Health Care Quality Week: Interview with Dr. Nicole V. Lang MD

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Health Care Quality Week: Interview with Dr. Nicole V. Lang MD

October 21-27 is Health Care Quality Week and Doulas of Capitol Hill is honored to feature one of Washington, DC’s most loved pediatricians, Dr. Nicole V. Lang, MD, and her practice at Washington Pediatric for this month’s Local Business Spotlight.

Dr. Lang is a board certified pediatrician with over 22 years experience in caring for children in the Washington metropolitan area.  She is the Founder, President and CEO of both Washington Pediatric Associates and the specialized extension of her practice called, Premier Pediatric Concierge Care.  The Concierge Service provides an even more personalized convenient and comprehensive approach to health, education and wellness. 

She is recognized locally as one of Washington DC’s Top Pediatric Doctors according to Washingtonian, Washingtonian Mom, Washington Parent and the Washington Post

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What led you to this career?

My life’s calling, since the age of 7, was to be a pediatrician. I am the first doctor in my family and greatly value taking care of “my children.”  I am truly living my dream. 

What do you enjoy most about work?

I absolutely enjoy helping new parents navigate parenthood and watching the evolution of growth and development of my children over 21 years.  I also love being able to positively influence children during their formative years. My motto is to help children make “Smart, Healthy, Safe Choices in Life” and encourage them to reach their full potential. 

If you are a parent, how was your birth and postpartum?

I am the proud mother of my daughter, Nia. I had a wonderful natural child birth experience in a hospital setting. I needed a lot of support with breastfeeding during the postpartum period and ultimately did find balance with supplementing with formula. I always say that my baby had the best of both worlds and is thriving today. 

What resources would you want parents to have?

I want all parents to have the book Touchpoints, written by my mentor and world renowned pediatrician, Dr T Berry Brazelton. This book focuses on a child’s social and emotional health, which is just as important as a child’s physical and cognitive well being.  He stresses the importance of having a holistic look at a child and supporting the family in any way possible. 

What's one thing you think the world needs to do to improve the lives of new parents (or people living in our service area)?

New parents need longer maternity and paternity leave to be with their newborns. We need to be a family centered society to help foster the love and support a new family needs in order to thrive. 

What do you think is the hardest part of expecting baby or becoming a parent?

The hardest part of becoming a parent is the amount of pressure parents (especially mothers) put on themselves to be the perfect parent. There is not just one way of parenting. It is a process of trial and error. It is important to trust your gut intuition because it will always lead you in the right direction.  Trust the process and remember Self-Care along the way. (Remember the airplane rule: parent put your oxygen mask on first then help your child).

What products or services do you personally love?

I am a wellness advocate for the company, Doterra.  I utilize a wide variety of their products personally and in my practice- from essential oils, soaps/lotions to vitamin supplements.  There is a new baby/kid product line now available too, that I love. This company also has a wonderful humanitarian mission that helps support poor communities around the world. 

How do you start each day?

My mother always taught me to count my blessings. I start each day with a prayer of gratitude for the gift of life, family, friends and nature.  I ask God to guide me and give me strength for the day.  I also tell my husband and daughter that I love them dearly. 

What's your favorite thing to do in DC?

My favorite thing to do in DC is to spend time with my family and friends—i.e. hiking in Rock Creek Park, visiting the Smithsonian museums or trying different ethnic restaurants (Cher Cher Ethiopian restaurant is our favorite)—as long as I am with my loved ones, I am filled with JOY!



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October is Miscarriage, Stillbirth, and Infant Loss Awareness month

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October is Miscarriage, Stillbirth, and Infant Loss Awareness month

For the 1 in 4 women to experience such a loss, it can be a difficult time.  The people in our lives try to be there for us, but often times the results are less than helpful.

After reaching out to a number of women who have been open about their experiences with loss, many of them had similar unhelpful things said to them during a time they are grieving.  

For those of you who wish to avoid such awkward or potentially hurtful statements, have a listen to those who have lived through it.

On this loss in relation to other children-

"At least it wasn't your first child"  - after confiding about miscarriage, a baby we had tried 1.5 years to conceive.

"At least you know you can get pregnant." - said after same miscarriage. Currently been unable to conceive for over 6 years now. (secondary infertility)

“You have two healthy kids, be GRATEFUL for what you have.”  - I can be grateful AND sad, you can have both emotions BRENDA.

“You’ll have another one.”

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Platitudes.  Avoid them like the plague.-

“It will happen when it’s right”- what does that mean?

"It wasn't meant to be” and that “we could just try again." It's not like I fell off a bike or ruined supper. Please don't imply I'm wrong for grieving by saying just make another one.


Comparisons Syndrome-

“It happens to everyone.”

“It’s more common than you think.”  

“It’s not that bad.”

Never say any sentence that begins with, "at least". -

“At least you lost the baby early. At least you have other children. At least you'll have more. At least you got to see the baby once before saying goodbye. Etc.

On this loss and the timing of it-
“It wasn't a real baby yet.” -18 days there's a heartbeat. That's pretty real.

“See the silver lining that you didn’t go full term.”  

‘So you weren't that far along, you were only 8 wks.’- I cannot say whether this particular woman was trying to console me or marginalize my loss but in the moment where the pain is constantly in your throat and the idea of loss is besieging your heart; it felt like a dismissal....The thing is we don’t lose a pregnancy.. it’s not a matter of getting to 40weeks gestation, it’s a matter of having a family member, it’s a matter of an entire life, with ideas, hair color and temperament joining your world; the world. Loss can be difficult for people to sympathize with; even people who have experienced loss and all the more when the loss is only physically felt by one person (mom). Loss is loss, and losing your unborn child is complicated because their body is part of your body; and you essentially lose a part of yourself no matter how many or few weeks they were there.

Anything religious.  Especially if you don’t know their faith or religious beliefs-

“The baby is in heaven now” or variation “the baby is in a better place.”

“God needed her to be with him.”  

“She is an angel now.”

“You will have another one.”

“It was Gods will and he knows what’s best.”

“You will be with her again someday (in heaven).”  - So many of these are related to religious faith and unless you’re talking to a deeply religious person it’s terrible.  And we don’t usually know how religious a person really is.

“It’s a blessing in disguise.”

Unhelpful advice-

“Give it some time and you’ll feel better.”  

“Just relax.”  -are you f*@#ing kidding me?!

Avoiding-

I think mostly for me it was the silence that hurt the most… when people didn’t know what to say or do, so they pretended nothing happened or that I’m not really a mother.


What was helpful-

“I’m sorry for your loss” -The only thing to say.

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The most helpful, honestly came in the form of someone being there to listen, or just to be present with me in silence and support, the general act of gently moving forward in the present even if it's to visit them for three weeks and just being loved and needed. But what also helped was that someone just admitted, "I don't know what to say, but I am here to listen if you want to talk to me.

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NICU Awareness Month part IV- Let's Tell Your Story!

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NICU Awareness Month part IV- Let's Tell Your Story!

By Summer Mobley

In the Social Media world, Tuesday’s are known as Transformation Tuesday’s. So, in honor of #transformationtuesday, here are some pictures to show how much the triplets have changed since they were born and in the NICU.

They have come so far and grown so much!


 Birth Pictures. (Left) Xander @ 4lbs, 6oz; (Middle) Isabella @ 3lbs, 13oz; (Right) Elly @2lbs, 15oz

Birth Pictures. (Left) Xander @ 4lbs, 6oz; (Middle) Isabella @ 3lbs, 13oz; (Right) Elly @2lbs, 15oz

 8 days old. (Top Left) Elly; (Top Right) Izzy; (Bottom) Xander.

8 days old. (Top Left) Elly; (Top Right) Izzy; (Bottom) Xander.

 4 months old. (Top Left & Bottom Right) Isabella @ 11lbs, 9oz;(Middle) Xander @ 12lbs, 1oz (Top Right & Bottom Left) Elly @ 8lbs, 10oz

4 months old. (Top Left & Bottom Right) Isabella @ 11lbs, 9oz;(Middle) Xander @ 12lbs, 1oz (Top Right & Bottom Left) Elly @ 8lbs, 10oz

 2.5 yrs old at their Early Intervention Graduation. (Left) Xander @ 34lbs; (Middle) Elly @ 22lbs; (Right) Izzy @ 35lbs.

2.5 yrs old at their Early Intervention Graduation. (Left) Xander @ 34lbs; (Middle) Elly @ 22lbs; (Right) Izzy @ 35lbs.

I talked about how life in the NICU and life outside the NICU can go at different speeds. As parents to NICU babies, we tried to pause one (life outside) and speed up the other (life inside). It didn’t work.

What did work, was the astronomical amount of support we received from family, friends and even strangers before and after the triplets were born.

