Guest post written by Maria Sorrentino-Magnuson, BSN, RN (Labor and Delivery) – Clinical Lead at Wumblekin
There’s a lot to learn during a first pregnancy – and even in the second, third, fourth and so on with the rapid evolution of culture and technology. Here at Wumblekin, we are firm believers in the importance of education, but realize the seemingly endless stream of information (and ~helpful~ tips from everyone you meet) can feel a bit overwhelming. That’s why we recommend building your care team as early on as possible; medical professionals who can give you individualized care and guidance from first trimester through the fourth.
Who all is on/or can be part of a care team? Here’s a mini-breakdown of titles and roles:
OB/GYN is a little bit like a square and a rectangle. An OB (obstetrician) is always a GYN (gynecologist), but not all GYNs are OBs. An obstetrician is a physician who specializes in labor, delivery, and postpartum care. A gynecologist is a physician who treats the female reproductive systems including STIs, menstruation, and fertility.
Education/Credentials: Medical school; four years of residency in obstetrics and gynecology; board certification
Family Practice Doctor/Primary Care Physicians
A Family Practice or Primary Care Doctor provides general care for any person at any age – everything from rashes and sore throats to heart conditions – and refer out to specialists when indicated. Some Family Practice Doctors even deliver babies; they attend vaginal deliveries and call in an OB/GYN physician partner if a cesarean is necessary. Some are trained to use forceps or vacuums but many are not. If you’re planning to use a Family Practice Doctor for your delivery, it’s important to ask who they consult with if a labor turns high risk.
Education/Credentials: Medical school; three years residency in general medicine
Maternal-Fetal Medicine Specialist/Perinatologists
These specialists are trained to care for complex medical problems or complications in pregnancy, labor, or birth. If your medical history puts you in the realm of high-risk, this is the doctor you’ll want to have on hand.
Education/Credentials: Medical school; four years of OB/GYN residency; three years of a MFM fellowship
Most of us are fairly familiar with anesthesiologists – they’re the doctors who put you to sleep when you got your wisdom teeth out and made sure you didn’t feel a thing when it came time to part ways with your tonsils. In textbook terms, anesthetics are medications that block sensation (pain) or awareness. During labor & delivery, anesthesiologists provide epidural pain relief and help ensure the safety of mom and baby during cesareans or other surgeries.
Education/Credentials: Medical school; four years of residency; board certification
Certified Registered Nurse Anesthetist/CRNA
Instead of an anesthesiologist, you may have a nurse anesthetist to subdue any pain sensations. CRNAs are advanced practice RNs who are licensed to administer anesthesia. They can also treat and monitor surgical patients.
Education/Credentials: Minimum of a Master’s degree; extensive clinical training; board certification
If you are delivering at a teaching hospital you might find yourself in the care of Resident Doctors. These are doctors in the midst of their required years of – you guessed it – residency. First year residents are often called interns (see: Grey’s Anatomy). They diagnose and treat patients under the supervision of an attending physician and their level of independence and responsibility increases with time.
Education/Credentials: Medical school; in progress, residency
Medical Students are still completing their medical school requirements. They’re often in a more observational role. Typically, they use this time to practice interview and patient assessment skills.
Education/Credentials: In progress, medical school
Certified Nurse Midwife (CNM)
Not all midwives carry the same title – it varies based on education and credentials. Nurse Midwives have the most rigorous requirements (see below.) They primarily train and practice in hospital settings and partner with OB/GYNs for high-risk or C-section pregnancies. As specialized nurse practitioners, CNMs not only care for women during labor & delivery, they often see and treat patients from puberty through menopause.
Sometimes referred to as “direct-entry midwives”, Professional Midwives are only trained in out-of-hospital births. No college degree is required, but they must complete an apprenticeship to gain their credentials through the North American Registry of Midwives (NARM). CPMs are not legally recognized in all 50 states, so be sure to check your local legislation before finalizing your decision.
Education/Credentials: Apprenticeship (usually two years); NARM certification
Your nurse is likely to be the one you write about in your child’s baby book. The most hands-on part of the labor team, they are right by your side the whole time assessing and caring for both mom and baby, reporting any abnormal findings to the midwife or doctor – and occasionally performing the delivery if the doctor doesn’t make it on time. (Nurses are rock stars.)
Education/Credentials: Two or four-year undergraduate degree; state license
Labor Doula/Birth Coach
Derived from Ancient Greek, Doula translates as “someone who serves”. There to provide emotional and physical support and mitigate non-medical pain, Doula’s services range widely from one individual to the next, but include everything from warm baths, massage, and words of encouragement to placenta encapsulation, lactation support, and even birth photography – though their role stops short of clinical care.
