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If you’re expecting a new baby, you may have been given the advice to hire a doula. You may have seen statistics of improved outcomes among those who’ve had a doula attend their birth. Perhaps you’ve heard that the etymology is from the Greek word meaning “to serve.” But how does a doula serve their clients? A doula is a non-medical birth professional who will guide you through labor, birth, postpartum and beyond. Your doula can discuss your options with you so you can make informed decisions, as well as provide emotional and physical support to ease your experience. While each doula offers their own style, there are certain services that most doulas will provide for their clients. Typically, a birth doula will provide at least one prenatal visit, one postpartum visit and continuous support during active labor. A postpartum doula usually provides support during the 12 weeks immediately following birth, sometimes referred to as the “fourth trimester,” but some will continue care after that as well. Simply put, a doula provides informational, physical and emotional support during the childbearing year(s). Let’s take a closer look at these three ways a doula can support you. The Basics If you don’t know your options, you don’t have any. This is a common phrase in the world of birth work. When you’re in labor, you’re exhausted, in pain and there’s often urgency inherent or implied in any choices you make. So, when an intervention is offered, many birthing people accept it without question. One method that can help the decision-making process is to check your BRAIN: Benefits: What are the benefits of the proposed intervention? Risks: What are the risks of the proposed intervention? Alternatives: What are the alternative options? Intuition: What does your intuition tell you? Nothing: What if we do nothing? What if we wait? When you’re in active labor, you might have difficulty remembering this acronym; that’s where your doula comes in. At your prenatal visits, you can ask your doula for guidance in preparing your birth plan, which can include contingencies for certain potential interventions. And as choices arise during labor, your doula can guide you through the benefits and risks and can provide you with alternative options you might not otherwise be aware of that are available to you. Your doula can remind you to check in with your intuition and can help you quiet your mind so you can listen to your instincts. The Body Although we tend to see depictions of people giving birth on their backs with their feet in stirrups, this is only one of many ways to give birth. Walking and dancing can speed up early labor. Side-lying or hands-and-knees can prevent tearing during the pushing stage. Sometimes labor stalls, and a change of position is often helpful to get things moving again. Your doula can suggest positions depending on your stage of labor. Some labor positions might require the support of another person – your doula could fill this role or assist your partner in doing so. Some doulas also provide massage or even acupressure, and most will do the “hip squeeze” that so many laboring people swear by. If your baby is presenting posterior, or “sunny side up,” your doula can apply counter pressure to alleviate back pain during labor. Some postpartum doulas will do light housework while you rest and bond with your newborn. Others might care for your baby through the night so you can catch up on sleep. Many doulas have also gone through additional training to offer breastfeeding support and may be able to assist you with latch issues and nursing positions. The Mind Pregnancy, birth and postpartum periods can be some of the most emotional times in a person’s life. A doula will hold space for you and help you process your emotions before and after birth. It’s normal to feel apprehensive, or even fearful, about labor and birth, and discussing these feelings is the first step. A doula can help you navigate your concerns in a safe space so you can be prepared emotionally for your upcoming labor. Many doulas will also guide you through writing your birth plan, which can lessen anxiety about the unknown. If you have a history of trauma, your doula can assist in communicating this, so you don’t have to relive the experience every time you meet a new medical provider. Most people will experience some form of what’s often called the Baby Blues in the immediate postpartum period. The third day after birth tends to hit hard, as hormones attempt to regulate, but the Baby Blues can continue for weeks for some new parents. A postpartum doula’s support can be incredibly valuable during this time. When the baby blues last longer than a few weeks, it could considered a mood disorder. Most doulas will recognize signs of postpartum mood disorders and will have resources available for additional support. Choosing the Best Doula for You With so many wonderful doulas in northern Nevada, you might wonder how you could ever choose just one to attend your birth. Some expectant parents are unfortunately restricted by cost. With so many expenses related to a new baby, it can be difficult to budget doula services as well. Thankfully, Nevada Medicaid now covers doula care, and some commercial insurances are following suit. Check with your insurance company to find out if they might cover part of the cost for hiring a doula. If your insurance doesn’t cover doula services, some doulas offer a sliding scale based on income. You may want to interview multiple doulas to find the right one for you. If you’re the kind of person who wants all the information you can get, a more detail-oriented doula might be the best choice. But if you tend to feel overwhelmed by too many options, you might prefer a doula who only offers additional information as the situation calls for it. If you want massage or acupressure during labor, you might want to hire a doula with those certifications. Or maybe informational and physical support are not as important to you as emotional support, in which case your best choice could be a doula who has experience with postpartum mood disorders or trauma support. Regardless of who you hire, be sure to clearly communicate your desires and expectations – not just for your birth, but also for your doula. The most important thing when choosing your doula is trusting your gut. You need to feel comfortable with your doula, as they’ll be tending to you at one of the most vulnerable times in your life. When you find a doula that you click with, who listens to you and supports your choices, you have found the best doula for you.

