Birth and Life in NOLA

I'm moving!

2010-12-03T23:09:00.001-06:00

My husband and I are moving to Nashville and my blog is moving to my new website, http://doulaheidi.webs.com!

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How to Un-Write a Birth Plan

2010-08-14T16:40:00.000-05:00

Birth plans and natural childbirth go hand-in-hand, don't they? Well, yes, and they are also often laughed at by Labor & Delivery nursing staff. I'm not saying that this should be, but it very often is what happens. I'm all about learning and choosing your options. But decidedly *against* having a multi-page line by line checklist posted on your LDR door.

Here's my suggested approach. Keep in mind that I wrote this at 2 am after not being able to sleep while all these ideas kept running amuck in my brain!

How to write a Great Birth Plan and then Deconstruct it.

First Draft: First trimester or even when you are TTC

Step One: Title this "The Way too long list"

Step Two: Create 4 sections:

Labor
Pushing & Birth
Special Circumstances
Newborn Care

Step Three: under each of these headings, list anything and everything that is important to you about your birth experience.

Now what?: Based upon your lists, consider whether or not your caregiver will be supportive of such requests. If you know this without a doubt, then you can readily move forward to Step Four. If you are unsure or are just guessing they will be because they have been nice during your GYN visits, ask around the natural birth community and ask your caregiver directly about how they handle natural births. These answers will give you an indication of whether or not you need to act now to change caregivers. Be certain of this, as your caregiver's protocols will have a direct and strong influence over your birth experience.

Step Four: Choose a couple of your most important items and discuss them with your caregiver at your next appointment. A friendly approach is best. "How do you feel about intermittent monitoring?" goes over much better than, "I refuse to be monitored during my labor." This dialogue will give you an idea of where your caregiver stands. A natural birth advocate will likely answer many of your unspoken questions within the first conversation. Resistance to your questions merits follow-up, but often is your first clue to seek care elsewhere.

(Note: For newborn care, follow same process with pediatrician.)

It is here that I must interject that there is a time and a place for every practice, from the most natural to the most medical. It is your responsibility to educate yourself by researching and asking questions so that you can determine this reasonably and responsibly.

Step 5: Review your list and note answers where you have received them and highlight questions that have now come to the top of the list. You will want to continue your research until your questions are answered. However, you may be able to seek this information from other sources within the birth community who are familiar with your caregiver and place of birth, such as doulas or childbirth educators.

Second Draft: After the first has been worked on a bit

Step 1: Sort through your first draft and transfer the items to a new list if you feel that they a) require further discussion or b) you have come to a compromise with your caregiver that is outside of their normal practice and needs to be noted.

Step 2: Research a bit deeper on each of these items to consider the options available to you, as well as their benefits and risks.

NOTE: You will always have options. They become fewer when an emergency arises, but labor and birth does not often involve true emergencies (ie, life or death). So your first question in a moment of choice is, Is this an emergency? If not, then proceed with standard questions: What are my options? What are their benefits/risks, advantages/disadvantages? What if we wait x time? What if we do nothing at all?

Step 3: Take a hard look at your list. Have you asked all the questions you need to ask? Are you satisfied with the answers? Do you need to revisit anything?

Step 4: Consider what preparation YOU need to make in order for your birth preferences to become real - additional support, classes, tools, etc.

Final Draft: Last few weeks before EDD.

Step one: Review your previous draft and see if anything can be marked off that you feel confident is well-understood between you and your caregiver.

Step Two: Transfer only those items that the nursing staff will need to be aware of when you are checking in at your place of birth. This should be short and to the point, friendly and easy to read. Anything more than a minute to read will likely not be read at all.

Step Three: Make 3 or 4 copies of this single page document to share with your caregiver (prenatally), the nursing staff upon checkin, post on the wall/have on hand in your LD room and to give to the nursery staff.

A footnote on the Unexpected = C-sections

It's like hurricane preparation. You don't want to think it will really happen, but it is certainly better to be ready for it than to be caught by surprise.

Who goes with you? The reality: Baby will be out and on his/her way to the nursery in the first 5-10 minutes. Then mom will be in surgery for another 45 minutes or more. It is important for mom to not be left alone. It is also important for someone, preferably the father, to be with the newborn to record all those precious first moments for mom to later see. Therefore, plan for who will stay with mom in the OR. If two persons are allowed to accompany, then the father and another can go in, then father can leave with the baby and be present for his/her care. If only one person is allowed, it is better to have a secondary person (doula?) go into the surgery and let dad wait outside ready to follow the baby to the nursery. Seeing the surgery isn't very important for most family members, and there will be plenty of crying to hear from then on!

C-sections, VBACs and birth satisfaction: one woman's story

2010-07-06T13:35:00.003-05:00

In the natural birth community, it is sometimes assumed that a woman who has a cesarean section will be dissatisfied with her birth experience. And in many cases, that would be correct. Or that a woman who has a natural birth with no complications will be thrilled about her experience. This is often correct as well.

But not always. In either case.

In my journey as a doula and childbirth educator, I have come to know that what TRULY makes the difference in a woman's birth satisfaction is NOT the checklist of what did or didn't happen during her labor and delivery. Rather, a woman's sense of understanding and choice in the decision-making process bears more emotional weight than any medical procedure or natural comfort measure ever could on their own.

