What’s with the comb?

What’s with the comb?

If you found one of these in your birth fair goodie bag you may be wondering just what combs have to do with birth and babies…

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We find that two plastic combs, like the one in the photo, are a handy addition to any birth bag. The laboring person can hold the combs as shown above, and squeeze during a contraction — if it feels a little uncomfortable, you’re doing it right! The combs work on a few levels to provide relief and comfort:

BONAPACE METHOD — Creating discomfort elsewhere on the body releases endorphins that may decrease the perception of labor pain.

GATE CONTROL OF PAIN THEORY — This theory says that the brain can only pay attention so many sensations at once. Pressure on the nerve pathways of the hand reach the brain faster, and crowd out the abdominal pain signals. Sterile Water injections and TENS units work on the same principle.

REFLEXOLOGY  —  In her book Special Delivery author Rahima Baldwin suggests that the points across the palm, at the base of the fingers, correlate to the uterus and that stimulating these points may help labor progress. While those in labor tend to stimulate these points without consciously thinking about it by holding hands with their partners or doulas, gripping bed rails or the edge of the tub, tugging on a rebozo, or clutching the bed clothes, using combs may be an efficient way to do so intentionally.

PSYCHOLOGY — Because the laboring person is in control of the the combs, they may feel less out of control of the sensations of labor. Being able to control the strength of the TENS unit may also have a similar benefit.

BREASTFEEDING — Our friend Megan of Blue Ridge Breastfeeding reminded us how useful a comb is after birth, too! Dragging a comb down the breast can be an effective way to break up, or even prevent clogged ducts. These combs might be a little sharp for this practice, and we suggest one with wider and more blunt teeth.

While we find that combs can be JUST the right tool for some families, and work less well for others, they are a great low-tech, low-intervention, budget-friendly tool to try.

We carry combs in our doula bags as one of many tools to help our clients through labor. If you’d like to learn more about how doula support makes birth a positive and empowering experience, CLICK HERE!

(updated 4/15/18 to include inclusive language, correct an error and provide more links)

 

Community Birth Story: Colette Josephine

Community Birth Story: Colette Josephine

imageFAA36 As told by Lilly:

The Wednesday before Colette’s birth just happened to fall on Ash Wednesday, a time of preparation for a spiritual journey, which is exactly what I was experiencing that day in my own way. That evening I felt off. I just did. Nothing was going right in my head, my thoughts and emotions were all a jumbled mess. The night before, I had gotten some beautiful words of wisdom from my dear friend Tabitha about all the fears of inadequacy I was having, she was so encouraging and assured me that all my feelings were a clear indicator that labor was soon to come. She was right. In retrospect I was displaying so many signs that I had also displayed just before I gave birth to our last child, Clare. I didn’t want to eat dinner, I had pressure in my bottom, I wanted to take my 3rd shower/bath of the day lol, and I really needed the kids in bed. All random things but all things that I had done the last time as I was approaching labor.

That evening I prepared a quick dinner, that I made a mess of repeatedly. I laid down in the other room while my husband, Colin, fed our four kids. I was so exhausted. But I wasn’t having any contractions or show or anything. So much of my “labor” that evening was getting over all these emotions I was having. Once Colin fed the kids he went to the gym and I put the kids to bed. I rushed through the bedtime routine and was grouchy, then I was sorry and just felt like I really needed to chill out. So I grabbed a nice bottle of wine and had a glass while I soaked in the tub. It was exactly what I needed. I texted with my doula Amy after putting the kids to bed and she really helped me through so much of the feelings that were troubling me. I had fears of delivering next week and what if the snow storm kept everyone from being there including Colin?! She assured me that those who are meant to be there will be there. She was so right!! But little did she know what that actually would end up looking like!

Colin came back home while I was in the tub, he jokingly asked me if I was in labor since I was in there. Haha no…so he went back downstairs to eat while I finished up and put Clare to bed. I met up with Colin downstairs and we watched a bit of a movie together before deciding it was getting late. We joked again about having the baby tonight but I told him that I was too tired and that I didn’t think it would happen. We went to bed at around 11pm/midnight, and shortly after I started getting small “Braxton hicks” contractions that didn’t demand any attention so I went to sleep listening to hypnobabies.

