Nannies and Baby Nurses and Postpartum Doulas, Oh My!

So many families these days are realizing that when a new baby comes along an extra set of hands may become necessary.  And many women now a days do not have immediate family members close by or even in the same country to help out when baby arrives.  So these smart families are turning to outside help.  

The options available to new families is vast.  From Nannies, to Baby Nurses, to Postpartum Doulas and more.  But what is the right choice for you? 

First you have to decide what it is you are looking for? Do you want someone to look after your baby for you?  Do you need someone to look after an older sibling while you look after baby and recover?  Do you need someone to help with baby and you and assist with breastfeeding? Are you worried about postpartum mood disorders? Do you need something completely different? 

Let's look at a few of your options?

Nannies are generally used to look after older babies and children and follow the instructions given by the parent. They often live in with the family and don't usually assist with housework or laundry or caring for the postpartum mum.  They are not trained in breastfeeding support or in recognizing postpartum mood disorders.  They often work with families for many years. 

Baby Nurses are usually hired to care solely for the baby.  They too are not hired to assist mum with her postpartum recovery, take on housework or do laundry.  As with Nannies, Baby Nurses are not trained to assist with breastfeeding, though if they have had babies of their own, they may have a basic knowledge.  And as their primary function is to care for baby, they are also not trained to recognize postpartum mood disorders or look after older children.  Baby Nurses also must be trained nurses if they are using that title.  

Postpartum Doulas are trained to work with families in the first few days, first few weeks, first few months after baby comes home.  They are hired to support a new mum and her family while she recovers from her birth.  Their main priority is the mum.  Helping her with breastfeeding support, making sure she is eating, letting her rest while the doula watches the baby, listening to her process her birth experience and recognizing if mum is experiencing any postpartum mood disorder symptoms.

Postpartum Doulas will also help with educating the new family on all things infant.  How to bath and diaper a baby, tips for helping to soothe a crying baby, baby wearing, showing families real life hacks on how to cope with a new baby in the house.  Postpartum Doulas educate and support with the latest, up to date, evidenced based information and not just anecdotal suggestions.  

Postpartum Doulas will help with light duties around the house including mum and baby's laundry, cleaning the kitchen, preparing meals and anything else that might alleviate any stress from mum so she can concentrate on her recovery.  They can also help when there are older children in the house, keeping them entertained and happy to ease the pressure off of mum or watching baby while toddler has some mummy time, so they don't feel left out.  

Postpartum Doulas are also trained in supporting a family that may have been blessed with more than one precious bundle.  When babies come in multiples doulas can be that extra set of hands either during the day or over night when having more than one newborn can be overwhelming.  

Postpartum Doulas also support the rest of the family, including partner and grandparents, by modeling helpful support of the new mum and baby, answering questions, offering resources and educating everyone to help bridge the gap between old traditions and modern practices.  

We as a society were never designed to raise our offspring alone.  Like our ancestors so many generations ago, we are supposed to have our babies and raise them in a community, surrounded by our women, our mothers, sisters, aunties and grandmothers.  Being supported while we recover and learning from these experienced women on how to care for our babies.  Today, however, we are disconnected from our families either by distance or fractured family dynamics.  Yet we still need the support to make mums recovery quick and easy and to learn the many things associated with having a baby.  Mum still needs to have the tools to feel confident in her role as mother and nurturer and she can't get that from a book or the internet.  New mothers need mothering.  Postpartum Doulas are a great option for women and families that want more from their postpartum experience.  

So if you are having a baby, think about what you need, what you want. And consider hiring a doula for you and your newly expanding family. 

I Want To Become A Doula!

When I gave birth to my third child almost 10 years ago I did so with only the support of my partner. We didn't think we needed anyone else with us.  We'd done this before.  Twice.  My partner was great, but the birth was a bit of a farce.  I was induced in the morning and by the afternoon things were progressing quickly.  I did not have an epidural as I had the first two times and my partner needed to stay with me the whole time.  He could not leave my side.  I needed him.  But as a result he was not able to eat, drink, or go to the bathroom.  When it came time to push the deprivation he had endured for eight hours took its toll and he fainted.  The staff were more concerned about him than me and my perfect birth was out the window.  After the birth I experienced lots of Breastfeeding issues that ended with my daughter back in the hospital.  I later suffered from postpartum depression that ultimately took over my life.  If we had support during the birth or the postpartum period I do believe things could have ended differently.

