Doula Or Midwife? What To Consider When Choosing Between Them

Looking for some help during pregnancy?  Here is what to consider when deciding on whether you want to use a Doula or Midwife when you are pregnant:

First, lets talk about the differences between a Doula and a Midwife. A Doula provides emotional and physical support during pregnancy and childbirth. They are not medical professionals and do not deliver babies.

So, what do they do?
Doula’s have different roles and can provide certain services depending on what you need.
1. Support women who are on bed rest to help prevent early births
2. Provide support during the birth process
3. After birth they help the mom during the first few weeks to help with feeding the baby and household tasks.
How does this work?

Before the actual birth a Doula usually:
– Meets with you to go over how they can help you and get acquainted. (normally during the 2nd and 3rd trimester).
– Instruct moms on relaxation and breathing techniques.
– Answer any questions about the birth process and what to expect.
– Go over labor and delivery and talk to moms about any possible complications and how they are handled.
– Develop a birth plan.

When labor occurs a Doula will:
– Administer Constant support
– Massage to help mother relax
– Guide you to comfortable positions
– Make sure fluids and nutrition is kept up during birth process
– Be an advocate to communicate preferences to medical staff
– Support soon to be dad

– After delivery:
– Support to parents when bringing baby home
– Teach care methods to parents
– Breast feeding education
– Keep mom hydrated, fed and rested

Studies have shown that moms to be that use a Doula have shorter labor, need less medication and are less likely to have a C-section.

Now lets go over what a Midwife does:

A midwife is a trained health professional. They assist with labor, delivery, and after after birth. Midwives can deliver babies at birthing centers, home or at a hospital.
Most families who choose a Midwife want little medical intervention and have no complications during their pregnancy.

There are different types of Midwives:
1. Certified nurse-midwives (CNMs) are registered nurses who have graduated from an accredited nurse-midwifery education program and have passed a national exam. They can practice in all 50 states and the District of Columbia.

2. Certified midwives (CMs) are non-nurse midwives who have a bachelor’s degree or higher in a health field, have completed an accredited midwifery education program, and have passed a national exam. Only a few states permit CMs to practice.

3. Certified professional midwives (CPMs) are non-nurse midwives who have training and clinical experience in childbirth, including childbirth outside of the hospital, and have passed a national exam. Not all states permit CPMs to practice.

What do Midwives do?

As stated above they can provide care before, during and after birth. They also can help with family planning, prenatal exams, order tests, monitor physical and psychological health, provide birthing plans, advise about diet, exercise, medicine and keeping healthy during pregnancy.

Here are some other tasks a Midwife can help with:
– Educating parents about childbirth and newborn care
– Support parents during labor
– Admit or discharge from the hospital
– Deliver babies
– Refer to doctors as needed

Reasons for a Midwife:

1. You want your childbirth to be as natural as possible with little medical intervention, such as an episiotomy, fetal monitoring, labor induction, etc.
2. You want the emotional, practical, and social support that midwives provide.

Hopefully this answers some of your questions about choosing a Doula or a Midwife. Good luck and Congratulations!

Pregnancy: What To Expect In The First Trimester

Chiropractic care is very helpful during pregnancy and especially if your baby is breech.  Keeping your pelvis aligned will allow your baby to have room in the uterus and keep the pelvic outlet open and unrestricted for an easier birth.

For new expectant mothers, pregnancy can be both exciting and scary.  This is because there are a lot of people telling you many things and you want to do the best for your new addition.

There will be changes in your body during this 9 month process and here are the most common ways your body will change.

1. Morning sickness: Around the 5th week of pregnancy you may feel nauseous.  Ginger tea, eating small meals and trigger point massage can help alleviate this.  This doesn’t only happen in the morning

2. Tender breasts: Breasts will become bigger, more tender and may even feel a bit tingly.  This happens around week 6.

3. Mood Changes:  Normally around week 7, little things may set you off that may have not before.  It is okay, hormones are changing in the body and it is something that will come up on you when you least expect it.

You may also experience heartburn, constipation, food cravings, taking a disliking to foods that you never have before, headaches.