At around 2:15am I realized that those annoying little “Braxton hicks” contractions were still there, but they started to feel a bit like real contractions. I figured I just needed to use the bathroom. So I got up and went to the bathroom, but it didn’t help. I realized that I quickly had to figure out if this was the real thing or not, and boy did I second guess myself!!! You would think that after having 4 kids, being a childbirth educator for 5 years and being a birth doula myself that I would be able to recognize signs of labor just like that…but it’s so different when you’re in the moment and you don’t see the signs you were expecting to see! I knew that worst case scenario, if this was it, that I needed to act fast because my track record is one of very fast labors, so I decided the best thing to do was to go and consult with Colin while he’s fast asleep.

So I walk over to his side of the bed and try to wake him up, he’s only been asleep for like 2 hours so he’s not really registering my presence. I have another contraction while standing there, this is really starting to seem like the real thing. “Hey babe, I think I’m in labor, I’m not sure, should I call the midwife?? I don’t want to bother anyone…I’m not sure what to do…” Lol his half asleep response was something along the lines of “You know if you’re in labor or not, so if you are then call and if you’re not then let me go back to sleep” LOL I love this man, straightforward and to the point which is what I needed him to be! I didn’t have time to keep second guessing myself, so I called the midwife at 2:20.

Now, in my head, those 5 or so minutes were much longer than they actually were. In my head the contractions were much shorter and spaced out as well. When I called the midwife I had a contraction. I explained to her that they’re only about 30 seconds long and are coming like every 5 minutes. Colin corrected me. I had had like 2 or 3 during the last 8 minutes…hmm I should pull up a contraction timer app, clearly my perception of time is off. Colin finished off the conversation with her, she said she was coming and calling the birth team. Colin went to fill up the tub for me after getting off the phone.

Once I pull up the app at 2:30 and timed my contractions the reality of what was happening hit me like a ton of bricks. I’m in full blown labor. Darn! How did I miss that?! How was it all happening so fast?! The contractions are closer to a minute and a half long and they’re coming every 3 minutes!!! Ok keep your cool Lilly. Put your head phones in, zone out, and pray for peace. I sit on the yoga ball and rest my head on the bed. Colin squeezes my hips together to relieve some of the pressure. It really helps. I feel his love and strength and it encourages me. We will be ok, we can do this.

I get a text message from Amy about getting the hot water heater temperature up, I told Colin he could run down to the basement and do that as soon as this contraction ends. Hurry Colin you have 3 minutes, go! Of course he takes forever! In reality he took like 8 minutes because he ran into some kind of energy saver feature on the tank that prohibited him from turning it up, who needs to save energy while they’re in labor?!? I don’t!!! Darn feature. Anywho, while he was gone I ran into a bit of an issue. I started feeling like I needed to push…I needed to stand up, I
could no longer sit and kicked the ball away. Hmmm what to do next…? Oh yes! Get a chucks pad for the floor! Ive seen this part enough to know I’m about to make a giant mess, tmi but let’s be real here lol. So I’m standing over the side of the bed with a pad on the floor to keep me from ruining my carpet and *trumpets sound off* my Colin reappears! I don’t care about the water heater at this point, I don’t even have a chance to tell him I’m feeling pushy, I just need him to get back to the hip squeezes ASAP, the next contraction is coming and I know it’s going to be a big one. So he squeezes my hips together (he told me later that he could actually feel the baby descend at this point which is pretty cool!) and GUSH!! My water broke! 2:57am. Thank goodness I saved the carpet ;)

I knew the baby was coming. Colin knew the baby was coming. He asked me if we should move, I’m in the middle of this contraction, sorry not moving. Ok it’s done! Let’s go! I run to the tub! He tries to get stuff cleaned up, no time for that. I get in the water expecting relief, nope doesn’t happen, I get another contraction, I feel pushy so I push a bit…that feeling…I recognize that feeling…the baby is coming right now. I feel for the baby’s head…yup! There it is! “Colin the baby’s coming!” “What?!” He looks. “Oh yea… the baby IS coming!” He gets in the tub behind me since I’m on my knees. (Mind you, he was so adamant about NOT getting in the tub lol!) he reaches for the baby’s head, I feel his hands on the baby’s head along with mine, I know everything will be ok. I make a primal loud groan and I push the head out slowly so as to not to hurt myself, check for a cord around the neck, none, ok cool, and I push the rest of the baby out on the next contraction that came quick! Baby was born at 3:03am <3 One thing about my husband that I love so much is his ability to keep us cool, calm and collected no matter what. A way that he does that is with perfectly timed jokes and quick wit. As he lifts the baby out of the water, the baby makes some noises, and he says “so how do you get it to breathe?” This made me laugh and relax because of how he said it, she cried right after. He asked if I wanted to know the baby’s gender and I said no, I was in shock and just needed to hold the baby and warm the baby up with a towel. Clare had woken up with my pushing sounds and so I told Colin to go ahead and get her as I called the midwife to let her know I had had the baby and make sure everything was ok. He got her and then went to get Caillyn, our oldest child <3 the birth team arrived shortly after Caillyn came in.