I became intrigued with the aspect of support during birth and the postpartum period and did some research.  By fluke I came across the profession of "Doula".  But how did one become a doula? How did you make this a profession?  I'm often asked this now as a doula trainer so I thought it would be a good idea to lay it out here for everyone to see the steps involved.  

When I first began my research there were really only two organizations that were available to choose from, especially for a Canadian.  I looked at both and sought some advice of other doulas I had met on line in doula chat rooms, remember this was before FaceBook.  One doula in particular suggested I look at each organization's Vision Statement, Position Paper and their Approach to Birth. When I did I found I was drawn to the Vision that CAPPA had toward birth and their doulas. So now I had a path. 

I started with the labour doula workshop.  It was two days and explored a doulas scope of practice, the stages and phases of birth, comfort measures, how to support women and their partners during labour, how to handle unexpected outcomes, how to support a cesarean section or a VBAC, pain medications and the doulas role, supporting Breastfeeding and offering resources to pregnant women and new mums, the business side of your job and finding clients and oh so much more.  It was amazing! 

I walked out of that workshop as a doula in training.  I could now work with women and support them in their births.  During the early years of my doula life I continued to run my Home Daycare.  The families I served were very forgiving if I needed to have my husband watch the kids or my Mum or had to call in sick one day every now and then.  I also spent a number of years working at Shopper's Drug Mart and had a younger teenage cashier agree to take a shift on a moments notice if I had to go to a birth.  I also found like minded doulas who I got along really well with and we worked as back ups for each other.  I was nervous giving up guaranteed income for the risk of being self employed, so in the beginning I took just one a month, and worked slowly to gain experience and immerse myself in the birthing community.  One day I realized I was becoming popular, in demand and I had to make a decision to either do this "doula thing" or quit.  By that time I was also a Childbirth Educator and Postpartum Doula.  So while my income was not Millionaire worthy it was comfortable enough to take away my safety net.  And I'm so glad I did.

During those early years I was also working on the steps to become certified.  Being certified was important to me because I believe if you are going to do anything, you do it right and you do it fully. These days being certified is becoming more important as our profession becomes more popular and clients are now requesting certification.  And, as we creep ever more closely toward regulation, certification will definitely become a requirement.  

The steps to labour doula certification are many but not difficult.  And CAPPA allows 2 years for you to work on these steps.  I also used an extension which was easily granted as CAPPA understands that life happens and family comes first.  

Steps to Certification- Your Road Map To Becoming Certified:

(For the sake of this piece I will discuss the current steps to certification as things have changed slightly in recent years. You should always check the CAPPA website for the most up-to-date list of steps)

The order in which you do these steps is not important except for signing up for CAPPA Academy.  CAPPA is unique in that it has an online certification process.  All your documents, forms, exam and steps are found in CAPPA Academy.  

Once you have signed up then you would be free to tackle the steps as you see fit.  Those steps include: 

- Become a member of CAPPA.  As a member and a trained doula you will appear in CAPPA's referral section so expectant and new parents can find you.  You do not have to be certified before you appear on the website. 

- Complete the preworkshop study that you would get when you register for a workshop.

- Read the manual that you will get and go over extensively in the workshop.

- Read 5 books from the reading list.  You'll probably read more than that as you find books that peak your interest and expand your knowledge. 

- Complete part one of the HUG Your Baby Training program.  This program gives professionals strategies and tools to help prevent or solve problems around newborn sleep, eating, playing and attachment.  Professionals will be able to boost parent confidence, enhance Breastfeeding and promote bonding. 

- Create a resource list that you can use to make referrals to new mums and expectant parents.  That list would include lactation consultants, support groups, midwives and more. 

- Attend a Childbirth Education Class.  

- Attend a Breastfeeding Class

- Pass the multiple choice and essay exam found on CAPPA Academy.  This is an open book exam so no need to worry. 

- Attend three births and have them evaluated by the labouring mum, her primary care provider (Doctor or Midwife) and her secondary care provider (nurse or secondary midwife) for a total of nine evaluations. 

- Sign and agree to CAPPA's Code of Conduct and Social Media Policy, Grievance Policy, Missions Statement, CAPPA Approach / Philosophy Statement, Vision Statement and Scope of Practice. 

And that's it! Once you have completed these steps you gather everything together that needs to be sent in to the office, make copies and send those copies in.  Give the amazing office staff 6 weeks to mark your package and if all is in order you will receive your certification and be able to use the letters CLD next you your name. 

