stormImagine this scene, the mom is in early labor and has back pain. She is unaware of what may be causing it and even more what to do about it. Her contractions are irregular but she is having a good deal of pain with each one. What do she and her partner do? They head into the hospital and get an epidural even though it is very early in labor. And in doing so she is kept more or less on her back and her baby who was posterior gets jammed into the pelvis in that malposition. What happens next? Often times she has a cesarean birth. What if she knew how to realign the baby? Could she have avoided a cesarean birth?

Imagine this scene, the mom is in early labor and the contractions are very irregular. She is unsure what to do. She calls her care provider who suggests she stay home for a while longer. But she and her partner are fearful and head into the hospital instead. Once there the provider suggests Pitocin to regulate the labor. And soon the baby is over stressed. And the mom gets an epidural due to the pain from the augmentation. What happens next? Often a cesarean happens. Was the mom even in labor? Could a liter of water for dehydration have  curtailed the irregular pattern? Could helping the baby turn into a more favorable position have helped? Would a nice soak in the tub be helpful in her being able to cope?

The mistake most often made by a couple is going to the hospital too soon. And the second mistake is staying at the hospital after they find out they are not in active labor. The studies show if you go to the hospital and are 3cm or less, you increase your chance of cesarean by 50% if you stay! Don’t go until you are working hard. Don’t go until your contractions are regular and strong. But often couples do not take a childbirth class. Or they take a hospital based class where they suggest going to the hospital at 611- contractions six minute apart lasting a minute for a full hour. That is a great time to go if you plan to get an epidural, but not if you are looking for a non interventive birth!

Pain coping skills should not be being learned in labor. Knowing how to gently realign a baby or move labor along should be something you have knowledge of before you go into labor. Know things to do in early labor to be able to rest for when labor kicks in harder. Take a good childbirth preparation class please. Don’t expect your doula or midwife or nurse to teach you while in labor.

Imagine this scene. The mom has had a long labor and finally the baby is placed on her chest. She has been laboring for more than a day. She is tired and did not take a breastfeeding class to help her be knowledgeable. She has a baby ready to nurse and has no clue as to how to help her baby latch on. She is at the mercy of learning techniques while being very sleep deprived. She did not think it was important to attend La Leche League meetings prior to the birth. She thought the nurses would be knowledgeable and be able to help her. But she is getting conflicting advice and has very sore nipples. She received 2 hours or more of IV fluid in labor, causing her baby’s weight to be inflated. But she did not know that. So when she is told her baby has lost too much weight, she is encouraged to use supplementation. She is given a nipple shield to protect her nipple, not knowing the problems that can occur from doing so. She is soon supplementing more and within weeks is breastfeeding vvery little or even at all. A breastfeeding support group or class could have helped these problems be avoided.

Imagine this scene. A couple has their baby and soon the the baby nurse is in to do the protocol procedures on the baby. She asked if she can give the Vitamin K shot in the thigh, Erythromycin in the eyes and the Hepatitis B injection. She offers to bathe the baby as well. The parents have no idea what these procedures are for and why they are done.  Will this cause any issues? Without knowing the facts on these procedures the couple is not making an informed decision and understanding the benefits and risks of doing so. A good class would help them to be fully involved in the decision making of their child.

So rethink the value of learning the things that can make a difference in your birth and soon after. Please don’t try to learn things in the midst of the storm.

 

 

 

Lately on many private doula pages I am on, there have been doulas discussing watching their clients being abused and what the role of a doula is when that happens. And it is a difficult situation. We can not give medical advice nor be disrespectful to a care provider, but when we see abuse and have to stand quietly out of the way it is very difficult. What many doulas have done, and I personally have chosen to do is to step away from taking clients who have abusive providers.

Recently I had to decline being the doula for a client whom I have been the doula for twice before. She continues to go to the same provider although she is not listened to and is even abused in my eyes. I wanted to be there for her but I can not enable her to continue on the path she chooses. And I am not going to get into why women allow this to happen to them… the vulnerability and issues behind it are outside of my understanding.

