I hit the 20 week mark in my pregnancy on Wednesday of this week!  I can't believe that it is halfway over already.  Honestly, I'm looking forward to the later stages of pregnancy.  They are my favorite part of being pregnant.  I'm also really looking forward to experiencing labor again.  Labor really is a magical thing as much hard work as it is.  
The second trimester is a great time to start preparing yourself both mentally and physically for the task of labor and birth.  At this point in pregnancy, there is plenty of time to solidify plans, evaluate those you have chosen as your caregivers, and to find a place of confidence from which you will draw during the labor and birth process.  If you haven't already, the second trimester is the time to schedule your childbirth preparation classes, and to hire your doula if you are planning to do so.
I wanted to take a few moments this morning to share with you how I am preparing myself for labor and birth the third time around.  Every pregnancy and birth is unique.  Mothers will find that each pregnancy brings a different set of needs, ideas, and hopes.  Because of this, I don't feel like relying on my past experiences with labor and birth, or even my experiences as a doula as enough to prepare for the birth of my third daughter.  I have chosen to actively prepare once again for this once in a lifetime journey.  
Earlier this week, I posted this quote on our Facebook page:"As explained earlier, the degree of pain a woman experiences in labor is strongly affected by her emotional state, her environment, and the attitudes of her attendants. Particularly with a baby in a difficult position, these aspects must be optimal for her to move forward." - Elizabeth Davis (world renown midwife and author) 
This quote was taken from her book with Debra Pascali-Bonaro, Orgasmic Birth.  I highly recommend the movie if you are planning to conceive or are on a pregnancy journey of your own.  
Taking into consideration this quote, we have some great advice to begin our preparations for labor and birth.  For most women, one of the greatest concerns they have about labor is how they will manage their pain.  It is fabulous to know that by doing a few simple things, you can create a situation for yourself that allows you to increase your pain threshold and reduce the need for outside medical interventions to decrease your experience of pain.  This quote is the guiding light of my birth preparations at this point in my pregnancy.
The Emotional State:
Finding a place where you can birth with confidence is the best thing you can do for yourself in pregnancy.  Spending your pregnancy exploring your relationship with yourself, your significant other, your children, and your extended family is so important.  These people will be your life support throughout the journey of pregnancy and motherhood, and in many situations in the labor room as well.  Reducing the possibility of tension between yourself and the people closest to you during the labor process is the first step in creating a state of emotional well-being.
"Making time to vent emotions, either by speaking them aloud or writing them down, is necessary in order to sort them out.  Learning to differentiate your feelings from your partner's or any other intimate's is a principal lesson afforded by the Blood Mysteries (times of menstruation, pregnancy, and menopause), essential for finding your new self and new voice for the next phase of your life." - Elizabeth Davis
Over the course of the last two months, I have surprised myself with outbursts of emotions that were held within and should have been given a voice long before now.  I've been working on giving a voice to feelings and concerns I have.  I had always thought that it was a sign of strength to not show emotion, but I have since found it weakens the body and the spirit.  I now know that releasing those emotions is healthier than holding on to them indefinitely.  Labor is not the time that you will want to just begin dealing with fears/emotions that might come up for you.  
Also, if you have experienced past birth trauma as I have, pregnancy is a time to revisit your feelings about what happened to you then, and how it may affect your labor and birth experience now.  I am approaching this pregnancy and birth from a very strong place of healing regarding my past birth experiences, and I am excited to have a new experience to add to these past ones.  Yet, I have found it necessary to approach this pregnancy and birth as a profound spiritual practice.  I have been training with Stephanie Dawn, the creator of Sacred Birth and author of the Sacred Birth Workbook, for over a year now in order to offer this approach to expecting mothers who seek to use their pregnancy and birth as a spiritual practice and use their spirituality to prepare for birth.  Her classes and workbook are my chosen childbirth preparation course this time around.  I feel like I understand well what is happening physically to my body in birth, and with her work, I am nurturing a healthy emotional connection to labor and birth, as well as equipping myself with spiritual tools that I can use in labor such as prayer, meditation, and affirmations to help me cope with the sensations I will experience.
The Environment:
The environment where you will give birth can have the biggest impact on how you will experience labor and birth.  The place and caregiver you choose for your birth is probably the most important decision you can make.  This time around, I have chosen a caregiver who is very thorough with me and takes the time to answer all of my questions in detail.  Because of my past experiences, and because I am a mother with special needs - VBAC (vaginal birth after cesarean) - I chose a caregiver who has extended experience in attending women such as myself in birth.  I am completely comfortable with the caregiver I have chosen and the quality of care I will receive as well as my ability to be comfortable in the place where I will birth.
Every woman's comfort level with care providers and places of birth will be different.  For some, the hospital will be the most comfortable place, for others it might be home.  It is important to look closely at the needs of your pregnancy and the possible needs of your labor and birth when choosing a birth setting and care provider.  Interviewing care providers is a good idea before settling in to someone particular.  Also, know it is ok to change your care provider if you no longer feel comfortable in their care.
A really good addition to the birth environment can be a doula.  I have chosen my business partner - Heather - as my doula this time around.  My sister who is also a nurse will be with me as well.  Part of a doula's job is keeping the birthing environment comfortable for the mother.  For example, one of my strongest memories with my second labor was nurses laughing loudly in the hallway.  I was having to vocalize loudly as I was experiencing back labor.  I was a bit self-conscious of this, and I had convinced myself that the nurses were laughing at me.  It made it very hard to concentrate on labor and it increased the pain I felt.  It made me cry.  My doula helped by telling the nurses that I was being disturbed by their congregating next to my room, and I calmed down as they moved on.  The lesson here is to have a birth team who understands your environmental needs, and can help you create a sanctuary for the birth of your baby.
The Attitudes of the Attendants:
As mentioned previously, along with birthing environment, those who will be with you during your birth - the birth team - will be among the most important decisions you'll make for your birth.  The most important of these will be your doctor or midwife and next your doula.  You should always feel respected by these attendants, and safe in their care.  You should always feel as if your thoughts and questions are heard and accounted for.  If they come into your labor room with a negative attitude or speak to you in a manner that makes you feel like you are lesser than or being disrespected, then this will impact the progress of your labor. You will no longer feel you are in a safe environment or protected, and your labor may stall.  For more information on Choosing a Care Provider and Choosing a Doula - click on the links.  You always want to ensure that you feel like you are the most important person in the decision making surrounding any needs that might come up during labor and birth.  Open communication is key to this.  This sort of relationship with your care provider is fostered during your prenatal appointments.  If you do not feel like you prenatal visits are adequate or what you would like for them to be, consider finding another care provider.  Why?  Think about what your labor and birth might be like with this same person that you already feel like is not giving you the care you feel you deserve.
The next consideration is who else other than essential people will you have in the birthing room.  My recommendation is that everyone have a job to do.  You don't want to feel like a circus side show while you are trying to cope with labor.  Your labor is not a spectator sport.  You also don't want people in the room who are too nervous or overly emotional in difficult situations.
I am planning on having my caregiver, my husband, doula, my sister, and my daughters (if all is going well and I still desire them there in labor).  Also, remember that your caregiver will likely have an assistant or several nurses which they will require in the room during the pushing/birthing stage of labor.  Most hospitals have a 3 person limit for non-personnel birth attendants, and that is a good rule.  The hospital room can fill up fast with nurses and nursing assistants depending on your needs, you baby's needs, and the desire of your caregiver.  
With these things in place, I am feeling confident that I will be ready come the day of birth for my third daughter.  It's so exciting and fun to plan for labor and birth.  I'm feeling strong kicks as I write, and I'm overjoyed to have this opportunity again.  I hope this helps you think about planning your labor and birth as well.  If you have any questions, feel free to email me at info@birthtrue.com, or comment below. 
Many happy days...
Kelli
   