When I received my certification from CAPPA it was one of the proudest moments of my life.  I am so thrilled to be a member of and trainer for CAPPA.  This organization is a true sisterhood of support.  Their motto is "Love Wins!" And they truly mean that! 

So if being a doula is something you have thought of, or you have more questions about how to become a doula you can check out CAPPA's website at www.cappa.net or find workshops on my website at www.torontodoulagroup.com/becomeadoula.htm or you can email me at kim@torontodoulagroup.com. 

Being a doula and childbirth educator is the most rewarding job I've ever had and I can't thank CAPPA enough for being such an amazing, supportive and forward thinking organization.  

The Real Doulas of Toronto!!!

As a doula I've spent almost 10yrs meeting and working with amazing women in the birthing industry.  No two of us are alike, except perhaps for our passion for supporting mothers, babies and their families.  So I thought wouldn't it be great to highlight for the people of the Greater Toronto Area and beyond some of the utterly fabulous women I work with on a regular basis.

I've set it up like an interview with their responses below.  The first doula I'd like you to meet is Carrie Barr.  Not only is she an amazing mom but an incredible birth and postpartum doula.  She would definitely be on my team should I ever become pregnant again....which I'm totally not....ever....and I mean ever....Carrie is one of our Durham Doulas.  So if you are pregnant or a new mum in the Durham Region, you need look no further than Carrie!

So without further delay, here is Carrie Barr!!!

1.  What brought you to become a doula?

I was fascinated by people's birth stories and horrified at the number of people coming home thinking they had an "emergency" section for blah, blah, blah reasons and would never have a baby normally.

2.  How do you think postpartum and birth doulas benefit parents?
Birth doulas help empower a couple for the birth experience they want, doulas reduce interventions and increase chances of successful breastfeeding.

Postpartum doulas help integrate the new family member into the house, provide breastfeeding support, create a longer breastfeeding relationship, provide sleep support and help design a postpartum plan for the family.

3.  Besides Birth support, what other related services are you passionate about?

Placenta encapsulation, waterbirth and every woman having access to support.
4.  Would say it is still important to have a doula with Midwifery care?
Absolutely, while midwives are amazing support they do not have training in comfort measures like doulas do and they have tons of charting to do which occupies their time.  Doulas and midwives make an amazing birth team.
5.  If you attend births in hospitals which is your favourite and why?

My favourite is Port Perry because it's small, quiet, and the staff have time to be attentive, they LOVE having doulas, the birthing suites are on the main floor with it's own entrance and the rooms overlook a private garden so women have a beautiful private view while labouring.  And they can walk in the garden!! No need for the blinds to be closed and the sunshine shut out!

6.  One of the biggest concerns is that doulas will replace the partner, how do you ensure that this is not the case?

I always tell clients that I am there to support both of them and that I always offer to show the partner what the client needs so that he/she has the opportunity to be involved on whatever level they are comfortable with.

7.  What questions do you feel are important to ask a birth and or a postpartum doula?
Experience, references, bias's, back up

8.  If you could put together the perfect support service package what would you choose?
All my services! A tub rental for a homebirth in which I was the birth doula, who then encapsulated her placenta and do 6 weeks 5 nights a week of pp support

9.  How do you juggle family and doula work?
I try to focus on services that allow me to be at home like tub rentals and encapsulation, I do pp nights so I am here when my family is awake, limit births to 2 a month and try not to take any when I have pp booked.
10.  How do you answer the question "You're a Do-What?"I provide professional support to pregnant and labouring women and sleep and breastfeeding support to families at home after the baby has been born!

10 Reasons Not To Not Hire A Doula

I read a blog entry recently about doulas called “10 Reasons to not hire a doula”.  It was, according to the author, meant to be a parody.  As a doula I found none of it funny.  And actually was annoyed by its perpetuation of the doula stereotype.  So I decided to write a rebuttal.  I’ll try for humour as best I can and I hope to not anger anyone in the process of examining the “10 Reasons not to not hire a doula”.

Point one, Expense.  Yes Doulas are an out of pocket expense for most people.  And as the writer of the blog was American who probably has to pay medical expenses to have a baby I can see where this would be an issue.  In Canada we spend our money on the acres and acres of crap you don’t need when you have a baby.  Thousands of dollars in nursery furniture and décor in a room your child won’t even use for the first 6 months of their life, clothes from Old Navy and Baby Gap that your infant will enjoy spitting up on and pooping in.  Have you experienced the explosive poop? You better hope it isn’t in the $40 Gap onsie, cause no amount of Oxyclean will get that stain out.  And what about the $50 Nike baby running shoes? You squeeze them onto your baby’s potato shaped feet and if you’re lucky you won’t lose one in the mall, never to be seen again. 