When I was 24 weeks pregnant, (TMI WARNING) I lost my mucous plug. I will spare everyone the details of this, but the after affect meant that I was put on home bed rest for the remainder of my pregnancy. I wasn’t allowed to walk or stand for periods longer than 3-5 minutes. I wasn’t allowed to sit for longer than 10 minutes. Basically, I had to lay down all day long. The amount of reading I did…who am I kidding?! The only thing I read in the 6 weeks I was on bedrest were emails and FB posts. The amount of Netflix I watched, on the other hand, was a lot.

Anyways, Ray took the brunt of the keep life moving and care for the outside of the womb child responsibilities. But when I say we had an ASTRONOMICAL amount of support pour in, I’m not kidding. My MOPS group scheduled visits and meals while I was on bedrest. The staff at our church brought us meals every other night for almost three months after the triplets were born. We had friends cook for us, clean our house and do our laundry; while others did our grocery shopping. My mom flew in to help us with Braelynn, my in-laws came to help us celebrate Christmas, my grandparents ordered our Christmas dinner and other family came to help once the girls came home, so I could still go see Xander in the NICU. Others took Braelynn for playdates and sleepovers while others helped pick her up from school. My triplet moms group sent us cards and words of encouragement. We met strangers who became friends. And so many people prayed for our kids to grow and thrive and come home.

NICU life, especially when it’s an extended stay, can be lonely and isolating. And at times it was just that, at least for me. But, it was so amazing to know that so many people were supporting us in a variety of ways. We had a tribe (we still do). Our tribe pulled through in so many ways.

Saying thank you 6,398,120,093 times would never even chip away at the mountain of gratitude we have for every.single.one.of.you.


 Isabella on CPAP, 5 days old

Isabella on CPAP, 5 days old

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NICU Awareness Month part III- Let's Tell Your Story!

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NICU Awareness Month part III- Let's Tell Your Story!

By Summer Mobley

There are a few days which really stand out in my memory from our time in the NICU. One of those days was December 11, 2015. The triplets were seven days old. It was the day that we got to hold the triplets for the very first time. Every day up to that point, we were more of an occasional participant. We could take their temperature, change their diapers, swap colostrum or breastmilk inside their mouths, or do hand-hugs (gently cupping the baby’s head and feet, while they slept in the isolette).

They triplets were all on CPAP (continuous positive airway pressure), which is a machine that sends air and oxygen to the baby’s lungs through small tubes in his nose or windpipe. It looked like they were wearing a mask & cap over their heads. They also had UVC (umbilical vessel catheter) lines, whichisa thin tube that goes into the arteries
in their umbilical cord after the cord is cut after birth. It allows for fluids, medicine & nutrients to be given, blood to be drawn & blood pressure to be taken.

On day seven, each of them had their UVC lines removed & IVs put in. Which meant we could hold them! Getting to hold them for the very first time was exactly all the crazy emotions you are thinking in your head right now. It was a combination of “YAY! Finally!” to “Holy Sh**! They are so small. DON’T.DROP.THE.BABY!” Add that to the combination of making sure you held them the right way, so their CPAP wouldn’t be blocked & not knowing what to do if your baby began to spell (Apnea – breathing stops or Bradycardia -  heart rhythm slows).

Praise God for our amazing nurses who taught us (seriously, PARENTAL COACH or CHEERLEADER should be in their job descriptions) what to do & what to expect.

Y’all, getting to hold our kids for the first time…It seriously rocked.

 R-Elly for the first time; L-Xander

R-Elly for the first time; L-Xander

It made all the crazy of the last seven days, the endless pumping and driving back & forth from home to the hospital, worth it. The crazy disappeared, for just a little bit. Instead it was replaced with the awe that my teeny tiny little humans where alive & fighting & that they fit INSIDE MY BRA. Now they are huge & barely fit in my lap. But that day (those days), it was so incredible to see and hold a baby so small.


When we were in the NICU, I wish there could have been a “pause on life” button so that...

...bills didn’t have to be paid.

...household responsibilities didn’t have to be done.

...other kids at home didn’t have to be cared for, fed or taken to school

...professional careers could be picked back up in a few months when things weren’t so crazy.

...grad classes didn’t have to be finished.

 Ray w/Izzy

Ray w/Izzy

...holidays split between home and hospital didn’t have to happen.

The day I went into labor for the second time, Ray was at GMU sitting in class. He was getting ready to stand up to give a presentation for his FINAL in one of his graduate degree classes. He quickly delivered his presentation and promptly left for the hospital.

The week following the triplets birth, Ray finished out the Fall semester of school. He also went to work. He had a limited amount of leave time and although this company


was very understanding, we knew we’d need him home for a little bit after everyone was out of the NICU. So, he’d wake up, get B to school, go to work, come home, do school work and go to the NICU. And repeat.

Braelynn was 5 years old when the triplets were born. She was in kindergarten. We had school drop offs and pickups, events and reading.

 All Elly at 5 days old

All Elly at 5 days old

We split Christmas of 2015

- 1/2 the day at home with Braelynn and our parents, the other 1/2 at the NICU with the triplets.

We missed out on a lot of important birthdays and special occasions. And all for good reason. And all without guilt. Yet I still wish I could’ve paused it all.

 Ray hand-hugging X & X w/CPAP

Ray hand-hugging X & X w/CPAP


But, we know, pause buttons on life don’t exist (otherwise we might all be stuck at whatever random age our parents liked us most at). Despite what is going on in the NICU, life outside it, goes forward, no matter what.

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NICU Awareness Month part II- Let's Tell Your Story!

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NICU Awareness Month part II- Let's Tell Your Story!

By Summer Mobley

The hospital the triplets were born at didn’t have private rooms in the NICU when we were there. Instead, they had multiple bays or pods.

 Pictured here is Isabella at 2 days old, weighing approximately 3.5 pounds. She’s inside an isolette. She was hooked up to a pulse oximeter, a heart rate monitor & an apnea monitor. She was also on CPAP & had an umbilical catheter. I promise I’ll explain all of these in another post

Pictured here is Isabella at 2 days old, weighing approximately 3.5 pounds. She’s inside an isolette. She was hooked up to a pulse oximeter, a heart rate monitor & an apnea monitor. She was also on CPAP & had an umbilical catheter. I promise I’ll explain all of these in another post

Imagine a rectangle & around the edges of the rectangle were isolettes (or bassinets or cribs depending on the baby in each station). There were approximately 10-15 babies in each pod. Down the center of the rectangle were sinks for handwashing & computer stations for the nurses. I’m sure there were other things down the center, but frankly, I wasn’t paying attention to those details.

When a baby is admitted to the NICU, it was protocol that only one baby could be admitted to a specific pod at a time. Which meant the triplets were each taken by their respective receiving teams to three different pods.

What this meant for us, was that each time we visited the kids, we’d have three stops to make. Or when we called from home to check on them, we’d have to make separate calls to each pod & each nurse.

It wasn’t like there was a mile in between them - they were essentially 50 feet from each other an&d through another set of double doors, but they were still separated. And thank God for my husband, because I was in such a fog the first few days, I couldn’t remember who was where or how to get there.

After I was discharged, & we would go to the NICU, we’d have to pick who to see first – Baby A (Xander), Baby B (Ellyse) or Baby C (Isabella). We’d arrive to the NICU, wash our hands & arms, put our cell phones in plastic bags & call their nurse to make sure it was ok for us to come back. Because they weren’t in private rooms & we shared a large space with many other babies & their families, if one baby in our pod was going through a sterile procedure at the time, we would be told “No, I’m sorry, you cannot see your baby at this time.” And so we’d wait. Or we’d move down the list to the next baby & pray that we could see one of them. Sometimes, it made me so mad knowing I had to ask for permission to visit my kids & mad that someone else was essentially in charge of the well-being of my children. Most of the time, this wasn’t an issue. And even in my anger, I was and still am SOOOOOO grateful that our kids were under such great, safe care.

The triplets were born at 1:27am and 1:30am. Xander was born 1st, Ellyse 2nd and Isabella 3rd. Izzy and Elly were born in the same minute, practically together, but Elly’s feet came out just before Isabella, so she is considered 2nd born of the trio.

It was so hard to follow anything that was happening in the Delivery Room that night.

 Pictured is just a sliver of the people present in the Delivery Room the night of the triplet’s birth.

Pictured is just a sliver of the people present in the Delivery Room the night of the triplet’s birth.

Ray counted 22 people in the room with us. Each baby had a team of 4 or 5 people with them (their receiving team). The team consisted of a NICU doctor, a nurse, a respiratory specialist and a neonatal specialist. There were two anesthesiologists for me, my two doctors, a slew of other nurses and I’m sure I’m missing someone of importance.

After they were born, their respective teams did the norm – weighed them, took measurements, took that “first” picture, the nurses held the girls next to me, so I could see them and then whisked them away. Ray followed the girls down to the NICU because he had a bunch of paperwork to sign.