Weight of the baby at this point is pretty small so you may only gain 3 to 4 pounds.  You may even crave food a bit less and lose a couple pounds.  That is not out of the ordinary and you should not be alarmed.  Your weight should start to increase the second and third trimester.

Light meals such as avacados, bananas, crackers, bread will help keep your weight up.

Things to look out for:  Risk of miscarriage is the highest in the first trimester.  Here are some symptoms to look out for to call your Obstetrician:

Heavy vaginal bleeding
Severe abdominal pain
Sudden immense thirst
Painful urination
Fever (over 101.5), chills or backache
Severe puffiness of the hands and face
Vision problems.

If you experience any of the above symptoms, call your Obstetrician’s office right away. If you don’t get someone on the phone within a few minutes, head to the nearest ER.

How Can I Tell Whether I’m at High Risk for Gestational Diabetes?

According to the American Diabetes Association, you’re considered at high risk for this condition (and should be screened early) if:

  • You’re obese (your body mass index is over 30).
  • You’ve had gestational diabetes in a previous pregnancy.
  • You have sugar in your urine.
  • You have a strong family history of diabetes.

Some practitioners will also screen you early if you have other risk factors, such as:

  • You’ve previously given birth to a big baby. Some use 8 pounds, 13 ounces (4,000 grams, or 4 kilos) as the cutoff; others use 9 pounds, 14 ounces (4,500 grams, or 4.5 kilos).
  • You’ve had an unexplained stillbirth.
  • You’ve had a baby with a birth defect.
  • You have high blood pressure.
  • You’re over 35.

In addition, a study published in the March 2010 issue of Obstetrics & Gynecology found an association between excessive weight gain during pregnancy – particularly in the first trimester – and the risk of gestational diabetes. Researchers found the risk highest in women who were overweight to begin with and in nonwhite women.

Keep in mind that many women who develop gestational diabetes don’t have any risk factors. That’s why most practitioners will order the screening at 24 to 28 weeks for all their pregnant patients as a matter of course.

That said, a small number of women might be considered at such low risk that they might not have to get tested. You’re part of this group if you meet all of the following criteria:

  • You’re younger than 25.
  • Your weight is in a healthy range.
  • You’re not a member of any racial or ethnic group with a high prevalence of diabetes, including people of Hispanic, African, Native American, South or East Asian, Pacific Island, and indigenous Australian ancestry.
  • None of your close relatives have diabetes.
  • You’ve never had a high result on a blood sugar test.
  • You’ve never had an overly large baby or any other pregnancy complication usually associated with gestational diabetes.

Chiropractic Treatment During And After Pregnancy Are Beneficial For Women

Adjusting to Pregnancy

The above is the actual headline from the August 7, 2007 Milford Daily News in Massachusetts. This article addresses the benefits of chiropractic care in pregnancy. The article starts by following the story of one chiropractic patient, Amanda Giampaoli-Martinez, who was receiving chiropractic care throughout her pregnancy. The story notes that when Amanda was ready to give birth she called her chiropractor Dr. Maryam Ahsan, to be present at the birth.

It was not two minutes after the birth of Amanda’s new baby girl, Arianna, that she was checked by Dr. Maryam. New mother Amanda recalled the activity by stating, “Dr. Maryam was driving when I called her and asked if she could come to the hospital. She just turned her car around.” Giampaoli-Martinez continued, “When I was having bad pain, (Dr. Ahsan) put me on my side and adjusted me while I was on the table.” Ms. Giampaoli-Martinez was pleased with her results and noted, “I went three times a week, and after a month my back pain was gone. I was also having shooting leg pain and the hip alignment helped to take that away.”

The article explains that the International Chiropractic Pediatric Association teaches a technique named after the associations late founder Dr. Larry Webster, called the Webster Technique. The article explains that the Webster Technique decreases intrauterine constraint, resulting in a quicker, less difficult delivery. This technique became prominent after it was discovered that certain adjustments had a high success rate in reversing the position of breech babies.