Perhaps saving some of that money to spend on the day of your birth might be money better spent.  When you are 90 years old and you can’t remember what you had for breakfast that day, you will be able to recall your birth.  You probably won’t be giving birth 20 times like Michelle Duggar so why not make the experience as calm and stress free as possible.  Having a doula helps you be involved in the birth, have your questions answered and makes you feel a part of the birth and not that the birth just happened to you.  Also for the dads, we make you guys look like rock stars.  We show you how to help and let you be as involved as you want to be, at your own comfort level. 

And if the expense is still too much for you, many doulas work on a sliding scale or you could get a doula-in-training who may work for expenses or free. 

Point two, apparently all women just want to get the baby out as fast as possible. Funny, this is the precise reason to hire a doula.  Studies have shown that having a doula has been instrumental in shortening the length of labour and decreasing the severity of the discomfort felt.  I really don’t think I need to say more on this one. 

Point three, “A doula may try to talk you out of having drugs.” That is crazy.  I’ve had two epidurals and they are wonderful things.  I’ve also done it without drugs.  I would never talk a momma out of having an epidural unless her baby was sitting on her perineum.  This is not the doula’s birth.  Its the momma’s birth and if she wants drugs, no problem.  Hook her up.  If she doesn’t, I can get her to the end.  If she wants to try to go as long as possible without, I’m there.  Whatever momma wants, momma gets.

Point four, if the doula becomes a peppy cheerleader, the author will punch her.  Well so would I.  You hire a doula that fits with our personality.  If you are dragging and the end is overwhelming you we can be peppy if that’s your style, we can be strong and tough, we can be the shoulder to cry on, we can give you hints and tips to get you over that hump.  So I encourage you to interview several doulas to make sure you find the right doula for you, one that fits with your personality.

Point five, Doulas do not offer the doctor help.  We are not medical.  We assist in comfort measure suggestions, tidying the room, helping mum shift position, getting cold cloths and ice chips, supporting mum’s leg during pushing, watching dad so he doesn’t faint, but never suggestions on momma’s medical care.  That’s just crazy.  Doulas help parents make decisions by ensuring they have all the information and in order to do that we read lots of studies, on the internet.  But we help parents navigate the crap that can be found on the internet so what they know is evidence based and up-to-date.  Though I’ll admit, there is the odd doctor I’d love to see have a head explosion, that is out of my scope of practice.   And I’ll address the “hippie” comment in point nine.

Point six, I agree you shouldn’t have dozens of people in the labour room.  But the people you have shouldn’t be spectators either.  The people you invite to your birth should be helpful and encouraging and supportive of your choices.  That may not be your mother-in-law or you teenage sister.  Birth is not a spectators sport.  It’s an intimate experience that you will remember for the rest of your life.  So choose wisely.  And as for the oblivion mommas used to experience and get their babies three days later?  Well in my opinion, that’s what’s wrong with the world today.  We are a messed up society because we messed up birth for so many generations.  I’ll jump off my soap box here as I could go on a tangent.

Point seven, Breastfeeding. Yes we help with breastfeeding.  If you don’t want to breastfeed that’s your choice.  Doulas support choice.  Many mommas though want to breastfeed and it isn’t easy.  The most successful breastfeeding mommas are those that have support at home and can have their questions answered and latches checked.  But if you don’t want to breastfeed, doulas can help in giving advice on safe formula feeding. 

Point eight, lady bits? Really? I can’t even come up with a decent response to that one. 

Point nine, Crunchy granola hippie doulas.  Let’s see, I shave my legs and arm pits, wear make-up, dye my hair and get my nails done every two weeks.  I recycle and compost because my city requires me to, not because I want to and my car is far from eco-friendly.  As doulas go, I’m lumpy oatmeal at best.  I don’t say Yoni. I say Vagina, because that’s what it is.  I don’t chant or wear flowy skirts and beads.  I wear high heeled shoes not Birkenstocks.  I have never been a hippie and would never be accused of being one.  This point is the one that irritated me the most.  I don’t have a problem with my doula sisters who are crunchy, they are beautiful women.  But that’s not who I am. 

Point ten, the best point. Postpartum Doulas are awesome and very helpful in assisting new moms in the early days and weeks of motherhood.  They help with breastfeeding, making sure mom is getting rest, getting good food, having her house tidied and her questions answered, all without judgment of her choices.