Education/Credentials: No legal training requirement, most complete certification programs
Lactation Counselor and Lactation Consultants (IBCLC)
Breastfeeding is hard – if you’ve heard it once, you’ve heard it a million times (and you’ll probably find yourself saying it a million times more.) Lactation Counselors and Consultants can make it a whole lot easier providing support in the areas of latch, pumping, and supply. A Lactation Counselor, the highest breastfeeding credential, can also assist in more complicated challenges like NICU admission, oral/motor dysfunction, breast abscess, mastitis, and more.
Education/Credentials – Consultants: 45-hour training course/certification
An attentive care team personalized to your unique needs and wants makes a world of difference for both you and your baby. If you’re looking for guidance in establishing your own, follow us on Instagram @wumblekin and submit your questions to our weekly “Ask An L&D Nurse Anything” hosted by our team of Wumblekin Experts.
Wumblekin is a curated pregnancy, birth and postpartum box company that demystifies pregnancy with evidence-based education and expert-curated products for mom and baby. Pregnant women are busy and there’s lots of noise out there. We want to help women who feel overwhelmed with pregnancy, labor and birth go from panicked to prepared. Learn more at Wumblekin.com.
NPR reports that, “Black women in the United States are 243 percent more likely than white women to die of pregnancy or childbirth related causes. There’s evidence that shows this gap is caused by the “weathering” effects of racism. Weathering is a term coined for stress-induced wear and tear on the body.” This statistic is true across all socioeconomic classes because “it’s a type of stress for which education and class provide no protection.”
There are amazing organizations working to improve outcomes for Black birthing people and we’ve compiled a list of places you can learn more as well as offer your support. Please leave any additional organizations or resources in the comments and we will continue to update this post.
National Birth Equity Collaborative (https://birthequity.org/): Creates solutions that optimize Black maternal and infant health through training, policy advocacy, research and community-centered collaboration. Donate here. Follow on instagram @birthequity and facebook
The Black Maternal Health Caucus (https://blackmaternalhealthcaucus-underwood.house.gov/Momnibus): Aims to raise awareness within Congress to establish black maternal health as a national priority and explore and advocate for effective, evidence-based, culturally-competent policies and best practices for health outcomes for black mothers.
The Blavatnik Family Women’s Health Research Institute (https://icahn.mssm.edu/research/womens-health): Optimizing quality of care for women across the life span and narrowing gaps in treatment and outcomes in underserved populations
ROOT, Restoring our own Through Transformation (https://www.roottrj.org/): Black women-led reproductive justice organization dedicated to collectively restoring our well-being through self-determination, collaboration, and resources to meet the needs of women and families within communities. Donate here
Black Women for Wellness: Black Women for Wellness has been working for over 20 years for maternal and infant health for Black women. Programs include nutrition education, chronic disease prevention, breast cancer support, reproductive justice, environmental justice, sexual health education, civic engagement and policy work.
Education and Community Resources
Mamas of Color Rising (https://mamasofcolorrising.wordpress.com/): A collective of working class and poor mothers of color around Austin, TX interested in organizing women/mamas of color around issues with accessing needs and building ideal community together. Donate here
Black Midwives Alliance Train and organize midwives to serve as advocates to address disparities in maternal health care that impact black birthing people. Central goal is to have a representative voice at the national level that clearly outlines and supports the various needs and interests of Black midwives.
My Brown Baby (http://mybrownbaby.com/): Providing service for those who need information and helping sort through the “beautiful struggle that comes with being black parents in America”. Follow on instagram @mybrownbaby and facebook
National Black Doula Association (https://www.blackdoulas.org/): Overall mission is to help fight the Black Maternal Mortality rate in the U.S. and beyond, through education empowerment. Provides a professional business directory and resource for Black Doulas & Trainers in the childbirth industry.
Natal: A Docuseries about having a baby while Black in the United States.
Homecoming Podcast: At Homecoming, we address two myths: 1) Hospitals are the safest place to give birth and 2) Black families don’t birth at home. We broadcast how Black families birth in love and choose to birth at home, unassisted or with midwives.
Birth Stories in Color: Birth Stories in Color is a podcast for people of color to share their birthing experiences- a space that specifically celebrates, mourns with and supports people of color and their transformation through birth.
Sisters in Loss podcast: Sisters in Loss is dedicated to replacing silence with storytelling around pregnancy and infant loss and infertility of Black women.
