It's funny, I can be completely obsessive about it in some areas, and then fly by the seat of my  pants in others....not always applied to the right situations. When I was doing my birth plan, I took in a 12 page checklist to my midwife, her eyes almost popped out of her head, and then found out that half of the things on the list  don't even get done here, or within that practice anyways. 

It's hard when you are scared and feel out of  control to figure out what choices to make, and know what you should put on your  birth plan. 14 years and many many clients later, if I were doing it again  (please let this not jynx me) this is what I would do differently. 

Honestly, I would probably still start with the  lengthly checklist, they can be really helpful when trying to figure out what options you have, what they are, and what really matters to you. Then I would go  through and figure out what are our top 5 most important things. What do I  really want to happen and what do I really want not to happen? I know, this sounds super complicated, but it's not as hard as you think, especially if you remember that many things are tied together in birth. I opted to have a home  birth with a midwife. There were certain blanket decisions that were made simply  because of this choice that I didn't have to put in mine, although I'm sure I  checked the box anyways, simply because the home birth aspect practically  eliminated them.

We sometimes forget that many of our decisions eliminate, or necessitate other things. If you say you want to know the pros
and  cons of every procedure prior to them being considered and to be told when they're being considered, do you have to state every one you want or don't want?  If say you want to move freely does that not eliminate everything that prevents  you from doing so? If you would like an epidural, you are in bed with an IV and  monitor and catheter among other things. When you think this way, can you see  how it can be easier to streamline things?

But what do you do when plans don't go as you hoped? I got lucky, because I didn't need to use a back up plan, but do you have  one? Do you need one? I'm no sure everyone needs a plan a, and b, and c, and x,  but rather I think we need 3 very important things: 

1.  A good understanding of our options, and the  knowledge that you'd rather have this over that.
   
2. Knowing how to ask good questions to get all the information that you feel you need. What are the benefits? Drawbacks?   Alternatives? What other decisions am I also making if I make this one (If I get  epidural do I also need an IV, catheter, monitor, waters broken etc)? What happens if we wait? 
   
3. As a couple (or you and your support person) you both need to be on the same page, so that if mom can't speak for herself, then the partner is able to, and feels confident enough to speak for you both.  
   
   Remember that birth plans can be a great tool to make sure everyone in the room is on the same page, but they are not a magic wand, and they can't take the place of open communication and making sure that everyone is on the same page. They can't make things happen the way you want them to, but they can encourage you to think about, and educate yourself on what's important to you, and in the event of surprises, allow you to determine which things you are willing to barter to allow you to have the best new plan. 
    
    
   Angelina Kiwanuka-Quinlan
   Director of Labour Support
   Precious Moments Babeez 

Your due date is very quickly approaching and you can’t wait to be off work with your little one.  Who doesn’t love paid time off? All you  have to do is figure out maternity leave, and it’s giving you a headache. Don’t worry, we’re here to help! 
 
There are some common facts that relate to all maternity and baby related benefits:
 -  All EI benefits have a 2 week waiting period. 
 -  If the waiting period has been served within the previous 52 weeks, you will not have to serve it again. 
 -  If the benefit can be shared with someone else, only 1 waiting period has to be served (so if mom receives sickness benefits or maternity benefits and serves the waiting period then the partner does not have to serve a waiting period). 
 - You must apply for benefits as soon as you stop working!
 -  You don’t need your record of employment to begin the process. 
 - If you wait longer than 4 weeks after your last day of work, you may lose your benefits.
 - Your income must be reduced by more than 40%. 
 -  You must have worked at a job or numerous jobs where Employment Insurance was taken from your cheque for at least 600 hours cumulatively in the last 52 weeks or since your previous EI claim, whichever is SHORTER!
 - It can take up to 28 days to receive benefits.
 - All benefit periods run from Sunday to Sunday.  If you have your child/become ill on a Monday, your benefit period does not start until the following Sunday. 
 - Until August 1, 2015 after the waiting period has been served, you may work while on leave. If your earnings are less than 90% of the weekly earnings used to calculate your benefits, your benefits will be reduced by 50% of all earnings  during that week. If your income exceeds the 90%, then your benefits will be reduced by 100% of your earnings. 
 -  EI  benefits are taxable!
 -  EI  benefits are generally approx. 55% of your earnings up to a maximum of $514 per week. 
 
