What is in my Birth Bag?

Each birth professional has their own specific tools, skills, resources, and special items they carry with them to births.  Each bag is different and unique just as are those doulas carrying these items.  Often we don't even use the items in the bag because our hands, voice, and energy is what is needed to support families during a birth.  I am happy to have some special skills that not many others share in our doula community.
In my birth bag I carry:
Tennis, Racquet, and Stress - Balls (for massage)
Container for ice
Battery operated tea lights
MP3 loaded with music
HypnoBirthing Recordings:  Rainbow Relaxation/Affirmations
Hypnosis Scripts
Combs for acupressure
Rebozo and scarf (learn more below)
TENS Unit (learn more below)
Peanut Ball (learn more below)
Birth Ball (learn more below)
Coconut Oil for massages
Lavendar scented lotion for relaxation
Hair Bands and extra tolietries in case you might have forgotten something
The Labor Progress Book and The Birth Book - Reference Materials


Additional Skills:
TENS Approved Training - DONA 2015
DONA Doula Certified - 2012
HypnoBirthing Certified - 2006 to present
Hypnotherapist - 2006 to present
Reiki/Energy Master - 2008 to present


What is a TENS (Transcutaneous Electrical Nerve Stimulation) unit & how is it used in labor ?


•The TENS unit works by passing mild electrical impulses through the skin, via electrode pads, into the nerve fibers which lie below. These impulses help the body produce its own pain killing chemicals, such as endorphins.


•It is controlled by the pregnant person or partner and not the birth doula. It works best if started in early labor.

•It is being used successfully in UK, Canada, Australia, and Europe.


Benefits of the TENS unit:
•Pregnant people report that the TENS unit was helpful with back labor and 50% state they would use it again.
•Research has shown that many women would choose to use a TENS unit for the second labor after using one the first time.
•It can delay the use of pain medication up to 3 additional cm.
•It does not interfere with the monitors or hospital equipment.
•The TENS unit can provide relief for the pregnant person 30 minutes after its turned off.


When and how not to use the TENS:
•Prior to the 37th week of pregnancy.
•On or over the abdomen (electrodes).
•In water:  take off before shower or bath. 
•In the presence of flammable gas.
•In the presence of very high or low blood pressure.
•If you have a high fever, tuberculosis or malignant tumor's.
•If you have cardiac issues/pacemaker, epilepsy, undiagnosed pain, rash, inflamed or infected skin, or metal implants.

What is a Rebozo and how is it used during labor?

A rebozo is a long flat garment used by women mostly in Mexico. It can be worn in various ways, usually folded or wrapped around the head and/or upper body to shade from the sun, provide warmth and as an accessory to an outfit. It is also used to carry babies and large bundles, especially among indigenous women. (From Wikipedia).  It is also used in Africa and other Latin American countries.


In labor, we use the rebozo as an additional tool in our tool bag.  The rebozo is a flat Mexican shawl that is long enough to wrap around a woman's body (about 4-5 feet). A rebozo is a multifunction tool for labor, used to assist the mother in various positions and for relaxation. If you do not own a rebozo, you can substitute a large scarf, sheet or piece of fabric.  It helps as an extension of the birth companions arms. (From Birthing Naturally).


There are many different uses for helping with counterpressure to squeezing hips, to sifting baby, and much more.  It is a great tool for doulas to use and it has use beyond labor as a baby carrier for parents.  Below are a few video's using various methods with the Rebozo.

How do you use a Birth or Peanut Ball during labor?


The Birth Ball is an exercise ball that has benefits for pregnant, laboring, and postpartum families.
During Pregnancy mothers find the following benefits:
The ball helps with posture which helps to prevent malpositioned babies. 
When a woman sits on an exercise ball the knees are apart with no muscle tension in the adductor muscles.
The pelvis is tilted forward.
This positioning helps get the baby in the right position for birth and can help with back pain.
During labor the birth ball is helpful:
Enables a woman to maintain an upright position
Gravity helps the baby's descent down the birth canal
Enhances baby's alignment in the pelvis
Provides pelvic relaxation by providing perineal support without pressure
Can encourage baby to rotate if necessary
Allows pelvic movement such as rocking, rotation and other rhythmic movements that may facilitate birthing
Fetal monitor can be used with the birth ball without disturbing the mother
Warm compresses can be applied to the perineum on the ball
Easy to do comfort measures such as massage or light touch massage.
Support while squatting
For back labor, a woman can lean over the ball, allowing good pelvic mobility and the effect of gravity to help the baby rotate
Can be beneficial when there has been a prior failure to progress
Contractions can be less painful and more effective
During the Postpartum Period:
The ball can be used for recovery from a cesarean or episiotomy.
Parents can sit on the ball and rock the baby.
Help with exercise during postpartum period for Mom.
A fussy baby can be laid on her tummy on the ball and the pressure may help relieve the baby's discomfort.



What is a Peanut Ball and how is it used in labor?


What tool in your toolbox can take 90 minutes off of the first stage of labor and reduce the pushing phase in half?  The peanut ball is a relatively new addition to the birth team.  It has been used in Physical Therapy for years.  Its appearance in the birth room though is recent.  A peanut ball is a tool for promoting labor progress for women resting in bed or used with an epidural.  We have found that a smaller ball is easier for most women to use (45cm).  It helps the pelvis to open and expand wide for an easier descent of the baby.  It keeps the pelvic outlet open when stationary.
We have found that the peanut ball is most commonly used when pregnant people need to remain in the bed, whether because of epidural use, complications, or simply because mom is exhausted.
In the blog, Science and Sensibility the following evidence was presented about the peanut ball:
In my search (Andrea Lythgoe), I found one study, presented as a poster presentation at the 2011 AWHONN Convention. Tussey and Botsois (2011) randomized 200 women (uncomplicated labor with an epidural) into two groups.

One group used the peanut ball in either the semi Fowler’s position (bottom photos) or the side-lying position (top photos), switching sides every 1-2 hours.

The sample size was small, but the results were very promising. The first stage of labor was shorter by an average of 90 minutes, and the second stage was roughly half as long (43.5 min in the control group, 21.3 min in the peanut ball group). The use of vacuum and forceps was also lower in the peanut ball group. There were no serious adverse events reported in the study. This looks very promising, and I will be watching for more studies on the peanut ball in future years.
Many have speculated that the more upright semi Fowler’s position might also be helpful in preventing the increase in operative deliveries seen with epidurals (Anim-Somuah (2011), but a recent Cochrane Review found insufficient evidence to demonstrate a clear effect. (Kemp, 2013)

A similar review looking at the benefits of upright positions in moms without an epidural did show some benefit. (Gupta, 2012)

Since it is known that babies in an Occiput Posterior (OP) position can increase the length of the second stage and the rate of operative delivery (Lieberman, 2013; Caseldine, 2013) the reports of posterior babies turning when the peanut ball is used may be a big reason for its effectiveness.
A simple tool such as a birth ball that is about $50 in cost can yield amazing results for mothers in labor.  The above studies yielded the following:   a decrease in the length of labor, reduction in cesarean deliveries, and a decreased use of vacuums and forceps to assist with delivery. Those using the peanut ball had their labor cut by about two hours.   Several local hospitals have them available and most birth doulas have added them to their toolbox.