We watch women being lied to…outright lies. They are told things that are not evidenced based and are totally biased. We watch women have their cervix stripped after asking to not have it be done. We have women have rough vaginal exams in labor only to be told that is why they need to choose an epidural. We have women have their amniotic sac broken without consent and sometimes even after telling the doctor they did not want that to be done. We watch their perineum being sliced without consent. We watch women get bamboozled into inductions that are not warranted and into medication they did not desire. And for some of us we see worse. When we see women shut down- not listened to- not being heard when they speak- not having a say in their births, we want to yell STOP! But we can’t. We can stand by her side and remind her of what she desired and try to help her find her power. But some women give their power away. They know what they wanted but they are quick to give it away. It makes us go home and cry for that woman and that baby and that birth experience.

I have attended over 600 births and I realized after the first couple of hundred that I had to put my foot down and protect myself from burning out. I had to say, no I will not be party to watching that abuse, that birth rape occur in my presence again, feeling powerless and being damaged emotionally by watching it. So there are providers that if a mom chooses that provider, I have to decline being her doula. There are only a few- one at Gwinnett Medical and two at Northside.  I am reminded of something an OB told me years ago, “ObGyns are either one of two kinds of people. Those who hate women and want to control them, and those who love women and want to support them.” I have found this to be true.

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Recently our local hospital that does more births than any other facility in the country came out with a form that is required by the patient and doula to sign. It is attached for you to see it. It must have come after doulas stepped outside of their scope of practice. I only did one birth there in 2014, so I have not heard the scuttlebutt of what caused this to happen. But it is a shame. The scrutiny of the doula in the support team is sad. If I go as a friend or family member I am not held to signing this agreement. But it seems that although the parents want a doula to accompany them, a nurse can decide that that doula has to leave. How do you feel about a hospital that can control that aspect? And this form is not about overstepping medical advice- it is about support – things your family members do and most nurses prefer for us to help with- but someone decided to make doulas sign it- controlling your choice in having a doula.

I have only been asked to leave by a doctor once- when he wanted to control the mom and dictate who she could have in the room, inviting some who were not invited and then saying too many were in the room and I had to leave. The mother watched in horror but without her voice. Later as she clung to my neck and cried about the horror she had just experienced at his hands, she broke my heart. I had a midwife decide the room needed to be cleared once and ask everyone to leave. She thought that was best. But again, the mom was voiceless. It breaks my heart when care providers feel the need to control the birth room without regard with the mom’s desires. That is about as dis-empowering as it gets.

I think women need to have their voices heard in labor and birth- but I also feel doulas have to know when to say no. I have cried many tears for women who allow their births to be taken away from them. It is always about control. And watching women give their birth choices away to someone else to control breaks my heart.

Here is the form that is now required to be signed if a doula remains in your labor room at Northside Hospital. If you can not read it from this pic- let me share some of the verbiage:

The role of the doula is to provide labor support, which may include emotional support and coping strategies for your labor and birth. The role of the labor doula does not include performing clinical task such as assessing your medical needs for those of your baby, diagnosing medical conditions affecting you or your baby, offering medical advice, operating any monitoring or medical equipment, removing or applying monitors, assisting you out of bed to the bathroom, making decisions regarding your care and treatment or providing instructions or information that would be required by a licensed professional registered nurse or medical provider. 

If at any time your doctor midwife or nurse believe that the doula is not adhering to his or her role in providing you with labor support or if your care providers believe that you’re doing is intrusive in the care and treatment provided to you during your stay at the hospital, we reserve the right to instruct the doula to leave the hospital. You may dismiss your doula as well.

10978551_10153121460466789_4188755323257192461_nSo although a doula should not be giving or providing medical advice or treatment, the document seems to possibly restrict us helping our clients get informed consent. The words like “being obtrusive in the care” and we are told all of the time to unplug a mom to help get her up to the toilet… and when we ask about this we are told of course we can- but if we do- this is grounds to have us dismissed… could be treading on tricky waters. So be aware of the situation your doula may be being put in by supporting you at this facility.

 

What is a foreign object? Some will ask if sexual toys are okay. Here is an article on the subject. But that is not what this article is about. This is about vaginal exams in pregnancy.

pelvic exam

Today I spoke with one of our doulas and sadly the same story was recounted. A client had gone into the midwives office, probably curious as to whether any changes were occurring. And the midwife probably said that she could certainly check and see. And there are always risks to that curiosity. It may not cause any issue at all, but for some women it causes her to have an irritable uterus. What does that mean? For this mom it means two days of irritable contractions that have kept her awake for days. But no real labor has ensued. And here is an article about how fatigue factors into medication use. Fear and Fatigue.

