest I ask my care provider to see if he/she will support my wishes.

Do you have any "black out dates" around my due date? This is a great way to also learn about their back up doula! Doulas are people too and sometimes we need to go out of town or attend a wedding etc. There's about a 3% chance of going into labor on any given day, so the chances of you laboring on the day(s) that your doula isn't available are slim but she should have a solid back up relationship regardless of black out dates! If your doula does have a black out date, ask if you can meet the back up doula if you'd like!

Do you have an hourly clause in your contract? Hourly clauses work a couple of different ways: Some doulas charge a base rate for their services and if your labor exceeds a certain number of hours an hourly fee begins to retain your labor support. Sometimes it's 12, 15, or 18 hours of labor support that is built into the existing fee and hourly labor support varies but it's anywhere from $12-$20/hour. I do not charge more based on the length of your labor nor do any doulas that I have a back up relationship with!

Most doulas have a clause in their contract about bringing in a back up (if needed) if labor goes beyond a certain number of hours. For example, 15 hours, if your doula is with you for 15 hours she reserves the right to bring in a back up doula to relieve her and bring in fresh awesome support for you (so she can get some rest! We're pretty awesome but we're not super human! Trust me, you want a rested doula). Check to see if you are responsible for paying the back up doula or if that is covered in your fee.

These are just a few questions you might consider asking in a doula interview. At the end of the day, I believe that it matters most how you personally connect with the doula. If you feel on edge, or like you're being judged by the person you are interviewing - she isn't the doula for you! It should be a pretty easy connection and someone you look forward to seeing.

Check out this post for a more complete list of doula interview questions!

 

Rebekah Lewis is a birth doula, professional belly binder and placenta encapsulator serving families in the North part of the Dallas Fort Worth area. She serves families in Denton, Cooke, Tarrant, Dallas, Wise and Collin counties.

 

 

 

 

 

Packing for Birth - A Doulas Advice

If you are in your third trimester, chances are you're wondering what you should pack for the hospital! There are lots of lists and ideas out there but here are some of my favorite recommendations.

My best tip for parents packing their bags is to pack in more than one bag. I recommend packing a Labor and Delivery bag and a Postpartum Bag. This helps reduce the amount of stuff you are hauling in while you're in labor. It also makes it easier to find that tiny tube of chapstick you really want but your partner can't find based on you directions between contractions (but don't worry, as your Doula - I've got you covered with an extra tube of chapstick!)

What you pack really depends on your personality. Moms show up with a couple of these items while others show up with this plus so much more! Do what makes you feel comfortable!

PACKING FOr Labor and delivery

For mom:

  • Birth plan: You should have the copy your provider has signed off on plus 2 more copies (one for your chart, one for nursery and one to hang in your L&D room)
  • Birth Affirmations (for my doula clients, pack these along with your birth plan in your booklet I gave you for me to quickly access in triage to hang up around the delivery room!)
  • Flip Flops (that you don't mind getting wet in the shower)
  • Your own pillow (in double pillow cases to keep it clean): labor and delivery beds aren't comfortable, this can help some.
  • Echinacea tincture or vitamin C for immune support
  • Chapstick
  • Suckers or your favorite candy to suck on
  • Snacks or honey if your food intake is restricted in the hospital
  • Hair ties
  • Toothbrush
  • A labor gown if you want to wear your own clothes
  • packing supplies and a cooler for your placenta if you plan on keeping it
  • Swim top or extra sports bra if you would like to have something on in the tub/shower
  • Unopened bottle of Olive Oil for perineal massage (if this is something you want, we can talk more about this with birth plans and ask your provider if this is something they routinely do and if so what do they use? Many hospitals only provide a jelly lubricant)
  • Relaxation Materials - music, essential oils and diffusers, birth ball, rebozo, massage oil and tools. (For doula clients, I've got you covered! We will talk about what's in my bag at your prenatal appointment.)
  • Depends Underwear - either your water has broken or it will break, this will contain the leaking!

for your partner:

  • Jacket - it gets cold and mom usually prefers this, labor is hard work!
  • Toiletries - labor may be long, you'll want to freshen up! (my client's husband most forgotten thing? toothbrush and paste!)
  • Swim trunks
  • change of clothes
  • snacks and money for cafeteria
  • cell phone and chargers
  • camera

packing for postpartum:

  • Pillow for Dad
  • 2 sets of clothes for Dad
  • 2 pair comfortable pajamas with nursing access
  • robe
  • nursing bra
  • breast pads
  • comfortable going home clothes (you will likely be the size you were at 6 months pregnant)
  • Toiletries (I recommend splurging on nice or fun shower stuff, nothing feels better than the first shower postpartum, treat yourself - you deserve it!)
  • Depends Underwear (these are great postpartum at home or if you don't like the hospital mesh underwear.)

packing for baby:

  • coconut oil (this is actually for mom and baby - it makes a great nipple cream, healthier than lanolin and makes wiping meconium off baby's bottom so much easier!)
  • blanket
  • newborn clothes
  • diapers if you prefer cloth, the hospital will provide disposable if that is your preference
  • infant car seat
  • baby book for footprints

if you are birthing at a birth center -

If you are birthing out of hospital at a birth center, you should also consider what you are going to eat after baby comes. You need something hearty with protein! A frozen casserole that you pop in the oven as soon as you get to the birth center is a great idea that works for any time of the day (just make sure it gets put in the oven so you don't have to wait on it!)! Crock pot soups are another great option.