Read on to hear one woman's story of her journey through two very different, yet ultimately similar birth experiences...

JESSICA'S STORY

Ever since I could remember I have been scared of childbirth. Not of pregnancy, but just of the birthing experience. I carried a tremendous amount of fear regarding my perception of the pain of childbirth and just the unknowns in general. Needless to say, when I learned that my husband and I were expecting our first child, I was all about the epidural.

I never took anytime or interest in educating myself. I mean really educating myself. Of course I read the generic materials that are out there, i.e. “What to Expect When Expecting” and read articles on various websites. Don’t misunderstand me, those resources are great; however, they are very “middle-of-the-road” …….for people just like me. I knew I didn’t want to feel any sort of uncomfortable sensation and would be getting the epi ASAP!!! So what was the point on learning anything further, right???

So here I am, four days past my due date (what seemed to be an eternity to me) and my water breaks at home. Contractions are about 10 minutes apart and are very mild. We head to hospital where I was examined and found to be 3 centimeters dilated. They ask me if I want an epidural and I immediately say, “Yes, the sooner the better,” as far as I was concerned. I received my epidural shortly after 7 am. I am now lying limp on the bed, what were already spaced out contractions are now slowing down even more due to the epidural. A pitocin drip is started to speed things back up. Most of day passes and after 5pm I am fully dilated. I push a few times for the nurse and maybe 4 or 5 times for my doctor. After a handful of pushes (literally a handful, I’m not lying) he says he doesn’t like the way the baby’s heart rate is looking and said that a c-section is necessary.

What do I say!?! I was completely unprepared for this. A cesarean section? Really? I didn’t want one but since I knew absolutely nothing I had no reason to disagree with him; I certainly had no educational knowledge to base any decision off of… 12 hours after being admitted into labor and delivery my daughter was born via cesarean section.

It wasn’t long after her birth that I began to find myself in a bit of emotional turmoil over the method by which my child was brought into this world. I was feeling as if one of nature’s most natural events had been stolen from me and that I had missed out on something amazing. I wanted to know more in depth what lead to this and what could’ve been done differently to have prevented this outcome, so I began my research. It was during this time that I really became enlightened on so many aspects of birthing, not just pertaining to my specific situation but also about the trend that our country was in regarding c-sections, the fact that my current doctor had an obnoxiously high c-section rate among his patients, and birthing knowledge in general. It was my goal to become as educated as I could regarding the subject of childbirth.

I knew that we would eventually have another child so I began to read everything that I could about VBACs, I even posted an online ad asking VBAC mothers for advice. I hounded nearly all of my friends (especially the ones who had delivered without any pain medications and another who had had a VBAC) with questions. Yeah, I was pretty obsessed with knowing all that I could. All of this new knowledge was wonderful, but it left me feeling and knowing that I had somewhat failed. I had failed to be more proactive during my pregnancy and perhaps, had I made different decisions, the entire outcome could’ve been different.

After the c-section my doctor had given me a list of very generic reasons why the surgery was necessary, one of which was that my pelvis was not shaped properly and, therefore, not conducive for a vaginal delivery. When I had discussed the possibility of a VBAC with him for the next delivery he was very negative and unsupportive. He said I could try but only if I were induced, which made no sense to me since induction increases the risk of uterine rupture. In so many words he basically said, “You can try but you will probably fail.”

I left his office in even more emotional turmoil. Not only did I have enough self-resentment over the complete absence of my involvement and my blind faith in the medical system in my first labor, but now I was questioning that maybe my body was not able to vaginally deliver a baby. Perhaps my body was broken.

Soon afterwards I consulted with a doula who gave me wise advice and who also helped me deal with and sort out some of the emotional issues that I was facing. She referred me to a few VBAC supportive doctors in the area and encouraged me to explore my options. I took her advice and did just that. I knew that I wanted a second opinion regarding my pelvis and that if I would attempt a VBAC then my best chance of success would be to be under the care of another physician.

I chose one of the referred physicians and requested that my previous physician send all of my medical records to my new OB. My new OB did a pelvic exam and found that, in her opinion, there was nothing wrong with my pelvis. We discussed what happened with my first birth and she reviewed my medical files that had been sent and concluded that I was a perfect candidate for attempting a VBAC.

Throughout my second pregnancy I continued my research, every day becoming more emboldened and positive that I could successfully do what my body was designed to do – deliver vaginally. I read numerous books and attended a Positive and Prepared Childbirth class, which was incredibly informative and useful. I created my birth plan and reviewed it with my husband and doctor. We were all on the same page. I had discussed with my doctor that I was hoping to go without any medical intervention and deliver naturally, but that I wasn’t ruling out pain medications either. If I were unable to cope or had no energy left, knowing that I would not have energy to push, I would consider other options. It was important to me to have resolved before the baby was even born that I would not feel bad or come down on myself if I needed pain medications or an epidural, or that if after giving it my all a c-section was needed then I would be okay with that. My doctor was very supportive; she really took her time with me. Each visit it became more apparent that she was truly interested and involved in my well being and that she recognized and supported what was important to me.