We have articles on the subject, but here are others opinions:  Peaceful Parenting, Pregnancy.Org and Science and Sensibility are just a few you can find in a quick search.  It is such a huge problem we have a few articles on this site: Vaginal Exams,  Come and Go Contractions and When a Woman Takes Her Panties Off!,  Why so much emphasis on not taking your panties off at the doctor or midwives office? Because it matters for a lot of moms. Read the articles. The risks outweigh any benefits if you are healthy and not showing a medical reason to do so.

So when we teach it, share it and encourage you to reconsider a vaginal exam unless there is a real medical reason, please trust that it is years of doulaing and listening to moms’ stories of their labors and births that cause us to believe that putting a foreign object in your vagina- and yes a hand of a care provider is a foreign object! But guess what? Your partner is not a foreign object but hopefully a rather familiar one! If you want to know more about that click here- Sex, Sex and More Sex!

Often times we hear women say, “I tried to go natural, but I chickened out in the end.” It is disturbing to hear them relate that to their birth experiences. I think often women will give in to the pressures from society, the medical staff or even your family when choosing to change their mind regarding medication in their labors. What every women needs is to be encouraged- to find more courage to keep moving forward. And they also need support in making the decisions that are the right decisions for them. If a woman is given the proper support  and encouragement and chooses to get medication that is not “chickening out.” That is making decisions based on what she needs.  Find supportive people to surround you in your labor that will help you find your courage.  Plus in an area where more than 90% of women get epidurals, it takes courage to even consider going without pain medication for birth.

Basic RGB

We recently had two clients in our group of doulas who achieved vaginal births in spite of the way their labors unfolded. I wanted to share their time lines so you could see how most anywhere else these births would have been derailed to the OR for a cesarean.  Look at the timelines and compare it to the stories you hear most every day that start this way.

This first birth was at North Fulton under the guidance of fabulous midwives and nurses. The doula met them at the hospital:

1st day:

  • Labor started that evening and they were in touch with their doula throughout the night

2nd day:

  • Arrived at hospital contractions were 3 minutes art, lasting 60 sec and had been for 3 hours.
  • (Last hr in the car in rush hour traffic)
  • They arrived 7am – checked and found to be 6cm dilated
  • Contractions went to 5-7 minutes, still lasting 1 minute but losing strength
  • Gradually picked up by noon
  • 1:30pm got in tub
  • Declined vaginal exam
  • 2:15pm – got out of tub – contractions slowed to erratic and shorter
  • 5:00pm checked by nurse – no change, confirmed baby was OP
  • Given options of fentanyl, epidural, break water or pitocin
  • Chose to do nothing
  • 7:30pm Checked by midwife -maybe 7 cm, otherwise no change
  • Contractions every 5 minutes, lasting 90 seconds and very painful
  • Chose to do ,1 dose fentanyl and await an epidural.
  • Declined breaking water or pitocin,  wanted to see if rest would turn the baby.
  • Made several refusals for checks or interventions through the night
  • Contractions remained erratic, but lasting 1 minute+

3rd day:

  • 10:30am 9cm dilated , effaced 90% with the baby at +2
  • Midwife broke water
  • 12:50pm anterior lip +1 baby flipped to anterior
  • Started pitocin
  • 2:00pm started pushing
  • 4:44pm – baby boy born vaginally

Thanks to the Lalani family for allowing us to share their beautiful slide show of the birth of their baby Julian. Charlotte Scott is the doula. And the beautiful birthing gown is the one we sell here!

[soliloquy id=”5118″]

This second birth occurred at Atlanta Medical Center with a fabulous midwifery group and a staff of nurses that were less supportive but not interfering. The mom was induced  due to low amniotic fluid.

1st day:

  • 4pm mom arrived for an induction but did not get a room until 8pm.
  • She was given cytotec at 9pm
  • Cytotec caused a bad response from the baby
  • But soon the baby recovered after giving the mom fluids
  • The mom received an ambien and encouraged to sleep the night to begin the next day

2nd day:

  • Pitocin was started at 10am
  • Her doula arrives 12:30 pm
  • But after Pitocin was started the baby had decels due to her uterus being hyperstimulated
  • By 1:00pm there was a better contraction pattern
  • At 1:40pm the mom was  standing forward leaning
  • Tootsie roll dance was following
  • 3:30pm much more active labor pattern
  • 4:30pm toilet sitting– really feels productive to her
  • 5:20pm singing and dancing
  • 5:55pm an exam shows she was 2cm dilated, 50% effaced and the baby at -2 station
  • 6pm her water broke
  • Contractions fade, mom sleeps
  • Her doula left soon after to give her a night of sleep.

