Get To Know Our Staff!

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Get To Know Our Staff!

Today's Interview is with owner and CEO of Doulas of Capitol Hill, Nicole Bruno. To inquiry with Nicole, please contact us at info@doulasofcapitolhill.com.

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1.      When did you find your Passion, or when did it find you?

My first passion I discovered as a young child, which was music. Music was a way to play, to escape and to be engrossed in something. It could always match my mood and make me feel better. After I had my daughter, it awoke my second passion, which was birth. The chance to help and spend time with women and families during such an important time became something I was truly invested in for the long haul. I love helping families feel confident and positive about their experience.

2.      If a kid walked up to you asking for your advice and you only had a few minutes to 'give ‘em your best tip', what would it be?

I would tell them to remember they have value. Our voice and presence and ideas are all needed in this world, and even when you are feeling down, you should be as kind to yourself as you would be to your best friend.

3.      What makes you proud of yourself?

Doulas of Capitol Hill makes me proud. I am proud to be making a difference in lives across the DMV. I am also proud of my daughter, who is 7, and has more confidence and wisdom that I ever had at her age. She’s the apple of my eye.

4.      What are your top three values?

Work hard, laugh a lot, and be kind.

5.      Tell me about your favorite book or movie?

This question is so hard to answer! I love to read but mostly I read a lot of self improvement books. If I am looking for some ‘mind candy’ I will read Nora Roberts. As for movies, I love watching action movies in the theatre, but I have literally no recollection of them as soon as I get home. Maybe I would pick the Hunger Games series. Katniss is such a strong female character.

6.      How do you like to be told you’re doing a good job?

I like reassurance. I am happy when someone notices and says ‘I see you are working hard. You are doing a good job. Be gentle on yourself.’ This is a tool I think about and use a lot with families in labor and postpartum as well.

7.      Who is your role model and why?

Would it be cliché to say Michelle Obama? I find her to be brilliant, poised, and gracious. In my life before becoming a doula and business owner, I worked in hunger studies with the SNAP and WIC programs. I think her work in gaining access and knowledge to healthy food is very important and she also seems like she is a great role model for working mothers.

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8.      If you had any superpower, what would it be?

I’d like the ability to be in two places at once. My daughter would like that too so I can always give her back scratches at bedtime. 

9.      Describe yourself in 5 words.
Nice
Lighthearted
Patient
Thoughtful
Resilient 

10.  How would you describe your (doula) style?

I think my doulas style stems from my values. I like to work hard and be present with someone, remind them to breathe, or laugh, or cry when they need to, and be very gentle with someone’s feelings in any particular moment. I am matter of fact in my information to not be confusing, but ultimately the more I can help someone relax and feel supported and safe, the better a job I am doing. I believe each birth and postpartum period is it's own unique experience, and I look forward to helping any way I can. I am grateful to have a job that is this rewarding.  

 

 

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What Happens If I Have To Be Induced?

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What Happens If I Have To Be Induced?

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There are many reasons your doctor or midwife might suggest that an induction (the process of artificially stimulating the uterus to start labor) might be necessary to have your baby. According to The Listening To Mother’s III survey, More than four out of ten respondents (41%) indicated that their care provider tried to induce their labor. Various reasons could include high blood pressure, low fluids, maternal age, or being past your due date.

So what happens if you need to be induced? Induction might seem intimidating, but knowing what to expect and understanding the process can help reduce the anxiety. Below is the common routine of an induction. If you have any questions don’t hesitate to talk to your doctor!

1.        If you are being sent from the office to the hospital, there is almost always enough time to stop home and get your hospital bag and eat a meal (always check with your doctor before assuming this is a safe step!) before arriving at the hospital for admittance.  If your induction is being scheduled, you may be advised to call the hospital the day of your induction to make sure there are beds available. 

2.       Most scheduled inductions start in the evening. You arrive at the hospital between 7-8pm and are placed in a labor and delivery room. Your assigned nurse will gather information, place an iv port, draw blood samples, and get you settled. Your doctor will come in and do a cervical check to determine which course of medication to start with. Most patients who do not have any dilation or effacement start with one of two medications:

          Cervidil: A medication placed against the cervix to soften and start the dilation process given every 12 hours. If this                          medication is chosen, most people will sleep through the night (as well as you can sleep in a hospital!) before Pitocin is                  administered. Other people may have light cramping that may keep them awake.  It's best to try to sleep.

          Cytotec: A medication taken orally used to soften the cervix administered every 4 hours. It is more likely to trigger                            contractions. Often two rounds of this medication are administered.

On occasion, a foley catheter may be used alone or in conjunction with medication. A foley catheter is used to mechanically dilate the cervix. With this method a small rubber tubing is placed inside the cervix and a balloon is inflated to stretch the cervix open. Sometimes your doctor or midwife may also want to break your water with a small hook in order to begin or speed up labor.  If your baby or contractions ever need more closely monitored they may need to break the water in order to place the internal monitors. 

3.       Once any medication is administered you and your baby will be continuously monitored. After the given time for the medication to take effect, your doctor will check you to see if the cervix has made any change. Another round of medication may be given, or it may be time to start Pitocin. (Be sure to ask if you can eat and shower before Pitocin is administered!)