Employment Insurance Sickness Benefit:

 -  A benefit  for people who meet the above criteria and cannot work because of sickness,  illness or quarantine.
 -  15 weeks  of benefits.
 - There are  a variety of ways that the two week waiting period can be waived or deferred,  especially if you are receiving sick leave pay from your employer, or sickness  and accident benefits from insurance benefits. Check with CRA to ensure that you  are not serving a waiting period you do not have to serve. 
 - This  would apply to a mother who is experiencing complications due to her pregnancy and was therefore unable to work.

Maternity  Leave:

 -  A benefit  for all biological mothers  including surrogates who cannot work because they are pregnant or have recently given birth.
 -  15 weeks of benefits.
 - Can begin up to 8 weeks prior to the due date. 
 - You  cannot receive benefits past 17 weeks after your due date, OR  the day you give birth, whichever is later.
 -  If your newborn is hospitalized, this 17 week period could
be extended by the number of weeks (s)he is in the hospital for, even if you  received benefits prior to the birth of your baby up to a maximum of 52 weeks.

 Parental  Leave:

-  A benefit  for biological, adoptive or legally recognized parents (such as being on the  birth certificate).
 - 35 weeks  of benefits.
 -  Can be  shared between parents but cannot exceed 35
weeks.
 -  Can be paid starting the baby’s date of birth.
 - Can only  be paid out during the 52 weeks after the baby is born or adopted. 
- If your newborn is hospitalized, the 35 week period could
be extended by the number of weeks (s)he is hospitalized.
 -  A parent  can return to work, work for a few weeks and decide that he or she should not  have returned to work and then utilize the remainder or a portion of the  remainder of the parental leave; however they cannot exceed the 52 week deadline. 
 - If a  parent is in the military and deployed the 52 week deadline is extended to 104 weeks. 
 
Parents of Critically Ill Children Benefits:

-  A benefit  for parents of a child under the age of 18 (can turn 18 after the certificate is  issued) who suffers from a critical illness or injury. 
 -  35 weeks  of benefits.
 -  Can be  shared between parents but cannot exceed 35 weeks. 
 -  You must submit a medical certificate filled out and signed by a Canadian specialist medical doctor. 
 - The 35  weeks must be utilized within 52 weeks of the date the medical certificate is issued, or if the claim is made prior to the certificate being issued, then from the date that the doctor certifies your child is critically ill or injured.

 
Compassionate Care Benefits:

-  A benefit for a family member or close friend that you consider a family member who is gravely ill and has a significant risk of death within 26 weeks. 
 - You must be providing care or support to this person (providing psychological or emotional support, arranging for care by a third party or directly providing or participating in the care).
 -  6 weeks of benefits.
 - The weeks do not need to be consecutive. 
 - Can be shared. 
 - Must be used within the 26 week period.
 - A doctor must provide a medical certificate. 

 
All of this information was condensed from a variety of
 Government of Canada websites.  We tried to cover any benefit that could apply during the perinatal period; from the possibility of a complicated pregnancy, to the potential of a premature or sick baby. In the even that you need to use more than maternity and parental leave, please do more research or contact Service Canada to determine the best way to facilitate your situation.

By Angelina Quinlan Kiwanuka

1) I have a midwife/doctor/family member so I don’t need a doula.

 A midwife is a wonderful addition to your birthing team, either in or out of the hospital, however, because they are medical professionals they are responsible for many tasks outside of direct support leaving a potential gap in care.  Your doula can fill that gap.  As doulas we have the privilege of not performing any medical tasks.  As a result, we are not responsible for tracking and charting, preparing tools, or watching a clock.  This allows our entire focus to be on the birthing parents. 
 