3rd day:

  • 6:00am and exam showed overnight she had progressed to  5cm, 70% effaced  and the baby remained at -2 station
  • 10am doula returned
  • 1:00pm 5cm, 75% effaced and the baby had moved down to 0 station
  • 1:37pm shower
  • 3:30pm epidural was placed
  • 4:00pm Pitocin was started back at 1
  • 4:30pm Pitocin was turned back off due to the baby having decelerations again
  • 6:15pm an internal pressure catheter was inserted and the midwife made a wonderful decision to add an amnio infusion to see if “floating” the baby would allow the baby to tolerate labor a bit more
  • 8pm restarted Pitocin
  • Doula stayed the night

4th Day:

  • At 1am she was dilated to 6cm, 90% effaced
  • 4am  the exam showed she was 7-8cm, +1 station , 90% effaced
  • And by 5;40 the mom began pushing
  • And a long labor ended in a fast pushing stage with the baby being born at 5:49am

And although ACOG says labor should not be halted for failure of progressing and ending in a cesarean should not occur until the mom is over 6cm dilated, I would dare to say that in most locations this story would have ended either on the 1st day or at least the 2nd with a cesarean, must less continue into the 4th day. Although there were many interventions offered and some declined. But the resounding piece of each labor was patience. No one was in a hurry to make these babies come. Both babies were eventually born gently. Neither mom had a rush to the OR for an “emergency” cesarean.  And although in postpartum the NF mom received negative feed back to not agreeing to a cesarean by the postpartum nursing staff and having wanted natural births,  they had gotten the outcome they desired, a healthy baby and mom. But even more the moms felt empowered to make decisions along the way, being heard and supported.

I think both of these births also are witness to how a doula’s support can make a huge difference. A doula not only offers great position changes and pain coping ideas, but the continued support that encourages a couple to keep moving forward despite long labors. Where you birth and who your care providers are really do make a difference.

 

I love this article on Intact Perineums by Gloria Lemay… it is fabulous!

intact perineum

I don’t usually just post a blog article by linking another- but oh my – just such wonderful information!

My observations over 594 births is just this- and you will find I agree so totally with Lemay.

Perineal massage during pushing usually causes the tissue to abrade and swell. I usually have to turn away as the doctor says he is helping her to not tear. I have thought, “crap!, I don’t see it!”

I have been teaching for years that if you keep your hand on your own perineum you will not only protect that space, but you will feel immediately reaffirmed when you feel the bulge of the baby’s head. Why is it that women are afraid to put their own hand on the perineum? I think it goes back to the MontyPython Meaning of Life- they have come to believe that they do not know how to birth a baby without someone helping her!

I beg women to get to know their vaginas and how they stretch long before the labor begins. The exercises of allowing your breath to stretch a bit further helps a woman have confidence in her body’s ability to stretch without tearing.

I love in Gloria’s article when she talks about how quiet it needs to be when a mom is pushing. There should not be any yelling or counting to ten- that is one of the most ridiculous actions I have witnessed in labor and births. I think women need to resist the urge to blast her baby out- but instead eases the baby out gently. It makes all the difference in the birth experience and the healing afterwards.

So, read this article- shoot- print it out and make your partner read it- share it with your midwife… read it over and over. Thanks Gloria for the work you do!

 

Do you know if your hospital is practicing evidenced based medicine for their labor and birth patients? The Cochran Collaboration is all about studies to actually see what is best and evidenced based. I sometimes think a couple should carry a notebook of evidenced based studies to counteract the mistreatment during labor.

EBP notebook

  • Have you been told that midwives are not as good as physicians for normal birth? Guess who is best?
  • Wondered if the support of a doula makes a difference? Check this out.
  • Do you think a home birth is less safe than a hospital one? Surprise!
  • Do they want you to wear their not so private or attractive hospital gown? There is no evidence that what you wear makes any difference in birth outcomes- but it can affect how you feel. Wear what you are comfortable wearing!
  • Do they require everyone to get an IV even if you decline or do not need any medication? Hmmm, not so!
  • Do they tell you that you can not eat or drink in labor? No fasting is needed!
  • Do they say that you must stay in the bed?  Get moving!
  • Do they want you on your back and your legs in stirrups for the actual birth? You can choose!
  • Do they want you to be on continuous monitoring? See what is best!
  • Someone telling you that water labor and birth is not good for you or the baby? Read the truth.
  • Do they believe an episiotomy is better than a possible vaginal tear? It is not true!
  • Do they want to cut the cord quickly rather than delaying the cut? See what is best!
  • Do they encourage actual skin to skin just after the birth? Hold that baby!

