What’s in My Doula Bag?

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Doulas have all sorts of tips and tricks up their sleeves to make pregnancy, labor, and postpartum a smoother process for birthing people. The majority of the work I do for you comes from my heart, my head, and my hands. In order to provide support, knowledge, and comfort, I don’t necessarily need a Mary Poppins-style bag with tons of trinkets; however, there are a few tools I occasionally use at births to improve your labor experience. Here is a private look into what items I keep in my doula bag.

The first item on the list is a rebozo. A rebozo is a traditional Mexican cloth woven by women for women. My gorgeous, authentic, deep purple rebozo is very special to me, as it was hand woven by local doula, womb care, and rebozo expert, Mayte Noguez of Womb Centered Care and her grandmother. I had the opportunity to take a workshop with Mayte where she taught about the uses of rebozo, as well as the history and cultural significance. The rebozo has many uses in the Mexican culture. It is worn as clothing, can be used to carry babies, and is often used in certain cultural ceremonies. During labor, a rebozo can be used in a variety of ways to help support the abdomen, put pressure on the hips to relieve discomfort, open up the pelvis, and much more. During prenatal meetings with our doula clients we discuss and practice the many uses for this extremely versatile tool.

The second and third items on the list are a rice heating pad and an ice pack. Heat and cold therapy both have benefits during labor. A warm rice pack can help relax muscles and increase blood flow, while a cold pack can help numb areas of discomfort and reduce swelling. A rice pack warmed in the microwave often feels good when placed on the lower abdomen or on the neck and shoulders. An ice pack may feel good on the lower back when experiencing back labor. Depending on the situation, we may alternate heat and cold, or just stick with one.

Item number four is an Elle TENS Unit. As a part of our doula support package, all of our clients are loaned a TENS Unit in the third trimester and we demonstrate how it use it properly. This device has a hand held control panel and four electrode pads that can be placed nearly anywhere on the body. Typically in pregnancy and labor, people choose to place the electrodes on their lower back. When the TENS Unit is turned on, it sends a very small electrical current into the electrodes. You can turn the strength up and down and change the electrical current to pulsate in bursts or a continues at a steady pace. It may sound frightening; however, it is very gentle, safe, and effective at reducing pain. The frequencies put out by the unit help block the transmission of pain messages to the brain. The electrical impulses also stimulate your body’s natural pain relief hormones. This offers a drug free alternative to pain medication, with less side effects.

Massage lotion is number five in my bag of tricks. Having a doula who is also a professional, licensed massage therapist can be a huge perk for Bravo Birth DFW clients. Massage is proven to increase labor hormones and decrease stress and pain hormones. Whether its a back and shoulder rub, foot rub, or a gentle hand rub as you drift to sleep, we want to provide an experience that is relaxing and as stress free as possible. The massage lotion we use is hypoallergenic, unscented, paraben free, and contains arnica extract, which is another all-natural pain relief substance. During prenatal meeting, clients are able to read the label of our massage lotion and even test a small sample to be sure there will be no negative reactions. If preferred, we can alternatively use good old fashioned coconut oil, or the lotion or oil of your choice.

Number six is a handy emesis bag. This one I always hope we won’t have to use, but it’s no secret that labor often causes nausea and vomiting. When I arrive at a birth, I generally take the emesis bag from my doula bag and put it right into my pocket. Nobody wants to be sick, but if the urge to vomit comes on quickly, I am ready and prepared to swiftly pull out the bag and hold back your hair or rub your back.

Number seven and eight: ponytail holders and unopened chapstick (not pictured) are a must in every hospital or birth center bag, but if you forget yours, no worries! I always have back ups. These always seem to come in handy at the right moment.

The only other things not pictured in my doula bag photo are my own personal items. I always bring a full change of clothes. You never know when you might get splashed from a birth tub or shower, or even other birth fluids! I bring personal care items like a toothbrush, mouthwash, and deodorant. There’s nothing more distracting than your doula trying to speak encouraging words in your ear, but all you can focus on is her coffee breath. I also bring my phone charger, a protein drink, healthy snacks, and a giant water bottle. I promise to never eat in front of you, but I do want to maintain my own stamina and strength to help support you during labor, no matter the length of time I’m with you.

So what’s missing from the bag? I used to tote around a birth ball, a peanut ball, and a pump to air them up. While I still believe these are extremely useful tools, the majority of hospitals and birth centers in Fort Worth and Dallas keep a full stock of them on hand. Using the balls they provide is a lot easier than traveling everywhere with my own. If you are planning a home birth and won’t have access to a birth ball during labor, I highly recommend purchasing your own. Not only will you most likely get a lot of use out of it during your pregnancy, but your baby will probably love to be gently bounced on it as a newborn as well. The other items I don’t keep in my birth bag that other doulas might are essential oils. I am happy to utilize whatever oils you provide, in whatever way you wish to use them. I think they can benefit birthing people in a lot of ways, but I prefer not to dispense my own. Everyone reacts to oils differently, and because I don’t want to cause any allergic reactions or respiratory issues for my clients, I only use what you provide.

