Better Together Birth Services

01/30/2025

👉 Epidurals trap you in bed!

Being stuck and immobile is a risk factor for prolonged or stalled labor as mama is not able to help their babies navigate the birth canal.

Labor that takes longer than expected can begin to raise concerns in the minds of providers:
- Is baby too big?
- Is baby in a bad position?
- Is something preventing baby from dropping down?
- Will mom be able to deliver vaginally?
These questions can precipitate a push toward cesarean section.

What can you do about it?
📍 Request your partner, doula, or nurse to help you to turn frequently to allow baby optimal opportunity to traverse down and out with the power of your contractions. (Optimally every 30 minutes) *Note, if the epidural is chosen after laboring for a long time and rest is needed, it's fine to rest for a few hours then begin to move around.
📍 Request a peanut ball to put between your legs while on your side (Peanut balls are shown to open the pelvis for baby's descent and shorten the length of labor and pushing)
📍 If your legs can handle it, try 20 minutes out of every hour on your hands and knees (have a support person close by)
📍 Request to sit up in "high throne" position after your epidural has taken optimal effect (be sure to trade this position out after 30 minutes as it can decrease the epidural's effectiveness)
📍 If your nurse is emptying your bladder with a catheter, make sure the catheter is in place within an hour of getting the epidural (or that a straight catheter is used at minimum every two hours).

If you're able to move, open your pelvis, and keep your bladder empty, baby has a much higher chance of continuing their journey through your pelvis and into this world!

01/30/2025

My job as a birth doula is to make sure your needs are met in the birth space. So whether you choose to have a birth without using pain meds or choose an epidural, I want to make sure you are well cared for. Here's a great post on epidurals so you can make a well-informed choice when it comes to bringing your baby earthside.

💉Hey there, mamas! We are talking all things Epidurals this week . . .

As a doula, I support you in whatever method of birth you choose. I have no lesser respect for the woman who chooses an epidural in the hospital than one who has a home waterbirth. Its your birth, your way. I'm here to be in the journey with you.

With that said, I want you to understand fully the option of the epidural, what it does, what its risks are, and the cascade of interventions that typically follow.

This post will be brief and bulleted, but I will go into more details in the next couple days.

Epidural Benefits:
🥳Pain relief from contractions typically within 30 minutes of administration
🥳 Ability to rest after a long early/active labor
🥳 Ability to conserve energy for the pushing phase
🥳 Single time intervention as a tiny tube stays in your back and gives you a continuous infusion

Epidural Side effects:
🥹 Temporary drop in blood pressure for mama (resulting in temporary drop in heartrate for baby) resolved with extra IV fluids and maybe meds to bring your blood pressure up.
🥹 Back pain
🥹 Ringing in ears
🥹 Headache (that may last long after birth)
🥹 Some epidurals are "one sided" and you only receive relief on one half of your body
🥹 Some medication DOES cross the placenta and can make baby "sleepy" for the first couple days after birth

Epidural Cascade of Interventions:
🥲Immobility due to numbness keeps mama in bed and risk of fetal heart rate drop 🥲 Keeps her on the monitor
frequent blood pressure monitoring, possible pulse oximetry device on finger
🥲 Smooth muscle relaxation may slow down contractions, so doctor may suggest breaking your water or starting pitocin now that you're "comfortable."
🥲 Since you cannot get up to the bathroom, a nurse will empty your bladder with a catheter (it's necessary to keep the bladder out of the way)
🥲 You will not be allowed to eat, and will only be able to sip clear liquids (and at some places have nothing by mouth). This is counterproductive in giving your body the necessary calories and energy needed for contractions and pushing!
🥲 With limited mobility, you may be stuck pushing on your back (making it harder for baby to rotate through the birth canal) and with limited feeling pushing can be difficult to navigate
🥲 Pushing time is typically longer with epidural. Most doctors will let you push for three hours (by which time you are exhausted) before suggesting vacuum cup or forceps assistance for delivery.
🥲 If baby is very high after 3-4 hours of pushing, the doctor may suggest c-section even if baby is tolerating pushing well

Stay tuned the next couple days for more information on how to navigate epidurals should you choose one.

01/24/2025

💙 It’s a boy!!! 💙
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Abbey and Jordan's journey to welcome their second son, Elias James, was a stark contract to the challenging experience they faced with their first son. After a long and exhausting five-hour pushing phase during their first birth, Abbey was determined and praying hard for a more positive, redemptive experience this time. They chose to labor at home throughout the day, feeling more comfortable and in control of the process. When they arrived at the hospital, the use of a TENS unit proved invaluable, helping Abbey manage her pain effectively and allowing her to focus on the moment. With the support of her husband Jordan, her doula and the nurses, who provided comfort measures and constant reassurance, Abbey felt empowered and ready to embrace the joy of bringing Elias James into the world. Though their regular doctor was unavailable, another skilled physician stepped in to assist with the delivery, ensuring that everything went smoothly, and Elias arrived after 5 minutes of pushing!!! Welcome to the world, little Elias!!
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Primary doula: Mal Loveing
Birth doulas: Mal Loveing and Megan Magyar
•

09/17/2024

Awaiting a baby….so much of labor support can look like waiting. Waiting for a contraction to start or to end. Waiting for mom’s breath and the long sigh out at the end. Waiting as we transition slowly from early to active to transition. Waiting empowers knowledge, observation, and action. Knowing when to step back and discerning when to step in. The ebb and flow of labor is beautiful. Hoping to see this baby today! But all in due time!