4.       Pitocin is given through an IV, administered with saline fluid, and managed by a pump. The dosage of Pitocin goes up by 2 every 30-45 min until your contractions are close together. The goal is for your contractions to be 2-3 min a part. Many hospitals have wireless monitoring so you may move, shower, and walk just like a non-induced labor!

From here an induction looks like a regular labor. This is where you would apply your comfort techniques, you water may break (or may be broken by the doctor or midwife), or you could choose an epidural or other pain relief such as nitrous oxide. There is no right or wrong way to have an induction- it is totally dependent on your body and your baby. Tell us- were you induced? What were the moments that stood out to you? 

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How Do You Become A Doula?

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How Do You Become A Doula?

So you want to be a doula! You probably know that doulas support families during pregnancy, birth, and postpartum. Perhaps you have come to discover the field after becoming a parent, or from another career path such as nursing or childhood development. Which ever way you landed here, we welcome you!

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What Is A Doula?

The widely accepted definition of a doula is a person who give physical, emotional, and education support during pregnancy, birth, and the postpartum period. It is a non-medical support person; they don't do things such as vaginal checks, doppler readings, or assessing newborns. A birth doula works along side your care providers and your birth partner while you are in labor in the home or the hospital. A postpartum doula comes to your home and helps with household tasks, newborn care, basics of breastfeeding and often provides companionship and sleep support.

The most important factor to being a great doula is providing NON-JUDGMENTAL support. This means the doula shares no opinion on various topics such as unmedicated births vs. epidurals, vaginal delivery vs. cesareans, or formula vs. breastfeeding. We are there in an informational and support role only. 

What Is The First Step To Becoming A Doula?

Step one is to take a training. We recommend an in person training to get some hands on experience prior to working with your first client. There are many doula training organizations; we have listed a handful below. Every training body has a slightly different ‘philosophy’ about birth and provides slightly different training curriculum.  An in person training is typically 2-3 days depending on your knowledge of pregnancy, birth and newborns before training begins. Most organizations have required reading material and also require in person client support before certification. You may work in the field before being certified.

CAPPA- http://www.cappa.net/labor-doula
DONA International- https://www.dona.org/become-a-doula/
ProDoula - https://www.prodoula.com/become-a-doula/
Best Doula - https://bestdoulatraining.com/doula-certification/
ICEA- http://icea.org/certification/upcoming-workshops/doula-workshops/

Once you are trained, the second step would be setting up your business with the state (generally as a sole proprietor or LLC). Think carefully about where you would like to be in the future before picking a business name!

3 Things to Consider Before Becoming A Doula:

On Call Time- Babies don’t read calendars. You may be on call and leaving your family at a moment’s notice. Postpartum time is more scheduled, but many times a person wants support within 24 hours of initial contact. Flexibility is key to working consistently in the field.

Running A Business- Doula work is very rewarding but it also requires some back end work such as invoicing, state correspondence and web design and/or marketing.

Obtaining Doula InsuranceCM & F offers specific doula insurance.

Doulas of Capitol Hill is a doula agency in Washington D.C. that hires doulas and newborn care specialists on a rolling bases. If you have taken an in person training and are interested in working with us, please submit a letter of inquiry and resume to info@doulasofcapitolhill.com. We are always looking for well qualified, non judgmental doulas!

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Snowflake Festival and Diaper Drive

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Snowflake Festival and Diaper Drive

Doulas of Capitol Hill is hosting its first annual Snowflake Festival and Diaper Drive benefiting the DC Diaper Bank!

When: Saturday Dec 23rd from 10am-12pm 

Price: Free!

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Where: Capitol Hill SE Neighborhood Library Meeting Room

What to Expect: There will be crafts, snacks, raffle prizes and the  chance to have your photo taken  with Olaf!

Where Do I Drop Off Diapers if I Cannot Make the Event?

District Taco
Seventh Hill Pizza

You may also give directly to the DC Diaper Bank via their Amazon Wishlist! 

Thank you’s go out to Seventh Hill Pizza, District Taco and Groovy Cards and Gifts for sponsoring this event!

We are Accepting the Following Donations:

Diapers & Pullups (open packages happily accepted)
Formula
Baby Food & Toddler Snacks
New and unopened bottles and nipples
New and unopened pacifiers
Food: non-perishable canned goods and dry goods
Pull-Ups
Wipes
Diaper Rash Cream
Tampons/Pads (we take open boxes as long as they are individually wrapped)
Shampoo/Conditioner
Deodorant
Toothbrushes/Toothpaste for adults and children
Lotion for adults and babies
Adult diapers
Cloth diapers
Toilet paper

Hope to see you there!

 

 

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Statement of Inclusivity and Beliefs

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Statement of Inclusivity and Beliefs

Though we have always lived and worked by these principles, we at Doulas of Capitol Hill have felt compelled to make a public and definitive statement about our values as a company.  Please read below for our Statement of Inclusivity. 