All of these tools can be beneficial during birth, but even without them, having a birth doula by your side can provide an invaluable level support for you and your partner. To set up a free consultation to discuss how we can support you in your desires for childbirth, contact us here.

Delicious Pregnancy Green Smoothie

Leafy green foods and protein should be two very important aspects of a pregnant person’s diet; however, during pregnancy, it can be difficult to incorporate all the nutritious foods our bodies need every day. Not only do many people experience food aversions and have little to no appetite in the first trimester, you may also be low on energy and not entirely motivated to plan out well balanced meals. Combine that with the fact that the majority of us live incredibly busy lives that don’t allow for a lot of extra time to cook each meal from scratch and it can be a recipe for unpleasant and unwanted health problems. Enter this delicious green smoothie recipe that doesn’t taste like freshly mowed lawn clippings. Bonus: you don’t have to be pregnant to enjoy it!

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I will be the first to admit that if you want to stay fuller longer, its best to eat your greens instead of blending them up to drink them, but if you find yourself struggling to meet the recommended daily intake for vegetables or protein, this green smoothie can help tremendously. The nutritional benefits are still abundant and here’s why:

Kale
Kale is low in calories but high in fiber, vitamins A, C, and K, and calcium. Fiber can improve the dreaded pregnancy constipation. Vitamins A and C are important for a well-functioning immune system, that is generally weaker during pregnancy. Vitamin K strengthens your blood vessels, which is necessary when your blood volume increases.

Spinach
Also low in calories, spinach is rich in folate and iron. Folate is an essential nutrient in pregnancy because it can prevent certain birth defects and decrease your chances of premature labor. Iron can help prevent anemia, which is common during pregnancy. Spinach also contains calcium which is important for you and your growing baby’s bones.

Cucumber
Not only does cucumber greatly improve the taste of this green smoothie, it’s made up of 95% water, as well as magnesium and potassium. All three of these work together to keep you well hydrated. Cucumbers also contain several antioxidants, which have a variety of benefits relating to organ function, disease prevention, and your overall health.

Avocado
Just like many of the above green foods, avocado is high in Vitamin K, folate, Vitamin C, potassium, and fiber. What makes it unique compared to the other ingredients is it’s high fat content. This type of “healthy fat” is shown to reduce inflammation and lower cholesterol. It’s a key ingredient to this smoothie recipe because it’s going to help keep you feeling full and satisfied longer.

Mango
Mango adds a touch of sweetness to the recipe, but it won’t spike your blood sugar levels because of its low glycemic index. The enzymes in the fruit help to improve digestion.

Coconut Water
Coconut water is another excellent way to ensure hydration and prevent constipation. It can also help treat heartburn because it neutralizes acid in the body. It’s preferable to using juice in a smoothie because it is lower in sugar.

Lemon Juice
The lemon in this recipe really helps to neutralize the bitterness of the leafy greens without adding a noticeable sour taste to the drink. Lemons are powerful detoxifiers and promote a healthy immune system.

Protein Powder
In pregnancy, experts recommend 75 to 100 grams of protein a day. Protein is essential for fetal brain development. Any type of protein powder should be fine for this purpose, but if you don’t already have a specific brand you’re partial to, Rainbow Light makes a great plant-based, vegan protein powder formulated for pregnancy and postpartum.

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Recipe
Yield: 2 Servings
Serving Size: 8-10 ounces

1 cup kale, packed
1 cup baby spinach, packed
1/2 cucumber, sliced
1/2 avocado
1/2 cup frozen mango
1 cup coconut water
1/2 lemon, juiced
2 scoops of protein powder (optional)

Put the ingredients in your blender in the order they’re listed and blend until smooth! This recipe makes two 8-10 ounce servings, so you can share the other portion with your partner or children or you can save it in the refrigerator for yourself for the following day. It still tastes delicious, just make sure you stir it first, in case the protein powder settles.

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Pregnancy can be extremely depleting on the body. It’s crucial that we care for ourselves so we’re functioning at our best. Eating well by incorporating green foods and protein is a great way to help us thrive in pregnancy, postpartum, and parenthood.

Alexandra Bravo LMT, CLC
Owner, Bravo Birth DFW

Early Labor | What I Wish I Knew

Welcome to part three of our blog series entitled What I Wish I Knew. This series explores various topics related to pregnancy, birth, postpartum, and parenting that parents wish they would have known more about before they experienced them. You can find part one here and part two here. Our first two installments of this series addressed common postpartum issues, but today we’ll be addressing birth, more specifically early labor. When we asked our doula clients and social media followers about what they wished they would have known more about before going through labor, many parents expressed their uncertainty in knowing how to identify early labor signs, as well as what they should do when it begins.