Xander stayed in the OR for a long time after the girls left and I realized the next day that I never got to see him before he went to the NICU. You see, Xander was born not breathing and it took his team an extended amount of time to stabilize him enough to go to the NICU. Ray and I recall knowing this, but we were told so much information those first few days, it was impossible to keep any of it straight.

Xander was in the NICU for 2.5 months. After discharge, I read his paperwork over and over and over again and it wasn’t until right after he turned two years old, that I noticed something. Xander had been intubated while in the Delivery Room. So, I dug further into his charts and discovered that he had been resuscitated three times while in the delivery room. To tell you how shocked I was when reading that is an understatement. I still get emotional thinking about how close we were to losing him and we didn’t even know it.

Xander had a much harder NICU Journey than my girls did. But if you saw him (or heard him) now, you’d never know it. He has an ear-piercing scream that is a constant reminder that his lungs work and work well. 😊


After the triplets were born, I wasn’t able to go see them right away.

I spent a few hours I recovery, then back to my L&D room, before I was transferred back to the High-Risk floor. It was at least 16 hours after delivery before Ray could wheel me to the NICU. he had already been a few times and was well versed at the routine and protocol.

We planned to see Xander first, so when we arrived at the NICU, we checked in at the desk, put our cell phones in plastic Ziploc bags, washed our hands and arms up to our elbows, called our nurse and headed back. When I got to Xander’s isolette, I was so taken back by his size, by the wires connected to him, by the CPAP mask on his face, by the noises the monitors made as his heart rate rose or dropped or his respiratory rate went crazy. It was so overwhelming.

Somehow, I was keeping it together. Until a woman walked by. Her name was Tara Irvine. We had never met before, but we knew each other’s names because we were part of a Mom’s of Multiples (MOM) group where we lived. MOM’s are band together in a way that I cannot explain.

Tara walked by and recognized my name. She introduced herself and gave me a hug. When I saw the badge she was wearing, I instantly knew who she was. It was at that moment that melted from the emotion of what was going on. Being known by someone who had walked thru what we were walking through meant so much to me that day. I don't recall seeing Tara again after that day and our triplets were transferred to a different hospital 10 days later.

Tara was a NICU Volunteer and it was my first time encountering someone who did this. But it wasn’t my last.

There were volunteers throughout our journey who held our babies when we couldn’t be there; who brought me water while I was doing skin to skin; who sat and talked to me like we were old friends; who sang to my son in the evenings when he was most uncomfortable. I am not sure the volunteers we encountered will ever know how much the giving of their time meant to our family.

Because of the impact the NICU (our nurses, admin staff, doctors, specialists, volunteers, lactation consultants) had on my family's life, I now volunteer at our local NICU.

If you are a volunteer, or have ever volunteered, anywhere for any reason...Thank You. Thank you for loving on others.

You are appreciated more than you know.


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NICU Awareness Month part I - Let's Tell Your Story!

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NICU Awareness Month part I - Let's Tell Your Story!

By Summer Mobley

September is NICU Awareness Month.

 This picture is of Elly’s, our Baby B, as she was being admitted to the NICU following birth.

This picture is of Elly’s, our Baby B, as she was being admitted to the NICU following birth.

Our triplets were born at 30 weeks gestation and spent 37, 37, and 70 days in the NICU. In honor of this month, I will share bits and pieces about our NICU journey - including our ups and downs, how we balanced time at how with our, then, five-year-old and how that time has eternally impacted our family.


Two is the number of times I went into labor with the triplets.

The first time was the day after Thanksgiving in 2015. My husband’s brothers and sisters and their kids were all visiting because I was on bedrest. That morning, the boys had taken all he kids to go hunt for a Christmas tree (the story of the tree deserves its own post). When they came back, we decorated the tree. That’s when the contractions started. I sat, quietly, timing them. After an hour I texted Ray, who sat across the room from me and confessed I’d had seven contractions in the last hour. He immediately stood up and told me to get my bag, call my doctor and load up in the car to head to the hospital. Fast forward, we were lucky enough that my doctors were able to stop my labor. I was 29 weeks pregnant at the time.

I went into labor, for the second time, a week later. This time, there was no stopping it. The babies were coming. (To this day, I blame Xander. I think he was tired of getting kicked by his feisty sisters.) I was 30 weeks pregnant.

 This picture is of me with three Doppler’s, monitoring the babies heart rates before being taken to the operating room.

This picture is of me with three Doppler’s, monitoring the babies heart rates before being taken to the operating room.

A few hours before the babies were born, one of the neonatologist who worked at the NICU came to speak with me and Ray. This had happened the week prior when I went into labor, so we knew what to expect from him, yet even so, his words were so hard to hear.

He spoke of what we could expect to find after the babies were born. Things like brain bleeds or holes in their hearts to respiratory distress and the need to be intubated. What it really boiled down to, is that the doctors really had no idea what shape our 30-week gestation triplets would be in upon birth. He promised that the team caring for our kids would do everything they could to make sure things were ok. It was so scary, yet so peaceful at the time. And not peaceful in the sense that I’m sure your brain jumped to, but peaceful in that we knew beyond a shadow of doubt, that no matter what, God was good, and God was in control.

Approximately 12 hours after my labor started the second time, the triplets were born at 30.4 weeks. They weighed 4lbs, 6oz; 2lbs, 15oz and 3lbs, 13oz.

Three is such a crazy number when I think back to our time in the NICU.

Of course, the obvious is that we had triplets. And yes, for the crazies that look at me like “Huh!? WTF?! Did you really just say tri…??” Yes, I said it and meant it. And yes, that means three babies. Thank.You.Very.Much.

But three had so many meanings, as a result for us.

Three times the amount of people in the operating room (Ray counted 22 people).

Three receiving teams (which I will get into on a future post).

Three Pods that the triplets were divided into.

Three phone calls we had to make to three different nurses every time we called the NICU for an update.

Three hands-on times, each spaced 30 minutes apart, and repeated every three hours.

Three also signifies the number of days post-birth that I got to go home. Except, I went home without the three children who occupied my body for 30 weeks. The three children who sent me into labor twice. The three children who I’m positive learned to fight each other in utero (and one who proved her karate skills by dislocating THREE of my ribs while I was pregnant). Three days after giving birth, I had to leave three HUGE chunks of my heart inside a hospital and we had no idea how long it would be until they’d be able to come home.

Three of us at home, waiting for the other ½ of family to grow big enough and well enough to join us.

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Three months before our whole family would be home, together, for the first time.

And in three months, from this moment, the three teeny tiny humans that I get to call my kiddos, will turn three years old. The time has gone so fast.


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Let's Tell Your Story- Fed Well

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Let's Tell Your Story- Fed Well

Sitara and Artemus (and David)

Today starts month 38 of breastfeeding my nursling. The journey has been unexpected in every way imaginable and I’ve been feeling a need to write it all out. Much like our changing bodies, the trimesters of pregnancies, and our ever so capriciously growing babes; breastfeeding for me has comprised of many stages, and I will present them as such.


Pregnancy

Everyone has some idea, or is made to think about how they would like to feed their baby when they are pregnant.  Artemus was a total surprise, and I spent most of my pregnancy just trying to come to terms with the fact that I would be a mom, and have to be in graduate school full time. I spent most of my pregnancy working long hours and getting as many experiments done before the baby was born. I also spent a lot of time worrying about how having a baby would change me, and I was really terrified of suddenly being bogged down by an infant. My pre-natal yoga teacher was also a doula and explained that if you were planning on breastfeeding your newborn, you just need to get used to the idea of being a happy cow for a while. This “happy cow” image in my head included sitting on a chair with a boppy and snacks and drinks by your side, in an old lady nightgown, rocking a nursing a baby.  Stuck in a room, all alone. What should have evoked happiness and joy, only made me feel isolated. It reinforced the idea of me losing myself to the baby. How would I ever be spontaneous again? How would I be a part of the world, if I were busy being a cow? I figured, my mother was coming to help for the first two months, and would help me learn to breastfeed, because I knew she had breastfed both, my brother and me. I tried to not think about it much. Maybe because I knew it would be hard, and I was already having a hard time. I spent an afternoon reading the breastfeeding chapter from the “What to expect when you’re expecting” book. Worst. Mistake. Ever. It was organized as a set of questions; sort of like an FAQ section if a website. What is mastitis? Is it normal for nipples to hurt? The book served as a great tool for making me sob in bed for 4 hours straight, thinking about all the things that were bound to go wrong with breastfeeding, David, (my husband now, then boyfriend), spent an entire trimester trying to placate me, while I rested my hopes on my mother’s nursing experience to aid in the success of mine.

