Sunday, April 22, 2012

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.

Friday, November 4, 2011

Pleasant Hospital Experience

It has been just over a year since SunnyBrook opened their doors to their new Women and Babies unit. I had not had the opportunity to attend a birth there until this past weekend. As it was, it was not my client but I was called in to back up my partner. I was extremely impressed.

The facilities were beautiful. Of course it still had that shinny new feeling to it and the paint was probably still wet but it was nice none-the-less. The room had a fabulous deep tub and the room was large and spacious. And to my delight there was a private mini fridge for mum and partner to bring nutritious snacks and drinks, or a small bottle of champagne. And best of all you don't have to keep food in a communal fridge to be stolen by others.

But beyond the cosmetics and bells and whistles of the hospital, one of the best things about this hospital is the staff. The first nurse I met was Aggie. I had met her when this program was done through Women's College and she is still a fabulous, friendly and caring care provider. Then we met Karoline and she was equally wonderful and caring. The doctor who came on shift while I was there, Dr. Nevo and the resident Stephen (I didn't catch his last name), they were both very patient and spoke calmly and slowly about what their recommendations were and what the procedures would entail. This goes along way to making a potentially stressful situation easier for mum and partner.

Unfortunately for our client the end result was a cesarean section but for the comfort and support of both mum and partner, the doula, me, was allowed to attend the section as well. I was very happy for that, as the situation did require more then one set of hands to keep mum calm and comfortable for the hour it took to complete the procedure.

Overall, the entire experience was more then I could have hoped for, for any couple having a baby. The respect for birth and women and their ability to give birth is a rare gem in our world today. While the bells and whistles are great, women have been giving birth without them since the beginning of time, but what they have always needed to give birth is kindness, caring, support and above all respect. And SunnyBrook Health Sciences Women and Babies Program has that in spades.

Can't wait for my next birth there.

Monday, March 29, 2010

Your Cervix and Emotions are Linked!

Were you aware of that? That your cervix is directly related to your emotions and stress levels? I'm sure it makes sense and if it doesn't then read on.

This weekend the Toronto Doula Group had two clients who's labour was directly linked to their emotions. The first, a client of my business partner, went into labour on Thursday. This was her second child and the contractions were about 7mins apart. As this was her second they opted to go to the hospital. Once there it was determined that she was 3cms, but her contractions had slowed down a little.

The client then decided that she would rather go home to labour a little more on her own. The nurse told her that it wasn't a good idea because she wouldn't know what was going and it would be safer to stay. She still refused and was next confronted by a resident. The resident told her that she needed to stay so her baby could be monitored and it was safer to stay then go home. (How did we manage to survive as a species without doctors and monitors???) She still refused and was getting upset about the way she was being spoken to. At this point her contractions had all but stopped. Finally the doctor came in and began to get belligerent telling her she couldn't leave and it was putting her baby in danger. He was headed for a cesarean section and would come back in an hour to discuss her nonsense.
After an hour and no contractions at all she got dressed and left. Unfortunately she was required to sign a "Against Medical Advice" form.
Over the next couple of days whenever contractions started and she began to think about going to the hospital, they would stop. She soon began to think about changing health care providers.
After some relaxation and fear release her water broke on the Saturday night. Her baby was born healthy and safely 4hours later.
It isn't fair for health care providers to undermined their patients wishes with fear and threats. If she had stayed like they wanted and not followed her instincts she could have very well ended up with a c-section. Something no one should have because of fear and tension inflicted on them at a time when things should be calm and stress free.

The second client was mine who was having a VBAC or Vaginal Birth After Cesarean. She had been using Hypnosis to remain calm and even to turn her baby to a head down position. Everything had been going well and her doctor was very supportive. He kept everything laid back and calm and even though she was approaching her due date, he had still not scheduled a c-section. Unfortunately at one week past due things changed and he told her sharply that she had run out of time and 72hrs from that day her section was scheduled.

This left my client in a panic. She had been having start and stop contractions (common for vbac mothers) for a couple of days and was shocked when she was given no time to discuss her options. She spent that weekend searching out an acupuncturist to help and took homeopathic remedies to help as well and again had start and stop contractions. She did several fear releases and worked hard on relaxation. But there was one thing still holding her back.

