A Doula’s Waterbirth Toolbag

Posted on 25 October, 2013 by Judith Halek

By Judith Elaine Halek

Published by Midwifery Today in 2000
Photos and Article: Copyright @ 2000
Judith Elaine Halek

In my tool bag as a water labor or birth labor assistant,
I include extra equipment besides the standard labor assistant accoutrements:

rubberized thong slippers
a one piece swimsuit or body leotard (in case I have to get into the water; first I take a shower)
a short terry cloth robe
a water bottle for myself filled with part juice or tea mixed with honey and water
an underwater watch to check a second hand during contractions
Rescue Remedy (a Bach flower remedy) for all attending the birth
one or two sterilized small inflatable pillows for the mother to lean against in the water
an infusion of raspberry leaf tea, a spoon and honey for the “drizzle” mentioned earlier
a bag of bendable straws for the mother in the shower or tub
an extra set of clothing if something gets wet
a green sixty-five centimeter birthing ball for birth attendants to sit on while the mother is in the tub or for the mother to use while in the shower
two rolls of soft toilet paper wrapped in a clean plastic bag o a small box of soft Kleenex
lavender essence oil (5 to 10 drops in the tub, great antiseptic); I also like to keep on hand a spray bottle of lavender: using a small spritzer bottle filled with purified, filtered or distilled water, I add 10 drops of lavender essence oil (I buy a large supply bottle then put into a smaller dropper bottle), ice chips to make it cool, and spray on the mother when she¹s in the waterbirth tub (I make sure ahead of time that lavender does not make the woman nauseous‹so far, all women like it)
hand lotion that is not greasy
lip balm because the water tends to dry out my lips and hands
three books: Water Birth, A Midwife’s Perspective by Susanna Napierala16; The Waterbirth Handbook, The Gentle Art of Waterbirthing by Dr. Roger Lichy & Eileen Herzberg17; and Water Birth, The Concise Guide to Using Water during Pregnancy Birth and Infancy by Janet Balaskas and Yehudi Gordon.18
thermometer: If I am attending a homebirth, I usually include a thermometer to check temperature of the mother if I suspect she might have a fever. It is amazing how many people do not have a thermometer in their homes. Generally a doula does not perform any medical procedures, and taking the temperature is such a procedure. I have the father take the mother’s temperature to see if it is high.
scooper: I also suggest to the parents that if the pool rental does not supply a scooper for scooping out fecal and birth matter released in the water during labor or birth, they purchase one from a local pet store, sterilize it and wrap it in a plastic Ziploc. Urinating in the water is fine. Urine is sterile and clearing the bladder will make room for the babies’ head to dip down. I suggest, however, that all labor attendants in the water use the bathroom facilities.
stainless steel or plastic bowl: Birthing the placenta under the water is medically safe. Generally it is up to the medical caregiver and his or her comfort level and experience in supporting this. Whether birthing at a home, birth center or hospital, I suggest parents bring a clean, large stainless steel or plastic bowl to place the placenta in if birthed in the water. A small bowl floating on the water will sink with a good size placenta.

Aromatherapy During Labor & Birth

Posted on 17 January, 2013 by Judith Halek

I have been a labor support doula predominantly in the New York, tri-state area since 1987. I have been flown internationally to attend births in Mexico, Germany, to name a few. Body work has been in my blood and life since I was 3 years old. My father remembers how I would run and jump into his arms at the end of a long day and hug, kiss and rub my little hands all over his neck and face and chest. He said it was one of the best parts of his days.

Now, many years later, I have discovered, beyond my own aromas, in labor and birth there are numerous scents to help enhance, soothe, uplift and support the mother, baby and her partner. You may use aromatherapy by mixing with tracer oils or in a diffuser accompanied by low lights and music to enhance the aroma. My favorites essences during labor, IF the woman is comfortable with the smell are moroccan rose and/orgeranium together or separate, lavender and/or neroli, together or separate. Clary sage is my all time favorite for stimulating the womb and encouraging the expansion and softening of the cervix.

Here is my research so far. Enjoy the aromatic experience!