Months 0-2

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My newborn baby was here! He was latching well, but had lost about a pound since birth (a lot of that was fluid retention from my long induction, but that’s a story for another blog). I was trying to get used to literally every person just seeing my boobs out. I was so terrified of so many things all the time! Would my big breasts suffocate my tiny baby? Was my body producing enough milk? Why was he not nursing for only 30 mins each session, like my pediatricians lactation consultants said was normal? Why was I crying and singing songs from “Tarzan” on repeat all day?  Why did I not care about being fun anymore?!!

The first few weeks were the absolute worst (what I really want to use are some pretty crass and terrible adjectives, but I will try to refrain). We had an ER visit for high bilirubin levels, we had several weight checks for the baby, and we had competing advice from different lactation consultants. We also had a false alarm tumor scare, which led to visits to a plastic surgeon and ultrasounds.  I was stressed out about building my supply before I had to return to school at the end of 8 weeks and finding good childcare. What I was proud of though was trying to find solutions. I found a great lactation consultant, who made me realize that my baby needed a nipple shield and also that he was just one of those kids that needed every feeding session to be one hour long. This is what I had been given, and so I just tried my hardest to work around it. David brought the baby over for every feeding and changed all the diapers for weeks and weeks. My mother took care of the house chores and cooking and cleaning. I realize this is a privilege that many do not have. For many weeks it seemed like this was going to be the rest of my life. That my entire life was going to be leaky breasts, a crampy empty womb, and the incessant and urgent search for my transparent nipple shields (those shields need to be glow in the dark and fluorescent orange in color). Then suddenly one day, when I least expected it, my 8 week old baby looked me straight in the eye, snatched the nipple shield, tossed it away and latched all on his own. In that instant I knew that inevitably, this phase was not forever.

2- 12 months

The next phase of our breastfeeding journey was marked by the constant stress of pumping “enough” for Artemus while I went back to graduate school. I was very lucky in that, as a graduate student working in the lab, I had responsibilities only to myself at work, and pumping a few times a day was easy to fit in my schedule. As the months went by, some days I would not pump out as much as others and the constant stress of being away from my baby, but my body being his only source of nourishment, took a toll on me. In addition, my academic advisor judged me for “wasting” my time pumping out milk, and accused me of being a “hippy” and nursing my child past the age of 6 months.

Another aspect of breastfeeding we both had to master was nursing in public. At first I spent a lot of time under a hot cover (he was a peak summer baby) in public, trying to make my breasts into a “hamburger” to shove into his tiny, tiny mouth. Once in a while I even found myself in the ugliest of attire locked up in a trial room at Anthropologie or H&M because my mom wanted to go shopping.  The transition from frenzied feeding under covers to sitting around the national mall on the weekend comfortably nursing my kiddo is somewhat of a blur. I made it though!

Life as a full-time graduate student working in a lab, and trying to finish up a dissertation is not your typical setting for having a baby. I had to decide that raising him would not be typical either. I spent long days nursing my kid, driving to work, working, pumping, nursing the kid, driving back, getting dinner ready, cleaning up, getting my pump ready for the next day, putting the baby to bed and then working on my dissertation till about midnight. I tossed the idea of sleep training, and we learnt how to nurse in bed, and co-slept. This was the only way I got some rest, and I couldn’t fathom a few nights of no sleep and having to use my brain all day in the lab.

One of the most unexpected events in my breastfeeding journey was wet nursing! Our daycare provider had a granddaughter who was about 6 months old when her mother had to have emergency back surgery. She had been exclusively breastfed and had never taken a bottle. Her mom also didn’t have any pumped milk. She refused formula and bottles for a few days and was surviving on fruit and veggie purees. Her grandmother was so worried, and the baby was quite hungry! As I was picking up my kid from daycare, I saw the hungry baby and asked our babysitter if she would like me to try to nurse her granddaughter. She was pretty desperate, so we tried it, and just like that the baby latched on! I nursed her 2-3 times a day for about a week, till her mother was back from the hospital.

Before I knew it (scratch that)-finally, after what seemed like forever, we were approaching the twelve-month mark. I knew at once that I would give up pumping at work, but also knew that weaning Artemus would be difficult. He was not ready, and surprisingly I was not either. Once again, the journey had led me to an unexpected outcome.

12 -24 months

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Just before Artemus turned a year old he started having ear infections.  Nursing him was the only thing that seemed to help with the pain and crankiness.  He was by now also reliant on nursing to fall asleep at night and also for naps. Tantrums started early, at about 12 months and nursing helped with that too. I had exactly a year left in my program, and my workload was really ramping up. I was once again sure I was the laziest parent that ever existed because I couldn’t fathom rocking the boat, and taking away the only thing that made me feel sane in this parenting role. A boob in Artemus’ mouth meant he was quiet. It meant he would nap. It meant he would calm down. It meant I could get more work done. We proceeded this way for the whole next year. I actually thought that nursing was finally fun! There was no more pressure on my body to be the primary source of nutrition and I still got all the cuddles and snuggles. My right breast had always produced less than my left breast,  so I decided to retire Ms right boob, so I felt like I had half of my boobs back! This might have been the most ridiculous thing I did to feel pseudo “normal” again.

At eighteen months old, Artemus had tubes put into his ears. The ear infections stopped right as I had some travel for work coming up. I thought 6 days away would mean he would likely forget about nursing. However, the first thing he wanted as I walked into the house was to nurse!!! The same thing repeated itself at about 22 months. At this point I was two months away from defending my thesis, and decided that once again, I would not wean till after I was done with school. To be honest, I was always relieved that Artemus was not ready to wean. By this point I had accepted that I was the parent who had never sleep trained their toddler, that Artemus still very much needed to be nursed to nap on weekends and that at least I still had right boob to myself!

24 months-37 months

The last year has probably been the most interesting year in terms of nursing my once baby.  I had about two weeks between finishing up graduate school and starting my post-doctoral fellowship. I could have weaned, but at this point I just knew that I did not want to. Instead we tackled potty training with success. I knew my toddler was growing up, and someday he may not need my body for comfort the way he still does. As the year progressed, he became more vocal about his preferences breastfeeding. It was a ritualistic practice for him. I would return home from work, and he would ask me to take my shoes off and sit on the couch, then he would climb into my lap for some milk. He eventually started talking about how he feels about my milk, how it is better than ice cream and how it makes him feel better. Never in my wildest dreams did I ever think that my baby would be discussing breastfeeding with me!

Since most people do not breastfeed toddlers in the U.S., I was very happy to have a few friends who had, and also a pediatrician who was very encouraging of extended breastfeeding. We are still nursing but Artemus is slowly self-weaning. I still do not know how or when this journey will end for us. For now I will just be a big cliché and say that I am enjoying (most) of our time together, fully aware that someday soon he will no longer need me to be his human pacifier. I will get full body autonomy back, and then probably screw myself over and get pregnant again!

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What Kind of Lactation Support Do We Offer?

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What Kind of Lactation Support Do We Offer?

We know most moms want to give breastfeeding a try .  It helps to have support to reach your goals (no matter how you choose to feed your baby)! DCH has several options for your support.

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  • Doula support- Did you know all of our birth and postpartum doulas have a breastfeeding module as a part of their doula training and certification? Professional doulas have a basic level of breastfeeding expertise that may include such things as breastfeeding positions, newborn technique and feeding basics. They are equipped to help in the immediate time after birth and also can provide daytime and overnight support and referrals to our CLC/IBCLC’s when necessary.  

  • Certified Lactation Counselor (CLC)- This level of breastfeeding support is a specialized training for professionals.  CLC's are able to help with many general breastfeeding issues such as sore nipples, correcting latch, and giving support on pumping, bottles, and returning to work.  We like to say it's like when you go to the doctors office and you see the Physicians Assistant. They are able to triage many of your general issues, but if you are dealing with something serious you see someone at the top of the field - in this case, an IBCLC.

  • International Board Certified Lactation Consultant (IBCLC)- The IBCLC is the highest level of lactation training that exists in the healthcare profession.  They are able to address common issues as well as more complicated ones such as recognizing a lip or tongue tie, low supply, and breast infections. An IBCLC can help you come up with a plan for supplementation and can guide you to various breastfeeding tools such as nipple shields or feeding systems.

Check out this great review on our Facebook page:

We had a wonderful lactation consultation with Kim the day after we got home from the hospital. We called Emily the morning we were leaving the hospital at 7:30AM -- not expecting her to answer! But she did and within minutes we had the appointment with Kim scheduled for the next day. Kim did a great job of listening to my concerns and guiding the conversation without her own agenda. She listened to what I was worried about/struggling with and addressed those concerns. It gave me so much peace of mind. I was very thankful.

If you are interested in lactation support, please do not hesitate to contact us today! It is always our first priority to help you feel supported as early as possible in your feeding journey.

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Celebrating Nurse's Week!

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Celebrating Nurse's Week!