Dr. Jeanne Ohm, executive director of the International Chiropractic Pediatric Association, explained the procedure, “There is no deep tissue massage with this technique. It’s a really light force,” she said. “Chiropractors will check the woman’s sacrum (pelvis bone) and press on different areas to restore balance. They (patients) turn her on her back and check her belly and a round ligament for tightness.” Dr. Ohm continued, “There are no known contraindications or complications to the adjustments. No one’s ever called back to report a problem, and I would definitely be the first to know. Osteopathic studies have shown the adjustments reduce labor time and fight dystocia (abnormal or overly long childbirth).”

The article also interviewed Dr. David Bilstrom, a board certified physical medicine and rehabilitation specialist, and director of Oasis Center for Health in Hinsdale. He feels that most medical doctors are unfamiliar with chiropractic care. He states, “Chiropractic care tends to be quite safe. In the right hands, I would feel very comfortable seeing the treatment done.”

Antioxidants Before And During Pregnancy Help Prevent Obesity, Glucose Intolerance In Children

Antioxidants play a crucial role in preventing the onset of disease, and they can make all the difference in determining whether or not children develop glucose intolerance or become obese. According to a new study out of The Children’s Hospital of Philadelphia (CHP), women who consume high amounts of antioxidants before and during their pregnancies may be protecting their children against diabetes and obesity.

Noting that diets high in bad fats and carbohydrates cause harmful oxidative stress that leads to obesity and diabetes, researchers decided to study the effect that antioxidants have in mitigating their onset. The team fed four groups of test rats either a high-fat, high-cholesterol diet or a healthier and more balanced diet. The first two groups received such diets with no additional antioxidants, while the other two received extra antioxidants with their diets.

At the conclusion of the study, the group eating the unhealthy “Western” diet with no added antioxidants had significantly higher rates of inflammation and oxidative stress than the other groups, and their offspring were larger and had higher rates of glucose intolerance. The Western diet group that consumed added antioxidants, however, produced offspring with markedly lower rates of glucose intolerance and no obesity whatsoever — and these conditions persisted even after two months.

“These results suggest that if we prevent obesity, inflammation and oxidative stress in pregnant animals, we can prevent obesity in the offspring,” said Rebecca A. Simmons, MD, a neonatologist at CHP.

The study shows that not only do antioxidants help prevent obesity, but they even do so when consumed as part of the Standard American Diet (SAD). This diet consists of high intakes of red meat, sugar, high fat rate foods, refined grains, dairy products and eggs.  This is not to suggest that consuming a SAD diet is beneficial, but rather that the incredible power of antioxidants to alleviate oxidative stress and its resultant diseases is strong enough to counteract some of the negative effects associated with the worst of diets.

Sources for this story include:…

Learn more:

The pros and cons to C-Section

In the United States, C-section is almost becoming an epidemic.  In “the old days”, you local doctor would be on call and when the baby was arriving, he/she would meet you at the hospital or home.  Now, C-sections are scheduled for the convenience of the medical doctor or for other reasons.  Read below!

In her living room, Caroline Nagy introduces the newest member of her family — the 6-week-old infant in a striped onesie cradled in her arms. “This is Alex Joseph. He was born May 24th — my birthday,” she says.

Their shared birthday wasn’t entirely a coincidence. Two weeks before her due date, Nagy was swollen, and uncomfortable. So she asked her doctor for relief.

“I was just miserable. It was like uncomfortable to walk; I couldn’t sit on the floor and play; I felt like I was neglecting my first kid because I just couldn’t move and I couldn’t do anything,” says Nagy. “So I asked, ‘Is there any way I can speed this up and have a baby earlier?’ ”

For Jackie McGinty, it wasn’t discomfort but timing that caused her to schedule her daughter’s birth by C-section eight years ago. McGinty’s first child was delivered by C-section for medical reasons, and although this time around she had hoped to deliver naturally, she had just moved out of state and wanted her family nearby to help with the baby.

“My mom was coming out and she was only going to come out for a few weeks. I needed her to be there after the birth. … So having the option to schedule it was good for us,” says McGinty.

Harm In Planning Too Far Ahead?

Stories like these are common. Statistics show that from 1990 to 2006 the percentage of women who induced labor more than doubled, and nearly a third of women were having cesareans.

