Tuesday, March 29, 2016

Has your doctor mentioned stripping your membranes? Have you had a cervical exam that ended with your physician telling you he/she stripped your membranes?
Stripping or sweeping the membrane is a form of inducing labor. During a vaginal exam, if a woman is already dilated to one centimeter; your doctor may mention stripping, which involves sliding a finger between the edge of the cervix and the amniotic sac. The Amniotic sac, or membrane, is "stuck like glue" to the cervix and the doctor will use his/her fingers in a sweeping motion in an attempt to separate the membranes from the internal cervix and lower uterus. This will make for a more vigorous vaginal exam, that often results in discomfort, bleeding,cramping, and irregular contractions afterward, which can last up to 24 hours. Some research suggests that it increases the risk of spontaneous rupture of the membranes, as well.
The doctor  puts her or his finger into the cervix—the mouth of the uterus—and uses the finger to separate the bag of water from the side of the uterus near the cervix.
This intervention aims to trigger a release of prostaglandins, the hormones that trigger contractions.
Although this is not a form of induction that uses artificial hormones to stimulate labor, an instead triggers the use of natural hormones....it is still not a "natural process".
Your doctor might encourage you to try this before going the route of a hospital induction using prostglandin gel and/or pitocin. This intervention may shorten pregnancies of women who are at term (41-42 weeks) and may also reduce the need for induction.
Remember, as with any and all procedures, your care provider should obtain consent before performing this or any other procedure.
It is also not ideal for the patient (you) to be asked about this while the physicians hand is in  YOUR vagina.

You should be given time to consider your risks and benefits and prepare for this, if it is something you want to consider.
Stripping of membranes and other mechanical methods of induction may begin labor but may also lead to additional interventions and synthetic forms induction. It is important for care providers to share all information with expectant mothers so that a well-thought out plan can be made.

Reasons You Would Not Want Your Membranes Stripped:
According to the American College of Nurse-Midwives (ACNM) Fact Sheet on Stripping Membranes1, there are five reasons why an expectant mother may not want her membranes stripped.  They include:

  • You have been told that it is not safe to have your infant vaginally.
  • You have had unexplained vaginal bleeding during your pregnancy.
  • You have been told that you need to have your infant urgently and it would be safest to have your labor induced by using medication.
  • You want to let your pregnancy and labor unfold naturally and there is no medical reason to have your labor induced.
  • If you have had a vaginal culture that says you have group B strep (GBS) in your vagina, you may not want to have your membranes stripped; there are no studies that have shown it is safe if you have GBS so this decision should be made with you and your care-provider making the decision together.

Thursday, February 25, 2016

If only I had a doula when I had cancer...by Laura Fortner

If only I had a doula when I had cancer

There are a few things that define who I am.  Mother.  Wife.  Doula.  Cancer survivor.  I had incredible doulas beside me providing support and information when I gave birth to my boys in Dallas and Seattle.  I look back on having cancer and wish that same support was available for that transformative and paralyzing time in my life. 

I needed another hand to hold, a non-judgmental, compassionate hand that sat with me and would rub my poor, sweet husbands back and wipe his forehead from the stinging sweat of stress. I wanted someone to sit next to me in the cold, foreign OR and tell me what was happening around me.  What was that strange smell? What are they hooking me up to now? I needed someone to promise me I would wake up even if they knew they couldn’t keep that promise. I ached for a medical jargon interpreter.  I often found myself wishing we had asked more questions or wanting to call my Oncologist at 3 am for clarification. 

 I did not know it at the time but so much was kept inside for fear that I may burden my loved ones. I craved someone to be my pillar.  I wanted to lean on that pillar and not fear that the weight of my troubles would eventually cause them to fall.  I know that is not realistic with family members or friends.  They love you and are invested in your well being.  They hurt when you hurt, cry when you cry, and are deeply, emotionally tied to the outcome.  Doulas are not.  I unknowingly hungered for that unprejudiced support. 

 My husband was emotionally and physically drained.  It would have been a weight lifted off his broad but broken shoulders if someone else was there to walk the halls with me, help me out of bed and get me in the shower.  We had amazing friends staying with us, but there was so much to be done to keep the house running that physical support could not be their only focus.  He needed comfort and relief.  He needed someone to tell him “This is normal.  Your anger is justified and real. I acknowledge it.” “The pain your wife is in will get better.  It is temporary.”   

It was a glaring hole in our lives that I could not fill for him.  When I look back on our struggle, I see how clearly a doula would have suited our ever changing needs.   I am incredibly thankful to be starting my third year cancer free.  I realize the value of support today more than ever in my life but I find myself wondering…….If I only had a doula when I had cancer.

Monday, January 25, 2016


I am so excited to share the news.....NORTH DALLAS DOULA ASSOCIATES has won BEST  IN DALLAS!
Although I have won twice before as an individual, for the first year ever, an entire team of doulas (MY PRACTICE) won!!!
North Dallas Doula Associates was established in 1999, with a goal and a mission to facilitate change and recognition of the professional doula and establish a well deserved place on the birth team. Our mission statement reads, "To promote, support, and preserve the nature of birth by educating and empowering families through childbirth and beyond". Little did I know we would eventually be providing education and empowerment to nurses & physicians in hospitals, and students in high school and college nursing programs. We grew from 1 doula (me) to 14 and provide an abundance of expertise and services collectively.

We live by 10 values:
1. Be intentional through consistency and commitment, be lead by integrity
2. Embrace and Drive Change
3. Create trust and non judgement through service
4. Be a witness and testify, hold space and be present
5. Pursue personal and practice growth through learning
6. Build, open, honest, and genuine relationships through communication
7. Build support and uplift the practice through sisterhood and transparency
8. Practice grace, alignment, and balance
9. Be passionate, determined, and confident
10. Be humble and grateful

Our practice has changed the way providers see birth and has allowed us to become colleagues and  team players on the pregnancy, birth, and parenthood journey.

We want to thank you for voting for us, supporting us, and being loyal to us.... We couldn't have done this without you!
We didn't just WISH for it WE WORKED for it....team work really does make the dream work!!!

With many thanks,
 The Best Doulas in Dallas!

Special thanks to Red Plum Photography!