Doulas of Capitol Hill loves working alongside nurses! Not only are they there to make sure you and your baby are safe, they are an integral part of your birth team for both physical and mental support. In celebration of Nurse's Week, today we feature Kristin Winston, Labor and Delivery RN at Sibley Memorial Hospital. 

What led you to this career?

 I’ve always had a lot of compassion towards people and love taking care of them so what better than to do it for a living! And ever since I became a nurse I’ve always loved labor and delivery and taking care of mom’s and babies! 

What do you enjoy most about work?

I love being apart of one of the greatest moments in my patient’s lives, which is giving birth! It’s such a special moment when they finally meet their baby!! 

If you are a parent, how was your birth and postpartum?

 It was wonderful! I remember every detail! Going through labor isn't easy, it’s tough and painful, but the moment I delivered my baby it all went away! When they put my baby on my chest it was so surreal, it was greatest moment of my life! The postpartum period was hard initially but snuggling your baby and seeing their sweet face makes up for all the sleepless nights! 

Kristin Labor and Delivery Nurse Sibley Hospital

What resources would you want parents to have?

Childbirth education for the pregnant moms and Emotional support and lactation support during the postpartum period. 

What is one unique thing about your business that your customers/clients love?

I try to make my patients feel as comfortable as possible during the labor process and I will try the best of my ability to carry out their requests for labor and delivery! 

What's one thing you think the world needs to do to improve the lives of new parents (or people living in our service area)?

Stop being judgmental! There are lots of different ways to parent and you do what’s best for your family and you do the best you can (that’s all you can do!!!!!!) 

What do you think is the hardest part of expecting baby or becoming a parent?

Fear of the unknown and fear of making mistakes as a new parent. 

What products or services do you personally love?

I love lanolin cream and gel soothies for that first week of breastfeeding. They are lifesavers! 

How do you start each day?

Waking up my kids! They are my joy and I love to start my day off seeing their smiley, sleepy faces!! 

What's your favorite thing to do in DC?

I love to try new restaurants! 

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DCH Celebrates Nurse's Week!

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DCH Celebrates Nurse's Week!

Doulas of Capitol Hill loves working alongside nurses! Not only are they there to make sure you and your baby are safe, they are an integral part of your birth team for both physical and mental support. In celebration of Nurse's Week, today we feature Lisa-Marie Cook BSN, RNC-OB, C-EFM, ICCE, CD, CEO. Lisa-Marie  is the CEO of Birthing Basics, LLC providing evidence-based childbirth education to women desiring natural childbirth and those experiencing a high-risk pregnancy. She is a Labor and Delivery Nurse with more than 30-years of experience working at various hospitals and Birthing Centers in the Washington DC area. Her work at INOVA Fairfax, INOVA Alexandria, and the George Washington University Hospital have provided many opportunities working with both midwife-attended natural births and physician-attended high-risk births.

What led you to this career?

I initially majored in biomedical chemistry with plans to become a physician. That dream ended when I realized that I was pregnant my junior year in college. I switched my major to nursing with hopes to continue my education after my child grew up. Once I had my second child and began my nursing career in the hospital, I found my calling and never looked back.

What do you enjoy most about work?

Perinatal nursing has become so specialized. I love my field of care and my biggest thrill is sharing my knowledge as both nurse and doula with the new graduate nurses on our unit. The best part about work is celebrating the birth of the newest human into the world and watching the faces of women as they embrace the child they’ve been waiting for. I am a total birth junkie and I have no qualms sharing that fact with the world. Being able to advocate for women and making them feel heard is empowering for them as my patient, but for me too, as their caregiver.

If you are a parent, how was your birth and postpartum?

I loved my birth experience. I took Lamaze classes in 1986 and was able to have an unmedicated birth for both my daughter, Angela, in 1986 and my daughter, Karissa, in 1988. There are no words to describe the moment each of my beautiful daughters were placed into my arms. As a nurse, “that moment” is one I so desperately attempt to capture and hold. We discuss “that moment” in my childbirth classes, I try to help women recognize the enormity of the miracle that they birth. It’s what I live for…

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As far as my postpartum experience went, no one told me how difficult it could be. Being a young mother still in college, I had to use every resource I could. I was a WIC mom. I was a Community Healthcare Clinic mom. I was that young mother who wanted to keep her babies. It wasn’t easy, but it colored my life and helped me recognize how vital maternity care and childbirth education is for women and their partners.

What resources would you want parents to have?

In my perfect world, every parent would have access to healthcare, Childbirth classes, Newborn care classes, Doulas, Midwives, Obstetricians, Pediatricians, Maternal-Fetal Medicine Specialists, Lactation Consultants, Breastfeeding support groups, Parenting classes,Counselors, and community support groups during the prenatal period as well as during the postpartum period. All the resources that they need for the best birth outcome and the resources they need to give that baby a great start to their future.

What is one unique thing about your business that your customers/clients love?

I provide a balanced philosophy of childbirth and I can provide statistics to back my evidence. They don’t have to “Dr. Google” anything. I get a lot of positive feedback after their birth experience, that learning about the anatomy and physiology of birth helped them understand when interventions became necessary. The “I WANT A NATURAL CHILDBIRTH” women thrill me when I feel like I gave them tools necessary for achieving that goal. I so love those “Ah-HA!” looks of wonder when comprehension dawns in their eyes.

What's one thing you think the world needs to do to improve the lives of new parents (or people living in our service area)?

Our women here in the DC area have some of the highest rates for maternal morbidity and mortality in the United States due to many factors. Women are coming into the hospitals with chronic diseases and co-morbidities that put them at higher risk. Many have limited support systems during pregnancy. We have women with families that are homeless, more women are going without prenatal care. We have a fragmented health care system where women receive inadequate prenatal care and show up at any hospital. It can take longer to get necessary records or we find that they have none. People are falling through the cracks. Recently, the closure of Providence Hospital and United Medical Center’s Labor and Delivery Units has significantly altered the care that all hospitals in-city have been able to provide. I’m not sure how our government can allow for hospitals to close maternity wards without recognizing the impact that it has on an entire community. Better health care. Period.

What do you think is the hardest part of expecting baby or becoming a parent?

I recently found out that I will be a grandmother in October! It’s giving me an entirely different perspective on pregnancy because of this little grandchild. I’m excited, but concerned. Our pregnant women are more anxious than I’ve ever seen in the past. I never understood why, until now.I’m beginning to realize what my daughter is faced with as she deals with issues like affordable childcare, risks for autism, and finding caregivers who are willing to be non-interventional. Big questions like, “What are my risks for cesarean?” become a reality. I don’t remember having to worry about anything other than “will I have to get an epidural?” Women want to be well-informed about every aspect of birth, sometimes it’s the very thing that causes them the most anxiety.

What products or services do you personally love?

Michele Peterson turned me on to “Earth Mama Organics’ Perineal Balm for Pregnancy and Postpartum” to “Take Care Down There.” Ursula Subinik’s Essential Oils are a treat every time I walk into a room she’s in. The girl exudes lavender and clary sage like it’s part of her being and her arnica oil has been nice to discover. Elizabeth Oldham and her entire birth support entourage have demonstrated the knowledge found through communication within a birth workers’ community. The doulas in our area are far wiser and supported than they ever have been because of these women. Can’t leave out Gail Tully’s “Spinning Babies”, she’s my “She-ro” on a daily basis.

How do you start each day?

With prayer. I ask God to help me through my day to give me the wisdom I need to care for each life I touch. I believe that my work is my ministry.

What's your favorite thing to do in DC?

I love walking from Arlington Cemetery across Memorial Bridge to the Tidal Basin. It inspires me to know that I’m in the heart of my Nation’s capital. Penny Simkin told me, “Lisa-Marie, you are in our Nation’s Capitol. You don’t have to take a flight to make your voice heard. You are there. Make a difference.” I hope I can make my world a better place one birth at a time. Hear my voice, “Let’s Birth Better!”

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DCH Celebrates Nurse's Week!

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DCH Celebrates Nurse's Week!

Doulas of Capitol Hill loves working alongside nurses! Not only are they there to make sure you and your baby are safe, they are an integral part of your birth team both for physical and mental support. In celebration of Nurse's Week, today we feature Karene Hansen, BSN, RN, labor and delivery nurse at Inova Fairfax Hospital.

1. What led you to this career?

It was a long and winding path, but in a nutshell, about 5 years ago I found myself in a bit of a life rut (and by that I mean quite a heavy depression) and had to really dig deep to figure out what I cared about enough to really live passionately for. In a very rare moment of epiphany it occurred to me that I might enjoy being a midwife...at a time when I knew very little about what that actually entailed. I started researching, reading books, and the more I learned, the more I realized this is my thing! I considered both the CPM and CNM pathways to midwifery, and decided that CNM was best suited to my skills and ambitions. The next thing I knew I was signing up for a doula training course, and putting together a plan to apply for nursing school. Midwifery is still on the horizon, but for now I am really enjoying the stepping stone that is L&D nursing, and also enjoy doula-ing on the side.

