The Birth Squad Dr. Ijeoma Okwandu & Dr. Kimeshia Thomas

Join us as we chat with two Black Doulas, SoCal-based Chandler Garrett and Bay Area-based Mish Akoro, about labor support. Including virtual care!

Learn more about Chandler at:
https://thebumpculture.com/
Instagram: thebumpculture

Learn more about Mish at:
https://homeofgoodmother.squarespace.com/
Instagram: homeofgoodmotherdoula



Terms:

Doula:  A labor coach or birth assistant who can provide prenatal, labor, and postpartum support. This includes helping to create a birth plan, manage pain during delivery, and assist with breastfeeding/lactation needs. 



Doula Training International (DTI):  Provides doula trainings online and in person, which certify birth doulas, postpartum doulas, and full spectrum doulas.



Doulas Of North America (DONA):  Founded in 1992, the organization both trains and certifies the non-medical birth support of doulas.



Hypnobirthing:  aims to help a woman deal with any fear or anxiety she may have around birth. It involves various relaxation and self-hypnosis techniques to help relax the body before and during labor and birth.



Birth Plan:  a written summary of your preferences for when you are in labor and giving birth. It includes things like what position you want to give birth in, what pain relief you prefer (if you need it), and who you would like to be with you at the birth.






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Meet birth warrior and expert, Dr. Nicole Christian-Genius who shares her experience with stillbirth and her path toward becoming a midwife.



Terms

Midwife:  Obstetrical providers who often work in conjunction with OB/GYN


CNM (A certified nurse midwife) - can deliver your baby if you have a vaginal delivery, and also provide routine health care outside of pregnancy.


LM (licensed midwife) - can provide prenatal care and deliver your baby.



Preeclampsia (formerly called toxemia):  High blood pressure after 20 weeks of pregnancy that leads to end organ damage. 


Signs/symptoms include headache unrelieved by pain medication, vision changes, protein in your urine, elevated liver enzymes, kidney failure, and low platelet levels. 


Treatment:  Magnesium is usually used to prevent seizures and IV blood pressure 


Eclampsia:  A seizure-related high blood pressure 



Placenta previa:  the placenta attaches low in the uterus. The placenta might partially or completely cover the opening of the uterus, called the cervix. Placenta previa can cause severe bleeding in the mother before, during or after delivery.

Stillbirth:  is when a baby dies in the womb after 20 weeks of pregnancy. Most stillbirths happen before a pregnant person goes into labor, but a small number happen during labor and birth. Stillbirth affects about 1 in 160 pregnancies each year in the United States.

Preterm labor:  labor occurring between after 20 and before 37 weeks gestation.



Fetal Kick Counts:  Ten movements (kicks, flutters or rolls) in one hour is considered typical fetal movement. 


Some things you can try to get the fetus to move are:



Drinking juice or another sweet beverage.


Drinking something that is cold.




Doula:  A labor coach or birth assistant who can provide prenatal, labor, and postpartum support. This includes helping to create a birth plan, manage pain during delivery, and assist with breastfeeding/lactation needs. 

Birth Center:  A facility where you can deliver with minimal interventions.

Home Birth:  When someone delivers at home. Usually a birth attendant is present to assist.  

Community Hospital:  A smaller hospital that serves a specific location. 

Academic Center:  A hospital that serves a large population of people. Participates in research and has trainees at different levels, which includes medical students, residents, and other higher educational programs. Also, may have the highest level of care. Usually affiliated with a school like USCF, UCLA, USC, Harvard, etc. 

Hypnobirthing:  aims to help a woman deal with any fear or anxiety she may have around birth. It involves various relaxation and self-hypnosis techniques to help relax the body before and during labor and birth.

Aromatherapy:  the practice of using essential oils for therapeutic benefit.

Lamaze:  involves psychological and physical preparation in various techniques (such as controlled breathing and alternative birthing positions) by the mother to reduce pain and facilitate delivery without unnecessary medical intervention.

The Bradley Method:  Course where women are taught relaxation exercises to help endure labor. Their support person is also trained to aid her in achieving a physiologic birth and to help keep outside factors from interfering with the process.

Peanut Ball:  is shaped like a peanut shell, where the middle circumference is smaller than the ends. To facilitate the desired upright position for successful labor progression, a peanut ball could be placed between a woman's legs while she is limited to staying in bed.




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We chat with two OB Anesthesiologists, Dr. Lydi Martinez and Dr. Brittany Burton, about the ins and outs of pain control in labor.



Terms



Anesthesia:  a medical intervention that prevents patients from feeling pain during procedures like surgery, certain screening and diagnostic tests, and tissue sample removal.  

Perioperative:  Around the time of surgery. This usually lasts from the time the patient goes into the hospital or doctor's office for surgery until the time the patient goes home.



Pain Medications (Analgesics) During Labor:  medications that relieve pain

Fentanyl:  a synthetic opioid.