Look, having a doula isn’t for everyone.  But having a stereotyped opinion of a doula and knocking them without really knowing who we are or what we do is just bad form.  So the next time you’re pregnant or the first time, look at what you want for your birth and the experience you will hold for a life time and consider the benefits of hiring a doula to ensure you get the birth you want, whatever it happens to look like. 

Did you know that in most hospitals you are allowed two support people? Presumably one will be your partner and the second can be...your friend, a family member, or a hired professional called a doula.  Having an extra set of hands to assist you and your partner can be very beneficial.  In the case of a doula, The assistance comes without judgement and with an expertise in modern birth and a knowledge of the workings of the hospital.

But what if you were told by your doctor that they didn't allow you to have a doula?  Do you think your doctor has the right to dictate who your support people are? One such incident was highlighted to me earlier this week and it got me thinking. 

Consider this, what are the chances your doctor will actually be at your birth? Having a doula offers you continuity of care.  Your own doctor can't offer you that.  The vast majority only work at their hospital once a week or less.  And as most hospital policies do not dictate the precise "who" you can have, where is it coming from that your doctor can say precisely who will be there to support you?

One reason could be that the doctor has had a past bad experience with a doula and has written off the entire profession.  A situation of one bad apple spoiling the bunch.  But like with all things, there is good and bad.  There are good doulas, and bad doulas.  Just like there are good doctors and bad doctors, good nurses and bad nurses.  But you might agree, that one bad experience shouldn't ruin the experience of all mothers and shouldn't take away a woman's choice for her own birth.  If we did that, then most of us wouldn't be seeing doctors at all, or going to hospitals. 

A second reason might be control.  Some doctors, not all, like to micro manage birth.  They like to control the process and don't like to answer questions.  Some feel the questions you ask are actually you questioning them as a doctor and as a professional.  Some think the doula is whispering in your ear and getting you to make decisions that go against medical advice, or that the doula is bad mouthing them behind their back. 

Nothing could be further from the truth.  A doula is there to support your decisions.  To help you in physical comfort and evidenced based information.  To remind you of your birth plan, that you and your doctor agreed to.  To help you cope when things don't go as planned and to be with you even when everyone's shift has ended.  They are not there to make decisions for you, but to help make sure you have all the information to make an informed consent decision.  And informed consent is your right as a patient. 

So what is a parent to do when confronted with having to choose between the birth team she wants and not upsetting their care provider? The easy answer is nothing.  It shouldn't be a choice.  Your birth should be what you want it to be.  With a care provider you like, who is supportive of your choices, in a place where you feel comfortable, either at home or a hospital or a birth center.  With a team of supporter of your choosing who will care for you, listen to you, and be with you every step of the way. 

But how do you do that? Research.  Interview, yes even doctors.  Go on tours of different facilities, ask questions, ask your friends, family, co-workers, prenatal teacher.  Research on-line, read books beyond What to Expect When Your Expecting.  Pregnancy and birth are all about choice.  Don't have that choice taken away from you because of fear and ignorance. 

Partners.....

What is the role of the partner in the birthing room? For so many generations partners either didn't want to be in the birth room or were barred from being there.  Women were surrounded by their female family members and women in their community.  They were supported with love and compassion and the skill of women who had birth before them.

These days the skill comes from doctors and nurses and midwives.  And the love and compassion comes from their partners.  This can put many partners in an awkward position.  To see the woman you love, in perceived pain, and unable to sympathize or make it go away.  Desperately trying to remember what was said in the prenatal classes, kicking yourself for not reading those pages she had flagged for you and scrambling to find the birth plan she printed off to bring to the hospital.  What is a partner to do when suddenly faced with labour day and being overwhelmed and under prepared?

Step One:  Remain Calm
Even if you are freaking out on the inside, stay strong and in control on the outside.  All that comedic drama we see birthing mothers and their partners pull in the movies is FICTION! She needs your strength even when you aren't feeling it yourself.

Step Two:  Be There
That may seem obvious but I don't mean just physically.  You must be there mentally as well.  So that means no iphone, no blackberry.  Watch her, not the monitors.  Hold her hand, rub her back, listen to her wants and needs and respond to them.  Don't be distracted by the buzzing of your phone with texts and calls from anxious family members.  They can wait.  She needs you now.

Step Three: You are Papa Bear
You are there to protect your family and make sure they are safe.  How do you do that? Ask lots of questions, follow your gut and don't assume every suggestion is right for your family.  Most protocols are based on averages.  And your woman is not average.  She is an individual and her birth is as unique as she is.  She should be treated as such.  Protect her and her space so she can feel safe enough to let go and work at her labour.