2. What do you enjoy most about work?

That's a tough one. It would have to be a tie between the relationships I develop with my clients/patients, and the constant and continuing opportunities to learn. The work of understanding and optimizing the experience of pregnancy and childbirth feels like a deep, fascinating well of information, skill, and wisdom that you can never hope to entirely master. To me that is actually quite a wonderful thing...it captivates my curiosity and is endlessly intriguing.

3. If you are a parent, how was your birth and postpartum?

I am a parent of four, and my births have all been relatively quick and uncomplicated. Especially my fourth, which thankfully was a planned home birth because my labor lasted about 30 minutes and my husband caught my son 10 minutes before the midwives arrived! Postpartum was a completely different story, however. I had low-to-medium grade postpartum anxiety/depression after my first two babies which went undiagnosed, but then with my third it hit hard and fast and I was very fortunate that my obstetrician was quick to see what was happening and guide me to needed help. I also had a lot of struggles breastfeeding with those first three babies, had borderline low milk supply, and in general really struggled with the newborn phase. My process of deciding to become a nurse-to-midwife began between my third and fourth babies, during which time I also started birth work as a doula, and I learned so much which really turned around the whole situation with my fourth child. I had no postpartum depression, breastfeeding was so much easier, no milk supply issues...I attribute so much of it to an education gap and I plan to make education a major focus of my career.

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4. What resources would you want parents to have?

Regarding childbirth, I would love to see pregnancy and childbirth education become a staple of our formal education system. High quality information on how to prepare for pregnancy and childbirth should be something we encounter long before the pregnancy and related decision making begins. So many of the difficulties I see parents encounter are issues that they didn't even see coming until they were hit with them in moments of duress. I would also love to see parents have more access to community during pregnancy and postpartum. Isolation and loneliness are a huge factor in postpartum mood disorders, and I think it would be amazing if we could figure out new and better ways to connect with each other in meaningful, supportive ways during that time. 

5. What's one thing you think the world needs to do to improve the lives of new parents?

As a bare minimum, I'd love to see longer mandated maternity leave for employed parents. In that same vein, I think we need to adjust our expectations for what the postpartum period should look like. New parents feel a lot of pressure to bounce back and continue with life as usual as soon as possible, and that's just not realistic. Once a person becomes a parent, life never really is the same again, and we as a society could do a much better job of supporting each other both physically and mentally/emotionally with that transition. I'd love to see much more transparency/honesty about the whole process, which really would allow us to be more prepared and more supportive of families as they evolve.

6. What do you think is the hardest part of expecting a baby or becoming a parent?

In so many cases, difficulty arises around unmet expectations. It is absolutely true that pregnancy can be glorious and there is nothing so incredible as bringing new life into the world. But we are also quite reluctant as a society/culture to be honest about the difficulties, and if your experience isn't all sunshine and flowers, the discrepancy itself can be really difficult. For example, I talk to so many women who were blindsided when morning sickness lasts all day long, or have never heard of antepartum depression so suffered in silence and sometimes from shame. We hear about babies not sleeping through the night, but so often don't hear it framed as physiologically normal, so we resist it and suffer for it instead of adapting to it as best we can. I believe if we had better education and more realistic, well grounded expectations we could really improve the overall experience of pregnancy and parenting.

7. What products or services do you particularly love?

I discovered baby wearing with my third baby and it rocked my world in the best possible way. I love all the baby wraps, slings, and carriers out there. As far as services, I think every family on the planet should have access to birth and postpartum doula support. Absolutely life changing.

8. How do you start each day?

With coffee! And a mad dash to get my kids off to school. ;)

9. What's your favorite thing to do in DC?

Without a doubt, the cherry blossoms! My life is not complete if I don't get to the Tidal Basin during peak bloom every Spring.

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What Do Doctors, Nurses, and Doulas Choose For Their Own Birth?

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What Do Doctors, Nurses, and Doulas Choose For Their Own Birth?

Written by Emily Smith

When people hear I’m a doula they may imagine it has something to do with home birth.  However, the majority of my doula clients are like the majority of the US population who deliver in the hospital with either a midwife or an OBGYN.  They may plan for an unmedicated birth or they may choose an epidural or some other pain medicine. Others may have a planned or an unplanned cesarean birth.  I think it’s important to say a doula who cares about non-judgmental support can and will support all their clients’ choices. Period.

But today’s story is not about my doula clients.  It’s about my personal experiences with birth. Because before I was a doula, I became a mother.

I have three children, a daughter and two sons, in that order.  I like to share that all three were born in different states. We aren’t military, but we’ve moved a lot.  

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During my first pregnancy I started looking for a doctor early on and called several OBGYNs but was soon frustrated that each of them wanted to start running tests.  After a few calls I contacted the Birth Cottage, an accredited free-standing birth center in Tallahassee. They had an open house so families could come and ask questions. After hearing about their training and expertise in treating healthy, low risk women and their close monitoring for even the slightest shift out of that category, we both felt confident.

During my first pregnancy I considered the possibility of delivering at our house rather than the birth center, knowing the safety and tools for treatment would be the same in both places.  But there was something psychologically reassuring to me, and also ironically foreshadowing, about needing to get in the car and drive to the birth center when I was in labor. It’s important that every person feel safe during labor because the hormones which regulate the contractions work best when people feel happy, safe, and unafraid.

The birth experience was not without challenges.  I did have doubts about my ability to go on without pain medication.  However, I told myself that the 7-minute drive to the hospital for an epidural would be worse than sticking it out.  I also had AMAZING support from my husband and my two best friends. One of them is a doula today.  During that moment of doubt, there was something powerful about locking eyes with another woman.  I take that moment with me into each of my doula clients births, ready to lock eyes if they need that.

Three months after my daughter was born I saw a screening of the film The Business of Being Born, a documentary by Ricki Lake about the maternity care system in America.

Three months after that we were living in Pennsylvania and I took my first doula training through Doulas of North America (DONA) International.

And then we moved again. This time to northern Virginia.  

When my baby was 14 months old I got pregnant with my second baby.  This time we didn’t have insurance, and didn’t qualify for Medicaid, so we knew we’d be paying out-of-pocket.  My calling around list came down to cost.

Today, the average hospital birth in the US costs between $10-30K. Just some perspective, Kate Middleton’s recent luxury birth costs less than a typical hospital birth in America.   In 2009 we were going to pay $3500 for all of our prenatal care, the birth, and 6 weeks of postpartum follow-up care with our Certified Professional Midwife.     

I asked my husband about his feelings of homebirth and he agreed quickly, saying we’d already had a low risk birth once, why not have the advantage of not going anywhere?  Comedian Jim Gaffigan said, “people always assume there is some laziness involved. ‘You didn’t want to go to the hospital?’ It was far. I didn’t feel like putting on pants.”  People are right. Jim, was right.

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We were glad to have chosen a planned home birth for our second baby because he made his appearance in just 2.5 hours, most of which I spent in denial that things were going so quickly.  Our second baby was coming out just as the midwife, Nicole Jolly CPM, walked in the room to catch his head and body. There is a good chance that he’d have been born on the side of the road with no doctor or midwife if I had planned a hospital birth.  Instead, I got to crawl into my own bed and rest immediately after!

Fast forward three and a half years.  We were surprised with our third baby. It was time for a big change. At 20 weeks pregnant we packed everything and drove from Alexandria to Colorado Springs. I interviewed midwives and chose Jessica Nipp CPM, of Holistic Homebirth.

My husband was having some pretty serious talk about a vasectomy after this baby, so this was my last shot to do all the things I’d learned about since becoming a doula.  Hypnosis for comfort? Check. (also, no insomnia!) Birth photographer? Check. Even better that she was family! Midwife who lived 10 minutes away and wouldn’t have to fight DC rush hour?  Check. And, this time there was a birth tub and it was glorious! The same way some women describe the relief of getting an epidural? That was me as my body sank into the water, my aqua-dural.  

So, here I am, 10 years into being a doula.  My own three out-of-hospital birth experiences, but also a ton of humility to know that every birth is unique, not better or worse.

They say you will fear what you don’t understand.  For me, learning about my options helped me to have more of them, and that knowledge led to less fear of the whole process.  

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Even though the majority of Doulas of Capitol Hill clients will give birth in the hospital, I’m proud that we can support and co-sponsor this public screening of Why Not Home with Heartsong Midwifery. The film’s director and producer, Jessicca Moore, describes herself as “not a particularly radical person,” but was moved to choose homebirth “for its simplicity and its power.”  Her intention for this film is to “challenge our cultural assumptions about what birth is and what it can be.”

