What Does Doula Mean?

Doula is a Greek word meaning woman servant.

Is a Doula a Midwife?

No, a doula is not a midwife. Doulas do receive formal training to assist in shortening and easing the labor.

Why Should I Hire a Doula?

Studies show that a doula can work to make your labor shorter by several hours, reduce the need for medication, and reduce the chances of needing a c-section! A doula is typically trained to assist with breastfeeding after the birth if you wish to explore this route. The doula also works to ease the stress and anxiety for the husband (or significant other) during the birthing process.

How do I Get a Doula?

You can begin by asking for referrals from your hospital, physician, midwife, or friends. Or you can search the Internet! DoulaNetwork.com offers a list of doulas, along with DONA. You’ll want to discuss your birth plan with your doula and insure that she shares your ideas and beliefs.

Doula Statistics

• 50% reduction in the cesarean rate
• 25% shorter labor
• 60% reduction in epidural requests
• 40% reduction in oxytocin use
• 30% reduction in analgesia use
• 40% reduction in forceps delivery

What is the Purpose of the Placenta?

The placenta is attached to your uterus and through the attached umbilical cord the placenta exchanges nutrients, wastes, oxygen and other gases with the baby. Whatever the mother ingests during pregnancy is passed through the placenta to the fetus.

By the third trimester the placenta looks like a disk, measuring about twenty cm in diameter and is about two to three inches thick!

What Happens to the Placenta?

The placenta is a temporary organ and you will deliver it after the baby is delivered. Your obgyn or midwife will examine the placenta to insure that all of it was delivered.

Spotting is typical in the first trimester of pregnancy. It does not usually indicate a problem or miscarriage, although if it changes in amount or heaviness of flow, you will usually need to be seen by your obgyn or midwife.

Take Folate

According to some studies, women who took folate before falling pregnant had a 40 per cent greater chance of having twins.

Breastfeed While Trying to Get Pregnant

Some studies show that if you get pregnant while you are nursing, you are more likely to have twins.

Live in Massachusetts or Connecticut!

Strangely enough, if you live in Massachusetts or Connecticut you are 25% more likely to have twins than for the U.S. as a whole.

Be 35 or Older

If you are over 35, your chance of having twins is significantly increased - and the chance increases the older you get. In fact, the highest twin and triplet birth rate is for those women between the ages of 45 and 49.

Be African American

African Americans are more common than other races to conceive twins.

Be a Twin

Twins are more likely to have twins themsleves!

Have a Maternital History of Twins

Unfortunately you have no control over this, but if you happen to have a history of twins on your mother’s side, this could increase your chance of having twins yourself. The twins tend to be fraternal, not identical.

Take Fertility Drugs or Fertility Treatments

These procedures help in further ovulation and fertility treatments have an increased rate of multiples.

Healthy Pre-Pregnancy Habits to Prevent a Miscarriage

• Exercise on a regular basis. Shoot for 30 minutes a day at least 4-5 days a week.

• Eat a healthy diet.
• Maintain a healthy weight.
• Work to keep your stress level under management.
• Take folic acid daily, starting three months before you are trying to conceive.
• Stop smoking.

Healthy Pregnancy Habits to Prevent a Miscarriage

• Stop smoking and do not expose yourself to second-hand smoke.

• Stop drinking alcohol
• Limit drinking or eating anything with caffeine.
• Avoid contact sports or activities.
• Avoid anything that could hurt your abdomen.
• Check with your obgyn or midwife before taking over-the-counter medications.

• A maternal disability, or medical leave, is the time that a woman takes off for a vaginal delivery (usually six weeks) or cesarean section (usually eight weeks).
• Family leave is the time spent caring for the baby and is available to the father and adoptive parents. The Family and Medical Leave Act (FMLA) grants everyone equal time of 12 weeks.

Are You Qualified for Maternity Leave?

You may think that after you give birth your company is required to provide you with paid maternity leave for several weeks while you stay at home and adjust to life with your new baby. Unfortunately, a good amount of companies do not offer paid maternity leave, and they are not required to.

Many women also do not qualify for paid maternity leave - depending on the length of employment and the size of their company. In order to qualify for FMLA leave, you must work for the federal or state governement or have been at your current job for at least 12 months and 1,250 hours (about 25 hours a week for 50 weeks). You also must have been employed by a company with a minimum of 50 employees within a 75 mile radius. If this criteria is met, your employer must offer you the twelve weeks unpaid, continue your health insurance, and provide you with the same position (or a position of an equivalent level) when you return.

What if my Company Does Not Offer Maternity Leave?

Most likely, you’ll be able to use a combination of short-term disability, sick time accumulated, vacation time accumulated, personal days, and unpaid family leave during your maternity leave.

If your company does not offer paid or unpaid maternity or family leave, you may have a couple of other options available. According to the Pregnancy Discrimination Act of 1978, if your company has more than 14 employees and held an employee’s job during a different type of medical disability, they must offer you the same position after your leave.

If you live in New York, New Jersey, California, Rhode Island, or Hawaii, you may be eligible for their state-run temporary disability plans. This will cover you during the time you are medically not able to work.