Different birth centers ask you to bring different things, you may also need to bring items like a fish net or certain delivery supplies. You will likely get a packing list around 36 weeks - just make sure to check it closely!

nOTES FOR FAMILIES LOCAL TO dENTON, tEXAS (AND LIKELY WHERE YOU ARE BIRTHING TOO):

A note for families delivering at Denton Presbyterian Hospital or Flower Mound Presbyterian Hospital. The cafeteria closes at 7:30 and after hours there aren't many options for food (cold cut sandwiches and chips etc) so you may want to pack some good snacks for Dad and Mom after the birth! Depending on when you give birth there are options outside of the hospital but the choices are slim late at night!

If you aren't birthing in Denton or Flower Mound, call your hospital or ask on your Labor and Delivery tour what the cafeteria hours are, they can be unusual, especially on weekends!

 

Rebekah Lewis is a certified birth doula serving families in Dallas, Fort Worth Texas including Denton, Fort Worth, Keller, Lewisville, Flower Mound, McKinney, Allen, Frisco, Prosper, Aubrey and the surrounding areas.

TENS unit for Labor

I currently include the TENS unit in the price of all of my doula packages. After training to use the TENS with my clients I realized how wonderful this tool was and how helpful it is in birth! I couldn't imagine not using every tool I have at my disposal to help my clients achieve the birth that they desire. It seemed silly to me to deny a client this option just because they didn't know how helpful it would be and they didn't rent it or choose a package that included it before labor. 

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I am excited to offer TENS unit rentals for doula clients! This is a non-pharmaceutical option to help bring pain relief in labor! 

What is a TENS? 

TENS stands for Transcutaneous Electrical Nerve Stimulation. It is a hand-held devise that connects via wires to 4 special stickers/pads attached to the laboring woman's back. The electrical pulses go just below the skin to stimulate the nerves. 

How does the TENS create pain relief? 

The TENS unit provides pain relief in two ways. The consistent nerve stimulation creates an increase in endorphins and that helps to reduce your perception of pain. It also works through what we call Gate Control - the nerve fibers in your body that carry pain receptors are smaller and slower "highways to the brain" than those that carry the touch receptors that the TENS unit stimulates. It is kind of like touching a hot stove, you knew you touched it because you felt your hand touch a hard object. You knew intellectually that it was hot and you should react and you have lifted your hand off before your brain has registered that it hurts. With the TENS unit, your brain recognizes the contractions but is previously occupied with the stimulation the TENS unit is providing and it reduces your perception of the intensity of the contraction. 

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I have a TENS unit that my chiropractor gave me, can I just use this instead? 

No, probably not. TENS are not made the same. Some stimulate the muscles rather than the nerves. Not all of them are set up to change settings like you need to in labor to meet the demands your body needs with the contractions. The TENS unit I exclusively use with doula clients is imported from the U.K. where TENS units are commonplace in hospitals as an alternative to epidurals (they don't use epidurals routinely) and the mother is able to control the intensity for upper back from lower back, left and right so it is exactly what she needs at that moment! These units also have different settings to change the pattern of the stimulation pulses. With other TENS units it's recommended that you turn them off and on to create a similar effect... what a hassle! 

Benefits of using a TENS unit

  • You maintain your mobility, you aren't attached to the bed to use it! It can be used in any location (not water, it is electric) so it's a great option for laboring at home, birth center or hospital birth! 
  • It does not have side effects! Just about every other thing that you might receive for pain relief has a side effect of some form (even seemingly benign things like a bag of IV fluids!) so this is a great low-risk option! 
  • You can take it off or put it on at any point in labor. It's a no obligation option! Research does show that it is most effective when used in early labor and then throughout but it's beneficial regardless. Unlike any intravenous drugs or epidural, there is a wearing off period where you have to wait for the drugs to leave your system. This isn't the case with the TENS. When you take it off, it's done. 
  • In a study regarding the use of a TENS in labor, the majority of women who used one in labor said they would do it again in a future labor! 
  • It can be effective for back labor! This is a big deal considering even epidurals are not always and effective pain relief option for back labor! 
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What else should I know?

  • You should not use a TENS unit before 37 weeks of pregnancy (unless you're already in active labor).
  • It can't be used in the water, so if you're planning a water birth it has to come off before you go into the tub. It is still fine to use it when you aren't in the water! 
  • It doesn't completely take away labor pains, this is just something to help - another coping tool. Some women report that they didn't realize how much it was helping until they took it off, so they asked to have it back! 
  • You cannot use it if you have epilepsy or a seizure disorder. You cannot use it if you have very high blood pressure or pre-eclampsia. 
  • You cannot use it if you have a heart arrhythmia or a pacemaker

 

I teach all my clients the ins and outs of the TENS unit at one of our prenatal visits so you aren't learning the device when you are in labor. Let me know if you have any questions! 

 

 

Rebekah Lewis provides birth doula services and postpartum belly binding in the North Texas area including Denton, Decatur, Gainesville, Krum, Aubrey, Flower Mound, Grapevine, Coppell, Highland Village, North Fort Worth, Keller, McKinney, and surrounding areas.