If you follow Birth True on Facebook, you might already know that I (Kelli) am expecting my third little one sometime in the early parts of July.  This pregnancy for me has been not much different than my other two so far in that the first trimester has been a roller coaster of not feeling well at all.  During my first pregnancy, I had some scary bleeding which we went in to the ER for and felt the need to be really careful for awhile afterwards.  For my second pregnancy, I vomited every day for about 5 months, most days several times.  This time around, I have been very tired, nauseous, and extremely forgetful.  Not to mention my immune system has been lower than normal so I've already had three seasonal illnesses.  Yuck!
What we know however, is that all of these things are not outside the scope of common experience for mamas in early pregnancy.  As we celebrate discovering our pregnancies and the adventure that awaits us, we soon notice as well that our body is going through some pretty drastic changes.  It is so easy to want to get started right away with all the baby planning, preparation, fitness, eating right, and stuff the books tell us we should be doing to have a healthy pregnancy.  But, the fact is... we just might not feel like it in the first trimester.  If you do, that's awesome.  If not, that's just fine too.  What is the most important thing for you to do early in pregnancy and continuing throughout the entire 9 or so months, is to listen to your body.  Tune into what your body and your baby need, and don't be afraid or feel guilty about listening.  Why?  This is the way you start establishing a framework for a healthy pregnancy.  Our bodies and babies are built with a system of communicating our needs to us if we take the time to listen.  
For example, if you are overly nauseous one day, consider whether or not you are drinking enough water.  Dehydration can increase our experience of morning sickness.  Eating small meals as you can throughout the day that are high in protein can also help with upset stomach.  The truth is though, that as long as we do our best to get in our folic acid and water, we can consider ourselves as doing ok.  We only need about 300 extra daily calories to grow a baby, and those caloric needs don't fully establish themselves until later in the first and the beginning of the second trimester.  I've found myself drinking quite a few peanut butter and whole milk homemade milkshakes sweetened with a low-glycemic coconut crystal extract.  So far, so good.
What about exercise?  Exercise is important in pregnancy.  I had vowed to walk and do yoga daily throughout my entire pregnancy.  I have to say I've done pretty well considering, but I haven't exercised everyday.  Most weeks it has been anywhere from 2-5 days out of the week.  The yoga is what I have been able to keep up with best of all.  There were some days that all I could do was sleep on the couch.  That seems to be passing now, and I am thankful.  I was beginning to feel a bit slobby.  The truth again though, is that when your body is going through so many big changes, extra rest and sleep is also very good.  Your body knows best.  Now, that the first trimester funk seems to be lifting, I am able to keep up better with what I want to do for exercise, and keep realistic goals.
So, what can you do to give yourself a foundation for a healthy pregnancy and birth in the first trimester that doesn't require too much physical agility or choking down spinach when all you seem to want to eat is dark chocolate?  The first two things that you can do aside from bonding with you baby and listening to your body is - choose the caregiver and place of birth that is right for you, and consider hiring a doula. (Follow the links for more information on those topics.)  You may learn more about what Birth True offers by looking over our Doula Services page.  Choosing who will care for you during your pregnancy and birth can make the world of difference in the outcome of both your pregnancy and birth.  It is good to talk to several doctors or midwives before settling on one.  It is also fine to change if you no longer feel comfortable with the care you are receiving.  You might also take moment to look over all your options for childbirth education classes.  There are so many different types and styles of classes, that you will find one to meet your needs and hopes for your birth.
While the 1st trimester of pregnancy has always been the hardest for me, it is a time to learn.  Learn to listen to your body's cues, and to settle in with the fact that in no time at all the potential is there for you to be holding your baby in your arms.  It is a time for cautious celebration, settling in, and as much as we can... flowing with the funk.