My contractions began at home on April 26^th, three days before my due date, around 8:30 pm and were about 15 minutes apart and lasting for about 25 seconds or so. The contractions were not at all what I was anticipating. There was no build-up to their intensity and no let down either. Contractions hit with full force/intensity from the very beginning, remained at that level for the entire contraction and were very painful. I labored at home until the contractions were 5 minutes apart and lasting for about 45 seconds. At that point we left for the hospital and I was admitted around 2 am on April 27^th. By the time 5 am rolled around I had been awake for nearly 22 hours, my contractions were coming every one and a half minutes and were one minute in duration. I was completely exhausted and was only getting a 30-second break between contractions. Because the contractions were so painful and the break between them was so miniscule, I could not even begin to relax. I was examined and was found to be dilated 7 centimeters.

At that point I asked for the epidural, I knew that I could give no more and that if I did not get some rest I would have no energy or will power to push. Considering that my first child was not “pushed out,” I knew that the pushing process was a crapshoot – could be fast or could be very long. I received the epidural and got some much needed rest. Later on I was examined and was fully dilated, but the baby was still relatively high at zero station so my doctor decided to let me rest a little more and allow the contractions to move the baby down a little further. Once the baby moved down enough, I began pushing. I pushed for about 45 minutes and delivered a beautiful, healthy baby boy. I was so ecstatic and proud – my body WASN’T broken. I delivered as I was designed to do!

Within seconds of delivering Judah, without even pushing, my placenta came flying out. That’s when my doctor knew something was wrong. I was bleeding heavily and there were no signs of it slowing down. Since I was a VBAC, my doctor’s first thought was to check to see if the site from my previous c-section incision had ruptured, but it had not. There was no rupture anywhere in my uterus.

At that point they realized that my uterus was unresponsive. It had stopped contracting, a condition known as uterine atony. Because of this condition the large blood vessels in my body that fed the placenta were continuing to bleed out. They were giving me pitocin and vigorously massaging my uterus in an attempt to help it begin contracting again. It wasn’t too much longer before I was being whisked away to the operating room. My doctor continued to work on me and they began a blood and plasma transfusion. I was knocked out at that point. I woke up in ICU, intubated. I was told that they got my uterus to contract but had done an ultrasound and saw pockets of fluid in my womb. Not knowing if it were blood (meaning I was still hemorrhaging internally) or just benign fluid they decided to measure the pockets, wait one hour and conduct a second ultrasound. If the second ultrasound’s measurements showed growth then they would need to do a c-section in order to fix the problem. Well, the measurements showed growth so a c-section was performed. Turned out that it was not blood, it was indeed just benign fluid. The surgery wasn’t needed after all, but I am so glad it happened.

While they were in there, two important things were discovered. The first was a uterine rupture, but not from my previous incision site. This rupture was in another location and was believed to be the result of all of the intense massaging that was administered. The second discovery was shoddy work performed during my first c-section. There are 7 layers of abdominal muscles that must be separated when performing a c-section. Apparently my previous doctor did not reattach those muscles when closing me up. Simply put, when my current doctor opened the site from my previous incision the first thing she saw was my womb! She did not have to go through all the muscles that one would normally have to go through. As a result of this “unnecessary” yet much needed surgery, a secondary uterine rupture was fixed and my muscles were reattached.

Please let me clarify that what happened to me that day was not due to the fact that I had a previous c-section. All indications point to the likelihood that I had developed preeclampsia during labor. Uterine atony and postpartum hemorrhaging could just as well have taken place during a c-section. Believe me when I say this was a very dramatic experience. In order to keep this story from being entirely too long, I’ve left out several other details of things that took place. But despite all of this, I feel more emotionally whole and restored than I did before, and not just because God said it wasn’t my time to die but because I successfully birthed my child into this world. I experienced that indescribable event.

It’s amazing the difference that mindsets and medical care providers can make (whether it be an OB/GYN or a midwife). Looking back at my first experience, my mindset at that time and my doctor at that time was a combination that lead to an unwanted outcome. Then there was my second experience, my redemption, where I decided to face my fears and arm myself with the necessary knowledge. I sought advice, found a caregiver who supported me on my journey and continued educating myself. I made informed decisions that I believed would lead to an outcome that I desired and it was a success!

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2010-04-22T11:00:00.001-05:00

Look, ma, no hands!

2010-04-02T16:49:00.001-05:00

How many of you would agree that internal exams during labor are just plain awful? Well, I can't promise that they'll ever go away, but SarahVine shares some tips in her blog on other signs of progress to look for - on the Outside! I can't wait to add this to my doula work.

http://sarahvine.wordpress.com/2010/03/07/how-dilated-am-i-assessing-dilation-without-an-internal-exam/

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2010-03-22T20:23:00.001-05:00

http://womantowomancbe.wordpress.com/2008/04/27/checking-dilation-without-a-vaginal-exam/

Doula Heidi is now on Facebook!

2009-07-08T00:52:00.002-05:00

Yes, you read it here first. I now have a page on Facebook devoted just to my doula business. Many past clients have come there and shared their comments and photos, so you should be sure to check it out. Look up Doula Heidi - Choices In Childbirth on Facebook today.

Courtney's Birth Story

2009-05-04T16:25:00.004-05:00

April 3, 2009

Dear Heidi,

Thank you so much for your support before, during and after Chas’s birth. Choosing you as our doula was one of the best decisions we made to insure that we had a positive birth experience. You were incredible and I won’t have another baby without you!