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To give you an idea of how insanely quick and intense it all was, I started timing contractions around 2:30 and had about a dozen contractions from the time I started timing them to the time she was born. They were lasting on average 1 min 16seconds long according to my contraction timer app! Once Caillyn got there I had already seen that this was in fact another girl and we rejoiced over the fact that we have the boys out numbered now since this baby #5 was our tie breaker! She was so excited! When the birth team got there I delivered the placenta just fine, got cleaned up and then we went to the bed to cut the cord, Caillyn was so excited to cut it! Colin then went to go get the boys to meet their sister!

Christopher, our 6 year old, had the best reaction! Colin went to go wake him up and said to him “do you want to come see something special? Mommy had the baby!” He instantly woke up and said “You’re kidding!!” Twice! With the most excited look on his face! He cartwheeled off of the top bunk! His smile went from ear to ear as he entered our room! Connor *our 3 year old*, on the other hand, was not impressed to be woken up at 3:30 am so he went back to bed lol. There was so much excitement in the room, so many sweet photos and moments as we all fell in love with baby Colette. She measured 7lbs 19.5in and is absolutely perfect! Everything was perfect, I couldn’t have imagined a better way to have welcomed this little girl, this beautiful gift from God. <3

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Click HERE to learn more about the Community Birth Stories Project or to submit your own birth story.

Community Birth Story: Leonid Ardent

Community Birth Story: Leonid Ardent

Leodin’s Birth on New Years’ Day

imageAs told by Julia:

I lived in a rural location with no homebirth midwives and no birth center. I hired the closest doula and she lived two hours away. I was not pleased with the OB practice, and one of the rotating doctors told me that my natural birth plan was not going to happen. I was ecstatic when, at 39 weeks and 6 days pregnant, the only certified nurse midwife in the area got hospital privileges and joined my birth team. With a doula and CNM, I was sure I could get the natural hospital birth I wanted for my baby.

The same day I found out that I would have a midwife, I woke up to bloody show. When I had a check up, I requested a membrane sweep. I regret asking for it and had no reason not to just be patient for labor to pick up on its own. Contractions started about an hour later. I ignored them and was able to sleep through them until about 4:00 a.m. when they really required my attention and I was too excited. For most of the day, contractions were 3-5 minutes apart lasting 1.5- 2 minutes.

Over the phone, my doula suggested I take a shower which felt good and contractions sped to 1-2 minutes apart. However, they slowed back down after the shower. My doula decided to come down and arrived at 7:00 pm. She suggested some positions since I was having a little back pain and I did lots of hip circles and pelvic tilts. As it got later, my doula gave me some homeopathic tinctures. We went on walks. I was in a lot of pain and making noise, not wanting to talk between contractions, but I could walk through contractions. I think this alerted the doula that I was still in early, decidedly prodromal, labor. She decided it would be best for her to go home and sleep and us to do the same. I was devastated because it was the end of the second day of labor and I felt I was in serious painful contractions. I cried but accepted it and went to sleep right away. We slept or at least were in bed for 12 hours. I had contractions in my sleep and they were strong when I got up to pee but my body did some rest.

The next morning, I got a lot of physical contact from my husband and repeated the word “open.” I visualized flowers opening with my husband’s guidance. I tried to hold off for a while in calling my doula to avoid another false alarm but she called and decided to come back. We continued doing lots of walks around the apartment complex. I did need to stop for every contraction now. My favorite during those times was to put my arms around hubby’s shoulders and lean down a little, putting weight on him and swaying. When he or someone else was not in reach at the time, I would put my arms up on the wall, head down, and lean. The worst was when I had a contraction while peeing or just after peeing and had to run to a wall or person. I spent a ton of time sitting on the birth ball or floor. Some hip squeezes which felt good and counterpressure on my sacrum for slight back pain. My doula had me use cleansing deep breath at the end of contractions. We all wanted to speed up labor since water kept slowing it so I pumped with a hand pump sitting on my birth ball by my bed. It made contractions much more painful so I stopped after a few minutes.