The increase wasn’t because of emergencies, says Jay Iams, a specialist in maternal fetal medicine at Ohio State University, but rather because women and doctors began scheduling deliveries for convenience — “convenience for the mother, for the family, for the physician,” says Iams. Sometimes, Iams says, it’s because patients say to themselves, ” ‘I want only my doctor to be there. I don’t want the person who’s on call.’ ”

Having a baby naturally requires lots of planning. But when it comes to the arrival date of your bundle of joy, experts now say that planning too far ahead can do more harm than good.

A full-term pregnancy lasts 40 weeks, but elective deliveries are often planned for two or three weeks earlier. And even though 37 weeks is also still considered full term, studies show that babies born even a few weeks too early are at greater risk for health problems than those who are born later. That has some doctors campaigning to curb the trend of scheduled labor and delivery.

Pediatrician Ed Donovan of Cincinnati Children’s Hospital says data collected over the past several decades show those babies have an increased risk of complications compared with waiting until the mother goes into labor spontaneously.

“It’s now really well-documented in national studies that the risk of the baby having to require intensive care in a neonatal intensive care unit — even the risk of infant death — is increased when the baby is born as little as two weeks before the due date,” says Donovan.

Organ Systems Maturing At Different Rates

The reasons for this are two-fold. First, without an ultrasound measurement in the first trimester, a woman’s due date could be as much as two weeks off, making the fetus 35 weeks instead of 37. And second, Donovan says the brain, heart, lungs, and immune system all mature at different rates — and some may need a little more time than others.

“Just because the lungs are mature doesn’t mean that the other organ systems are mature,” says Donovan. “A baby born three weeks early with mature lungs may not be ready to eat because the brain’s not fully developed.”

According to Donovan, doctors realized they simply weren’t very good at determining which babies were ready and which weren’t. And Iams says the large numbers of sick babies made many doctors begin to think differently about early deliveries.


Courtesy of March of Dimes

A baby’s brain still has a lot of growing to do between 35 and 39 weeks in the womb.

“Thirty-seven weeks is term, but they became the most common occupants of neonatal intensive care nurseries,” says Iams. “And the pediatricians naturally said, ‘They could have waited.’ ”

Still, many women and even many obstetricians remained unaware of the risks because it didn’t fit with their experience.

“People see their friends having babies early, and sometimes women go into labor on their own at 37, 38 weeks — and that’s not unusual and those babies are fine,” says Jennifer Bailit, an obstetrician at Metro Health Medical Center in Cleveland. “But those are babies that have told us that they’re coming and that they’re ready.”

Convincing Mothers It’s Worth The Wait

Bailit is part of an effort led by Iams and Donovan to reduce the number of scheduled deliveries before 39 weeks across the state of Ohio. Bailit says that she often has to explain to women the importance of those last few weeks — and that the discomfort is normal but something that needs to be endured for the sake of the baby.

“It’s tough to be pregnant, and sometimes when you’re in the moment it’s hard to keep the big picture in mind,” Bailit says. “When we guide people toward that kind of thinking it really helps them say, ‘I’m doing this for my baby; it’s worth it.’ ”

In addition to helping doctors like Bailit educate pregnant women, Iams and Donavan asked doctors at the 20 largest hospitals in the state to document a medical reason every time a woman was scheduled to deliver before 39 weeks. And much to their surprise, Iams says in under 15 months the rates of those deliveries dropped from 15 percent to under 5 percent. And more important, the number of babies admitted to neonatal intensive care also decreased.

And the idea is catching on across the country. The March of Dimes has taken what began in Ohio and a few other select states and extended it nationwide in a campaign it’s calling “Healthy Babies are Worth the Wait.” Alan Fleischman of the March of Dimes says the rate of elective births in the hospitals the organization has surveyed is about 30 percent.

“Most hospital leaders don’t believe they have this problem until they actually measure it,” says Fleischman. “And when they do, they’re surprised.”

As in Ohio, their preliminary data show that in only a short period of time, even hospitals with very high rates of scheduled deliveries are able to reduce them to about 5 percent or less by making a few simple changes — and in turn, increase the likelihood of a healthy baby.