I wonder if this film will be to someone what The Business of Being Born was to me?  I love my #doulalife.  

Dr Jessica Taylor Goldstein, OBGYN says, “the documentary shows inspiring stories of how medical professionals can collaborate to make birth better, and how women can be empowered in the process. Medical professionals and women need to see this film because it demonstrates what some of us already know, low risk birth should be considered simple and normal.”

Come see this film!  Or if you can’t come see it, consider donating to the fundraiser, as proceeds will go to a college fund for the children of Camilla Yrure CPM, a friend and colleague who passed in 2017.  Tickets and donations can be found on the Eventbrite link.  

-Love, Emily

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How To Swaddle My Baby Like A Pro

Swaddling is well known to help babies feel calm and more secure, as it is mimicking the pressure and snugness of the womb. According to www.HealthyChildren.org "The American Academy of Pediatrics (AAP) says that when done correctly, swaddling can be an effective technique to help calm infants and promote sleep." To learn how to become a Swaddle Master check out our video below! 

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A VBAC Story: Elisa, Tim and Elora

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A VBAC Story: Elisa, Tim and Elora

 Baby Orion, Born Via Cesarean Birth

Baby Orion, Born Via Cesarean Birth

Since my son Orion was born early (36w3d) by emergency c section, I felt that I was pregnant on borrowed time in my last few weeks. I anxiously awaited the arrival of Baby #2 feeling confident I could rock this vbac. My mantra was my body was made for this! I focused on the moment when the baby would be placed on my chest and imagined how amazing that would feel!

The day baby arrived, I was 38w4d along. I think I was already stirring or in a light sleep when I felt a warm trickle and my water broke in bed around 3am. I immediately knew what it was and heart pounding, I pushed my husband Tim awake saying "I think my water just broke." Thankfully it was not a huge gush so I was able to contain it until I got on the toilet. We called our doula Emily Smith and even though I was excited (mostly) I was also a little bit scared. I told myself “It's baby time! You can do this!”

Tim called his mom Sandie to come stay with our son Orion (2y3m old). It was funny to hear the one sided conversation they had as Tim only said "yes" and within two minutes she was at our house!
Grandma was ready!

The time on my phone was 3:20am when I grabbed it to go downstairs. I snuck into Orion's room and have him a kiss goodbye, making sure to whisper "I love you" to my first sweet baby one last time before I became a mother of two!

Once downstairs we called the doctor's office and Dr Bright told us yes we should go to the hospital. We let Emily know we were on the way and to come meet us there. I grabbed a banana and headed to the car, running down the final checklist with Tim - although we had been packed for weeks!

On the way to the hospital I started to have some contractions, but they were not long or intense. It felt more like period cramps that came and went. We arrived at the Inova Birthing Inn and got checked in. I changed into a hospital gown and was hooked up to the fetal monitor. It was weird to have tight bands on my belly, but I was comforted to see the baby's heartbeat and it was cool to see the waves of my contractions printing out on paper.

Contractions began to come more regularly. I was able to breathe through them, in and out my nose, and close my eyes to picture myself sitting peacefully on a beautiful beach.

While we waited for Dr. Bright, the midwife on call came in and we were happy to be in her care. She checked my dilation and I was 3cm and 80% effaced! It wasn't as much as I was expecting, but you have to start somewhere.

At one point, I was breathing through a contraction and the nurse asked me if I was having one. I said yes, but it's not bad. She told me she could see it lasted about 60 seconds, but I was probably feeling the peak, lasting about 20-30 seconds.

Finally around 4am, we were asked to move into the delivery room where we had much more space. I also remembered the room from my brief labor with Orion and I think that made me a little uneasy at first knowing anything can happen here. That feeling faded when my doula arrived! I felt so relieved she made it and we wouldn't be alone.

I had to get antibiotics right away in my iv, so they hooked me up to a pole with the hanging iv bag. The antibiotics burned in my arm so I was very happy when they were done. I took the pole on wheels and got up. I wanted to get up to walk and move through my contractions. Emily turned down the lights, put on clary sage in my diffuser to move things along, and Tim put on music for us. It was time to get this labor started!

The atmosphere was calm as we worked through the light early labor contractions. I kept up with my nose breathing, chatting in between, and going to the beach in my head. I swayed my hips, using gravity to hopefully make some progress. We laughed about the fact that I was "pole dancing my baby out" and we shared our boy/girl names. We didn't know the sex of the baby and I was so excited for the surprise!

At some point I started to get tired of walking. When you are in labor you lose all sense of time, so I don't remember how long I was walking. I went to sit on a rocking chair. It felt good to sway and rock while breathing through my contractions. I kept picturing my beach and beautiful clouds.

The contractions started to come longer and stronger. I had to start breathing out and keeping my voice low. Moaning "oooooh" and picturing a flower opening. I also would say "oooooh open, oooh-pen" I concentrated on handling each contraction as it came and trying to truly release each one. Emily encouraged horse lips - flapping my lips with an out breath - to let it go, so I'm sure I sounded funny but I didn't care!

Tim was encouraging, a strong hand to squeeze through each contraction. He was rubbing my back and arm. Whenever he had to step away, Emily was there to hold my hand instead. I felt very supported and did my best to block out all other noises/distractions from the hospital environment around me.

I started to feel nauseous, so someone  got my trash can for me. It was the same one I was attached to when I was in labor with Orion. The perfect height and strength for leaning over, this time on all fours. Emily grabbed the peppermint oil for me to smell and that held off the nausea at first. Then as you do in labor, your body wants to be empty and you have to go to the bathroom. Tim helped me to the toilet and I stripped off my gown. I remember grabbing the gown just saying "off" and off it went.

I labored on the toilet for awhile. Emily placed a strand of white Xmas lights in the bathroom so we could keep the lights low.  

When the contractions started to get intense, it felt best to be on all fours hovering over my trash can as I felt I was going to get sick. I started to throw up and as much as that sucked it also felt better. Someone wiped my mouth with a warm washcloth and kept offering me sips of coconut water which I only sometimes accepted.

My lower stomach was getting so tight with each contraction and I felt that it could not rest. The cat/cow back stretch and trying to breathe deep helped. Tim and Emily were both by my side keeping my voice low, encouraging my moaning and breathing and helping me to let each contraction go. At some point I started to shiver and shake. We put a towel down under me and I think someone covered my back with a towel or a sheet to warm me up. I think the shaking was from adrenaline though and not from being cold.

At this point my nurse came to tell us baby's heartbeat wasn't doing what they wanted so we needed to try a few things. I had to first switch positions and then we can try fluids and then oxygen to help baby out. I started to get freaked out. I know a baby in distress is a reason for a c section and I kept thinking what if all this labor is for nothing? I tried to stay calm and just focus on my contractions. I also didn't have much of a choice. I must have been in active labor because each contraction demanded my attention and I found myself focusing all my efforts inward to relieve the tightness and get through it!

At some other point, Dr. Bright checked in and recommended that I get an epidural. She said because I was a vbac, it would be a good idea to have it placed even if I did not want the medicine yet. I declined and asked if I could think about it. In my head I wanted to get to 8cm (this is how far I got on my own with Orion before the c section) before I got an epidural and I felt things were progressing quickly. A few more intense contractions though and I started to lose my resolve! There was just no resting, the contractions were coming so fast!

We had to move to the bed for baby's heart rate. I tried to stay in another position knelt up leaning over the back of the bed, but I found myself pushing back to all fours when my contractions came. The contractions were coming closer together - longer & stronger. I started to get this scared panic feeling. I wasn't sure I could keep coping! I wanted the contractions to stop! I started to ask for my epidural. The bottom of my stomach was so sore and tight! I felt like I couldn't get away from the pain, couldn't rest, wasn't really able to let them go!

Dr Bright checked my progress. I flipped on my back and she guesstimated that I was 6cm dilated. This number was deflating. I started to lose hope and drive! I started to feel overwhelmed thinking I wasn't to 8cm yet! I think at this point I was angry with contractions. I kept moaning but louder, as low as I could, and started saying "come on baby" in between my very deep breaths!

We had to wait what felt like forever for the anesthesiologist! Just before he arrived, I started to throw up again. There was nothing left to come out. Emily told us every time you throw up your body can dilate 1/2 to 1 more cm. It did feel good as when you are throwing up for that moment the belly pain was gone.

I was getting a little miserable. But somewhere in there I had a peaceful moment of rest. Leaning back in childs pose I stretched and relaxed my belly. Someone was rubbing my back and I was able to place my head down on the pillow for a moment. That was the best!

The anesthesiologist finally arrived and I had to change positions to get prepped. I remembered getting the spinal for my c section was the scariest part last time. I was in very active labor now with contractions coming so close together I couldn't compose myself. The doctors/nurses said I had to keep very still and they had to work on me even through my contractions, but it would be good to distract me from the pain of placing the epidural. I was terrified and started to panic and scream. Emily and Tim kept me breathing, but also made me focus. "Lock eyes with Tim, Lock eyes with Tim. You can do this" I had Tim's hand and his eyes doing my best to focus on him and breathe!