She said that my contractions were definitely longer than the norm, staying around 1.5- 2 minutes in duration. I was starting to be in a lot of pain, moaning and crying at the peak of contractions. She said it sounded like time to head to the hospital and that sounded good to me. Contractions in the car sucked because I could not move.

It was 10:30 or 11:00 pm so we had to go through the emergency room, which was empty. They were going to send for a wheelchair but I asked them not to. A nurse walked us up to labor and delivery. The lights were dim. I put on a hospital gown. did some contractions on a birth ball. My midwife arrived as well as an L&D nurse for 20 min electronic fetal monitoring which we had discussed at an appointment and I was fine with. I asked if I needed to lie on the bed and she said no, I could be in any position so they set blankets on the floor and I got on my knees leaning on the birth ball. It was officially midnight, New Years’ Day 2012, but I had no sense of time at all, a very inward focus and oblivious to all around me. We used intermittent monitoring; baby heart tones checked with doppler every 1/2 hour and my blood pressure checked every hour. I declined routine IV.

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I had not had a cervical check but I had some typical signs of transition. I was burping a lot and then threw up a few times. Lots of crying. The nurses brought in the delivery cart because everyone thought I might be ready to pop! After sometime, that proved not to be the case yet. My doula suggested we try to whirlpool which was next door. It felt wonderful but contractions slowed down and I spent the next few hours getting them back to where they had been before the tub. My doula reminded me to take it one contraction at a time, but I kept thinking ahead to how much longer and worse they would get and feeling that I did not have recovery time in between. I went back to my room and did a squat to try to move baby down. When I sat up I felt very wet and told my midwife. She did a pH test that showed my water had broken.

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I was feeling desperate and needed encouragement. I knew that a cervical check would be risky as I could have a low measurement, but I requested one. I asked that if I am in transition, to tell me the number, and if I am not, to just say ” not in transition.” I heard “not in transition.” I was disappointed but just kept doing what I was doing. I did not attempt any visualization or other coping techniques because I was just too exhausted and could not think beyond the pain. I cried through every contraction and was saying “I can’t do this” “I need this to stop.” I got in the shower and sat on the bench and cried. There was no room for my husband so he sat outside the shower curtain which made me sad. My doula gave me an herbal drink approved by my midwife which had cohosh. I walked through the hallways with my parents and my birth team started taking turns sleeping. I was encouraged to eat and drink but I was not interested. I was likely dehydrated, hadn’t eaten in a long time.

After hours more of labor, I made a plan which I didn’t share with anyone. I would get another cervical check and if I was not in transition, I would ask about drugs. What I really wanted was a break from labor so I could sleep, fearing that my exhaustion would necessitate a c-section. I could deal with the pain but I was just so indescribably tired. I asked the midwife to tell me everything this time. She said that at the last check, I was 4 cm and 100% effaced which was a staggering announcement. That means it had taken me over three days of labor to get from 1 cm to 4 cm. At this check, I was 5-6 cm. With that news, I immediately asked about my pain relief options. My options besides water were an opiate called staydol or an epidural. She went over the details of each as well as the risks. My doula reminded me that epidural could slow labor and might not relieve me very well or in the right places. I decided to get each, though I had planned for no pain medication.

I was absolutely exhausted after days of contractions and little sleep and my body was involuntarily collapsing between contractions. I thought that the drugs would allow me to sleep while my body worked so I could wake up with the energy to push. I chose to get the staydol to take the edge off during the two hours before I could get an epidural. The midwife said that I would need to get electronic fetal monitoring but I was fine with that because all I wanted at that point was to be in the bed.

I got in the bed and was fitted with contraction strap, baby heartrate strap, blood pressure cuff, IV in my wrist with a saline/electrolyte solution and later the staydol. The drugs started setting in and allowed me to sleep between contractions. The contractions were slightly numbed and I made hmmming sounds through them which helped. My husband was very sad during this time as he felt he had failed as my birth partner (he told me this later when I pressed him, at the time I was high on staydol and not much aware of how he was doing.) The anesthesiologist came in and everyone had to leave but my husband. I was terrified to move for fear of paralysis or spinal fluid leak, which was so hard during contractions. Then, I went to sleep immediately. The room was dark and my whole birth team slept which was much needed.