The impending c-section. It was causing her stress and tension in her body and until that was released her contractions would continue to stay blocked. We had a long conversation and she decided to call the hospital in the morning and explain her situation. The act of making that decision let her contractions change and begin to get stronger and closer together. She needed to release that fear and stress and let her emotions go so she could let her body do what it needed to do.

So how does one do these things. Hypnosis. Having a Doula. Getting practical and non-fear based childbirth education.

Friday, June 26, 2009

Unmedicated Birth

Is it possible in this day and age to have an unmedicated birth? With all the media attention on planned c-sections and the world of famous people spouting the necessity of pain medication and planned inductions for timing when your baby comes. (Don't get me started on that one)

I think it is possible, if you truly want an unmedicated birth. There are just a few things you need to do in order to increase your odds.

First off, have a midwife, family doctor or an OB who is laid back and supportive of natural birth. Find a health care practioner who believes in what women's bodies can do. You aren't looking for a surgeon. You are looking for someone to assist you in birthing your baby.

Secondly, work with a doula to help guide you and support you and be you and your partners advocate in achieving a natural, unmedicated birth.

Thirdly, choose your childbirth classes wisely. Choose non-hospital based childbirth classes, where you can discuss options for pain such as birth balls, tubs, showers, massage and more.

Fourthly, choose a hospital that has such things as tubs, showers and supports natural, unmedicated birth. Yes they exist.

Fifthly, let go. You cannot control your labour. Your body knows what to do, you have to have faith that it will do it. You need to let your body go, get into the contractions and let them do their job. You have to surrender to them and let them work at bringing your baby down dilating your cervix.

Monday, April 20, 2009

The value of a supportive word...

This was not the topic I was intending to write about but sometimes situations arise and you can't help but voice your outrage and concern.

A friend recently came home from a VBAC birth and told me how the doctor basically told her client to stop wasting her time, it was just going to be a ceserean any way, he refused to take responsibility for her and that walking around was a complete waste of time. The client did everything she could and my friend had her doing things we never knew a labouring woman could accomplish while in active labour.

Unfortunately after more then 24 hrs it did end up in a ceserean section.

But why would a doctor come into a hopeful and happy situation and burst every balloon in the room with his words. When a woman is in labour she is so open to the connotations of words. A woman who feels supported and loved and safe will do amazing things during her labour. Her discomfort will be diminished, her labour will go faster, she will not fear the process and listen to her body, and she will preceive the birth in a much better light regardless of the outcome when her basic human needs are met.

Now I'm not saying that in the case of my friend her client would have had a vaginal birth if her doctor hadn't been such a mean guy, but perhaps she would have had a better outcome, a more pleasant experience, a shorter experience, who knows.

Kindness costs nothing, it doesn't infringe on our health care costs but the benefits are huge and it would go a long way if doctors and nurses and friends and family would remember that when talking to a pregnant or labouring woman.

That's my soap box for today, perhaps I'll get to write the next post I was planning on and chat about why you aren't too fat, short or old to have a baby.

Thursday, April 2, 2009

How to Hire a Doula?

The last few weeks I've been hearing a lot of people ask questions about hiring a doula and what to look for. In fact just yesterday I recieved a call from a woman who had been 'chatting' with a woman who claimed to be a doula and it all sounded very suspect. In fact she had originally spelt the word doula wrong. My advice in that case...run away!

So I thought I'd put a few things down that will help the novice pregnant family look for, interview and hire a doula.

First!
Why are you hiring a doula? Do you even know what one is?
"A doula is a professional who provides emotional, physical, informational and practical support for the expectant, laboring or postpartum mother. She does not perform any medical tasks but actually compliments the medical birth team."1

Consider what you kind of support you are looking for. How do you envision your birth or postpartum period going? Do you need support during your pregnancy and labour? Then you are looking for a labour doula. Are you looking for support after you come home with the baby? Breastfeeding support or help with twins? Then you are looking for a postpartum doula.

Many doulas are both labour and postpartum doulas so if you need or want both then you need to ask the doulas you speak to what their services include.