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Let's Tell Your Story- World Breastfeeding Week

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Let's Tell Your Story- World Breastfeeding Week

Kim ,Ellie, Owen and Maren: Reducing Stress and Anxiety While Breastfeeding

*Kim Hawkins is one of Doulas of Capitol Hill's awesome doulas and also happens to be a Certified Lactation Counselor. If you are interested in speaking to her about supporting you through pregnancy, birth and postpartum, please inquire!*

Breastfeeding my three children has been one of my favorite things about having a baby. The snuggles, the joy in providing them their food and the ease at being ready to nurse as soon as they are hungry. But nursing is also hard and sometimes getting to a place of it feeling easy doesn’t always happen. Sometimes breastfeeding is tough and the relationship isn’t what you want it to be. The list of reasons include getting the latch right, sore nipples, low milk supply, late night feedings or figuring out how to use a nursing cover in public.

But the often the reason it’s hard, especially in the beginning, is it’s all you think about. With all three of my kids I had a lot of stress and anxiety regarding breastfeeding. It’s was the questions that constantly played in my head: How does that latch feel? Is the baby in the right position? They are falling asleep, should I wake them up? Did they eat enough on that side? Should I offer the other breast? Should I just let them sleep? And the list goes on and on.

It can feel lonely because as much as our partners can be supportive and helpful, it can feel as if it’s all on the nursing mother’s shoulders. But here the secret to breastfeeding success- SUPPORT. You don’t have to go through it all alone, there are a lot of people who want to help you be successful, from your partner to your doula to professions such as IBCLC’s and CLC’s. Here are some ways to help reduce the stress and anxiety and get support for breastfeeding before the baby is born, during the early days and beyond!

1.      During pregnancy: Meeting with an IBCLC or a CLC to discuss breastfeeding helps to answer questions you may have, be prepared of what items you’d like to have on hand, discuss your health history that may affect breastfeeding and what to expect during the early days. This is also helpful for partners to hear so they can know how to best support mom, because even though she’s doing the work of providing the food support from partners is key in success during the early days.

2.      At the hospital: Your doula and nurse will help with the first latch during the golden hour of birth. I’ll be honest, the first latch is usually awkward and not great but that’s okay! The first latch isn’t a make or break it in determining your breastfeeding relationship. It’s to get the hormones started to get milk production going and get the baby colostrum. During your stay at the hospital, ask for help from the postpartum nurse and the Lactation Consultant at the hospital. They can help with latch and answer any questions you may have.

3.      At home: Your doula will visit you soon after you come home from the hospital and can help answer some basic questions but even better is scheduling a visit from an IBCLC or CLC to really go in depth with you about latch, positions, any issues you are having and make sure you feel confident in what’s going on. Having support in your home environment can feel invaluable that first week at home as you’re adjusting to life with a newborn. And this isn’t just for the first baby! Adding a new baby to the household can throw things off and different babies can have different challenges.

4.      Beyond the early days: As the baby gets older new questions usually come up. This includes pumping, introducing a bottle, returning to work and introducing solids. Seeing or having a phone consultation during these times with an IBCLC or CLC is an awesome resource.

5.      Peer support and support groups: Finding your local La Leche League and USA Breastfeeding sponsored groups offer a knowledgeable leader and support from other moms. Local new mom groups such as PACE help with peer support of other moms going through the same struggles and successes. Lastly, online groups on Facebook, like DCH Village, usually means there’s other moms who are able to quickly answer questions that pop up.

Regardless if you decide to nurse, to supplement or formula feed, the doulas, IBCLC’s and CLC’s with Doulas of Capitol Hill are here to offer nonjudgmental support. Whatever decision you make that is best for YOUR family is the most important thing. We’re here to help support you to help ease your stress and anxiety!

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Let's Tell Your Story- World Breastfeeding Week

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Let's Tell Your Story- World Breastfeeding Week

Jackie and Ryder

My breastfeeding journey…the Good, the Ugly, and my Truth

My breastfeeding journey began when I was pregnant. I knew I wanted to breastfeed and I planned on breastfeeding for at least a year. I researched, purchased all the products I needed and waited on my little guy to arrive so that we could start our beautiful journey together. I had an unexpected c-section birth, but my milk still came in without any issues. My first issue with breastfeeding came hours after my little guy was born. We had a consultation with the in hospital lactation consultant. She helped me latch my son and noticed that he was not getting a good latch and gave me a nipple shield to help him. He was able to latch then and nurse. Things were going great until a day or so later, another lactation consultant visited us and told me that I should not use the nipple shield anymore. I was a new mom, with no breastfeeding experience and knew I wanted to breastfeed for the long haul, so I took her advice. My son and I had a horrible day and night of breastfeeding. I could not get him to latch, he was frustrated and hungry and I was frustrated and exhausted. Finally, at some point that evening, my husband said to me, “Just use the shield.” Some damage had already been done as my son had lost almost 11% of his body weight. When his pediatrician checked him that next morning (she is also a lactation consultant), she told me not to worry about the nipple shield and that if it came to it, she would work with me and him to wean him off of the shield. We were released to go home, but we had to have a few extra weight checks, due to him losing so much weight at the hospital. After going back to the nipple shield, he started gaining weight immediately, and the pediatrician was not worried about our breastfeeding journey anymore.

^^^accurately displays how I feel about pumping to this day!

^^^accurately displays how I feel about pumping to this day!