We slept for about 4 hours and when I woke up, my midwife was there. I was 10 cm dilated! I opted for an in-and-out catheter. She had me labor down for an hour which just meant letting my body bear down and move the baby without pushing. I got another vaginal exam and the baby was at +2 station. Time to push! There was a discussion between my midwife, doula, and myself about whether to leave the epidural as is or turn it down for pushing. The anesthesiologist agreed to let it be turned down half way and I was glad to get some sensation back to work with. I was still tired but had some energy from sleeping. At first, I could not feel the contractions so I had to be told when they were going on but I could push at my own pace and will. I started on my left side with legs bent and apart. Birth team helped to hold my legs. My first two pushes were ineffective. I tried exhaling while bearing down. I ended up peeing with both first pushes!. Finally, I got a real push and knew what they were supposed to feel like. The epidural was wearing off.

On the first push, everyone saw baby’s head with hair! I was asked if I wanted a mirror and I said I didn’t want to see myself tear and everyone said I should have it. I was expecting something small but it was a full length mirror. It did help to see which pushes were bringing the baby forward. After a while, I flipped and pushed on my right side. It was taking a long time to get baby’s head to clear my pubic bone because my pelvic floor muscles were too strong. My doula and midwife agreed it would work better on my back semi/reclined position. My knees were up and I would grab my legs and lift my chin to my chest. I still slept between contractions which I was feeling somewhat now. The OB who had to oversee my midwife since she was new was called in because they thought I would be delivering in any second. Delivery took longer than expected and the midwife actually apologized to the OB who left for a time. That was discouraging. Four pushes per contraction that were each eight seconds long seemed to be best. The most effective part was at the end of each contraction so they kept trying to make me sustain it.

The room was all natural light and Eva Cassidy music. I puked on a nurse. Finally, baby cleared the pubic bone and did not pull back into the vagina each time. It took many more pushes for him to crown. The contractions got closer together and stronger. I pooped a little bit. Finally, I felt a ring of fire which was the best motivation to keep pushing. The worse pain was in the upper part of the vulva around the clitoris. They said the cord was around baby’s neck so I stopped pushing and panted though I felt my body continuing to bear down a bit. He was out with two hours pushing total. I reached down and helped move him to my belly in the position advocated by Birth Without Violence with belly down and knees bent. It had only felt like seconds when my husband cut the cord, but my midwife said that it stopped pulsating after only two minutes at which time she clamped it.

Baby was grunting and nurses tried to stimulate and suction him while he was on my chest. Lots of mucous was in his lungs. I agreed for him to be brought to the warmer for suction and oxygen. At first, I declined pitocin for the placenta so the nurses got to worse massaging my uterus. I had excessive hemorrhaging so they needed to give me pitocin to control the bleeding. My midwife said that I had “countless” first degree tearing everywhere, including one in the labia which needed suturing because it exposed a blood vessel, and a second degree perenial tear. Because of the extent of the tears, the OB stitched me up. It hurt like hell and she did not give me a local analgesic. When I asked her about it, she said that I shouldn’t be able to feel it and the only thing she could do was turn my epidural up. Nope.image

After about 15 minutes, baby Leo was back on my chest and we attempted breastfeeding. Ian had his hand on Leo’s back ala Birth Without Violence. I learned that I had elevated blood pressure for the last few hours of delivery and postpartum so I needed to be on the watch for preeclampsia but I did not get it. From my first contractions, labor was four days long and my doula counts it as 25 hours active labor.

I am conflicted about my choice to get an epidural. I was exhausted and it allowed me to sleep and possibly gave me the energy I needed to push. I am grateful for a vaginal birth with no augmentation or assistance. Recovery was horrible. Tearing hurt. My back hurt where the epidural was inserted. My arms and torso were in extreme pain from the effort of pushing. My face was swollen from pushing. Leodin had feeding issues which I think were at least partly caused by the epidural. He was so sleepy, he would not eat anything from any source. He went 18 hours without peeing and longer without eating. I pumped endlessly and had to force feed Leo, tracking every cc he was able to keep down. All of these issues were temporary and we did come out of it healthy!

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Find the birth story of Leo’s little sister Ary here.

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Click HERE to learn more about the Community Birth Stories Project or to submit your own birth story.