Second!
Where do you find a doula?
Ask your friends and coworkers if they had a doula or if they know someone who did. Word of mouth goes a long way in hiring a doula. If that search leaves you empty handed turn to the internet.
You can start by a google search. "Doula Toronto" and see what you get?
Or you can search the many different doula referal sites such as:
http://www.torontodoulagroup.com/
http://www.doulacare.ca/
http://www.babyontheway.ca/

Third!
Once you've found and called several doulas (you can email as well but I suggest calling) get a feel by the ones you speak to who ou might like to meet in person. Each doula should offer a 'no obligation, no cost' interview to chat and answer questions with both you and your partner. If they don't, then they are not the doula for you.

I suggest interviewing 3 or 4. If you only have one or two that's okay too, but make sure that the doula you hire is the one for you. If it doesn't feel right or you just don't connect with the doula then they aren't the doula for you. Keep in mind too that the doula has to get a feel for you too. If she does not feel the connection then she may decline being hired. Don't take it personally, if she's not feeling it then she won't be at her best for you when you really need her.

But what do I ask?
You want to know where they trained? When they trained and if they are certified. Being certified is not the be all and end all but it is an extra step in training that I feel shows dedication to their field and respect for their training and continuing education. Now you may find that a doula you really connect with is in the process of getting their certification or has done a hundred births but is not certified. Don't worry.

As long as they are trained by a reputable training organization and is a member in good standing then you are good to go. As I said, being certified is not the be all and end all so don't get hung up on it if the doula you like isn't certified.

Fourth!
Check their creditentials. Go to the websites of the organizations they trained with or call them and see if they are a member in good standing. Are they a member of any other organization, call them and see if they are a member in good standing. If they aren't, you won't be able to find out why but that is a red flag! run away.

Fifth!
Ask questions. Labour Doula
What made them decide to become a doula?
How long have they been a doula?
How many births have they done?
How many births do they do in a year?
What do their services include?
Do they work with a back up Doula?
What are the terms of their contract?
What additional services to they offer?
What is their childbirth philosophy?
What is their opinion on pain medication?
When during the labour do you call the doula?
Do they have references?
Where and with whom did they train?
Cost?

Postpartum Doula
What kind of training and experience do they have?
How do they see the role of the doula?
What kind of services do they offer?
Are there different packages available?
Ask for references?
Why did they decide to become a doula?
What do they find is the most challenging aspect of their work?
How will they help the partner/family/older children?
Do they have back up?
What can you expect from a typical day?
Do they help with breastfeeding?
Are they opposed to bottle feeding?

Finally, I've alluded to training organizations. The two main ones are CAPPA, and DONA.
Have a look at their websites, you'll be able to find doulas on their sites too.

http://www.cappacanada.ca/
http://www.dona.org/

And trust your instincts! Hiring a doula is 50% experience and 50% personality. There is a doula for every woman and a woman for every doula. You'll find the right one, she's out there waiting for you.

1. The Doula Advantage by Rachel Gurevich - available a most Chapter and Indigo stores.

Wednesday, March 11, 2009

Hypno...what?

"You should read, Hypnobirthing by Marie Mongan." I say in all seriousness. Instantly a look comes across their faces and you can almost read their thoughts. 'We can't hire her, she is way too crunchy granola for us...' or 'Hypnobirthing...what kind of crazy mumbo jumbo hippie crap is she talking about.'

The funny thing is, I'm not crunchy granola, more like lumpy oatmeal and hypnobirthing, despite the name is not mumbo jumbo.

Contrary to popular belief Hypnobirthing will not allow your partner or me to make you bark like dog or act like a chicken during labour. It will however allow you t become completely relaxed and free of tension. When you are in this state, you are better able to listen to your body and follow your instincts.

You will still be completely conscious but during your contractions or surges as they are called, you will be able to go into a deep relaxation with the help of breathing and imagery.

Some of the best birth's I've been to have been Hypnobirths and my clients have been able to go unmedicated, and have been relaxed and stressfree.

So whether you take the classes or just read the book, I suggest that this state relaxation is something you should strive for in your labour. And it isn't surprizing for me to say that having a doula will aid in that goal