 Obstetricians can also be pivotal in your birthing experience as needed, but what most people don’t realize is that they work on a rotation, so depending on how many OBs are on your hospital’s rotation, there could be a very slim chance that the doctor you
 hired will actually attend your birth. Even if your doctor is present, he or she will spend very little time in your room and is there primarily to catch the baby. Even the labour and delivery nurses have medical responsibilities, and work on a shift rotation. A doula is the only guarantee of continuous, focused support. 


 A family member can be a great support during your birth. 
There are some perks to having a Doula in lieu of, or in addition to a family member (not your partner).  A Doula is an educated resource, even if he or she has read a book they just don’t have the same level of knowledge or experience that a Doula has in a
very unique environment.  As well, because you have a professional, paying relationship with your doula, you are much more likely to ask her to do the things you need. Because your family is there voluntarily, sometimes they’re willing to do the fun stuff, but not get in there when things get a bit messy. 
As an outsider, a doula also doesn’t have any of the baggage or
expectations that family often has which means nothing gets taken personally, and old grudges, or new hurt feelings just don’t come into play. 
 

2) We’ve been to class, and practiced our breathing, so we know what to do.

Many students attend class every day of the semester, do the homework and still fail, or do poorly on the exam because of the added stress. Wouldn’t it be great to have your own personal cheat sheet so that when things get intense, she can keep you on track? There’s also no possible way that everything could, or should be covered in a few days of class, doulas are great at filling in the gaps. 


3) A doula is a stranger who will intrude on this intimate and private moment.

As you have interviewed your doula and met with her a couple times prior to the birth she is no longer a stranger.  You have shared your fears and hopes and desires with her and have put faith in her that she will help you through.  

Secondly depending on where you chose to birth, it won’t be particularly private. A hospital birth can have nurses and doctors and residents coming in and out as well as anyone you have in your birthing party.  A doula  can help you maintain peace in that environment through music and focus, by helping you ignore some of the background stuff, and explaining the importance of others. 


 4) I already have a baby so I know what to expect.

 My mother had six children, and my partner is one of 10. According to both moms, none of those births were the same. Every birth has its own quirks and its always helpful to have someone who knows all the versions of “normal”.


5) A doula will protect me from the hospital staff, or interfere with medical advice.

A doula’s role is to be the resource not the source which is why just as much of a doula’s job takes place before the baby is ever born.  It can be hard to know where to go for good information, how to interpret the information you’re given, and to know what you need to know.  A doula can be very helpful in providing you with reliable well rounded sources, and teaching you how to determine if what you’re reading is accurate.  What this does is empower you to know if the medical advice takes everything that’s important to you in account or if you need more information. It also allows you to work effectively with the hospital staff instead of feeling like you’re on opposite teams. 
 
6) A doula looks down on births in a hospital setting and really wants all births to be at home.

 Just like labouring moms, all doulas have environments where they feel most comfortable.  There are some who will only do homebirths, and others who will only work with midwifes, however, all of the doulas on our team believe in working with any family, wherever they feel most comfortable, and with whichever care
provider they feel is best suited to them.  
 

7) A doula will not support the use of pain medication during labour and will leave if I get an epidural.

A doula is there to support the needs and wishes of the client. 
Our goal is to provide you with the resources so you can best determine  what choices you would like to make, and if you choose to make different ones  along to road, to make sure each decision is an informed one.  It is not our place to make those choices for you, in fact there are many doulas who have out of preference, or necessity, birthed with various forms of pain medication themselves. 


 8) I have to breastfeed to have a doula.

The primary responsibility of our doulas is to ensure that you have all the information you want and support you in your choices. We support breastfeeding/bottle feeding/ both, circumcision/non circumcision, caesareans, epidurals, etc. provided you feel
that you have enough information to make an educated decision. 
And we support helping you find more information if you need it. Our personal choices should never be a factor. 
 