-A guest post from March of Dimes.  Thank you Ali Shaw.
This year, for the first time, a World Prematurity Day will be observed on Thursday, November 17 by the March of Dimes, along with organizations in Africa, Europe, and Australia. An estimated 13 million babies are born preterm and of those one million die as a result of their early birth, according to an October 2009 March of Dimes report on the global toll of preterm birth. 

Kentucky will participate in World Prematurity Day by hosting a Healthy Babies are Worth the Wait® symposium at the Hilton Suites Lexington Green Hotel in Lexington, Kentucky. Leaders within the quality improvement program will discuss ways to further lower preterm birth rates in the Bluegrass state. Healthy Babies Are Worth the Wait® is a partnership between the March of Dimes, Johnson & Johnson, and the Kentucky Department for Public Health. Now in its fifth year, the program has been working to educate women and perinatal providers about the problems of preterm birth and particularly late preterm birth (delivery at 34-36 weeks gestation). The program’s goal is to decrease the singleton preterm birth rate in selected areas by 15 percent by incorporating numerous known strategies for prematurity prevention, such as smoking cessation, early prenatal care, and avoiding unnecessary deliveries before 39 weeks of pregnancy. The successful program now is being adapted for use in New Jersey and Texas.

Additional Prematurity Awareness events that are happening throughout the month of November in Kentucky include supporters wearing the March of Dimes signature purple, (especially on Nov. 17 to recognize the March of Dimes and to celebrate the strides that we are making in giving every child a better chance at a healthy start to life), volunteers changing their facebook photo to a baby picture (either a premature or a healthy baby), Signature Chefs Auctions being held across the state, and the LG&E building on West Main Street in Louisville being lit up in purple lights throughout the month. 