You arrived at the hospital so quickly after Donny called and told you that things were moving a lot faster than expected. I remember being so relieved when you walked into the labor and delivery room. I felt like it would all be okay. Things were moving fast, but our support team was in falling into place.

You helped to settle Donny and me into the process, and you were obviously poised and experienced. Your confidence in the labor and delivery room was indispensable. You helped to orchestrate all of the players and you served to be my ‘voice’ when I really couldn’t communicate effectively. I would have felt so isolated without you there telling everyone what I couldn’t.

Finally, thank you for the brilliant counting technique you used during the contractions. Having you count to 20 and then back down again helped me to know that the end of that contraction was coming. It provided me with something else to focus on beyond the pain.

As we talked about after Chas was born, I am so grateful for your decision to serve women and families in this way. You are excellent at what you do and Donny, Chas and I are so glad that you were able to support us through this process.

We will call you again in a year or two when Baby #2 is on the way!

With Gratitude,
Courtney, Donny and Chas

Bursting with Life - Zoe's Birth Story

2009-04-30T14:56:00.003-05:00

Every once in a while, my clients find time in the midst of their new-parent whirlwind to write the story of their labor and birth. Here's one from Holly and Kyle, a precious couple who I had the pleasure of supporting recently. It's a little long, but worth the read.

ZOE'S BIRTH STORY (as told by Kyle)

Holly went into labor early on the morning of March 19th. She woke me up at 3:00 to say that she thought she was having rhythmic contractions. It turned out that they were coming about every twenty minutes. We decided to call our doula, Heidi Rau, to let her know that labor had begun. She told us to relax at home till the contractions were around 4 minutes apart. With our excitement, we decided to stay awake and rent a movie; Moulin Rouge. About halfway thru the movie, we decided to get some more sleep. Around 6:00 in the morning Holly woke up again with the contractions having increased in intensity slightly. By now, they were coming every 10 minutes or so. By 8:30 am, the contractions were coming every 4 to 5 minutes apart and we decided that it was time to get our things together and to head to Touro Infirmary. It was really exciting to think that our little Zoe was really going to be joining us soon, after all of the excitement and expectations over the last nine months. We took the car and headed to the hospital.

We parked and walked into the LDR at Touro and went to the nurses station. They checked us into LDR 4 and the nurse hooked Holly up to the monitors. Heidi got there a very short while after us and we watched some TV while we waited for the doctor to talk to the nurse. Heidi got us walking the hall and some stairs at the end of the hall. Holly did a bunch of bellydance stuff going up and down the stairs. It was funny to see her doing the dancing moves out of context like that, and in a hospital gown. The next few hours were passed walking the halls, sitting on the birthing ball, and generally just passing time in between contractions. During this whole thing, Heidi was helping Holly to keep moving about and trying different things so as to progress the labor as well as to reduce the pain of contractions. We were all in good spirits and spent much of the time lauging and joking around.

With everything that was being done, Holly went from being 4 cm dilated to 6 cm dilated in about two hours. About this time we started spending some time in the room because Holly’s contractions were getting more intense. We massaged her back for her during the contractions and helped her rest. Heidi knew exactly where to put pressure on Holly to relieve her aches and pains. At 5:30pm the nurse checked her dilation and found that she was only at 7 and her water had still not broken. Hearing this, Heidi told us that she had seen this many times before and that she thought the embryonic sac was cushioning Zoe and was more than likely what was preventing Holly from dilating further. She recommended that we have her water broke. The doctor came at 6:30 pm and agreed that her water needed to be broken so as to progress the labor. Once her water was broken, the contractions came on strong and Holly went into active labor.

When she was at 9cm Heidi had her kneel on the bed and rest her chest on the birthing ball so as to help get her to 10 cm and to encourage movement of a partial blockage of the cervix. There came a time when holly was having a very hard time getting thru the contractions and not pushing. To get thru this, Heidi recommended a breathing technique that would help her resist the urge to push before it was time. When Holly could not resist the urge to push any longer, Dr. Peret came in and Holly started actively pushing. Our little Zoe was born twenty minutes later.

Throughout this whole process Heidi’s presence was a comfort to both Holly and myself. She was very aware of what Holly was going through and made very good efforts to help holly not only deal with the pains of the contractions, but to also help progress the labor. I know that if we did not have Heidi there that Holly would have ended up on with an epidural to deal with the pain, and that she would have been in labor for much longer than she was. Our short time in the hospital for the labor was, for the majority of the time, a lot of fun, which was facilitated greatly by our Heidi and pain management techniques she had to offer. Heidi's presence there was also a great comfort for me, because we had someone there with us the whole time to help encourage us and generally help guide us thru the delivery process. I know that if Holly and I have another baby, we hope that Heidi will be available to help us again.

Grieving Birth

2008-05-08T22:32:00.004-05:00

Many years ago, I sat in a restaurant with a woman who poured out her heart to me over the loss of her child to miscarriage. Miscarriages are common enough, a sad part of the real world for women. When we hear of such a loss, what is our reaction? Sympathy? Compassion? Sadness? Would we ever think to say that she should be happy? Or that she maybe wasn't pregnant in the first place? Sounds crude to even imagine such a reaction. Yet those were exactly the reactions this woman had dealt with.