The first three weeks of my son’s life were tough on me. I was recovering from major surgery and was thrust into motherhood and trying to figure out breastfeeding. He wasn’t taking a bottle yet so all the feeding were on me. When the pediatrician gave the ok to start introducing a bottle, I felt a weight lift off of me, finally a small break. Getting that small break meant pumping on top of exclusively nursing. So when I wasn’t feeding (which he cluster fed a lot in the beginning), I had to find the time to sit and pump. After the first 3 weeks, I started to get the hang of things, and it was actually pretty nice. I had to do a lot of sitting any way since I was recovering from surgery. I spent so many mornings and nights cuddled up with my son in the glider in his nursery. I think back now on those times and remember them fondly. I remember thinking to myself, people said this breastfeeding thing was going to be hard, but I think it’s kinda easy and I enjoy it. We were also co-sleeping, so it made life so much easier to just scoop him up and nurse him, versus having to go downstairs to make a bottle. But soon I was on the mend from surgery and life slowly got back to “normal” or the new normal.

I took 12 weeks of maternity leave, but while on maternity leave, my husband and I decided that it was best for our family for me to become a stay at home mom. I was excited to take on this new journey, to be able to witness all my sons first and to take care of him full time. As I took on my new normal, breastfeeding became more and more of a challenge for me. I felt like I was always sitting on the couch with my boobs out. If I wasn’t feeding, I was pumping. Either my nipples were sore or cracked or my boobs were engorged and painful. I had always been athletic and wanted to get back into working out. That also presented its challenges. I had to find a sports bra that fit, I had to make sure I was drinking and eating enough and the right things to not effective my supply, and try to fit in a workout around feeding times and nap times.  Around 4 months postpartum, I began to feel touched out. I was still recovering from surgery, still carrying baby weight, and felt like I constantly had someone attached to my body. I didn’t want my husband to hug me or even kiss me, I couldn’t deal with the constant contact. I needed some alone time, that I felt I never got. But on the flipside, I also felt very lonely like breastfeeding had stranded me on a deserted island. I felt like I couldn’t go out, or if I did go out, I had to think about nursing in public or pumping, etc. and while I am feeling supportive of mother’s nursing in public, I myself had a hard time with it. My son hated the nursing cover and to be honest I did too, it was a pain in the butt.

So I was touched out but also lonely, and then I had changed my entire life, I became a mom, I stopped working, and I couldn’t work out like I used to. My life felt so foreign to me and while I loved my son and loved being with him, I also was very sad and felt like a horrible mom because of it. I would sometimes think to myself, “This is the way things are supposed to be. Mom’s give up their lives to have babies. You will figure it out soon.” But a few more weeks went by and I hadn’t “figured it out” yet, and I started talking to a few of my friends about my feelings. My husband and I had a long discussion and decided to start supplementing with formula. My son did great and the break was helpful, it helped us continue our breastfeeding journey for longer than I probably would have without it. The mommy guilt I felt was horrible. I put so much pressure on myself. “I am a stay at home mom, there’s no reason I shouldn’t breastfeed.” “You are so lucky you can breastfeed, so people can never do it.” “Breastmilk is the most nutritious for the baby.” I felt like a failure sometimes, I hadn’t even made it to 6 months and I was thinking about quitting.

We continued nursing until my son was 7 months old, we slowly increased the supplementing until my son was mostly on formula. He was only really nursing in the morning and at night and my husband and I made the decision to just wean him. And I actually think my son was ready because he really didn’t have any issues transitioning. He would (still does occasionally) pull at my shirt, but I think it was more out of comfort than anything else. When our breastfeeding journey was finally over, I was a little sad to think about all the time and closeness we shared that we wouldn’t have any more, and I was a little guilty, but truthfully, it was the best decision for our family. Ending my breastfeeding journey was a HUGE weight lifted off of me. I wasn’t resentful anymore, my boobs stopped hurting, I could get back into working out (something I truly enjoy), the baby weight began pouring off of me and I began to feel like my old self again. I know there will probably be some moms who read this who think that I am super selfish for wanting those things (to be able to work out and lose my baby weight), but the truth is I changed my entire life to be a mom and if working is the one thing that brings me joy and makes me feel good about myself, then I’m going to do it.

                 Printed with Permission Photo from Green Still Photography

                 Printed with Permission Photo from Green Still Photography

When I was preparing for breastfeeding, I never read any stories like this, I never read anything about how breastfeeding made the mother feel. I read about the benefits of breastfeeding, the how to’s and more, but I never read anything about the emotional toll of breastfeeding. So to the new mom who reads my blog post and maybe relates, it’s ok to feel how you are feeling and doesn’t make you a bad mom. One of my doula’s told me, “If it weren’t for formula, many babies on the earth would not survive.” It took me some time to be ok with ending our breastfeeding journey before I thought we would, but it’s the best decision I have made for myself, and really for our family, because we are ALL now happy and healthy!

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Let's Tell Your Story- World Breastfeeding Week

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Let's Tell Your Story- World Breastfeeding Week

Meghan and Asher

Before I actually went into labor, I joked that my biggest fear was the part where they hand you the baby and send you on your way, and suddenly you are solely responsible for a tiny, helpless new person.