Kentucky recently received a “D” on the March of Dimes 2011 Premature Birth Report Card, better than last year’s “F.” Factors that contribute to preterm birth improved in Kentucky. It earned a star for reducing the percentage of women of childbearing age who smoke and for lowering the late preterm birth rate.

Since 2006, Kentucky’s preterm birth rate has dropped to 13.6 percent. In Kentucky, the rate of late preterm births is 9.7 percent; the rate of women smoking is 27.3 percent, and the rate of uninsured women is 22.8 percent.

The United States received a “C” on the March of Dimes Report Card. Grades are based on comparing the state and the nation’s 2009 preliminary preterm birth rates with the March of Dimes 2020 goal of 9.6 percent of all live births. The U.S. preterm birth rate is 12.2 percent down nearly 5 percent from the peak of 12.8 percent in 2006. 

Preterm birth, birth before 37 weeks completed gestation, is a serious health problem that costs the United States more than $26 billion annually, according to the Institute of Medicine. It is the leading cause of newborn death, and babies who survive an early birth often face the risk of lifetime health challenges, such as breathing problems, cerebral palsy, intellectual disabilities and others. Even babies born just a few weeks early have higher rates of hospitalization and illness than full-term infants. At least 39 weeks of pregnancy are critical to a baby’s health because many important organs, including the brain, are not completely developed until then. 

The March of Dimes says its 2020 preterm birth goal can be achieved by a combination of activities: giving all women of childbearing age access to health care coverage, fully implementing proven interventions to reduce the risk of an early birth, such as not smoking during pregnancy, getting preconception and early prenatal care, progesterone treatments for women who are medically eligible, avoiding multiples from fertility treatments, avoiding elective c-sections and inductions before 39 weeks of pregnancy, and by funding new research on prevention of preterm birth. 

The March of Dimes is the leading nonprofit organization for pregnancy and baby health. With chapters nationwide, the March of Dimes works to improve the health of babies by preventing birth defects, premature birth and infant mortality. On November 17, 2011, the March of Dimes and its global partners will observe the first-ever World Prematurity Day to raise awareness that preterm birth is a serious problem worldwide. For the latest resources and information, visit marchofdimes.com or nacersano.org. Find us on Facebook and follow us on Twitter. 