AROMATHERAPY LABOR & BIRTH

BASIL General tonic, can relieve nervous tension, flatulence and nausea and aids digestion. Credited with the power of relieving the pain of a woman in labor.

BERGAMOT A “ray of sunshine.” This is said to uplifting, light and refreshing, helping relieve depression and anxiety. Helps to renew energy during the labor.

CHAMOMILE The “Matriarch” of oils, very gentle, soothing and calming to the mind and body. Helps calm the irritated, fretful or nervous person. Helps to renew energy and ease during the labor.

CITRUS Generally quoted as having some degree of photo toxicity, which is of relevance in maternity care, for these are otherwise considered to be among the safest oil to use during pregnancy.

CLARY SAGE This essential oil must not be confused with sage. Don’t use sage for the baby’s sake – it leaves too high toxic residues in the body. Clary sage is a milder version, although still should be used with care. Helps respiratory, muscular, and uterine systems. Mild analgesic. Facilitates birth; uterine tonic. Euphoric. Helps breathing by calming the lower part of the spinal cord. Works on the uterus or that influence hormone balance, during the labor to stimulate contraction or after the birth of the baby to aid the mother’s recovery. This works well as a muscle relaxant, relieving stress and tension in the body. During the labor, it has a very special action of toning the muscles of the uterus and is particularly effective if the mother’s contraction is weak and irregular and progress towards the birth of the baby is slow. In this case, apply a little oil to the belly between contractions using the circular clockwise strokes, applying a firm but gentle pressure using the flat of the hands in the comfortable position. Concentrate on relaxing the muscles of the lower belly allowing the baby to move downward to press firmly on the neck of the uterus. Apply this massage for 10-15 min or until regular contractions is established. NOTE: Some practitioners advise that this be used during labor only. Before using this during pregnancy contact someone knowledgeable in essential oils.

GERANIUM Circulation-stimulating. One of the best circulatory oils – and if the circulation is good, breathing will be easier. Good for uterus and endometrium. Contractive effect – pulls together dilated tissues, so excellent for after the birth. Good for the whole female reproductive system. Antidepressant, known for its uplifting effects. Has a great benefit as it is used to massage the lower back.

JASMINE Works on the uterus or that influence hormone balance, during the labor to stimulate contraction or after the birth of the baby to aid the mother’s recovery. Reassure and boost confidence during the labor. Because of its actions on the uterus, it is invaluable during childbirth. It can strengthen contractions, yet relieve pain and due to its anti-depressant quality, can help with post-natal depression. Has a great benefit for massaging the lower back with Jasmine.

LAVENDER Circulation stimulating. Slight analgesic effect. Calming. Antiseptic; antibiotic; disinfectant; slight antiviral properties; anti-inflammatory.Promotes healing of open wounds – can be used instead of antiseptics.Accepted by everyone. Good for headaches, fainting, and bringing around after shock. Restores unbalanced states to a more harmonious state, and has been said to strengthen contractions. Has a great benefit as it is used to massage the lower back.

LEMON OIL Active phototoxic ingredients of lemon oil is mainly the furancoumarins bergapten and to some extent oxypeucedanin. However, some suggest that distilled lemon and lime oils, and expressed mandarin, tangerine and sweet orange oils are not phototoxic.

LEMONGRASS The effectiveness in stimulating stress related weakness has been shown to help in encouraging milk production and digestion.

NEROLI Works on the nervous system and facilitates easy breathing, especially during panting (if this is used to stop pushing). Its calming effect increases the oxygen supply to the blood and brain and helps the woman to avoid hyperventilation.In low doses (1-2 drops per day on a diffuser) it has a sedative and calming effect; in higher doses, it is a stimulant. Has a great benefit as it is used to massage the lower back.

NUTMEG Analgesic. Calms the central nervous system; alleviates anxiety. Increases circulation – good for blood supply.

NEROLI This oil may be one of the most effective anti-depressant oils; it is useful for insomnia, hysteria, anxiety and other stress-related condition.