The position I had to be in for my epidural was hard to maintain. I was really uncomfortable to say the least! They needed me sitting on the edge of the bed, hunched forward with my feet up on a chair in front of me. They started to wipe down my back and place a plastic piece on it when all of a sudden - a large contraction came and I felt an incredible pressure downward! So much pressure I started to scream and I was begging to get down.

I lost sight of Tim in this moment and grabbed on to my new nurse Eric who happened to be standing directly in front of me, probably to help keep me still during the epidural. I had a death grip on his two arms although my focus/gaze was everywhere else. I was screaming these high pitched panic sounds!

Emily roped me back in saying "Breathe out, blow out the birthday candle, blow out the birthday candle as hard as you can, like you never have before" I blew out the biggest breath I could and kept doing that over and over again. She told me "It's OK, you are ok, that's your baby! That's your baby, this is what you wanted!" I remember thinking why did I want this? But I knew she was right. I did want this!

There was no time to place the epidural, our baby was coming! It was time to push!

Things got chaotic at this point. All of a sudden lots more people were in the room and things were happening around me. The midwife was back. I tried to get away - I wanted out of there. I tried to go back to all fours facing the foot of the bed, but then ended up laying on my back with legs up in stirrups. Emily and Tim were on either side of me at the head of the bed.

The contractions kept building and I had to switch gears from breathing out to bearing down and pushing. This switch took a few contractions to get the hang of. There was so much pressure, stretching and pain! I kept screaming, moaning, grunting, pushing and groaning. Emily and Tim encouraged me to hold my breath directing all my energy down to my belly and push! There were lots of cheerleading nurses around too. Someone was counting for me and directing the pushing.

Another nurse held up a mirror for me to see. I was shocked and then frustrated to see when I would push baby's head would crown, but in between contractions and pushing it would go back in! How will I ever get this baby out?!?

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Since I was prepped for the epidural and I thought I had felt a pinch of the needle, I really thought there was pain medicine on the way! I kept thinking it's OK, any minute now the meds will kick in! I only found out afterwards that I never got any meds!

I was instructed to let the contractions build and to push with them. I could only breathe out fast panting breaths in between. At some point there was an oxygen mask on my face in between pushing. I think it was Emily who instructed me to place my hands behind my legs to give myself some leverage to push. I didn't want to let go of my supportive hands to hold, but it was good to have a strong grip on my own legs!

Each push moved baby into a new position further into the birth canal and closer to being born. Emily later told me I only pushed for about 20 minutes!

When baby's head was crowning, I felt incredible pain and burning as I tore. At one point I got frustrated and yelled "pull it out!" I decided contractions be damned, I will push now! But that didn't help. I had to wait just a moment more to let it build. The hardest part was the largest part of the baby's head. I had to wait and breathe but there was so much pressure.

I remember asking “hair?” because this baby's full head of hair was visible in the sonograms! We had previously joked that I would push harder when someone tells me they can see baby's hair! One more big push and pop baby's head was out! There was a gush of fluid helping them along. This was a relief!

I felt twisting and more pressure as I pushed out each shoulder and then gush - the rest of baby slipped right out! I screamed "My baby! My baby!" The midwife placed the warm baby on my belly and it was amazing! I still had lots of pain and burning, but I did it! I had given birth to my baby!!!

It was 7:26am, only 4.5 hours since my water broke! This had been a fast labor! I was surprised baby didn't cry much at all when they came out, but instead was just alert.

At first we had no idea if baby was a boy or a girl. We were just so thrilled baby was here! The nurses were wiping baby off and Emily said “they don't know!” Someone opened baby's legs and we were so surprised to find out we had a baby GIRL! We were both shocked and I think Tim was the one who shouted out “It's a girl!” It was such a happy wonderful moment! She was absolutely worth the wait!

Elora Lynn was 6lbs 6.7oz, 20in long. She had an Apgar score of 9! She was perfect healthy and so beautiful! We did it!

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Let's Tell Your Story- 'The Car Ride Was Epic'

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Let's Tell Your Story- 'The Car Ride Was Epic'

In honor of World Doula Week, Client Sarah L was willing to share her birth story, featuring some of the many ways a doula can be helpful in labor, birth and postpartum. 

When we found out we were pregnant it was a little bit of a shock, we were hoping to get pregnant, not preventing but it happened sooner than we expected.   I had always thought that I would want midwifery care during pregnancy and maybe choose to give birth in a birth center, I had been born in one, but in the whirlwind of this news we initiated care with the OB I had been seeing since I was fresh out of college with the plan to deliver at the hospital where she worked.  Despite this choice I knew that I still wanted to try for as non medicalized a birth as possible in that environment. As a nurse, I knew what a hospital delivery could mean in terms of unwanted and unneeded interventions and I was apprehensive about accomplishing a low intervention birth.

My husband and I had countless conversations about how we would work toward an intervention free birth in the hospital.  I was pushing for doula support. I had attended births as a nursing student with doula support and had several friends who were midwives who really encouraged a doula.  My husband took a lot of convincing. He thought we was all the support I needed, he said that I was, “formidable” and would not only be able to handle the work of labor but also handle the staff at the hospital.  I wasn’t as confident. Although I had studied birth in school, the fear of the unknown of how labor would actually go for me continued to make me apprehensive about a hospital birth without the support of another woman trained to aid others during this time.  After several lengthy discussions my husband agreed to meet with the doulas. My husband had been concerned that if we hired a doula his role as coach and birth partner would be undermined, after meeting with the DCH doulas he was ensured of his role and was impressed by the breadth of knowledge of each of the doulas.  

Our doula, Emily, was a great support during the last weeks of pregnancy.  She helped us to form our birth preferences, gave us lots of resources and was always a call, email or text away when I had questions.  I felt my first early feelings of labor in the middle of the night, thinking they could just be more Braxton Hicks, which I had felt my entire 3rd trimester I went back to sleep.  Something in me, however thought, 3-15-17, that would be a great birthday.  When I woke up that morning and was still feeling the same sensations now and again I texted Emily to let her know what was going on.  I told her we had planned a walk and she encouraged that along with a good breakfast. When I had to stop several times on the walk to get through what I was now realizing were contractions and when that good breakfast didn’t stay in me for long, I gave Emily a call to let her know what was going on.  I had thought that I would need/want her support for much of labor, but when it came to it I was okay with the physical work of labor, but I needed her there to be my sign posts, help me to determine where I was in labor and help to interpret what was happening. She worked with me over several phone calls and texts to time my contractions and help me get into a good breathing pattern.  

New mom snuggling baby

I found a groove in labor sitting backwards on the toilet in the bathroom attached to my daughter’s future nursery.  I wanted to be alone, I was completely inside of myself and didn’t even want my husband there. I had my cell phone on the back of the toilet, checking in with Emily and my mom.  My husband would come in from time to time to bring me water and check on me, but I would promptly send him away. At some point I felt cold and began to shiver, thinking I was just chilly I asked my husband to draw me a bath.  I forgot to share this small detail with Emily (had I she would likely have told me I was in transition and to get to the hospital ASAP!). On the way to the bath my water broke. I called Emily and let her known that and that I was feeling a lot of pressure, she very calmly told me to call my doctor, she wanted the “go to the hospital” call to come from them.  I was so worried about getting to the hospital too early, so having her support put me at ease. She gave me some great breathing techniques to help relieve the pressure and get me through the car ride across DC and said she would meet us at the hospital.

The car ride was epic.  I was feeling so much pressure it was difficult for me to sit down.  As we pulled up to the turn before the hospital I told my husband that I felt like I had to push.  It was something out of a movie. In my head, as crazy as this sounds, I was still worried we could get up to L&D and they would tell me I was like 6 centimeters.  Thankfully, the term “rectal pressure” got the attention of the staff pretty quickly. They brought me right back to a room, checked me and let me know I was ready to push!  My baby was coming fast, the staff asked if I wanted to wait for my doula, but baby girl was not waiting on anyone. Two pushes and she was out, moments later Emily walked through the door.  After the placenta was delivered I was still bleeding. All of the interventions I had avoided in birth started to pile on, there were injections, IVs, manual removal of clots, it was much worse than labor!  While my husband was busy admiring his new daughter, I was so thankful to have Emily there holding my hand and support me through the management of the bleeding, taking a few treasured photos, and helping me to initiate breastfeeding.  

Although she wasn’t physically with me for my labor and birth, the support that Emily provided me throughout my labor and immediately postpartum was invaluable.  As she said when she arrived I, “reached my goal of laboring at home and having my baby in the hospital!”

 

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