     Childbirth in the United States was once in a very dire place.  The outcomes for mothers and babies were poor to dismal (like in our part of the country - rural Appalachia).  However, it did not remain that way.  Pioneers in the care of women and children such as midwife and founder of the Frontier Nursing Service, Mary Breckinridge worked hard to change that.  Improvements in care included above all an approach that centered upon education of the women, their families, and their caregivers.  Using this approach, Breckinridge achieved better outcomes in her service than the physicians of the day were achieving in the hospitals.  
     The reality of childbirth improved for women in the US for a time.  There have been dips and surges in the safety of childbirth and the outcomes of birth for mothers and babies, but what is concerning at the present is that the US and Canada both are "low on the list of optimal perinatal and maternal outcomes" when it comes to industrialized countries and even some developing countries (Klein, The Journal of Perinatal Education, 20(4), 185-187, 2011).
    Many attribute this change and poor outcomes for mothers and babies to the high rates of surgical birth (c-section) in the US - 34% or 1 in 3 women.  But, a recent study conducted in Canada by Dr. Michael C. Klein, MD, CCFP, FAAP revealed that "a substantial number of women, even late in pregnancy, were uninformed about the risks and benefits of key procedures and approaches that might be used in birth."  Dr. Klein wrote an editorial about his findings and his recommendations to address those findings in the most recent edition of The Journal of Perinatal Education cited above.  He also stated that, "Only 30% of the women had attended childbirth education classes; books and the Internet were their main sources of information."
     Looking at the sources of information women are accessing during pregnancy and the fact that so many remain uninformed show a possible lack of finding truly useful or reliable information from the books they choose and the websites women visit and a disconnect between women and their care providers when it comes to patient education.  There are many great books and websites for pregnancy and birth, but there are also many inaccurate information sources.  We also have seen a reduction in the number of care providers offering complete childbirth education either through their private practice or the birthing facility.  Many "childbirth classes" meet only a few times and include basically what to expect when it comes to hospital routine and policy as well as a tour of the maternity ward.  These are important classes for women to take so that they can be prepared and anticipate certain experiences during their birth, but there is also a great need to have complete childbirth education including pregnancy nutrition/exercise, stages of labor, comfort techniques for labor including both natural and medical coping strategies, possible medical interventions that might be necessary and the risks and benefits of each, breastfeeding, postpartum, newborn procedures, and early newborn parenting.  In order to cover all of these topics, it is imperative that women and their support persons meet with their educator over an extended period.  Many childbirth educators who are certified through the various organizations in the numerous styles of education have a required amount of hours or equivalent of those hours that they must meet in order to label their classes as - Lamaze, Bradley, Hypnobirthing, Brio, CAPPA, ICEA, etc...  This hourly requirement ensures that educators and the women they serve have the necessary time to cover all of these important topics that allow women to have the ability to act on the information they receive.
     Another very disconcerting aspect of Dr. Klein's study revealed that obstetricians younger than forty "were less favorable to birth plans, less likely to acknowledge the importance of the woman's role in her own birth experience, and more likely to view cesarean surgery as 'just another way to have a baby'.  They were also more likely to believe that women who had cesarean surgery 'did not miss an important life event.'"  Physicians also had misinformed beliefs on cesarean surgery being "as safe or safer for mothers and babies as vaginal birth" - 20%.  "Half of OBs were not supportive of doulas, and 70-80% of providers felt that home birth was unsafe.  Epidural analgesia was another area where many providers, especially obstetricians, felt that the procedure did not interfere with labor or increase the frequency of instrumental birth (Klein)."  This is despite the scientific evidence showing the contrary on all of the four points above.  Klein points out however, that it is important to recognize that 20% of the OBs in the study had attitudes that aligned with midwives.  So, we see that though a minority there are OBs who feel otherwise about routine intervention and the risks involved in normal birth.  Klein found that women who were attending midwives for their care were less favorable to the use of technology and more supportive of women's roles in their birth experiences, possibly illustrating the difference between the obstetric and midwifery model of maternity care.  
The following photo is linked to an interview with Julie Daniels, CNM of Frontier University describing the difference between the obstetric and midwifery models of care.  This post is continued after the jump.  
 

Dr. Klein questions "how informed decision making can take place when so many women approaching their first birth are ill-informed and so many care providers think they know, but what they believe is not evidence-based."  Many organizations invested in childbirth education are making strides to empower women with scientifically based information, such as Lamaze International and their Six Healthy Birth Practices campaign.  But, Dr. Klein also asks, "how can you make a revolution when so few individuals are unhappy with current maternity care practices?"  Dr. Klein believes that "The most unhappy and well-informed women select midwives, if available.  The most fearful women select obstetricians."  This may be so, but we must figure in the cultural norms and the fact that so many women are ill-informed.  (I was one of those ill-informed women during my first pregnancy.)  The famous quote from Diane Korte and Roberta Scaer, "If you don't know your options, you don't have any", says it all.  Interjecting my personal experience here, I can't tell you how many times I get confused with being a midwife when I tell people that I am a doula.  This is even after I describe what it is that I do and that it involves no medical or clinical responsibilities.  There is so much misinformation that many don't understand what a midwife even does.  This information is residual from the smear campaign of midwives in this country throughout the early 1900s, taking midwives from the primary maternity caregiver to almost non-existent.  Not that OBs are not great birth attendants.  We need OBs and their services very much.  OBs are trained surgeons and are trained to manage high-risk situations.  In many situations, they are the best possible care provider.  We need cesarean surgery to be available when it is medically necessary, but we also need to know that just like open heart surgery it is not physiologically normal and should be reserved for emergencies and true medical necessity and not used as a prophylactic.  In a systematic review, there were 33 areas were c-section was found to cause more risk than vaginal birth and 4 areas where vaginal birth was found more risky than c-section.  Surgery is never a walk in the park.  We can be thankful that c-section is a relatively safe major abdominal surgery, but we need to recognize it as surgery.
     But, the real issue to address here is women having access to the information they need to make informed decisions and then the support they need to access their options.  The beginning is the recognizing of a need for information.  It is the recognizing that women deserve better.  It is understanding that childbirth is a normal bodily function of the female body, and should not be treated as an illness, but as a very special time in which extra attention must be paid to health, safety, comfort, and proper support.  What raises this recognition - education.  It is so important for educators to reach both women and their care providers, for we are all working toward the same things - as positive outcomes as possible in individual situations, and satisfaction and dare I say pure joy in the experience of giving birth.