All the rest, I thought I would take as it came. Drugs during labor? We’ll see how it goes! Breastfeeding? We’ll try, and hope it works out. C-section? Let’s try to avoid that, but if it happens, it happens.

It didn’t take long for this zen acceptance to be exposed as a sham. I had a long and difficult labor, which ended in an unplanned c-section after 3+ hours of pushing. Asher was face-to-the-side, hands up, and definitely not coming out the old fashioned way. When the OB looked at me and said, “You can push all night, but this is never going to work,” I was devastated. It turned out that I really did feel strongly about having a natural labor, but I didn’t realize it until I knew it was 100% not happening.

That was strike one.

Asher was born just after midnight on February 2nd, and at first latched like a champ. I felt vaguely victorious, like I was showing my body who was boss after its total failure in the labor department. But one circumcision and a sleepy day later, my nipples were bleeding and Asher’s latch was falling apart. Soon a nurse was pressing formula and a pump into my hands in the middle of the night, explaining my baby had lost too much weight and needed supplementation.

Strike two.

I burst into tears in my hospital room, suddenly desperate to be able to say my son was exclusively breastfed and feeling like a failure. The nurse was sympathetic but unyielding, and my husband fed the baby formula from a tiny cup while I pumped. Things didn’t exactly improve from there: I ended up with an incision infection, a few follow-up surgeries, and a supply that wasn’t keeping up – Strike three.

We embarked on a schedule of breastfeeding, pumping, and supplementing. Every time I mixed a bottle of formula, I felt shame. Despite all my pre-baby declarations, I had internalized the idea that breast was best, that formula was bad, that breastfeeding was the only way to bond with my baby. My body had let me down, and in turn I was letting my baby down.

But of course, none of that is true. The lactation consultant I called in in a last-ditch effort to “fix” my breastfeeding relationship brought me back to my sense. She reminded me that it doesn’t have to be all or nothing. Breastfeed as much as you can or want to, but the real mantra to internalize is fed is best. I worried that using formula would mean I’d lose my meager supply and have to give up breastfeeding. It didn’t. For several months of my maternity leave, I actually ended up going exclusively to the breast. I worried that feeding from a bottle wouldn’t feel like bonding. But he looks at me with the same happiness and appreciation no matter what or how he’s eating.

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Asher turned six months old this month. He’s a happy, inquisitive baby. When people meet him, they ask about his baby mohawk (born with it), or his blue eyes (mine) -- no one ever asks how he’s fed, because it really and truly doesn’t matter. Breastfeeding can be an amazing and joyful experience, a painful nightmare, or some mix of both -- but at the end of the day, it’s just one way to feed a baby. So whether you’re all breast, all formula, or some combination of both, you’re rocking the most important part: keeping that tiny, helpless new person happy, healthy, and fed. Period.

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Which Hospital Should I Pick To Have My Baby?

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Which Hospital Should I Pick To Have My Baby?

There are many hospitals to choose from in the Washington DC area, and Doulas of Capitol Hill has been to them all! While we would never tell you which hospital was right for you (a key factor in our non-judgmental support philosophy!) there are pros and cons to all hospitals when considering where to deliver. Here are a few things to think about when making the decision.

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What's In Our Birth Bag? Hint: It's Not What You Think

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What's In Our Birth Bag? Hint: It's Not What You Think

One of the most common questions we receive on a doula interview in Washington D.C. is ‘What do you bring with you to a birth?’

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Families interviewing doulas like this question because our bag represents the tangible. It represents tools, structure and vision. These concepts can be powerful for you when trying to grasp how you will work through the process of birth and your postpartum period.  It may also help you envision how your doula will accompany you along that journey. 

Though every doula is different, the answers heard are often similar. For a birth doula, the commonly included items include massage oil, battery operated candles, or a rebozo – various tools that may help you find comfort during your labor. Some people prefer to rent specific tools such as a birth pool or TENS unit. Your doula will also carry some personal items including snacks, toiletries and a sweater. 

Postpartum doulas often receive a similar question and maybe surprisingly, the answer is also similar. We bring with us things that may help us as you navigate parenthood and learn what tools work best for you and your family. Looking into our bags during a postpartum shift, you may also find few personal items for us to use in time we are supporting you. 

Tools serve a purpose and we often use them; however, by focusing on the tools we carry and the information we offer, we are providing a false sense of power. Tools and instruction can do nothing alone. The power behind doula support is in the intangible.

So what do we really bring with us?

Relief. That feeling you have when you are overwhelmed and someone you trust walks through the door at just the right time.

Reliability. The ability to relax because you know things will be taken care of.

Comfort. That memory from your youth when your mom brushed the hair out of your face with her hand.

Foresight. Not having to ask for water when you're thirsty because it is being offered.

Dedication. We are in it with you, until the end. We want your success, however you define it, and will help you learn as you go.

Knowledge. Family. Community. Companionship. Friendship. Security. Insurance. There are so many things we provide that don’t come in a box or a bag. We share these things in our touch, our smile, our laugh and our skills. So go ahead and ask what we bring with us when we work! Let us explain why the only thing you need is us by your side, with our proverbial birth bag filled with expertise you can't find anywhere else. We look forward to supporting your journey into parenthood!