So please look at your care provider and birth location’s approach to a healthy birth. If they have a whole notebook of protocols- shouldn’t you have a notebook of real evidence to help direct them? 🙂

 

 

 

 

Why do you get a vaginal exam when you are in the last weeks of your pregnancy?

Here are some reasons some moms shared with me and some reasons I have heard.

vaginal exam

Curious if you are dilating?  “Because I was all excited to know if I had dilated any.”  Dilation does not mean anything.  Moms could be dilated several centimeters for weeks and not go into labor. This could cause anxiousness either way- I am not dilated and my body is not working or oh my goodness, I am dilated so I must be about to have a baby any moment. “Trying to make a decision about an induction” If you are considering an induction it is helpful to know how dilated you are to find out if your cervix will need ripening or if you can be directly induced.

Want to have your membranes swept or stripped? ” I was hoping to avoid an induction with Pitocin since I was already a week past my guess date.” This is one of the lowest interventions to getting things going if you are sitting on the ready button. So if you are postdates and facing an induction it may help release some prostaglandins to get you going. Did you know if your baby and body are not ready the sweeping could cause your uterus to become irritated and could even risk having your water break without contractions, thus leading to induction methods to continue the labor your body was not yet prepared for.

The nurse told me to take my panties off. “Because that was what the doctor and nurse told me to do…but in my last few pregnancies I said no thank you. The nurse was always confused and somewhat put out that I was not agreeing to what she told me to do. My doctor though was fine with it.” You must remember there is risk to an exam; risk of infection, risk of your water breaking, risk of information that may make you anxious and nervous, risk of having an irritable uterus. This can lead to contractions that are painful enough to keep your attention and now allow you to sleep without really putting you into labor. Entering labor with little sleep is no fun. So, you get to decide if you want to take your panties off. You can receive a GBS test with the mere use of a swab without any fingers entering your pelvis at all.

I thought I had to have an exam. “Everyone was asking me if I was dilated any and what the exam at the doctors office showed. “ We have clients who never get an exam unless there is a medical indication for having one. Yes they manage to go through the last months of their pregnancy without an exam and some even do not have any or very few during their labor. There is really very little value in the information an exam provides.

I had some medical concerns. ” I had a cyst that I wanted them to check out. Turned out to be no big deal.” There are reasons to have an exam if you feel you have an infection, are bleeding, or contracting very early in your pregnancy where they may need to stop your labor. But thinking your baby may be too big is not a reason to have an exam.

Remember to use your B.R.A.I.N. Ask what is the benefit of this exam. Is there a real medical indication that an exam is needed? What are the risks to having this exam? Do the benefits outweigh the risks? What is your inclination internally- what does your intuition lead you to want to do? What would happen if you decided not to take your panties off? Is there an alternative to having an exam? And here is the most important thing to ask. What will happen now that you are examined next?

For instance one of our moms had an exam at 35 weeks since according to her doctors she was showing some signs of pre-preeclampsia.  She did not understand any further reasoning behind the exam except that she may end up needing an induction. But they would not be inducing her anytime soon- she is premature at this stage and not showing any signs of full pre-eclampsia. They are just being watchful. But what if during the exam her water had broken- or they introduced some germs that could cause an infection that caused her water to break? Then she could end up having to be induced and having a baby who was early and had some problems. Was that exam worth the risk? If she was actually showing more signs of pre-eclampsia- not just an increase this visit in her blood pressure, maybe so.

But you get to be part of that decision. It is your vagina, your baby, your body, your birth.

Some more food for thought- Pregnancy.org

I often hear these phrases:

  • Will they let me?
  • Am I allowed to…?
  • Is it okay if I…?
  • Do I have to…?