The vision statement of DONA International, the organization from which Heather and I received our training, is: A doula for every woman who wants one.  This holds quite a bit of value.  The standard fee for doulas vary depending upon the city/town where the doula is working and can be anywhere from $1,000 or so to as little as a few hundred or so.  There are also varying skill sets and levels of experience that doulas have that can impact the fee that they charge.  
The big question is - Are the benefits of a doula worth the money I'll have to spend for her services?
Dr. John Kennell, MD one of the founders of DONA International stated, "If a doula were a drug, it would be unethical not to use it."  In his work (along with the other founders of DONA) with pregnant/birthing women and babies, he noticed the positive impact that continuous physical and emotional support had on the laboring woman.  This support was beneficial regardless of the type (non-intervention, intervention, or necessary intervention) birth the mother was having.  It was even noticed that having this support could help a woman avoid unnecessary medical intervention in birth and increase her satisfaction with the process of birthing.  Kennell and his colleagues chose the term "doula" to describe this woman to woman support.
Research into the impact of a doula on the outcome of birth has shown that the presence of a doula can:

• result in shorter labors with fewer complications
• reduce negative feelings about one’s childbirth experience
• reduce the need for pitocin (a labor-inducing drug), forceps or vacuum extraction
• reduce the requests for pain medication and epidurals, as well as the incidence of cesareans

Penny Simkin, another DONA founder, childbirth educator, and birth counselor, found in her research that a woman's recollection of her birth experience is one that generally does not fade with time.  Simkin was shocked that women could remember their births with such great detail and accuracy years later.
The birth of your baby is an experience that you want to be as positive an experience as possible.  Proper preparation for birth and continuous support throughout the process is key to ensuring that the birth be a satisfactory memory.  
So, you may be thinking that your care provider or the hospital nursing staff will be able to give you all the support you need.  True, they will be able to support you through your clinical and medical needs throughout the labor and birth experience.  However, so much of labor and birth goes beyond the medical requirements.  It is also the case that most of the time, your care provider and the nursing staff will have other patients in the midst of labor as you are and will not be able to devote undivided attention to your needs.  This doesn't mean that they would not love to be able to, but the nature of their work requires that they provide the clinical and medical services to multiple women simultaneously.  Some women and their partners are surprised by the amount of time they spend on their own in the laboring room.
Another thought women often have is, what about my partner?  Can't they be my support?  They should be my support, right?  Yes, that too is true.  Mothers should choose those significant others, family, and friends that they wish to be present for them throughout the birth process.  There is nothing that can take the place of the support of these people for the laboring woman.  Not even a doula.  However, a doula is a different sort of support person in birth.  Doulas are highly trained professionals who are familiar with the unique needs and requirements of the laboring/birthing woman.  Doulas have skills that they have worked hard to learn that they can use at various points throughout labor and in more complicated situations to help ease a woman's fears and discomforts.  Doulas can also help the other support people better support the laboring mother through sharing techniques and offering suggestions.
The goal of providing doula services with Birth True is to provide any woman who desires this support the opportunity to have it.  As I mentioned previously, Heather and I do our best to make this possible for any mother who calls us and truly desires the benefits of having a doula at her birth.  We could not find the strength to give our time and efforts to this sort of work (both of us being mothers ourselves) if we did not feel like it was a necessary part of healthy pregnancy, labor, and birth regardless of how the woman plans or needs to birth.  Doulas are necessary in both med-free and medicated birth.  They are necessary in both vaginal and surgical birth.  They are truly an asset to any mother who places a value on a doulas presence in her labor room.
If you would like to talk more about what a doula can do for you, feel free to comment here, use the contact form on this site, or email us at info@birthtrue.com.  Have you experienced the support of a doula?  Please, share that experience with us as well.

We are so excited to have this resource - free teleconferencing!  As rural women, it's amazing what technology can do to link us together and make information available.  In celebration of Empowered Birth Awareness Week, we are offering a FREE Teleconference titled - Why Take a Childbirth Class? and What is a Doula?  Register by emailing birthtrue@gmail.com to receive the call in # and access code along with some helpful links.  Share this with friends and other expecting mamas you know who may be interested.  This is for women and birth professionals everywhere!  Can't wait to meet you on the call!
-Kelli