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How Can We Be Better?

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How Can We Be Better?

Doulas of Capitol Hill prides itself on building and running its business from three guiding principles- Supporting the Family, Supporting the Community, and Supporting the Profession. We believe in inclusivity, respect for every family, and participating in dialogue to engage in growth and understanding of those in our communities. In an attempt to do all of these things better, we are proud to announce a 4 hour workshop, led by Dr. Jocelyn Imani, entitled:

Cultural Competency For The Childbirth Profession

Photo by Jani Bryson/iStock / Getty Images

This 4-hour course cultural competency training is for doulas, midwives, nurses, childbirth educators, and other birth workers who serve a multiracial client base. The course will help students learn of how employing best practices of cross-cultural engagement directly impact and enhance the quality of services given to expecting and postpartum mothers of color. The course is intended for practitioners in the field who are committed to changing the world through providing holistic and comprehensive care for their clients.

 This course is designed to build upon the foundation of knowledge attendees already have, not shame or berate them for what they do not know. Expectant and postpartum mothers face many fears, anxieties, and concerns regardless of ethnicity and/or racial background; however, mothers of color and mothers birthing children of color face a uniquely different set of challenges. Many of their apprehensions are exacerbated by the current socio-political climate and increased and omnipresent coverage of horrific events via social and mainstream media. This course is designed to empower birth workers to have the crucial conversations necessary to be more relevant to a diverse 21st century clientele.

Jocelyn Imani is a cultural consultant, historian, and community builder. She holds a PhD in History from Howard University and a B.A. from Fisk University. She has worked with the National Park Service, the Smithsonian Institution, and has been a professor at several institutions. She actively works to make shared space - public lands, museums, educational institutions, etc. - more relevant and accessible to all populations in an ever-changing America. She believes firmly in the power of one and uses her resources to empower individuals - and by extensions organizations and communities - to act as catalysts for change. She is a native of Nashville, TN, but has lived in Washington, DC since 2009.

This workshop will be held Sunday, January 22nd from 1-5 pm in Washington, DC (location TBA). The price of this workshop is $40 per person, but in an effort to make it accessible to everyone who wishes to attend, please feel free to email us if there is a financial hardship. To purchase a ticket, please visit this link or inquire with Emily at emily@doulasofcapitolhill.com.

We hope to see anyone and everyone at this workshop, and we thank you for your support in the community!

 Nicole and Emily

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The Best Kept Secret to Postpartum Recovery

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The Best Kept Secret to Postpartum Recovery

Today's guest blog comes from Katherine Bayer, an experienced D.C. based Physical Therapist that specializes in pregnancy and postpartum health and recovery. With a focus on manual work and functional strengthening, she has started her CAPP-OB certification under the APTA section of women’s health. She has spent time in an array of physical therapy settings, including hospital-based PT, rehabilitation, and outpatient facilities, along with experience as a massage therapist. To reach out to Katie with questions or appointment requests, please email  her at Katie@conciergephysicaltherapists.com.

Congratulations! You have a beautiful baby and these will be some of the most amazing moments of your life. Your body, on the other hand, has just gone through the ringer and is now expected to care for, feed, change and carry this beautiful bundle without another thought.

Rarely do doctors recommend physical therapy during pregnancy or after; but let's think about it. Really truly think about what your body just went through- and wonder...why?

Many people think these pains and other issues are “normal”, and just apart of the whole pregnancy package.  THEY ARE NOT.  I understand that this baby is now your number one priority. But if you aren’t taken care of, it’s much harder to care for someone else.

I didn’t always treat pregnant and postpartum women. Or, I guess I did, but didn’t stop to think about them in this light. But as time went on and I saw the same pattern of pain and muscular dysfunction in many of my female patients, I started taking notice. I realized after I had my own kids (twins via C-section and a single via VBAC) that It doesn’t matter how many months or years you are after delivery. These problems will often follow you if you don’t take the time to treat them now.  

During pregnancy, your body changes immensely- your rib cage circumference increases 10-15 cm, pelvic ligaments loosen, breasts increase in size by two pounds, your center of gravity shifts forward. And then- it’s time for delivery. Either vaginally or via C-section that little (little?!) baby has to get out a small hole to enter the world. And no matter how it happens, it’s traumatic to your body.  On top of that, the minute you become a mom, you are needed in a very physical way. 

So where does a PT fit into this postpartum picture? I’m glad you asked!

Doulas of Capitol Hill Concierge Physical Therapists

Ouch!
After both a vaginal and C-section delivery, you may have muscular pain, pain along your incision, joint pain, nerve pain, or any myriad of possible other dysfunctions. We can help by using manual techniques and exercises to improve your joint mobility and normalize your soft tissues to reduce your overall pain.  

Move Right!
Learning correct body mechanics with all the new baby activities will lessen pain and reduce risk of further injury. You will be nursing, bottle feeding, changing, carrying, lugging car seats, possibly carrying heavier older siblings, in addition to your other regular daily tasks.  We can teach you how to do so with less stress to your body, lessening pain and preventing future injury.