This past year I had the amazing privilege of getting to work with Heather Gallagher to document our family from the end of my pregnancy through Harvey’s first birthday. I love that Heather offers this “year in the life” photography package because it focuses more on how the whole family changes and grows over a year rather than the more typical baby milestone photo packages I’d seen before. We have two older children and this year was HUGE for them in terms of changes and I’m so grateful to have these priceless images to remember our whole family unit over the course of the year that we welcomed baby number three into the fold.
If you are in the Austin area, I highly recommend Heather Gallagher not only for this year-in-the-life package but for any of your photography needs (especially birth photography!). She also travels for photo sessions from time to time!
Heather is also a full spectrum doula which you can learn more about by reaching out to her at email@example.com or following her on Instagram @lifesaspectrum.
Our first photo session was a maternity photo shoot at the Austin Public Library which is one of our favorite places to explore together. The kids quickly became comfortable with Heather and were up to their typical silly antics.
The next time we saw Heather was for the birth! She arrived just 40 minutes or so before Harvey was born and probably would’ve missed it if she hadn’t had the foresight to be hanging around the area ‘just in case’ which I’m forever grateful for! Birth photos are the most beautiful images in the world and I look back at mine often. It can be hard to remember the details when you’re in “laborland” and having all of the little moments captured is not only really special but has also helped me in the processing of my birth story.
Postpartum Photo Session
Heather came back a few days later for a Postpartum shoot which really captures our big kids and how they were changing as they stepped into their new roles.
Two Months Old Photo Session
We had another photo shoot when Harvey was about 2 months old and It’s really special because we actually ended up moving soon after so I love having these images in the home that he was born in.
6 Months Old Photo Session
When Harvey was six months old, we had a photo session at our new home and I also got to model some of my sweet friend Hailey’s breastfeeding clothes from Chapter Goods. This are definitely my most favorite photos of nursing which is such a huge part of my journey as a mother and feels extra tender this time since we don’t plan to have any more babies.
9 Months Old at our Favorite Brewery
This is one of my favorite sessions which is so funny because it was actually pretty short and really casual! My kids were in a great mood and we were all in our happy place: Jester King Brewery in Austin. I loved that we captured the short window where Adelaide’s two front teeth were missing and Harvey had changed SO much since 6 months old!
One Year Old Birthday Photo Session
We finished our year together with Heather capturing Harvey’s 1st Birthday party! Of course I love all of the images but more than that, it was so nice to not have to worry about where my phone was so I could be taking pictures as well and I am in way more of the photos than I would’ve been as well. I think it helped keep everyone else off of their phones as well especially when it came time for the smash cake—I noticed that everyone didn’t do the typical thing of all trying to film this moment because they knew Heather had it covered.
It’s so surreal to have more than a year captured of our family and putting together this blog post was so much fun as I went back through all of the images. It was defiitely hard to pick my favorites and I’m sure my favorites will change over time! I hope you enjoyed this glimpse into a year in the life of our little family! If you are in the Austin area, I highly recommend Heather Gallagher not only for this year-in-the-life package but for any of your photography needs (especially birth photography!). Heather is also a full spectrum doula which you can learn more about by reaching out to her at firstname.lastname@example.org or following her on Instagram @lifesaspectrum. Thank you Heather!!!
Comprehensive & Evidence-Based Childbirth Course from The Birth Hour
I’m so excited to announce The Birth Hour’s signature online childbirth course. Know Your Options is THE most comprehensive online childbirth course in existence! In this course, we will take you from the final weeks of pregnancy through postpartum and newborn care covering all of the evidence-based information for all types of birth, no matter what you are planning!
If you are worried about navigating today’s birth system have maybe had a bad birth experience where your power was taken away from you in the past, we want to help!
But, despite doing your research, you’re still feeling overwhelmed and unprepared and that’s OK. We have totally been there too. There is still time to prepare and we are confident that we can help you achieve an empowering birth. This is our expertise and passion!
IMAGINE WHAT YOUR BIRTH WOULD LOOK LIKE IF…
You didn’t have to choose between an unmedicated birth and a hospital birth.
You’re informed in every single decision you and your partner make.
You feel empowered to speak up when it comes to how you labor and birth your baby.
Because THAT is exactly what this course will do: It gives you options so you can choose where and how to give birth based on all of the most up-to-date evidence based information available coupled with learning to trust your instincts and make decisions based on what is right for YOU.
What exactly do we cover? 12 Incredible Evidence-Based Modules
Module 1: Pre-Labor
Intro to decision-making & advocacy in birth.