You see, her miscarriage was different than most. She gave birth to a healthy child at around 40 weeks gestation. He's alive and well today. But she was originally pregnant with twins and one of them died much earlier in that pregnancy. The response from her family and friends was mixed. Some offered tentative condolences, not quite sure how to handle the fact that she was still obviously pregnant. Some congratulated her that she had a healthy baby. Some thought she was crazy to believe she had ever been pregnant with twins.

Regardless of what everyone else thought or how they responded, one thing was certain: this woman had lost a child and needed to grieve. But how and when does that occur? How does a woman grieve a death and celebrate a life all at the same time? It is complex. It is confusing. It is real. In this case, I believe it took years for her to feel free to fully embrace the pain of her loss. How many women are never given the permission to acknowledge that grief?

In our day of advanced technology, women learn so much sooner that they are pregnant. Miscarriages that would have gone completely unnoticed because they occur so early are now officially documented. I read somewhere that a high percentage of pregnancies actually begin as twins, yet in most of those cases only one of the babies survive to term. Add to that the frequent use of fertility treatments that result in higher numbers of multiples, and it is clear to see that there are many, many women facing the conflict between the emotions of life and death.

Having a living, healthy child does not diminish the pain of the death of that child's sibling. Ask any parent who has suffered the death of a child at any point in life. The fact that a child dies in utero and hasn't yet been held and kissed and touched only means that those longed-for moments are also lost.

Do you relate to this story? I encourage you to embrace the grief. Give yourself permission to feel it fully and allow yourself the time to heal.

All In A Day's Work

2008-02-19T21:07:00.002-06:00

A Day’s Work: Heidi Gonzales and Heidi Rau
by Emilie Bahr

Posted: Friday, February 15, 2008

Heidi Gonzales and Heidi Rau share a name and a passion for the birthing process; they are doulas — professionals who assist women before, during and after labor but do not deliver the baby.

If you’ve never heard of a doula you’re probably not alone. Although women have been assisting in births for as long as women have been having babies, the idea of hiring a professional is creeping into vogue, at least in the New Orleans area, Gonzales and Rau said.

A doula is not the same thing as a midwife, who often is certified to deliver babies and, in the case of some certified nurse midwives, can even prescribe medicine. Gonzales is in her second year of training to become a midwife, a process she expects to take five years.

Doulas offer emotional support and advice and calm the patients during labor. They instruct in techniques some believe can shorten labor and lessen pain.

The women also help soon-to-be mothers craft a birthing plan — a guide kept in their medical file that includes what type of laboring methods they prefer and what drugs, if any, they want to rely on, when they want to begin breastfeeding — and help ensure their wishes are honored.

“We’re there really as educators and supporters,” Rau said.

Many of Rau and Gonzales’ clients are first-time mothers confronted with what can be a confusing and intimidating process. Others have used a doula for a previous pregnancy and can’t imagine labor without one, the women said.

Life as a doula can be stressful. Much like an obstetrician, doulas can face around-the-clock call and lengthy labors.

“It’s one of the professions that you have to be dedicated to,” Gonzales said. But “it’s a privilege” to be so intimately involved in the birthing process.

Over the past few years, Gonzales and Rau, who recently formed a business partnership, said they’ve noticed an increased demand for their services. It’s a result they attribute in large part to media attention, the increased presence of doulas and midwives on various cable baby shows and a renewed emphasis on natural birthing practices.

Today, Gonzales and Rau each assist in anywhere between 40 and 60 births per year. The women have worked in just about every hospital in the city and say their presence in the birthing room is no longer viewed as extraordinary.

“When you walk into a hospital, people are no longer asking, ‘Who are you and what are you here for?’” Rau said. Nurses are often thankful for a doula’s involvement, she said, particularly because women who labor naturally often require more attention.

One thing typical of any woman who enlists a doula’s help, she said, is that “she wants to be in control of the birthing process.”

Gonzales and Rau estimate there are about a dozen doulas in the metro region. Gonzales started her practice, Mommies Matter, after Hurricane Katrina. She was in her 11th year in the Navy at the time.

“I wanted to be a part of birth in the city,” she said.

Rau, a part-time office administrator and editor, began Choices in Childbirth in 2000. She turned to the profession based on a desire to get involved in maternity education.

“I wanted to dispel a lot of the myths that are propagated about delivery and birth,” she said.

Rau described her standard client as on the higher end of the educational and income spectrums while Gonzales has often worked with teen mothers. The standard cost for a doula runs between $500 and $1,000, a fee often paid out-of-pocket, Rau said, though some insurers are beginning to cover part of the cost.

Doulas often become closely connected to their clients, the women said.

“There are certain ones that you become a part of their lives,” Rau said. “I’m not Aunt Heidi, I’m Doula Heidi for some of them.”•

The Doula FAQ

2007-09-27T22:45:00.003-05:00

As a birth doula, I provide emotional, physical and information support during pregnancy and birth.

My clients are most often married couples, although I have worked with single moms and unmarried couples as well. My role is to support the family unit, which often extends beyond the mother and father to include the expectant mother's parents, in-laws, siblings and friends.

My doula service essentially includes 2-3 prenatal meetings, 1-2 postpartum meetings, availability by phone or email for consultations throughout pregnancy, on-call status during your birth month, provision of a back-up doula should the need arise (Heidi Gonzales, my business partner), and attendance at your labor, birth and early postpartum.