Although inductions at 39 weeks and beyond are considered safe, some doctors feel that unless there is a medical reason to deliver early, the best labor plan for women is an old-fashioned one: Hang in there and wait until labor starts on its own.

References: Gretchen Cuda Kroen, National Public Radio

Can Chiropractic Help With Fertility?

Well, since the nerves that regulate and control your reproductive system exit from the spine, it would make sense that if there is anything preventing impulses to be sent to and from your reproductive system, infertility may result.  When we remove that interference through a gentle adjustment, your body has the capacity to heal itself.  This is when we start seeing great results from chiropractic.

A study on infertility and Chiropractic

In a study published in (JVSR),  Journal of Vertebral Subluxation Research,  this study examined the effectiveness of chiropractic for infertility.  15 women, who ranged in age from 22 to 64. They were adjusted using a different techniques and nerve interference was removed from the system.  Until this study, they all had problems becoming pregnant.

The Results with Chiropractic:

After receiving chiropractic care, 14 of the 15 subjects became pregnant within 2 to 20 months of starting chiropractic care. The 64 year-old woman was the only one who did not conceive.

This is just one study showing results from chiropractic care.  Other case studies on infertile women have similar results and I have witnessed it first hand with my patients.   So, if you are having a hard time conceiving, you may want to check us out.

Pubic Pain During Pregnancy

Pubic pain during pregnancy is called Symphysis Pubis Dysfunction and can be pretty severe.  During pregnancy your body changes and the baby grows larger putting more stress on the round ligament, sacrum, hips and low back. SPD is one problem that is fairly easy to rectify by chiropractors.  Aligning the pelvis is key along with taking pressure off the round ligament.

What is SPD?

First, lets talk about how your body changes during pregnancy.  Your pelvis becomes more easily moveable getting ready for child birth.  Your body begins releasing a chemical called “relaxin” to loosen ligaments in your body and make the birth process easier.

Symphysis Pubis Dysfunction (SPD) can occur in 25% of pregnant women because the pelvis can rotate, move forward or shift to the side causing the fibrocartilage tissue to inflame and cause pain.  If you have ever had this, you know how painful this can be.

What are the symptoms?

Discomfort in the pelvic region (usually the center).  Pain may also occur in your low back, hips, legs and the sacroiliac joint.  You may hear a popping or clicking when walking and have difficulty climbing the stairs.

How can I help?

The Webster Technique has proven to be quite successful when used on my pregnant patients experiencing SPD pain.   It is primarily used to turn breech babies but it also alleviates aches and pains that most pregnant women feel are “normal” during pregnancy.  Relaxin stays in the mother’s system for 9 months after the baby is born.  Keeping the whole body aligned is important so that when the ligaments and bones are now back to pre-pregnancy status, the body functions the way it ought to.  Chiropractic is non-invasive, safe and effective.

11 Ways To Help Your Baby Turn From The Breech Position

Being told you have a breech baby can be scary. Years ago obstetricians were prepared and trained for vaginal breech births. Now, Cesarean dates are given to expectant mothers weeks before their due date if ultrasound shows the baby is breech, including:

1. Footling breech – feet first
2. Complete breech – baby sitting on heels (Buddha Style)
3. Frank breech – bottom first, with feet up by head

Breech babies make up about 4 percent of pregnancies. Here are some great tips to do help your baby turn head down.

  • Webster Breech Technique from a certified chiropractor
  • Acupuncture choose one that specializes in pregnancy and knows the points to stimulate for turning a breech baby.
  • Swimming as often as possible. This keeps your body and pelvis loose and relaxed. Do in conjunction with headstand below if you have help.