08/20/2024

Does the partnership model sound like something you need in your life? Does the idea of getting something running from the ground up sound intimidating? Here are a few simple steps to get you started.

- Find a few local doulas who share your birth philosophy. Meet with them. Discuss your needs and your options to support one another in fuller ways. Determine your perfect size. (We have found 5-6 doulas is the ideal number. More gets confusing. Less makes it hard for multiple doulas to be off at one time.) You must have the right team in order to make the partnership model work.

- Determine what services you will and will not offer. Will you specialize in birth? Postpartum? Bereavement? Make sure you are all willing to offer the same services when you are covering for each other. Determine which licenses and trainings you want to keep active within your certifications. Identify any services you WILL NOT provide. (We have contracted not to attend unassisted births as this may put us at risk for acting outside our scope of practice.)

- Determine your birth attendance pay rate. (We have chosen a set fee rather than hourly and, if more than one doula attends, we divide it based on the percentage of time each was in attendance.) Decide when that money will be collected, where it will be held, and how soon after birth it will be transferred (and by what method).

- Decide how you are going to manage your calendar. How long will shifts be? Who will record and maintain the calendar? How will you share it with each other – and with clients? What is your process for switching doulas mid-birth? How quickly should your doulas guarantee arrival at the birth when on call? How early will you complete the following month’s calendar? How often will you meet as partner doulas to maintain continuity and work on scheduling?

- Brainstorm how to introduce your clients to your partner doulas. Will you host monthly meetings? Virtual meet and greets? Will you facetime or meet in person with each individual client?

- Determine how you are going to advertise, whether you will need a name, a logo, a website, and a social media presence. Who will manage any and all of these?
Write up a contract (include everything above) and have each doula sign it. Then, file it away safely.

Congratulations! You are ready to start thriving in your doula business and feel more supported as a doula than ever before.

08/20/2024

Our Reviews Say it All!

“I already love the doula I’ve been working with, and I was a little nervous about the idea of working with other doulas at birth. I was even nervous about going to the event, afraid it would make me more anxious leading up to labor. But it did the exact opposite! The evening felt casual and I was able to personally talk to each doula there. I got to learn about each person’s background and passions with pregnancy and birthing. I honestly walked away from that evening feeling completely comfortable having any of those wonderful women attending my birth! They’re all so passionate and knowledgeable and I would trust each and every one of them to help guide me in labor and birth." (Marissa)

"I had an amazing experience with this company. I was educated and supported the entire time. I felt confident and was able to make well informed decisions throughout my birthing process and beyond." (Shenier)

"Hannah and her Doula practice were very professional, very approachable and personable. I loved the chance to be able to meet all of the Doula's each month to get to know them and feel comfortable when and if they were going to be present at my labor. . . I would highly recommend her Doula practice to any first time moms or other moms planning on having more children." (Miranda)

"Hannah and the rest of the doulas on her team are AMAZING! They empower and support you and your partner so that you can feel prepared for birth and after. . ." (Anastasia)

Birth Doulas of Michiana

08/20/2024

Birth Doulas of Michiana

Here’s how we work:

We are a group of local, certified, birth doulas that provide continuous care and compassionate education through pregnancy, birth, and postpartum. We commit to a high level of care and provide continuity in our service model, so our clients are well cared for no matter which one of us shows up at their birth.

Our clients contract with us privately, as we each maintain our own, independent, businesses. We provide 24/7 support for our clients from the time they contract with us. We do our own prenatal meetings (in person and virtual) throughout pregnancy and early labor. Then, when they are ready for someone to come support them in person, we notify our primary on-call doula. This doula responds, providing support for the parent(s) as they bring their baby earthside.

If the birth process continues all night, the doula in attendance knows they will have relief the following morning. At 7am, the next doula comes in, well rested and confidently prepared. This guarantees our doulas are getting proper rest and are able, 100 percent, to be present with our clients when fresh energy is needed most.
Our call schedule is from 7am -7am (24 hours), with a primary and a backup doula assigned each day. Our clients can receive a copy of our call calendar one month in advance, and they can meet us at one of our local and monthly “Meet the Doula” events.

The partnership comes at no additional cost to our clients, as we manage all birth attendance compensation between the doulas at our end.

This partnership has not only allowed us to set healthy boundaries, but it has enabled us to be fully present with our own families at important events. No more running out of a birthday party because a client has called! No more begging for childcare! No more wondering if my backup will actually be available when I need them to be available! No more 48+ hour births! No more wondering if my clients will receive the same level of care if I’m not the one attending their birth. We can now plan vacations. We can rest and practice healthy self-care after long births. And, we can offer more services to more clients across our area, because we now KNOW that someone is always available to care for them.