ROSE Uterine relaxant. Helps ligaments to soften, enabling the pelvic bones to expand; and to regain elasticity after the birth. Natural antiseptic. Slight analgesic effect. Good cardiac tonic. Reassure and boost confidence during the labor. Works on the uterus or that influence hormone balance, during the labor to stimulate contraction or after the birth of the baby to aid the mother’s recovery. Has a great benefit as it is used to massage the lower back

ROSEMARY May be used in late pregnancy with caution, but are thought to be toxic in early pregnancy. Do NOT use if the mother develop high blood pressure during the pregnancy or labor as it may unduly stimulate the circulation if high blood pressure develops.

Aromatherapy During Pregnancy

Posted on 17 January, 2013 by Judith Halek

I have been doing Bodywork for the pre/post natal woman since 1987. In my work, I combine a number of modalities which result in the sessions becoming uniquely tailored to each individual. Based on what the woman or partner is going through, I will work accordingly with the aromatherapy essences.

Enjoy the touch, smell, sense of well being the aromas bring to you, your baby, or partner you are working with. Let the room become infused with the essence of healing!

The following is a list of essences to assist and/or avoid during the time of pregnancy.

BASIL General tonic can relieve nervous tension, flatulence and nausea and aids digestion.

BENZOIN Helpful in all “cold” conditions, such as flue, colds, coughs and bronchitis and for the relief of gout and rheumatoid arthritis. Beneficial in times of sadness and loneliness as combined with neroli or rose.

BERGAMOT Safe throughout pregnancy. Effective in helping treat the irritation, stinging and tenderness caused by urinary tract infections which may develop during pregnancy. Uplifting, light and refreshing, helping relieve depression and anxiety.Used as a treatment for loss of appetite, colic and intestinal infection.Caution: phototoxic and can cause a skin reaction when exposed to UV light, from either sunlamp or sunlight.

BLACK PAPER Stimulating oil, its principle areas of action being on the respiratory, digestive and urinary system. Blends well with the fortifying benefits of frankincense and sandalwood and can restore tonus to lax, smooth muscles. Gives relief from stiff muscles and with its pronounced stimulating action on digestive tract, can help with constipation, flatulence, loss of appetite and with atonic dyspepsia. Caution: only small amount is ever needed.

CEDARWOOD Should NOT be used during pregnancy.

CHAMOMILE Safe ONLY after 16 weeks. Effective for relieving muscle spasm experienced as back ache, or discomfort due to infection within the urinary tract.

CYPRESS Safe throughout pregnancy /Avoid during the pregnancy (conflict). A powerful astringent and circulatory tonic that is useful as a treatment for varicose veins and hemorrhoids. Also helps relieve excessive foot perspiration commonly experienced during the pregnancy.

FRANKINCENSE Safe Throughout pregnancy.One of the most useful oil for use during pregnancy. Effective in helping the user cope with extremely stressful situations, inducing a state of concentration. The fortifying action gives tonus to loose skin and can help with engorged breasts.

GERANIUM Safe throughout pregnancy, Good for poor circulation, edema, breast engorgement, stress and anxiety. Helps to restore hormonal equilibrium. (Contradiction) Should be avoided during the first trimester of pregnancy, and only used in low dilution for the remaining time, unless under the guidance of a professional Aromatherapist.

JASMINE Safe only after 16 weeks. Calming and relaxing, encouraging optimism and confidence.

JUNIPER In homeopathy, under the name of threatened miscarriage and metrorrhagia, however AVOID the use of juniper during the pregnancy, this primary due to its action on the kidneys.

LAVENDER Safe throughout pregnancy. Has a wide range of therapeutic qualities:

·Analgesic

·Encourages the healing of damaged tissue

·Prevents excess scar tissue developing

·Relieves headaches

·Settle the stomach

·Stimulate the immune system, helping protect the user from infection

·Useful in helping treat constipation

·Has a smoothing and gentle presence for helping reduce high blood pressure

Frequently used to enhance the action of many other essential oils. In case of morning sickness, place a drop of the oil on a handkerchief and inhale.

LEMON Safe throughout pregnancy. Helps tone the circulation and reduce tissue congestion. Stimulate the immune system, improving the use’s resistance to infection. Caution: Phototoxic, may cause irritation.