There are also some remedies you can try at home. These include:

  • Breech Tilt – begin at 32-35 weeks gestation. Do 3 times daily for 10-15 minutes each time, when you have an empty stomach, and the baby is active. Prop one end of an ironing board securely on a sofa or chair 12 to 18 inches high (or may use slant board). Lie down, bend knees but keep feet flat on board. Relax, breathe deeply, avoid tensing. May also use pillows on a flat surface to raise hips 12-18″ above shoulders. Gravity pushes the baby’s head into the fundus, tucks it, and baby can then do a somersault to a vertex position.
  • Flashlight or rolling pin – try moving slowly down from the top of the uterus toward your pubic bone while you are in a breech tilt position.
  • Massage – start with your left hand at the bottom of the abdomen and your right hand just above it. Move move your hands clockwise around the right side of your tummy. As your right hand reaches the top of your abdomen, slide the left one over your right and move it down the left side of your tummy. Your left hand leads as you you come full circle, continuing clockwise. Massage gently as you would to apply lotion. Massage for ten minutes or more up to several times each day.
  • Clothespin – place on the small toe of each foot at the outside corner of the toenail; sideways so that the toenail and toepad are stimulated for 30 minutes per day, this is an acupressure point that is a “moving down” point. You can also do this with just finger pressure as you remember to do it.
  • Motion Sickness band – place with the bead four fingerwidths above the inner ankle bone – another acupressure point that is used for stimulation of the uterus. Do not use this point if you are experiencing any pre-term labor.
  • Glass of orange or other juice – follow this with a side-lying position with your hips positioned higher than your feet. Babies move more after a sugar high!
  • Pelvic Tilt- with an ice pack on the top of your tummy on an empty stomach, 10 minutes twice a day. Do this while lying on your back on the floor with knees flexed and feet on the floor with three large pillows placed under your buttocks. Try this in conjunction with headphones and visualization.
  • Cat stretch – start with all fours, then lay your head and chest flat on the floor with your buttocks in the air, as you round your back and return to all fours.
  • Knee-chest position – by kneeling with hips flexed slightly more than 90 degree, but with thighs not pressing against your tummy and your head, shoulders and upper chest are flat on a mattress for 15 minutes every two waking hours for five days.
  • Visualizing the baby moving down with the head very deep in your pelvis, several times a day; especially in conjunction with positions and exercises below.
  • Belly Relaxing followed by Inversion – Partner places a shawl, sheet, towel or rebozo under mom’s hips as she lays on the floor. Lift up on the corners of the cloth and shimmy her from side to side moving your hands up and down to wiggle her belly from side to side. These should be very small movements which mom should find very relaxing. Do this for about 5 minutes. Then mother kneels on the stairway landing. Walk your hands down 2 or 3 stairs into an all fours position; have your partner support your shoulders to balance you. Remain in this position for about 5-10 minutes or as long as comfortable. Also do this on an empty stomach.

Dr. Amie Gregory is Webster Certified.  This is a technique specifically for babies in the breech position and it is effective about 80% of the time. It is painfree, gentle and helps get you ready for delivery as well.  It can also help with pelvic pain and low back pain.

  • Medical Professionals will recommend External Version after around 37 weeks.  This is uncomfortable and quite invasive.  If you have a breech baby, this may be the best way to get your baby face down and ready for birth.

Sources: Brenda Lane: Turning a Breech Baby

Can Chiropractic Help When I Am Pregnant?

Yes! You will be glad to hear that chiropractic adjustments can significantly reduce labor time. Mothers giving birth for the first time have averaged 24% shorter labor time and repeat pregnancy labor times decreased 39% (Fallon, 1991). Chiropractic adjustments during pregnancy can also reduce the likelihood of experiencing back pain during pregnancy (Diakow, 1991). You can be adjusted and relieve stress and dysfunction in your body until the birth of your child (Penna, 1989).

During pregnancy, weight-bearing changes occur when we have an added load to our abdomen. This can cause an added stress to the low back, hips and other areas of the spine. Chiropractic treatments help your body stay relaxed and comfortable and may also help facilitate your birth.

Here is how we can help:

Sacral misalignment can cause twisting and tightening of pelvic muscles and ligaments. This can prevent your baby from tipping comfortably into the proper position in preparation for child birth. Chiropractors using the Webster Technique can address this situation naturally by adjusting your pelvis and reducing the tension on your muscles and ligaments.  Your baby will innately move into the proper position and you will save yourself from a cesarean birth. It has even been successful with twin births as well!

We would love to help you during and after pregnancy to keep your body working properly.  Give us a call at (650) 353-1133.  We are right in the heart of downtown Redwood City, CA!