I hope this post serves to soothe some anxieties, and explains how your doula can still support you in this tumultuous time. If you have any questions or concerns, please do not hesitate to contact me!
My Doula Bag - Updated
A few years ago, I posted about my doula bag and it’s contents. Things have changed since then, and I wanted to re-write the post to tell you about it. I’m still using my ZUCA bag; it’s compact but has plenty of room for my supplies. The double wheels make it roll easily and quietly, and handle steps and curbs with ease. Also, the top of the bag is a seat, that I’ve found very handy at the side of a hospital bed or sitting behind a laboring person on the birth ball.
I purchased the organizing pouches that fit in the ZUCA to keep things neat and accessible. First up is the largest pouch that sits on the bottom of the bag. This one isn’t too exciting, it’s my personal bag. These items come in handy for long births when I need to freshen up.
Personal Pouch
*Full Change of Clothes
*Brush & hair ties
*Toothbrush, toothpaste, mouthwash
*Wisp toothbrushes
*Deodorant
*Medications
*Saline spray & artificial tears (hospitals are very dry!)
Fairly self explanatory, the next pouch is my Snack Pouch. These are mostly for me, but sometimes are helpful if the family didn’t pack any or labor is moving quickly. This pouch also holds mints and hard candies, to freshen breaths and soothe dry mouths. I also like to have Awake Chocolate for a caffeine boost when I can’t get a cup of coffee or tea.
Now we get to the fun stuff, all the doula tools and tricks! I’ll explain each of these as we go.
Environment Pouch
*Battery operated candles - these are a great way to calm the room, turning down the lights increases melatonin, which has a synergistic effect with oxytocin!
*Washcloths - hospital washcloths are scratchy and sterile white. I bring soft, colorful ones for my clients. These little touches make a big difference!
*Ice bag - if cool cloths aren’t enough, or the laboring person wants cold on their back or hips
*Contact solution & lens case - again, hospitals are very dry and this is an item easily forgotten by clients and their support people
*Honey sticks - I use these to give laboring people or a woozy support person a quick boost.
*Acupressure bands - these are great for points in the wrists, especially P6 for nausea.
Remedies Pouch
*Rescue remedy tincture & pastilles - these are a great way to soothe an anxious laboring person or support people!
*Calm, Focus, and Tummy drops from Calm-A-Mama - I don’t use these often, but I have them for my clients to use at their discretion.
*TENS unit and accessories - this is a great tool for early labor! Read more about it in this post.
*Essential oils, carrier oil, and gauze squares - there are a few oils that are useful for labor when used with discretion. I rarely put them directly on the laboring person, as their sense of smell is very sensitive, and I want to be able to get the smell out of the room if needed. These are in the clear packing pouch and sit on top of the other items in this pouch.
Labor Tools
These are the items I use at nearly every birth I attend, so they reside in the small pouch right on top.
*Unscented lotion - I use Lubriderm since it is so lightweight and non-greasy. and I am not allergic to it. My clients tend to want a lot of massage, counter pressure, and/or acupressure, so this gets used quite frequently! I also have a little tube of magnesium lotion, which is great for leg cramps.
*Tennis balls & massage tools - these help me save my strength when moms want massage or counter pressure for long periods of time.
*Saline spray & artificial tears - another set, this one for my clients! Hospital air is so dry, and dry eyes or noses are annoying in day-to-day life, but even more so in labor!
*New chapstick - dry lips are really common in labor, especially when laboring people are coping with deep breathing or moans and groans.
*New hair ties and clips - a flyaway hair is a nuisance, especially in labor!
*Bendy straws - a doula staple! It’s so important for laboring people to stay hydrated, but it is hard to drink out of a cup in some labor positions.
Whew! We made it through all the pouches! Lastly, I have a few items that ride loose in my doula bag, or in the interior pockets.
*Rebozo - an incredible tool! Rebozos have an amazing history and have been used for centuries to comfort pregnant people and those in labor. If you want to learn more, come to a class! The wooden spoon goes along with this in order to make hip squeezes easier!
*Phone charger - I have to stay in contact with my family, and occasionally other clients. I also use my phone to look techniques or positions up when I’m out of ideas!
*Reference materials - these are great when I want to share a technique with a nurse or support person before trying it, or when I need new ideas.
*Thank you notes - I love to give a little note to great nurses and providers! Personal connections matter, and I’ve made friendships with nurses from this small gesture.