The fee for all this is $800, with a deposit/retainer of $300 due at the time we sign the contract and $500 balance due by 37 weeks in your pregnancy. I offer a $50 discount for those who choose to pay the fee in full at the beginning.

I've been a doula and childbirth educator since 2000-2001 and have attended about 30 births at this point. I am a Christian and truly count it as a gift from God to have the privilege of witnessing the miracle of birth on so many occasions.

Katrina-versary

2007-08-21T00:09:00.001-05:00

Katrina is nearly 2 years old. It’s hard to believe. So much and yet so little has changed since then.

I spent a few minutes tonight remembering. I invite you to view my archives and read the September 2005 entry. There I share the story of my return to the city I love so much.

Blessings,
Heidi L. Rau

My moment in the centerfold

2007-08-05T00:38:00.000-05:00

I never thought I'd say this, but I am proud to be found in the centerfold of a New Orleans magazine this month! No, I'm not ashamed. It is quite an honor, really. Nina did a fabulous job capturing my true essence.

Ok, I know what you're thinking, but stay with me here! I was privileged to be interviewed in June for the summer edition of Nola Baby magazine. The article is about how midwives and doulas serve women during pregnancy and birth. You should soon be able to read it online at their site.

Thanks again to Nina and the staff for their wonderful magazine. :)

Katrina|Babies

2006-11-27T22:42:00.000-06:00

To say that 2006 has flown by is a massive understatement. In the months that have passed since I last posted to this site, I have taught three prenatal class series for the Community Center for Life. I've been the doula for a half dozen births. I've also seen a significant part of my family relocate to another state because of the effects of Hurricane Katrina. Nonetheless, I am grateful to be here and continue to serve women throughout the Metro New Orleans area with education and support for pregnancy and birth.

My schedule is filling up for the December 2006 through February 2007 window as far as doula clients are concerned. I work with another wonderful doula, also named Heidi, and will be mentoring some aspiring doulas during the next year, so we can all work as a team to see that your needs are met. Contact me for more details on my availability.

Until next time...

Blessings,
Heidi L. Rau
New Orleans

Class is in Session

2006-03-16T20:33:00.000-06:00

On Monday, March 6, I began teaching a prenatal class series at the Pregnancy Testing Center in Gretna. The five-week course takes place each Monday evening on Lafayette Street and is a free service of the PTC. We are pleased to have Dr. Mompoint, OB/GYN and Dr. Bettencourt, Pediatrician, scheduled as guest speakers. If you have questions about the class, call the center at 504.227.9090.

Home Delivery

2006-01-09T22:44:00.000-06:00

No, I'm not talking about babies born at home, although that's a good topic and a great idea!

Have you ever attended a class and felt uncomfortable with the formal classroom surroundings? Maybe you prefer one-on-one teaching and learn better that way. What about fitting classes into your schedule on the same night every week for 6-10 weeks? Did you opt out of taking classes for any of these reasons? Would you?

You now have an alternative. I'm opening up my services to include private Childbirth Preparation Classes done in your home on a flexible schedule. Interested? Email me at expectingnewlife@aol.com or call me at 504.453.2634 and we'll discuss the details.

I am taking new doula clients in 2006 and am also working towards a traditional childbirth preparation class (location may be Metairie) in the Spring. I'm considering resurrecting my weekend class that was supposed to happen in October, but was obviously cancelled due to Katrina.

Education and support during pregnancy go a very long way in making your birth the best experience it can be. Together we will make a great team! Contact me today.

Business Is Blooming

2005-11-19T20:22:00.000-06:00

I'm happy to announce that Choices In Childbirth is open for business once again. Two couples have recently allowed me to be a part of their birth days and three more have hired me as their doula for upcoming dates.

My experiences at East Jeff and Ochsner post-Katrina have been encouraging, especially considering that they are among the few places where women can give birth in New Orleans these days. In both instances, the nursing staff was very supportive of my clients' goal of natural childbirth and did everything they could to help. Thank you to those special women!

If you are pregnant and would like professional support for your upcoming birth, be sure to contact me at 504.453.2634 to schedule an interview and learn more about how my doula services can make your birth a more satisfying experience.

Home, for now...

2005-10-12T01:24:00.000-05:00

I've made it back home (again) and it seems I'll be here more permanently now. Lots to do to catch up on a missed month (where did September go?) and figure out what "life as normal" will be. For starters, I want my mail! We went to the post office today and had the equivalent of 2 days' worth of mail, not six weeks.

Though I don't know when I'll be resuming doula work or childbirth education, I'm open to inquiries from expectant moms in New Orleans who are interested in either. Email me and we'll discuss what options are available.

For those who have wondered, we have food, water, electricity, etc. and a secure roof over our heads. Actually, work in our apartment complex has begun in earnest and it's looking much better around here, even as compared to before the storm (in some ways)! Security is good. There's nothing like having a humvee pull up to your front door - literally - to deliver water & MREs! Now *that's* curb service!

Hurricane Katrina & Me

2005-09-21T19:18:00.000-05:00

So much has happened in the past three weeks. There is much to tell, but here are some of the highlights of my experience since Hurricane Katrina changed the landscape of New Orleans and the Gulf Coast.