Step Four: Plan Ahead
You can't show up for the birth and expect awesome.  No one wakes up one day and decides to run a marathon and win. You have to train or your twitter feed from the finish line will end with #fail.  Listen in prenatal class and practice the comfort measures you are taught.  Most importantly create the birth plan together.  This way you will know what she wants and why and how important each item is to her.  Know what you are fighting for when you are Papa Bear. 

Step Five: Know Your Limitations
Know what you are capable of.  What are your strengths and weaknesses? If you cannot do steps one to four with 100% of your abilities, get help.  Preferably a Doula who will assist you in all your steps and do it so you end up looking like a rock star.  Take all the credit, she won't mind.  Being honest about your ability to assist momma and asking for help is what she needs.  Being macho is not a welcome trait in the labour room, but honesty is.

Answer these questions: Can you be all she needs? Can you handle everything you may face? Do you have the stamina to run this marathon with her? If a voice in your head said no at any point, ask for help.  She'll love you for it in the end. 

My Completely Biased Favourite Places to Give Birth in Toronto

I currently teach prenatal classes at York Central Hospital. Because the program is run by an outside organization I often get couples that are having their babies in other hospitals. I realized the other day that I have an obvious bias toward certain hospitals. So as such, I thought I would try to keep my biases out of the classroom and share them here instead.  

Sunnybrook - Having your baby at Sunnybrook is a definite experience. If I were to have another baby and had to have a hospital birth it would be here. The facilities themselves are practically brand new. Private labour rooms double as your postpartum room and are roomy with most medical equipment actually hidden behind cabinets and stored away. The bathroom holds a wonderful deep tub with jets and room for partner should they choose to join mum in the water. And there is optional dim lighting in there too. And the most practical touch of all, a mini fridge to hold your drinks and food to use during labour and postpartum.

But all that is just window dressing. The staff make your birth experience at Sunnybrook truly fabulous. The nurses, who are your main contact at the hospital, are definitely there for you. Whether you are choosing an unmedicated birth or are looking forward to your epidural, the nurses will be there to assist you in executing your birth plan as best they can. I have rarely seen women pressured in to procedures they don't want to the sake of expediency. They are open and friendly and caring. The doctors as well are a rare breed in the world of maternity care. Several I have seen are open to choice, one was even supportive of a clients desire to have her baby in water. Something we only really see with midwives and homebirths. Whether you are hoping for more then 5mins in your appointment or delaying your cord clamping by 2hrs, there is a doctor at Sunnybrook for you.  

Toronto East General - Until Sunnybrook came on line, Toronto East was my top pick for hospitals in Toronto. Like Sunnybrook the staff is fabulous. The nurses are kind and caring and the pressure to get an epidural is minimal. The facilities themselves while older are still good, with big rooms and tubs in almost every room.

The doctors are also unique in offering breech vaginal delivery and discussing choices with informed consent as opposed to pressuring patients into what will work best for the doctor and their schedule. Toronto East General is also one of only two hospitals in Ontario that have been awarded an official Baby Friendly Hospital by The World Health Organization and Unicef. Not even Sunnybrook has this. As such they also have an amazing breastfeeding clinic to help you in getting the support you need in that critical time after birth when you and your baby are learning to breastfeed.  

Mount Sinai - While many doulas would not even have Mount Sinai on their list at all, I have had too many good experiences not to have them on my list. Mount Sinai is the only hospital where my clients have not ended up in a cesarean section. Almost 30 percent of my clients have birth there and none have had a surgical birth. That's amazing. While the facilities are old and in the process of being updated, the staff are fairly good with staff who are open to natural birth, even if they don't always understand a woman's desire to go natural. I have seen women pressured to accept interventions simply to speed up the process, but if you enter into your labour with a plan in mind, educated on your options and with good support who will advocate for you then you may not fall prey to unnecessary procedures.  

The Others - The rest that round out the list include North York General, of which I have a certain fondness, having been born there myself. Markham-Stouffville, for its recent achievements in reducing their cesarean section rates. And Scarborough Grace where I had my own children with an amazing OB.

So that is my completely biased list of hospitals in Toronto. If your hospital isn't on this list, odds are it isn't one of my favs. But I'm just one doula. Your birth will be what you want it to be and what you allow it to be. But wherever you are having your baby I always recommend a doula to help you get the birth you want.