*Business cards - always good to have on hand!
*Lactation keychain - the bead on this keychain represents the stomach of a newborn. It is a great tool to help encourage moms who are concerned about babies’ small, frequent feedings.
That’s it! I hope this blog was helpful to you. I would love to know what your favorite tool or trick in your bag is, so leave a comment below!
Acupressure for Birth
I just completed a wonderful course on acupressure for birth. I learned a few useful acupressure points in my doula training, and have found them helpful in some labors. I jumped at the opportunity to expand my knowledge with this course! I really enjoyed learning more about how my hands can be used to support a laboring client, beyond simple touch and massage.
Using acupressure for nausea on a client in transition. Photo courtesy of Tara Ruby.
First, let’s briefly discuss how acupressure works. Acupressure and acupuncture are age-old therapeutic modalities, originating from ancient China. When using acupressure, we are focused on certain points of the body that correspond to certain conditions. Research shows that using these points stimulates the parasympathetic nervous system. (The autonomous nervous system controls our ‘fight or flight’ responses, while the parasympathetic controls our ‘rest and digest’ functions). We know it is essential for the birthing person to be as relaxed as possible during labor, and the parasympathetic nervous system helps by slowing the heart rate, increasing gland activity, and relaxing sphincter muscles. (Remember, the cervix is a sphincter!) Evan, one of the instructors of the course, summarizes it this way: “acupressure gives us a direct line of influence into the most basic functions of the nervous system’s control over the birthing process.”
I think the most helpful things I learned in this course were how to use acupressure for postpartum and cesarean births. In the postpartum period, we can utilize points for fatigue, uterine recovery, and lactation. When supporting a cesarean birth, we can not bring things with us into the OR, and many of our comfort measures that we use in labor are not appropriate. Using acupressure allows us to help the mother to remain calm and be present during their surgical birth. It can also help alleviate some of the discomforts common to cesareans, such as headache and shortness of breath.
Acupressure is useful for many situations in labor, birth, and postpartum; everything from anxiety and nausea, to bleeding and lactation. For most conditions, there are multiple points that can be stimulated to increase the effects. It is important to be trained in acupressure, as some points can induce labor, and should not be used without permission of one’s care provider. On the other hand, using inappropriate points will not bring about the helpful effects we desire.
Further Reading:
www.acupressureforbirth.net
Acupuncture or Acupressure for Pain Relief during Labor
Acupressure to reduce labor pain: a randomized controlled trial
Acupuncture or acupressure for induction of labor
TENS
Elle TENS Unit
What is TENS?
TENS stands for transcutaneous electrical nerve stimulation. The device uses small electrical pulses to stimulate nerve endings in the skin and muscles. This feels like a tingling sensation on your skin. This helps relieve pain by interrupting pain signals to the brain (gate control theory), and helping your body produce endorphins.
Is TENS safe?
TENS is absolutely safe when used properly. In the study, there were "no adverse effects on mothers or newborns."
Is TENS effective?
In the study cited below, the conclusion states: "TENS is an effective non-pharmacological, non-invasive adjuvant pain relief modality for use in labor and delivery. TENS application reduced the duration of the first stage of labor and the amount of analgesic drug administered."
What are the benefits?
TENS is self administered and self controlled. It can be turned on and off, with the effects dissipating immediately when removed. TENS also allows you to keep moving and be in any position you like. You are also completely clear-headed, unlike some pharmacological pain control. TENS may also help you delay or avoid pain reliving medication.
What are the disadvantages?
TENS can not be used in water. It also can not be used if you have epilepsy or a pacemaker. The pads should not be placed over broken skin.
TENS is most effective when you begin using it early in labor. For this reason, I loan TENS units to my clients, so they can use it even before calling me if they chose.
For further reading:
http://www.ncbi.nlm.nih.gov/pubmed/9544709
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4297467/
http://www.birthbeyondbias.com/birthbeyondbias/2014/7/1/close-the-door-gate-control-theory
https://www.fitpregnancy.com/pregnancy/labor-delivery/tens-the-natural-labor-tool-no-one-talks-about
https://www.babycentre.co.uk/a542581/using-a-tens-machine-in-labour
http://www.honeybeemama.com/2013/07/tens-unit-for-labor-pain-relief.html
http://www.medscape.com/viewarticle/494120_10