What is evidence-based care, intro into increasing your odds of getting family centered care.
Last Weeks of Pregnancy.
Cervical exams: what they are, what they do/don’t tell us, when they are useful and when they are not.
How to tell the difference between labor and false alarms.
Module 2: Planned Cesarean
Gentle or Family Centered Cesarean. What is it?
Questions to ask your doctor to make sure you’re on the same page (includes free download).
Video of Gentle Cesarean.
Module 3: Early Labor
Overview of labor, divided into stages and phases. Normal variations of length of each stage.
Early Labor Coping Strategies.
Spontaneous labor: When to call your provider
Module 4: Induction
Why might your labor be induced?
How is labor induced?
What are some risks of induction, and how can you improve your odds of your induction ending in a vaginal birth?
Risks of induction/cascade of intervention.
Module 5: Active Labor
How can you cope with active labor?
When should you leave for your birth location (or ask the midwife to come)?
What should you pack, whom should you invite to be there, and how will you make your wishes known in labor?
Typical interventions upon arrival at birth location.
Module 6: Transition
How will you cope with the most intense phase of labor?
What pain medication options do you have?
Why might you need a cesarean during labor, and how can you reduce your risk of needing one?
Module 7: Pushing
How can you reduce your risk of tearing?
What breathing techniques and positioning are helpful in pushing?
What happens if your baby needs help getting out?
How can you best advocate for your preferences during labor?
Module 8: Baby’s First Day
What interventions might be offered to your baby in the first hours of life?
Immediate newborn procedures.
Hep B & Circumcision.
What is going on with the mother before and after the birth of the placenta?
How can you get off to the best start with breastfeeding?
Module 9: Postpartum Recovery For Mom
What are the signs that a parent may be experiencing mood & anxiety disorders?
What are the essentials to have on hand for recovery after birth?
How can you plan ahead and make those first few weeks after birth easier on yourself?
Giving yourself time to heal and knowing when to call for help.
Module 10: Establishing Breastfeeding
How to establish a robust milk supply.
Positioning and latching theory.
What tips and tricks can you try to make breastfeeding as comfortable as possible?
What signs can you look for to know when things are going well or when you need to call for help?
Module 11: Bottle Feeding
What if breastfeeding doesn’t work, or you don’t want to do it at all?
Choosing a formula and Safe formula preparation.
What is the best way to bottle feed?
How do you choose which bottles to use?
How and how much to feed.
What is paced bottle feeding?
Module 12: Newborn Care Basics
Why might your baby cry, and how can you calm them?
How do you decide where your baby will sleep?
How do you get your baby to sleep?!?
Newborn hygiene: diapering, bathing, dressing, nail trimming, snot sucking, etc.
PLUS Bigger-than-a-Bonus: Back-2-Work Breastfeeding Course
Then, we’ve got you covered when you’re going back to work with an additional six module Back-2-Work Breastfeeding Course that you will get completely free as part of enrollment in the Know Your Options Childbirth Course!
This is an additional 6 Module Course designed to take the guesswork, worry, and stress out of maintaining your breastfeeding relationship with your baby when you return to paid work.
We will help you:
Identify specific strategies for pumping, storing, thawing, and feeding breastmilk.
Troubleshoot ways to boost milk production.
Guide you in making plans with your employer, your baby’s caregiver, and your family.
Get organized with sample schedules and checklists.
Lifetime Access + MORE Bonuses!
Oh, and you get lifetime access to everything! I’ve actually already had a few mamas who are still in the trying to conceive phase sign up because they wanted to be sure to get in on the course while they can!
You’ll also get a thirty page Course Planner and Note-Taking Guide that you can print out to keep you and your partner on track throughout the course. All of the key takeaways from each lesson are included with space to jot down any questions you have along the way and make note of any essential info you want to remember down the road!
More than a dozen bonus downloads to help save you time along the way and get organized before going into labor—with everything from a hospital bag checklist to printouts for your fridge of who/when to call when in labor! After baby arrives, you’ll have even more invaluable bonuses as you prepare to soak up the 4th trimester with your new baby.
Setting boundaries with your loved ones is one of the tricky things about having a baby that no one really talks about in childbirth preparation. But Stephanie and I have both personally dealt with this and we know how important it is so we want to go over how to get on the same page with your partner and how to approach issues with your extended family. Be sure to grab my favorite free printable download yet that goes over some of the questions you should be asking each other and tips on how to navigate and set postpartum boundaries.