When Should I Begin Researching my Maternity Leave Choices?

Experts suggest beginning a dialogue with your employer shortly after the first trimester. You don’t want to wait until you are visibly pregnant, but many complications can arise during the first trimester and the miscarriage rate is highest during that time. Federal guidelines require that you give a minimum of 30 days between requesting leave and taking it, but you’ll want to give your employer more time. When you have the conversation, try to make it positive and discuss your plans for returning after the birth (if you plan to return to work). You can try to negotiate maternity leave and work out a plan that works for the both of you.

How do I Find out More About My State’s Laws?

Many states offer additional benefits to the federal FMLA laws. To find out more you can contact your state’s Labor Office.

This test measures your baby’s heart rate during contractions in order to make sure that she is getting the necessary oxygen from the placenta during labor.

When is the Contraction Stress Test Administered?

This test is usually done at the very end of pregnancy, prior to an induction.

What is the Contraction Stress Test Procedure?

You will lie down on your left side and have two elastic belts with monitors placed on your belly.  One monitors the baby’s heartbeat and the other monitors your contractions.  If you are not having contractions on your own, an injection of Pitocin (Oxytocin) will be given and you will be monitored to see how your baby responds to the contractions via an electronic fetal monitor on your belly.  The test lasts until you’ve had three contractions, each lasting 45 seconds, within a ten-minute span.

What do the Contraction Stress Test Results Mean?

Normal results of a contraction stress test occur when the baby’s heartbeat does not slow in response to the contractions. This is a “normal” or “negative” result and typically means your baby is reacting fine and will do so for at least the next week.

Abnormal results of a contraction stress test occur when the baby’s heart does slow down in response to a contraction (deceleration).  This means the test result is “positive” and signals that your baby may be under stress.  You will typically be recommended for delivery soon and be induced or schedule a cesarean section.

Earlier Studies on Anti-Depressants

Previous studies indicated that there was not an increase in stillbirths, miscarriages, or premature births when pregnant women take selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Paxil, and Zoloft.

Anti-Depressants Cause Birth Defects?
Unfortunately reports released this year are showing an increased risk to babies whose mothers take anti-depressants. One study this year contradicts studies in the past, saying that there is an increased risk in birth defects for women who take SSRIs in their first trimester. Sandy Zeskind, a research professor in pediatrics at the University of North Carolina-Chapel Hill, says that babies who were prenatally exposed to SSRIs had adverse effects on their central and autonomic nervous systems.

Further research is being conducted on this topic.

Anti-Depressants Cause Withdrawal Symptoms in Newborns?
Another study showed an increased risk for newborn withdrawal symptoms for women who take SSRIs in their third trimester. These withdrawal symptoms were the result of being cut-off from the medications that they had been receiving through the mother’s placenta. The most commonly reported symptoms were irritability, increased crying, tremors, shortened breath, nausea, and convulsions. These symptoms typically lasted only one to four days after birth, and rarely lasted more than a few weeks. Because of this, doctors are being urged to recommend to their patients that they lower their dose, or stop taking anti-depressants altogether, two weeks before their due date.

Anti-Depressants Still Being Prescribed
That said, some women are still being coached to treat their depression with anti-depressants, after weighing the risks. Doctors say that halting the use of antidepressants when a woman becomes pregnant may be harmful to the baby - due to the withdrawal symptoms the mother experiences, and the loss of assistance that the medication provides. Other physicians say that if a woman is severely depressed and psychotherapy is not helping, it is best to take anti-depressants to avoid weight loss and preterm delivery.

Alternatives to Anti-Depressants
Depression can be treated in a number of ways. Women may go to therapy or counseling. They may join a support group - in person or online. They may undergo psychotherapy. Depending on the cause of depression, some patients will engage in light therapy, take supplements, begin an exercise program, or change their diet.

Blood Pressure:

Urine:

Weight:

Fundal Height:

Baby’s Heart Rate:

BBT - basal body temperature
BCP - birth control pill
BD - baby dance (making love)
BF - breastfeed or boyfriend
CD - cycle day (if you are charting the length of your menstrual cycles, this is the number of days after the start of your period)
CF - cervical fluid
CM - cervical mucus
CNM - certified nurse midwife
CONTRAX - contractions
DD - due date or darling/dear daughter
DH - darling/dear husband
DPO - days past ovulation
DS - darling/dear son
DTD - do the deed (making love)
DW - darling/dear wife
EDD - estimated due date
EWCM - egg white cervical mucus
GBS - group b strep
GD - gestational diabetes
HPT - home pregnancy test
IUI - intra-uterine insemination
IVF - in vitro fertilization
LMP - last menstrual period
LP - luteal phase
MC or M/C - miscarriage
O - ovulation
OPK - ovulation predictor kit
OPT - ovulation predictor test
PG - pregnant
SAHM - stay at home mom
SO - significant other
STD - sexually transmitted disease
TTC - trying to conceive
UTI - urinaty tract infection
WAHM - work at home mom

What am I missing?