What is Early Labor?
Early labor is the first stage in the labor process, during which your cervix begins changing. It is also sometimes referred to as pre-labor, or the latent phase. During pregnancy, a normal cervix is firm, closed, long, and pointing toward your back (posterior). In early labor, the cervix begins to soften (ripen), open (dilate), thin (efface), and move forward toward the birth canal. This begins to occur through a complex series of chemical and hormonal changes in the body. Early labor is defined as the period of time that your cervix is between 0-3 cm dilated. It is generally the longest and least physically demanding stage of labor.
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How Do I Know if I’m in Early Labor?
Oftentimes, early labor is so mild that you may not even notice it. Other times, you may experience some of the following symptoms:

• Menstrual-like cramps
• Low back ache
• Increased pressure in pelvis or vagina
• Fluid leakage from vagina
• Inconsistent contractions or contractions 10 or more minutes apart
• Increased vaginal discharge
• Bloody show
• Loss of mucous plug
• Nausea, vomiting, or diarrhea

If you think your water has broken, notice more bleeding than light spotting, experience severe pain, or a decrease in fetal movement, be sure to contact your healthcare provider.

What Should I Do in Early Labor?
Birth is often likened to a marathon. In a marathon, you want to avoid exerting all of your energy at the very beginning, so you will have the stamina to make it through until the end. The same is true for birth. If your mind and body become too fatigued early on, labor may become more difficult than necessary. So if birth is a marathon, rather than thinking of early labor as the beginning of the race, it may be helpful to think of early labor as the day or two leading up to the race. You will want to hydrate, eat well, rest as much as possible, and go about your life as usual. Don’t get caught up in the idea that you have to do anything to get active labor to begin. The time for that may come later on, but this is likely the only stage of labor that you’ll have the opportunity to rest comfortably through, so be sure to take advantage of that as much as possible. Although the thought of finally being done with the discomforts of late pregnancy and meeting your baby may be exciting, try to avoid doing too much physical activity which could exhaust you before the more strenuous work needs to be done.

In a high-risk or special circumstance pregnancy, you will want to discuss with your provider during your pregnancy what you should do in early labor. Some conditions may necessitate monitoring or intervention.

Doulas and Early Labor
If you have hired a birth doula, it may be a good idea to touch base with them during early labor. Although you likely will not need them to come to you right away, your doula can still be of importance during this time. They can help you differentiate between early and active labor, offer support and encouragement, and answer any questions for you. Communicating with your doula also allows them to begin to prepare themselves to be with you in a timely manner when you request them further along in labor.

How to Choose Your Pregnancy Health Care Provider

Having a great health care provider can be an essential part of a satisfying pregnancy and birthing experience. In the Dallas-Fort Worth metroplex, we are fortunate to have so many wonderful obstetricians and midwives. Finding the best health care provider for you before or during pregnancy may seem daunting, but these simple steps can make the process a little easier.

Evaluate your priorities. Are you seeking a provider who is known for working with special circumstances, such as VBAC or twin births? Would you prefer to birth in the comfort of your home or a mbirth center, or would you feel more at ease in a hospital setting? Are you interested in delaying umbilical cord clamping at birth and want a provider who will support that decision? These are just a few factors to consider, and at times it all may seem overwhelming. Everyone has different needs in pregnancy and birth, so make a list of what is most important to you and what might be a deal breaker to help you narrow down your search.

Consult an expert. If you are still unsure of where to start in deciding what your priorities are, a birth doula can help. When you hire a Bravo Birth DFW doula, you receive two private prenatal visits with us. Part of the visit is spent exploring all of the options available to you and getting to know your preferences. We support you and provide information as needed to help you narrow down your primary goals for birth. We also have the privilege of working with many different care providers in the metroplex and can often make recommendations on who may meet your needs.

Shop around. You may fall in love with the first OBGYN or midwife you meet. If that’s the case, great! Your intuition is a powerful thing and you should trust it. It is entirely possible to find the right fit on your first attempt, but if you’re unsure for any reason, don’t make the mistake of feeling like you’re locked into a permanent relationship with a provider. You can interview several people before making a decision, and keep in mind it’s never too late in your pregnancy to change to somebody who fits your needs. When considering a provider, be sure to evaluate your feelings on the other physicians who share a practice with your own provider. There’s always a chance your primary doctor will not be on call when you are in labor, and one of their partners may be there to assist in your delivery. It’s important you are comfortable with them, as well.

Seek out recommendations. In the age of technology, almost anything can be found on the internet. While you can’t always trust everything you read, it can be helpful to hear from others who have first hand experience. Google and Facebook reviews are a good place to start. Reaching out to a local pregnancy and parenting group can be another good source of information, and most people are more than happy to share their experiences with others. Having inside information on anything from the provider’s communication style and bedside manner to the length of the wait time for prenatal visits may be extremely helpful.

Consider your budget. Birth is an investment and it may not be the time to scrimp on a cheap experience; however, spending beyond your means or going into debt with a baby on the way may not be a feasible option. Find out if your ideal provider accepts your health insurance, what the out of pocket cost is, whether you can set up a payment plan, and what the timeline is for paying it off. Finances don’t always have to be the primary dictator of our decisions, but starting out on the right foot when having a baby is wise.

Finding a pregnancy health care provider who aligns with your needs doesn’t have to be stressful when you know what you want and what to expect. With the variety of options available in DFW, combined with your intuition and the knowledge you gain while deciding what your preferences are, you will be confident and fully equipped to find the right provider for you.