Morphine:  a non-synthetic opioid.



Epidural catheter:  a very fine plastic catheter, or tube, that is placed through the skin into the epidural space in your spine. This temporary catheter is left in place for a defined period of time

Epidural space:  space filled with fluid that surrounds your spinal cord; like a liquid sleeve around your spinal cord.



NPO:  Nothing by mouth. 

Aspiration:  Breathing in a foreign object (for example, sucking food into the airway).

Spinal Cord:  the long, cylindrical structure that connects your brain and lower back. It contains tissues, fluids, and nerve cells

There are five levels, starting at the top and going downward: Cervical (C), Thoracic (T), Lumbar (L), Sacral (S), and Coccygeal (Cx). These main sections include a group of vertebrae, each of which is given a number that increases as you move down the spine.



Spinal headache:  caused by leakage of spinal fluid through a puncture hole in the membrane that surrounds the spinal cord. This leakage decreases the pressure exerted by the spinal fluid on the brain and spinal cord, which leads to a headache.



Blood patch:  a procedure in which a small volume of your own blood is injected into a patient's epidural space to stop a leak of cerebrospinal fluid (CSF).



Retained products of conception:  intrauterine tissue that develops after conception and persists after medical and surgical pregnancy termination, miscarriage, and vaginal or cesarean delivery. (For example, retained pieces of placenta after delivery).



Postpartum hemorrhage: 1000ml or more of blood loss in the first 24 hours after delivery




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Dr. Jess Daigle, NICU specialist, shares her story of having a a baby in the NICU as well as her professional experience as a physician who cares for preterm babies.



Terms:

Premature infant (premie):  babies born more than 3 weeks earlier than their expected due date (i.e. earlier than 37 weeks).

24 weeks | Fetal viability:  the point where a baby can survive outside the womb with medical support. 

32 weeks | Fetal brain development:  the point where your baby no longer needs medication for cognitive support. 

34 weeks | Lung development:  the point where your baby may or may not need steroids for assistance with lung maturation. 

Steroids (Betamethasone):  is a steroid that can help speed up lung development in preterm babies.

NICU:  the intensive care unit of babies who are sick or born early.  Hospitals have different NICU levels that they offer:

Level 1 NICU | Basic care - provide care for healthy full-term babies. 

Level 2  NICU| Advanced care - offer care for babies born at or after 32 weeks.

Level 3 NICU| Specialized care - care for very sick babies and offer access to a wide range of pediatric specialists and equipment. 

Level 4 NICU| Highest level of care - provides a full range of healthcare providers and equipment for very sick babies. 

Neonatologist:  a pediatrician who specializes in premature babies or newborns with high-risk or complex health conditions.

Pulmonary surfactant:  low levels are noted to cause neonatal respiratory distress syndrome (NRDS), a significant cause of morbidity and mortality in premature infants.

Progesterone: a hormone produced by the body that plays a role in pregnancy maintenance. 

Cervical insufficiency:  Inability of the cervix to retain a pregnancy in the absence of signs and symptoms of clinical contractions, labor, or both in the second trimester 

LEEP:  is a treatment to remove precancerous cells from the cervix. Can be performed in the clinic. 

Cold Knife Cone:  Similar procedure as a LEEP where more tissue is taken. Performed in the operating room. 

Cerclage: a treatment that involves temporarily sewing the cervix closed with stitches. This may help prevent preterm birth.

Jaundice:  is an immature liver, which is common in preterm babies. 

Aspiration:  breathing in a foreign object (for example, sucking food into the airway).

Social worker: helps individuals, groups, and families prevent and cope with problems in their everyday lives.

Tracheal tube (trach):  tube placed in the windpipe to help with breathing. 

Ventilator machine (vent):  mechanical ventilators are machines that act as bellows to move air in and out of your lungs. 

Feeding tube:  delivers a liquid nutrition formula directly into your digestive system.

Speech therapy:  The goals of speech therapy include improving pronunciation, strengthening the muscles used in speech, and learning to speak correctly.



Links:

PSI (Postpartum Support International): An organization that aims to raise awareness about the emotional changes that women experience during  and postpartum by educating and training the community https://www.postpartum.net/about-psi/ 

Early Childhood Intervention:  https://www.cdc.gov/ncbddd/actearly/parents/states.html 




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Featuring Dr. Brandye Wilson-Manigat (a.k.a. Dr. Brandye), one of the leading experts in Women’s Sexual Health and author of "My Oh My." In this episode we discuss how women can reconnect with their passion, excitement, and desire so that they get their sexy back



Learn more about Dr. Brandye and her book

drbrandyemd.com

www.youtube.com/@dr.brandyemd5384



Terms:

Low libido:  a decrease in sexual desire.

Menopause:  diagnosed after you've gone 12 months without a menstrual period.

Postpartum depression:  a medical condition that many women get after having a baby. It's strong feelings of sadness, anxiety, and tiredness that last for greater than 2 weeks after giving birth.