9) All doulas are the same, they wear long skirts and Birkenstocks and support only  “alternative” methods.

 Anyone who has met me knows that there couldn’t be anything further from the truth.  People come to doula work from all walks of life, with all different philosophies and backgrounds. Yes there are some who are more “crunchy” than others, this is why we generally set up 2-3 phone interviews to start.  That way you can find the person who best fits your personality and lifestyle. 
 

10) I can’t afford a doula.

 Spread out over a 32 to 34 week span (assuming you don’t find out about your pregnancy until approx. 8 weeks), the average cost of a doula is approx. $3.50 to $5.50 a day.   That’s probably less than what most couples spend on a Timmy’s coffee on their way to work each day.

If it’s still a struggle, we have gift certificates, or we can set up a fund that your friends and family  can make a donation to as one of the best shower gifts. 

Also many people spend as much, if not more on nursery furniture, or a stroller or many unnecessary baby accessories, something a doula can help prevent.  If a doula is truly worth it to you, you’ll find a way. 
 
 
11) A doula would interfere with the bond between my partner and myself in labour.

I have known many couples in my life, and very few of them work in tune with each other.  This isn’t to say that they don’t want to be helpful to each other,  sometimes they just don’t seem to speak the same language, or do a very good job of reading each other’s minds.  The more intense and important the situation, the more difficult this seems to be. What if you could have a translator and a coach at the same time?  Not someone to take over, but rather someone who understands what she’s trying to say, or what she needs and can tell you, in your own language, how you could help give it to her?  That’s what a doula does.  She doesn’t stand between partners, but rather, sometimes builds a bridge. 
Even if this isn’t you, even if you’re super connected, it can be helpful to have someone to ease through the background stuff to allow that connection to flourish, and to allow each of you moments to regroup and recharge.  

By Angelina Quinlan Kiwanuka
 

 When I was pregnant with “T” I puked all the time, a lot! It sucked! 
I was also one of the lucky ones who had morning/afternoon/evening/all
the yucky time sickness until 5.5 months pregnant. Even knowing that morning
sickness usually means that the HGC levels (good baby making hormones) were
increasing, which meant baby “T” was good and stuck, didn’t make me feel better
(just because you don’t have morning sickness doesn’t mean that the baby bump is not ok, it’s likely that your body is just less sensitive to hormonal changes).


There were a few things that inevitably made things worse:

* Fatigue
* Stress
* Excessive exercise
* Temperature changes, especially heat increases
* Hunger
* Being too full
* Dehydration

Here are some of the things that can help make things a bit better:

* Take it easy and get lots of sleep Drink lots of clear fluids
* Try and stay out of the heat Eat small meals frequently, skip the big meals all together
* Avoid foods that would generally make your stomach icky i.e. food high in fat, rich foods, or foods that are fried, along with being highly spiced.
* Don’t worry too much about a balanced diet, eat what will stay down within reason (I’m not promoting a diet of solely of pickles and ice cream).
* Vitamin B6 either in foods or supplements can help, as well as ginger or peppermint. Don’t forget to consult with your care provider before taking any supplements.
* Some alternative therapies can also be helpful i.e. acupressure, acupuncture,
aromatherapy, reflexology, and homeopathy.  Make sure that all care specialists are aware of any treatment methods, including supplements/teas etc. as they may
conflict.
* For extreme morning sickness there is a prescription drug called diclectin, consult your midwife/doctor to determine if this is the best option for you.

Motherrisk (www.motherrisk.org) has a lot of great resources regarding morning sickness, as well as information and studies regarding the effectiveness and safety of diclectin.


Forgoing all of those suggestions, I think the best piece I have heard so far is this:  Carry Ziploc bags with you everywhere, one of the large freezer ones.  They’ve just become your new best friend. They’re great for easy clean-up. Just zip and toss.

Any tips and tricks that worked for you that aren’t listed here?