This partnership has facilitated increased doula education, constant access to resources and ideas through communicating with our partner doulas, a sense of local community and collaboration rather than competition, and guaranteed quality care to every client we serve. With this model, we can offer more services to more clients and are able to guarantee the support they need for the birth they want.

The creation of Birth Doulas of Michiana has been one of the most empowering moves in my twenty years in the birth world. I feel more supported, more free to be present with my family, more validated in my need for boundaries and rest; and I no longer have to worry about distressing phone calls from bailing caregivers for my children!

Birth Doulas of Michiana

08/20/2024

I absolutely love working with this partnership! The shared expertise, the camraderie, the best, most positive support for our clients, and the encouragement... it's just priceless.

Last week, we covered boundaries as a doula. This week, I want to share one of the most empowering moves of my doula career: Birth Doulas of Michiana

The following is an excerpt from an article I wrote for DONA INTERNATIONAL Magazine Fall 2022.
. . . . . . . .

Burning out the Solo Candle to Ignite the Partnership Model: A New Approach to Boundaries in Healthy Doula Practice

Hannah E. Norton, RN, CD, Childbirth Educator, Mental Health Coach

I slammed the phone down on my desk and buried my head in my hands as the tears began to flow. Another babysitter had just bailed on me. This was the fifth time this month, and I was beyond frustrated with trying to find someone to care for my boys while I was away at births.

The general problem was that I could never depend on my childcare as mamas don’t go into labor on a planned and predictable schedule. I had to cover all the hours my husband was at work – including overnights – with an “on-call” sitter who wasn’t guaranteed any hours, but who needed to guarantee me their availability within an hour of being called. This was a sour deal for both of us!

I could see how doulas burn out within two years. It’s not simply being called to births at all hours that is stressing us all out. It’s managing life – and missing significant milestones, birthdays, holidays, and sleep. So. Much. Sleep!

My boys were paying for this lifestyle as well. They never knew when I – their mommy – would be home, or who they might be staying with, or who they would wake up to find in their home because I was gone overnight, again.

The job was losing its luster. My passion for providing quality birth support was still as hot as ever, but my ability to juggle the stress of an on-call life, and making sure my boys would be loved and well cared for in spite of it, was wearing me thin.

I knew there had to be another way, but the only models I found online were private contract doulas that worked with a backup doula or an agency. I started praying and dreaming. What would it look like to get a group of like-minded doulas together, all of whom could share a call schedule? This would provide all of us the opportunity to maintain healthy life balance, take time off when needed, and have solid, guaranteed backup if we were sick or had a family emergency. What would it look like to never again feel trapped in a 48-hour birth, yet also guarantee my clients the highest level of care no matter the length or outcome of their birth?

A local doula friend and I started throwing around some ideas. We had connections with several other local doulas who would likely be interested in working together. So, over coffee, Mal Loveing Better Together Birth Services and I brainstormed the services we would offer, as well as our advertising, commitments, standards, compensation, and client management plans.

Thus, began the journey of Birth Doulas of Michiana. Within six weeks, we had secured three contracted doulas (for a total of five), created our first on-call calendar, scheduled our first monthly “Meet the Doula” event, consulted on our standards of practice, developed a website and logo, and stated our group’s values and mission statement.

** Stay tuned this week for more about how we work as a partnership and how you can establish a partnership model yourself!

03/24/2024

03/19/2024

02/23/2024

There’s a certain camaraderie in knowing you’re not the only doula leaving your home in the quiet of the night.

To know there’s another awake, assisting, serving, affirming, empowering.

Two mamas work to bring babies earthside.
Two doulas travel opposite directions to come along side.
Two stories unfolding.
No one alone.

This is a doula partnership.
This is what I love!

Birth Doulas of Michiana

02/23/2024

💕 It's a girl! 💕

It was 5:00 pm and my phone began to ring. I answer and the voice on the other end says, "I am pretty sure my water just broke." My first thought was "Wow! This was exactly how this mom's first labor started!" My second thought was, "😳 I gotta go. Her first labor was fast; statically, this one could be even faster."
By 6:30pm, I had arrived at their house, mom was laboring beautifully with contractions were coming every 5-7 minutes. Mom breathing through them with ease.
Things continued progressing and by 8pm she was ready to head to the hospital. The wonderful BabycareTENS unit was this mom's best friend during the 30 minute car ride.
At 9:00pm, we were getting settled into the L&D room. Mom was 5cm, 90% effaced.
9:30pm midwife came in, chatted for a few minutes and encouraged mom before leaving to go have dinner. She had hardly shut the door behind her when the next contraction came. This one sounded different. I looked at the nurse and dad and mouthed, "She's pushing."
The midwife hurried back in to discover baby was quickly making her appearance!
Momma beautifully breathed and pushed through 5-6 more contractions.
Then, at 9:49pm - Hollyn Grace entered the world!

Congratulations to big brother and mom and dad! Thank you for letting me be a part of Hollyn's arrival 🥰.

Primary Doula: Hanna VerMeulen
Birth Doula: Hanna VerMeulen