Adrenal fatigue:  tiredness and other symptoms which are thought to be due to long-term exposure to stressful situations.

Autonomic nervous system:  a component of the nervous system that regulates involuntary processes like heart rate, blood pressure, breathing, digestion, and sexual arousal.

Pelvic Floor muscle:  The muscles of the pelvis that support the body. Can be affected by pregnancy, traumatic birth, weight gain, chronic cough, etc. 

Urinary Incontinence (UI): involuntary loss or leaking of urine

Stress UI: when your bladder leaks urine during physical activity or exertion.

Urge UI: the sudden and very intense need to pass urine and you're unable to delay going to the toilet.

Endometriosis:  a disease in which tissue similar to the lining of the uterus grows outside the uterus, which can cause severe pain in the pelvis and make it harder to get pregnant.

Fibroids:  usually noncancerous tumors made of smooth muscle cells and fibrous connective tissue that develop in the uterus.

SSRIs (selective serotonin reuptake inhibitors):  A class of medications used in the treatment of major depressive disorder, anxiety disorders, and other psychological conditions. Works by increasing levels of serotonin in the brain

Antipsychotics:  a type of psychiatric medication to treat psychosis.

Antihypertensives:  Medications that lower blood pressure.  

Beta-blockers - a type of antihypertensive that causes the heart to beat more slowly and with less force.

Diuretics - a type of antihypertensive that helps reduce fluid buildup in the body.

Testosterone pellet therapy:  can help improve a postmenopausal women’s sex drive and decrease vaginal dryness.

Placebo:  a harmless pill, medicine, or procedure prescribed more for the psychological benefit to the patient than for any physiological effect.




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We chat about fitness in pregnancy and postpartum with Dr. Aldene Zeno urogynecologist, fitness enthusiast, and author of “Thriving Through Pregnancy with Fitness and Black Mama Magic.”



Learn more about Dr. Aldene and her book “Thriving Through Pregnancy with Fitness and Black Mama Magic.”

https://draldene.com/

https://www.amazon.com/Thriving-through-Pregnancy-Fitness-Black/dp/B0CSX4SJHK/ref=sr_1_1?crid=4D3VVNZIJ1AL&dib=eyJ2IjoiMSJ9.BCdcKC8fv9rSLEgwfzo0Tg.ltBpSftCdIa7ZpDpGf3fhZkyq7H-AhqHP-UKgB08c7o&dib_tag=se&keywords=aldene+zeno&qid=1709482319&sprefix=aldene+zeno%2Caps%2C144&sr=8-1



Terms:


Urogynecology: a specialized field of gynecology and obstetrics that deals with female pelvic medicine and reconstructive surgery.


BSN: Bachelor of Science in Nursing refers to someone who has earned a bachelor's degree in nursing.


Urinary Incontinence 



Stress: when your bladder leaks urine during physical activity or exertion.


Urge: the sudden and very intense need to pass urine and you're unable to delay going to the toilet.



Fecal Incontinence: when you are not able to hold your feces or stool until you get to a toilet.


Prolapse: when the uterus, bowel, bladder, or top of the vagina slips down from their normal position and bulge into the vagina.


PCOS: Polycystic ovary syndrome is a condition in which the ovaries produce an abnormal amount of androgens, which are male sex hormones that are usually present in women in small amounts.


Male factor infertility: caused by factors such as abnormal sperm production, blockage of delivery of sperm or low sperm production.


IUD: a type of long-acting, reversible contraception (LARC) that provides birth control for 3 - 12 years depending on the type. Can be hormonal or non-hormonal.


BMI: a person's weight in kilograms divided by the square of height in meters. 



Screens for weight categories may lead to health problems, but it does not diagnose the body fatness or health of an individual.



ACOG: The American College of Obstetricians and Gynecologists is a professional association of physicians specializing in obstetrics and gynecology in the United States.


Hypoglycemia: a condition in which your blood sugar (glucose) level is lower than the standard range.


Labor down: the process of not actively pushing once you are fully dilated to 10cm. 



Some people wait one to two hours before pushing, which allows the baby to move down the birth canal naturally.



Rectus diastasis: an increased distance between a part of the abdominal muscles at the midline caused by weakness in the anterior abdominal wall.


Pelvic floor therapy:  Physical therapist trained to evaluate and treat issues that involve the pelvis, such as pelvic pain, pain with intercourse, or leaking urine.


Pelvic Floor muscle:  The muscles of the pelvis that support the body. Can be affected by pregnancy, traumatic birth, weight gain, chronic cough, etc. 


Kegels:  Exercise used to contract your pelvic floor. Think:  holding your pee when you go to the bathroom—same muscles. 


Mastitis: inflammation that results in breast pain, swelling, warmth, and redness of breast tissue that sometimes involves an infection.



Most commonly affects women who are breast-feeding







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