Women feel they need to have permission to labor and give birth the way they desire. I wish that women would see they have power in their births. They can refuse to lay down. Refuse to put on a hospital gown. Refuse to have their legs put into stirrups. They can decide to move and behave the way they desire in labor. And they can not be forced to do something they do not want. They may be coerced or bullied, as I see moms often are. But in the end, they can yell, “NO!” And they can say, “I don’t give you informed consent!” But they often say they do not want to fight in labor. So they give in, they agree to things they do not want. They allow coercion to dictate their desires. I hate this!

giving up

I recently had a conversation with a colleague. She was upset at the state of some of the young women she had recently encountered who were pregnant. Their desire to wear high heels outweighed their desire to have an optimally aligned pelvis and therefore a baby who was most likely misaligned. They were not willing to take classes but instead opted to give their births over to their doctors and do whatever they told them to do. They were not taking any ownership of their decisions. It was as if they were just going through the motions of pregnancy without any intention of their own. This colleague was so saddened that this was the direction birth is going today.

I hope she is wrong. I hope there is a resurgence of women who desire to be fully involved in their birth experience. Women who want empowering classes, know all of their options and know it is best if you have strong conversations with your care providers prior to your labor. It is best to have a clear understanding of their support- or their lack of support for the kind of birth you may desire. But the bottom line is, IT IS YOUR BIRTH!

I have been known to say, “Ask forgiveness, not permission.” But the truth is you do not have to be granted forgiveness for having the birth you desire- after all it is your body- your baby- your birth.

Here is an email conversation I had this week:

I am very interested in hiring a doula to support me and help me VBAC (Vaginal Birth after previous Cesarean) in *************.”

I asked a few questions about her due date and location for her birth.

I am birthing at *************, and am looking for someone who have assisted in VBACs before. I was ten days early, spontaneous labor with my first.”

Well if any doula has been doulaing for very long she has experience with VBACs. I was curious if she was setting herself up for a real chance for a VBAC. So I asked a few more questions about who she had chosen for a care provider and what preparations she was taking this time and the reasons for her previous cesarean.

I have seen Dr. ****** for two appointments thus far and have another one next week. Is there a certain Dr/practice that you are familiar with that are VBAC friendly? I am still early and have not had an in-depth discussion about VBAC, but was told from the first appointment that there should be no reason not to allow me a TOL. (Trial of Labor)”

I have to be honest. I was quite shocked at the practice she was with offering her support in having a VBAC. This practice is not known for natural births nor supporting VBACs as of the last I had heard. I told her she needed to have some really frank conversations early on to make sure they had changed their policies. Ask them how many VBACs are successful within the practice. I also found out that her first labor was where her water had broken- no labor started- and yes she had recently had a vaginal exam- and then the augmentation had failed to have her give birth vaginally. She then shared this with me:

I was starting to get this feeling that maybe they would try to bait and switch me at the end. I have an appointment on Wednesday of next week and will discuss in detail the likelihood that they will really support my VBAC wish. My water did break and it was four days after an exam. I progressed to a ten, but baby was “sunny side up” and after 4 hours or pushing he was not fitting through my birth canal. I ended up needing a blood transfusion  from the cesarean and just had a hard recovery, and would like the chance to have a positive birthing experience (either vbac or cesarean). You have definitely enlightened me on taking more action now and not waiting.

So the baby being OP was the issue. Not the size of the baby. She is a perfect candidate for a vaginal birth. And her intuitive voice had already led her to believe the practice was not really being fully supportive of her desires. I suggested she take our Aligned and Ready workshop to help her have an optimally positioned baby this time. I also encouraged her to ask more questions and question their evasive answers.  I encouraged her to do a bit more research of her options.

“I called my current hospital and they stated they could not give out which doctors perform VBACs, but to call around to the providers and ask. So I just called my current practice without revealing who I was and she stated that no doctore there who was VBAC friendly. Definitely an eye opener.”

bait and switch

She is doing her research. She is aware that the Trial of Labor was not really going to be a true trial of labor at all with her current practice.  A few days later I received this email from her:

 I just wanted to update you since you have been such a blessing thus far. I have officially switched to Dr. ****’s office. I will officially be his patient in May. I researched and just loved everything I read about him. At what week would you suggest coming to your workshop “aligned and ready”? Also, at how far along should I book one of your doula’s? Thanks a million times over.”

I was happy she had done her research after I offered her a few names of practices that were truly supportive of VBACs. I encouraged her to take the class at her earliest chance. And it is great she is hiring a doula- hopefully a Labor of Love one and encouraged her to do so sooner than later!

I am often still shocked -although I see it a lot- when practices lie or lead a woman to believe she has their support in the type of birth she desires. There are no excuses for a bait and switch mentality ever.