Core? What Core?!
Ideally, you start to work your “core” (both abdominal and pelvic floor muscles) immediately after delivery.  This will involve both learning how to activate as well as relax these muscles correctly. We can show you how.  It can be a frustrating process to get these muscles firing again, but the good news is that once you do, you can strengthen them doing pretty much anything during your day (yea for easy!!).  You may have heard in the news lately that in France OBGYNs refer all patients to pelvic floor PT immediately after delivery and it is covered by government healthcare. Oui! Oui! They have it right.

Finding your core now will help prevent future injury. To all those woman many years postpartum that I have treated for hip, low back and knee pain: I wish you had seen a PT for your abdominal and pelvic floor strength and posture soon after having your kids. The healthcare field as a whole needs to make a mental shift to start treating the mothers as well as the babies. Hey you, new mom, that means that you might have to put yourself first once in awhile too.  

So find a physical therapist, ideally one who specializes in the treatment of pregnant and postpartum women. At Concierge Physical Therapists, we can see you in your home, so that means not dragging your baby and all the baby accessories along with you. (Woohoo!)  No matter who you decide to see, just do it. Trust me, it will be worth it.

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SSRI's Pregnancy, and Motherhood: I am a Medicated Mom.

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SSRI's Pregnancy, and Motherhood: I am a Medicated Mom.

Today's guest blog comes from DC mom and former client Katie B. She shares her path to motherhood and her journey with medication to manage her anxiety and depression. She is an amazing mother and shares her story so that others can learn, grow, and feel safe about getting help in various forms when needed. 
 

I have wanted to be a mom for as long as I can remember. Every time I see a baby I have an instinctual response to snuggle him or her, and I calm down almost instantly when I hold one. I couldn’t wait to get pregnant and start a family—so much so that for several years I have had intense dreams that I am giving birth or already have a baby. Yet for much of the time leading up to conception, I was terrified of actually going through with it.

For my entire adult life, I have lived with depression and anxiety, so I knew that I was at a higher risk of developing perinatal and postpartum symptoms of both disorders.

I have a strong relationship with my psychiatrist and also reached out to a psychiatrist who specializes in postpartum disorders to discuss medication options that are safe during pregnancy and while breastfeeding. While this relieved much of my anxiety of being medicated during this period, I went through months of processing my guilt and conflicted feelings over the risks of staying on meds vs. weaning myself off them. There are still many unknowns about the long-term effects of SSRIs (I’m on Celexa) on children.

woman on beach PPD Doulas of Capitol Hill

What really solidified my decision to stay on meds was the constant message from my ever-patient psychiatrist: the negative impact of maternal depression on children is significant. He reminded me of my severe depressive episode several years prior to conceiving my son. During this period, I could barely function. I experienced disordered eating, had low self-esteem, barely interacted with my husband, and felt fatigued all the time. There were also times when I literally felt like I needed to jump out of my own skin because I felt so bad about myself. I knew that motherhood alone would be a shock to my system, and adding depression and anxiety on top of that would be devastating for my family and me.

I luckily had a healthy pregnancy working with the amazing Midwives of Medstar at Washington Hospital Center, and with Nicole as my doula. My mood remained stable and anxiety was at bay for the most part. A huge contributor to my feeling consistently positive about staying on meds was the overwhelming acceptance and support from my care providers to participate in ongoing psychiatric treatment. My midwives never questioned my decision and when they asked about my mood, it was without judgment or overreaction---what a relief.

When my son Eli was born, I felt the rush of many different emotions coming at me seemingly all at once, which was overwhelming, as it is for most new moms. The emotion that most surprised me was fear. I can honestly say that for much of the time in those early weeks, I was terrified of my own child, mostly because I didn’t know if I would know what to do in response to his distress, or if he would take to nursing without fussing.

I also did not feel completely attached to Eli right away, which scared me and contributed to feelings of guilt that I was a bad mother. At two weeks postpartum, I called my psychiatrist who temporarily increased my dose of Celexa, because I started to ruminate on the littlest things, and couldn’t fully rest even when Eli slept.

The med change helped, but what really made the difference was keeping in touch with Nicole in the early days, and having her help me during the day a few times per week once my husband returned to work. While being able to nap and shower while she was at my house was a lifesaver, what I truly cherished was the advice and support she gave me, as well as the reminder that I was doing a good job—and also at this stage all I really had to worry about was keeping Eli safe and fed!

When Eli was five weeks old, I joined a P.A.C.E. group with eleven other new moms who had given birth around the same time. P.A.C.E. (Parent and Community Education) has been around the D.C. area for 40 years and is an 8 week educational and supportive group facilitated by a mental health professional who also happens to be a seasoned mom. Within a few weeks, I was essentially gifted a “mom village,” where each week we shared our insecurities, fears, and early parenting triumphs. The group normalized my early experiences with Eli, and helped me avoid isolation in the house, which in turn kept my depressive symptoms in check. We still keep in touch over email and social media, and have monthly “Moms nights out,” which I truly cherish.

Eli is 5 months old now, and I just returned to work on a part-time basis as a Clinical Social Worker. While it feels like I’ve been a mom forever, this journey is only still just beginning, and my experiences as a new mom living with mental illness has inspired me to be a support to other women with similar challenges. I am forever indebted to my mom village, care providers, loving husband and family, and of course-- my trusty SSRI-- for helping me develop a healthy relationship with Eli, and also with myself as a mother.