LEMONGRASS The effectiveness in stimulating stress related weakness has been shown to help in encouraging milk production and digestion.

MANDARIN Safe throughout pregnancy. Helps soothe and settle the nervous system and digestive tract, encourages optimism. Caution: possibly phototoxic.

MARJORAM A powerful sedative, an aphrodisiac and can lower blood pressure. It is therefore NOT recommended for use during pregnancy.

MELISSA Can promote relaxation and good sleep and it is a very gentle oil, is safe to use over a long period of time or with delicate or frail people.

MYRRH Should NOT be used at all during pregnancy due to its use as an emmenagogue to promote menstruation.

NEROLI Safe throughout pregnancy. Acts as a sedative for the nervous system, relieving stress and state of depression. Also good for nourishing the growing layer of the skin in treatments for stretch marks.

ORANGE Safe throughout pregnancy. Helps tone and stimulate the digestive tract, and is useful for digestive upsets. Bright and energizing. Caution: phototoxic.

PARSELY Should NOT be used during pregnancy or on children.

PATCHOULI Safe throughout pregnancy. Good for treating inflamed skin and preventing the development of infection. Also works well as a nerve tonic and is useful in helping overcome anxiety. However, rather like ginseng, a lot depends upon the state of mind of the individual.

PEPPERMINT Safe only after 16 weeks / has to be avoided during pregnancy (contradiction). Valuable for helping treat all digestive problems, nausea and headaches. Also relieves breast engorgement by reducing the circulation to breast tissue. May used in footbaths to refresh and deodorize tired and aching feet. Caution: skin irritant in concentration. In case of morning sickness, place a drop of the oil on a handkerchief and inhale.

ROSE Avoid using rose during pregnancy unless under the provision of a professional Aromatherapist.Relaxing and soothing when experiencing anger or intense emotions. The profound positive effect on the emotions, it can be related to its influence on the female productive organs.Also helps regulate hormone balance following childbirth.

ROSEMARY Safe only late pregnancy / Avoid during pregnancy (contradiction). Avoid in cases of high blood pressure. Good for encouraging the circulation needed for the production and flow of breast milk. Also useful for states of tiredness and fatigue.

ROSEWOOD Has a gentle yet positive effect and is of particular benefit during pregnancy.

SAGE Can be a very useful oil for pregnancy and childbirth, yet it can be toxic in certain circumstances and should be strictly avoided unless the treatment of a fully qualified Aromatherapist. It is not for home use.

SANDALWOOD Safe throughout pregnancy.Recommended for impotence, physical tonic, especially for the reproductive organs.Useful when treating urinary tract infections. Relaxing and supportive.

TEA-TREE Safe throughout pregnancy. Aid the damaged tissue while helping prevent the development of infection.Its antiseptic and antifungal effect is good for treatment for female problems, such as fungal conditions, urinary or sinus infections.

THYME Toxic in certain circumstances and should not be used during pregnancy.

YLANG YLANG Safe throughout pregnancy. Good for high blood pressure, stress, anxiety. Anti-depressant. Because of its “heady” aroma, it is not recommended to use on those prone to headaches. Effective against introversion, emotional coldness, anger and frustration and is recommended for frigidity and impotence or for those with sexual debility.

Essential oils to be completely avoided during pregnancy:

·AngelicaAniseed·Armoise·Arnica (not to be confused with homeopathic remedy)·Basil Birch Black Pepper Boldo Leaf Buchi Caluamus Camphor·Caraway· Cassia Cedarwood Chamomile Cinnamon· Clary Sage Clove·Cedar wood· ElecampaneFennel· Fir Ginger Horseradish Hyssop·Marjoram· Melissa Mugwort· MustardMyrrh· Nightshade Nutmeg· Oregano Origanum· Parsley Seed Pennyroyal·Peppermeint Pine Rose Rosemary Rue Sage· Sassafras Savin Savory·Southernwood Stinging Nettle Tansy·Tarragon·Thuja·Thyme (both Red and Linalol)·Wintergreen Wormseed Wromwood.

Essential oils that must be used with caution during pregnancy:

·Chamomile · Clary Sage ·Peppermint ·Rose·Rosemary