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Most babies weigh just one pound and are roughly the size of an eggplant when they reach 24 weeks of development inside the womb. It is a crucial stage when internal organs begin functioning, and the babies' respiratory and central nervous systems are still developing.     So, in November 2021 when Kallie Johnson experienced a premature rupture of amniotic fluid around this point in her pregnancy, her care team in Winnemucca decided to transport her via Care Flight to Renown Regional Medical Center. The team at Renown Children’s Hospital immediately began discussing the risks of delivering at 24 weeks with the Johnson family.  Moving Forward with Hope Knowing the stakes, Kallie remembers never feeling rushed to decide about delivering her baby preterm. “I felt educated and supported by my care team at Renown throughout our entire stay, starting with the education they provided about what it meant to deliver my baby early,” Kallie said. “The team really helped me make the best decision for myself and my family.”    Together, Renown employees and the Johnson family moved forward with a healthy set of nerves and a powerful feeling of hope.  Weighing in at one pound 11 ounces, Sloan entered the world on Nov. 19, 2021, via emergency Cesarean section. Her birth was classified as a micro preemie because she was born before week 26 of pregnancy and so small that she fit inside the palm of her father Sterling’s hand. A full-term pregnancy is classified as reaching 39 weeks.   A Fighting Chance  Called a fighter by many Renown Children’s Hospital care team members, Sloan spent over five months in the neonatal intensive care unit (NICU). She was placed on a ventilator, fed through a feeding tube and monitored 24/7, overcoming daily challenges with the Renown team and her family.  As a result of being born prematurely, Sloan developed a grade one brain bleed and a congenital heart defect called patent ductus arteriosus, a persistent opening between two major blood vessels, causing too much blood to flow to the lungs and heart.   To meet the oxygen needs of her tiny lungs, Sloan was intubated and developed a severe oral aversion and high-arched palate as a result. The effects would lead to difficult developmental and physical challenges that she still conquers today. Yet, with the help of her care team – including physical, occupational and speech therapists, dieticians and doctors – Sloan continues to make progress every day.

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To better protect our patients, visitors and employees, cloth masks are no longer allowed at Renown facilities. Surgical masks, KN95 and N95 masks are allowed at Renown facilities. Appropriate face masks will be provided for visitors and patients who need one. With recent surges in the infectious COVID-19 omicron variant, many have sought to upgrade their face masks. But, let’s face it, shopping for face masks with adequate protection can be a challenge, especially considering the countless variations and the rise of counterfeit masks. Follow our straightforward guide below which includes some common red flags to help you discern between a high-quality face mask that provides proper protection and those that may be counterfeit. Types of Masks Qualities of a Real N95 Respirator Mask According to the National Institute for Occupational Safety and Health (NIOSH), N95 approved masks form a tight seal around your face and include a disposable respirator that removes particles including bacteria, viruses and dust as you breathe. N95 masks that are NIOSH approved undergo strict quality assurance and performance requirements to ensure mask respirators filter out up to 95% of hazardous particles. As a rule of thumb, N95 masks will not have ear loops, commonly used in cloth or surgical face masks. N95 respirators will contain two elastic bands or head straps that fasten behind the head, one securing the crown of the head and the other resting at the base of the neck, providing a snug fit and seal. Some other common signs that an N95 might be counterfeit include lack of all proper labeling, misspellings of NIOSH, decorative fabric and claiming to be approved for children. Currently, masks in adult sizes are the only masks to undergo NIOSH’s quality assurance and testing process. Respirators approved by NIOSH will include a testing certification (TC) approval number and will contain specific labeling on the facepiece of your mask. Find a full list of Center for Disease Control (CDC) and NIOSH requirements here. Identifying Real KN95 Respirator Masks Often preferred due to comfortability, the KN95 respirators were initially designed to meet Chinese standards for medical masks. Firstly, if a KN95 mask claims to be approved by the CDC, it is counterfeit as the CDC and NIOSH do not support any respiratory protective devices according to international standards. However, when KN95 masks are fitted and worn appropriately they do provide more protection than disposable masks. Legitimate KN95 masks will display a manufacturer number, GB2626-2019, ensuring accordance with current Chinese respirator standards for all masks made after July 1, 2021. Unlike N95 masks, it is important to note that KN95 masks are available in children's sizes. You might run into KN95 masks claiming to be “FDA (Food and Drug Administration) approved” or “FDA-registered,” but be aware that this does not mean much and is a misleading statement. What this indicates is that a mask maker has submitted paperwork to the FDA, but the product has not been thoroughly tested for proper filtration and protection. Surgical Masks Medical procedure masks often referred to as surgical or disposable masks vary in their protection according to a variety of factors including fit and filtration. The CDC defines medical procedure masks as “variably shaped, including flat pleated, cone-shaped, or duck-bill. Medical procedure masks are loose and are not expected to provide a reliable level of protection against airborne or aerosolized particles as N95 respirators regulated by the National Institute of for Occupational Safety and Health.” However, these types of masks provide more protection than cloth masks and are certainly better than wearing no mask at all. Often popular due to their level of comfort and cost-effectiveness, surgical masks can be knotted in the ear loop areas to provide a tighter seal and can be layered for additional filtration. Depending upon your budget and level of comfortability and protection, one variation of mask may suit you over another. Please remember to do your part in limiting the spread of COVID-19 and wear a surgical mask, KN95 or N95 mask when visiting Renown facilities.

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