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1 in 5 Suffer with Postpartum ______?  (HINT: It isn't Depression)

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1 in 5 Suffer with Postpartum ______? (HINT: It isn't Depression)

 

Today's guest blog is written by Heather McMillen, LPC is a licensed professional counselor with a private practice in Alexandria, VA specializing in Maternal Mental health. Learn more about her and her practice here. "When I started my private psychotherapy practice, I knew I wanted to do something that used my helping skills in a different way. Through my own experiences and research in birth trauma, I noticed the similarities of how women react to trauma across the board. The additional struggle of caring for a newborn while processing trauma added an extra layer of challenge to help these women and the draw towards improving mental health during pregnancy and postpartum feels very natural to me."

 

Throughout the work in my practice I have participated in several trainings and attended the Postpartum Support International Conference. Through this education I have learned that PPD (Postpartum Depression) is being grouped into a larger classification of Perinatal Mood disorders that is now specifically including anxiety. It was not until I started seeing such a large amount of highly anxious pregnant women and new moms in my practice that I realized:

 We need to get the word out!

 Postpartum anxiety is as pervasive, if not more so, than depression.

I think it’s the expectations we put on new motherhood that make the mothers keep the debilitating anxiety even more secret than depression. Anxiety is almost easier to hide, it can be a secret suffering of obsessive thoughts, catastrophic visions of the future and physical symptoms that are ignored or covered up.

Becoming a parent is an anxiety-producing event; there is no doubt about it. We know that change of any kind stimulates anxiety as a way of dealing with things that are unpredictable. Anxiety, and the chemicals that create the sensation, keep you extra alert and ready for challenges. When the brain interprets a situation as a threat, the fight or flight response is activated. Once this happens the survival system for the human body kicks in. The heart begins pumping more blood, digestion shuts down and breathing may shorten. The brain shifts from processing information using problem solving and rational thinking. The brain is now in survival mode looking for a way to stay alive. The problem is that this system is old for our current day lives. This survival system is designed to help you RUN and get away from a tiger that may be threatening you (or your baby’s) life. You don’t need increased blood pressure to deal with strapping your baby correctly into a car seat.

If the anxiety system is working well, you will use it to create productive changes. “I am concerned about the right way to get the car seat installed, I will look for a professional to help.” In this way the anxiety spurs an action that reduces the perceived risk and the anxiety response lessens. New motherhood has many many areas for concern and hyper-vigilance. It makes sense and is normal for moms to worry about baby’s kicking, eating, sleeping, breathing, pooping, and the list goes on and on. This is part of the confusion for figuring out if the anxiety is normal or if it has gotten out of control. A woman who just became pregnant or gave birth suddenly has a tiny vulnerable person to keep alive. There are a lot of new things to worry about.

The intrinsic anxiety that comes from new or repeat motherhood can keep women from getting the help they need.  The healthcare providers expect mom to have a lot of questions and write off her anxiety as something to get used to as part of having a baby. Often a woman’s anxiety is seen as complaining or feminine overreacting. I have heard many stories from clients about their worries being invalidated when they do express them- “your fine, don’t worry, it’s nothing”.

This type of well meaning response only serves to activate the worry even further because now she feels unheard and alone in her concern, maybe even feeling “crazy”. A woman needs to be able to access help when the thoughts and anxious feelings start limiting her behavior, affecting her relationship with the baby and interfering with her ability to feel joy. Intuition is also important to pay attention to when trying to decide if you need extra help. If something does not “feel” right it IS worth following up with to get clarification.

When women talk about their fears and realize they are within normal or treatable limits they can see a light at the end of the tunnel. Just speaking the thoughts out loud can be therapeutic. When the thoughts are alone with you in your head they can have so much power. Speaking them out loud with someone who can really hear you can help you gain amazing perspective. Social support will decrease stress in general and will in turn reduce the general physical anxiety symptoms, which allows the brain to reduce the survival response. Once the brain relaxes the fight or flight reaction, mom can relax- I mean really relax.

That will help break the cycle of physical and mental anxiety. Self-care for new moms is a whole topic on its own but that is a cornerstone of the treatment for anxiety. A big part of the work I do is helping reduce the guilt that is associated with self-care so that women can truly address their anxiety symptoms.

Self-care is not a luxury; it is imperative. 

Mindfulness exercises, physical exercise and sleep are also tools that can be useful in treating postpartum anxiety.

 Postpartum Support International's motto is You Are Not Alone.

There are many resources available to support, educate and facilitate change. Human beings are social animals, we are programmed to need support during challenging times. If reading the information here about anxiety makes you wonder about your own symptoms please know that everyone qualifies for help.  PSI has many wonderful resources on their website including free support groups, online support groups, a “warmline” and a list of local therapists- and the resources are not just for depression! An excellent book to read for more information is Dropping the Baby and Other Scary Thoughts by Karen Kleiman and Amy Wenzel. Share your experiences with your friends and family as well- The best way to reduce the stigma for new mothers and mental health in general is talking about it!

 

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