We left town the Saturday before Katrina hit and headed up to northeast Louisiana and stayed with some people we know there. As things progressed that first week, we realized that other living arrangements would have to be made. We weren't sure where we were going, but we called a bunch of hotels and found that most had only a single night available. We drove around and settled on one, figuring we might end up in the shelter the following night. The next morning at the free continental breakfast, we learned that space had opened up for us for a few more nights' stay, and within the same ten minutes we learned that FEMA was going to start paying for TWO WEEKS' hotel stay for evacuees!! We were the very first to sign up at our hotel. Some families who had been staying at the shelter were sent over to stay as part of this program. But get this... by that same evening, the hotel decided not to participate in the program any further and limited it to only those who had already signed up that day. Wow!

The hotel staff was wonderful. They were kind and helpful and the place just felt like home. Among the many perks was high-speed Internet access, which was our link to the outside world. I even spent some time at the pool and got a decent suntan. Hadn't done that in years. We became acquainted with other evacuees who are now like family to us. So that has been our home for the past couple of weeks. The Red Cross came daily bringing military MRE meals, snacks, and water. This made a huge difference, as the expense of eating out daily was not an option for us. Seeing that truck pull up with supplies was like Christmas every day! :) The local shelter was relocated from the civic center to a building one block from us, which gave us ready access to Red Cross registration and free hot meals there.

Once we got word that Algiers was being opened up for residents to return, we made plans to drive down. We left Monday morning and headed toward Lafayette, where my friend Michelle was prepared to host us for the night. We stopped in Alexandria to have lunch, a "last supper" of sorts, as we figured we might be living off of MRE's for a while. I saw an Outback Steakhouse sign and pulled up there, but it looked closed. So we went next door to a family Italian restaurant that looked like it would be a decent alternative. The place was mostly empty, but the staff was friendly and the chef even came out to check on things. When we were ready to leave, the waitress told us that our bill had been paid! The person did not want to be identified, but sent a message to us saying that "The Lord is taking care of you." I was pleasantly *not* surprised, as I already knew in my spirit that this was going to happen (although it never has happened to us before).

Our short stop in Lafayette was a treat. Michelle & Michael have two adorable girls, Havilah & Simka, who I think are the cutest kids around! The dinner conversation along with Havilah's animated contributions made for a fun night. Sorry that it was such a short visit, but we had to leave early the next morning.

So at 4 am we were up and packing the vehicles. We were out of Lafayette by 5 am and made it to Morgan City by sunrise. We didn't run into traffic until Luling and even that was limited. The signs of wind damage were as far west as Des Allemands, where trees were down all along Hwy. 90. When we started getting into the affected area, I turned off my music and just focused on what I was seeing. As we drove further into the westbank, I could just feel such a heaviness in my heart, just the grief of what has happened to our city. I didn't see as much damage as I expected to, but I think that's only because we were moving quickly. At the one checkpoint we encountered, at Terry Parkway and the expressway, there was a huge steel billboard with multiple support posts that was just twisted and bent in half. Trees are one thing, but steel?!!

As we drove down DeGaulle, I could see how the landscape has changed. Maybe it wouldn't be apparent to a visitor, but with so many trees down it looked desolate. When we got to Woodland, signs of life appeared in abundance -- the fire dept., police, military, etc. have taken over the nursing home, Catholic retirement community and Holy Cross college. There were trucks and tents everywhere! Electric crews were working at the intersection, which was a good sign, although we knew that earlier in the week our apartment had power.

Pulling in to Maple Leaf was shocking. No one was there. (It's normally bustling with activity.) Trees down all over the place, siding and shingles strewn in the street. A mess. Corners of buildings damaged, some roofs gone. It was hard to even recognize our apartment building. When I finally found it and pulled over, I broke down and cried. It was so overwhelming, the reality of it all. Believe me, watching it on TV is so different from being there. Video does not convey the heat, the eerie silence and the stillness.

When we left before the storm, there was very little time to prepare. Many things were left undone. So my prayer throughout the storm was that God would put a supernatural protection over our apartment and my car. It was all I could think to pray. There are old evergreen bushes/trees in our courtyard. They were twisted and snapped in half. Huge trees had been broken in many places. And these were the healthy ones, not the termite-rotten ones with hollow trunks. We walked around the back and checked on my car. Not a scratch. Not even water inside. The back fence was intact. The windows were not broken. We walked to the front and opened the door. Dry and hot and smelling of two rotten refrigerators, but otherwise ok. Amazing. Upstairs... not even a sign of a leak from the roof. On the back patio, there were wicker baskets on top of a small storage cabinet. They had not even moved!! All I could say is "Thank you, Jesus!"

But no electricity. :( So we began the grueling work of unloading the van and gearing up for cleaning the refrigerators, not knowing if we would have to leave again in a few hours. We shortly learned that we had *just* made it in to the city before they closed the re-entry and turned people away!! Again, "Thank you, Lord." Had we left any later, we most likely would not have been allowed in. A couple of hours into the work, we noticed that our maintenance supervisor was home. The power came back on in our grid, and he was able to switch the breaker to get our apartment back on! Yay! Air conditioning! And he later helped us get the refrigerators out of the house. YUCK!!! But again, so glad it is done and we had help.

