Here I have another blog post with another great doula and business woman, Rebecca, of Blissful Birthing. Through her time as a doula she has seen the ins and outs of the medical field and the care women get from their healthcare team. This one is a goodie! Enjoy!

Q: How long have you been a doula and what do you do with Blissful Birthing?

A: I became a birth and postpartum doula in January 2014 after leaving medical school and searching for a career where I would be able to have a meaningful impact on the lives of others. My "postpartum" journey was very different than most as I did not birth any of "my" children - I was a foster mom from 2013 until 2022. When  Cameron, my first baby, came to me at one week old I was thrown into life with a newborn and, despite my extensive experience with young children, it was still an adjustment. About a month into his stay I asked my mom, who I was living with at the time, if she would be able to wake up for Cameron's 11pm feed as I was exhausted. I slept for 13 hours that night without moving! THAT is when I realized just how beneficial overnight postpartum support was for new parents (and I didn't have to recover from delivery!).

While Blissful Birthing is an agency, I am still active in direct client care. I have an AMAZING team of doulas who provide exceptional support to our clients before, during, and after the arrival of their babies. Postpartum support, specifically overnight postpartum support, is by far our most sought-after service, followed by placenta encapsulation.

Q: During your time as a doula what has been the biggest physical challenge you find women encounter either intrapartum or postpartum?

A: I think the biggest challenge women experience in this perinatal period is not being fully prepared for the changes their body is going to go through and for how long that is going to restrict their activities. The placenta is about the size of a dinner plate and when it detaches from the uterus during the third stage of labor it leaves a sizable wound. Whether baby has been delivered vaginally or via c-section this needs to heal to prevent excessive blood loss and infection. What can be tricky is we don't see this wound so when women start to feel better that does not always directly translate to being fully healed. It is not uncommon for women who are two to three weeks postpartum to increase their activity level because they have stopped bleeding only to find that it has started up again! This can be frustrating and prove to be a bit of a mental, as well as physical, setback.

Q: In all of your years of experience, what do you find women need from healthcare professionals that isn't given? Either after pregnancy or during pregnancy.

A: Evidence based, individualized care. My background in the medical field provides me with an understanding, from a liability perspective, as to why providers have blanket policies that are one size fits all. Our medical system has become very factory-like and it allows providers to move from one patient to another on "auto-pilot," for lack of a better term. They know their dictation for all clients at, let's say 24 weeks, will essentially be the same. Billing for appointments is streamlined. But we deserve better. Our babies deserve better. Women should not be faced with such tremendous backlash when they question why a test is being ordered when they have no risk-factors. Unfortunately we have become accustomed to accepting these recommendations as requirements. 

Another thing is the language that is used in emergent situations. VERY rarely are true emergency c-sections performed (meaning that the mother must be put under general anesthesia because baby needs to come out NOW), yet a scroll through Facebook mom groups could have people thinking that it's common. What IS common are unplanned c-sections where a woman is in labor and something changes where it is decided with her provider that delivering vaginally may not be the best option. All the time I see women being booked for repeat c-sections instead of a trial of labor after cesarean (commonly referred to as TOLAC or VBAC) when there are fewer risks associated with a VBAC in almost all situations. Very rarely are women receiving pitocin in labor told that it carries the risk of uterine rupture. But mention wanting to try for a VBAC and the risk of rupture (which is less than one percent!) is all providers can talk about! Don't get me wrong - I fully support primary and repeat c-sections when they are the mother's decision (whether she chooses to be informed or not). It is the lack of transparency and evidence based care that I am not alright with.

Q: Where do you find fitness fits into a woman's life either while she's pregnant or post giving birth?

A: Juggling the demands of pregnancy (doctor appointments, prenatal classes, nursery preparation, etc) and daily life is a lot. And things only get more hectic once baby is earthside. New moms tend to prioritize the needs of their baby over their own needs. Maybe they'll be able to squeeze in a walk or two each week with baby, or a couple of at-home fitness videos, but unfortunately that's usually where it ends. I think a huge part of that is that for the first 6 weeks (at a minimum) women need to recover from birth. Then they want to get into a "normal" routine in the 2-6 weeks they have, if they are lucky, before returning to work. Fitness tends not to be a priority in the time surrounding the birth of a baby if it was not a priority before.

Q: What do you find is the best thing to do for postpartum anxiety and depression?

A: Having supports in place and ready to go, should they be needed, is something that not all women do. We would all like to think about the early months of our babies' lives as exciting and joyous. But there is a huge hormonal shift that happens during delivery and that effects all women differently and at different points in their postpartum journey. Reaching out as soon as you become overwhelmed and not waiting to "see if things get better" is the best thing a woman can do if she doesn't already have professional support in place. 

We have a decent number of clients who opt to encapsulate their placenta to help in their postpartum recovery. This is a practice historically linked to Traditional Chinese Medicine and is not something new. When our iron levels are low our mood, energy, and overall bodily functions suffer. The placenta is an iron-rich organ and many women report feeling more even-keeled, less tired, and like their milk supply is supported when they consume their placenta after delivery. I totally understand that this practice is not for everyone! At the very least I would urge women to ask their doctor about taking, or continuing to take, an iron supplement after delivery.