The Red Cross came through for the first time in our complex and delivered sandwiches, MRE's, water, and ice! YAY! I'm beginning to love the Red Cross. So now we have electricity, safe running water, cleaned/removed refrigerators and air conditioning. And I am writing you this email from my home computer. But we might have to evacuate again tomorrow due to Hurricane Rita. We don't know what tomorrow holds, but I am so glad that I know Who holds tomorrow. It is clear that staying here is not a realistic option for now. We don't have jobs, we don't have income, we don't even have mail. We've been using credit cards to pay for everything, so as not to deplete what we still have in the bank since we don't know how long that will have to last us. (Which for me isn't much in the first place.) The existence is at a bare minimum standard. We are still under dusk to dawn curfew and there is a LOT of work to be done before normal life can be resumed. For now we are asking God for direction on what to do next, where to go next. There are many things yet unknown.

Inside our apartment, it is as though everything is the same as one month ago, before Katrina. But stepping outside it looks like the end of the world has come. It is a very strange and somewhat unsettling contrast. While all this devastation has been happening, I know that God has been taking care of me. Yet while I know that God has been taking care of me, the reality is that New Orleans for the most part has been destroyed. And I suppose that's my point in sharing all of this with you, to try to paint a true picture...

If you have read this far, thank you. I'll try to keep this updated as it is relevant and as I have access to the Internet. In the meantime, thank you to those who have prayed and to all who have been so kind - friends and strangers alike - and wanted to be sure that I am doing ok. I am living day by day, hour by hour really, curious to see what the future holds.

Life as I know it

2005-09-01T21:18:00.000-05:00

It appears that I will be living in Monroe, Louisiana for a while. My city, New Orleans, is in a heartbreaking condition now. I'm homesick and realize that home as I know it will never be the same.

For now, I must find a life here. So I am going to look into working as a doula in this north Louisiana community. Ladies, if you need a doula, send me an email!

Hurricane Katrina

2005-08-30T22:05:00.000-05:00

I've evacuated the city because of Hurricane Katrina, and as of today (Aug. 30) it looks like it may be a while before I'll be going home. Please keep me in your prayers!

CNN talks about Doulas

2005-08-26T16:47:00.000-05:00

We're in the news!! Even CNN has picked up on the benefits of doulas.

Read an article from August 23, 2005 about how doulas are Mothering the mother during birth.

2005-08-22T19:13:00.000-05:00

Heidi L. Rau, Doula Extraordinaire!

Don't miss out!

2005-08-22T11:41:00.000-05:00

Have you registered yet for my October class: Labor, Birth & Beyond?

In addition to a pregnancy overview and newborn care tips, you'll learn what normal labor and birth look like; what movements and positions to use to keep labor going; and how to use comfort measures to relieve discomfort and stay relaxed through the whole event.

You will also learn what you might encounter when giving birth in a hospital setting, such as common interventions and what your options are. There is so much more, but I can't cover it all here. You'll have to come to the class!!

Here are the details:
October 8 and 15, 10 am - 5 pm
5708 Airline Drive, Metairie
ONLY $100 per couple

Space is limited, so sign-up today! Registration closes September 17, 2005.

Is your house a wreck?

2005-08-22T11:23:00.000-05:00

We all struggle with keeping our lives organized. How much more when a new baby is on the way (or has already arrived)? There are new additions of clothing, furniture, care products, and more. Not to mention the fatigue that often comes with late pregnancy and always comes with caring for a newborn.

There is hope! A doula friend of mine told me about the FlyLady. No, this isn't a comic book character. The FlyLady teaches quick and easy ways to get your home and your life clean and organized. Check it out at www.flylady.net and start seeing changes even today.

Move it, baby!

2005-08-20T19:42:00.000-05:00

As a doula, one of the most frustrating things is when a woman's labor moves agonizingly slow, despite movement and good upright positions. It's been a mystery to me until now. I think I've found the answer.

In my reading lately, I have been learning about "optimal fetal positioning" or basically, getting baby into the best starting position for labor. There is a great site where you can learn about this online at www.SpinningBabies.com/BellyMapping.html. Gail Tully goes into great detail on how to determine where your baby is positioned, then how to position yourself so that baby will move (or stay) in the best spot.

Ladies, this is so important! If you can start labor with baby in the right position, his/her head will help the cervix to dilate at a good pace, and you won't have to wait while baby turns itself around during labor. (Or worse, face what can happen if it stays in the wrong spot - backache throughout labor, LONG labor, exhaustion, and sometimes a C-section!)

Spend the time reading and acting now (while you're comfy) and you'll spend less time in labor!!

Birth In New Orleans

2005-08-17T17:56:00.000-05:00

Giving birth soon? Get prepared. Get support. Get what you deserve.

Every woman deserves a doula. "What's a doula?" you ask. Doula is the Greek word for slave. Specifically, a woman who serves another woman. And in contemporary terms, a woman who is trained to support a woman during labor and birth. Doulas provide emotional, physical and information support to laboring women and their families that will help to make labor and birth a more satisfying, empowering experience.

I'm a doula. You deserve me! Hire me today!

If you don't know your choices, then you have none. Learn what your choices are for labor and birth. Childbirth preparation classes that present "freedom of choice based on knowledge of alternatives" are sure to cover your options and prepare you to make intelligent decisions. My classes are conveniently condensed to fit in two Saturday sessions and are centrally located in Metairie.

My classes are accessible and invaluable! You need them! Register today!