Active Management of Third Stage of Labor & Birth


Jacqueline Levine, Childbirth Educator/Lactation Consultant, has taken a hard look at the Third Stage of Labor and Birth.
If this stage is “managed” or not may have an impact on your breastfeeding.
Take a look at what this long time professional has to say…..

Prophylactic pit is just  part of that package of “Active Management of Thirds  Stage of Labor” (AMTSL) and there’s  a really great analysis of that concept  and its consequences  in “Optimal Care in Childbirth” Romano and Goer’s  great book.  They contend, and studies agree,  that the medical model of birth…induction and pit to augment labor and other protocols…are modifiable causes of PPH (Post Partum Hemorrhage),  and all woman do not just bleed to death after birthing their babies.   

We know that docs think that medical intervention is always the answer to a problem… never the cause.   I quote from the Goer/Romano book “…research fails to provide ANY evidence that universal application of AMTSL   results in clinically important improvements in maternal outcomes in developed countries, while documenting that it introduces harms”  (p379).     

 In 2010, Cochrane reviewers raised many issues about the trade-offs between the benefits and harms of managing third stage, including worries about prophylactic pit for all women regardless of their risk profile. The key phrase for looking at PPH is, I think, “developed” countries.   99% of deaths due to hemorrhage are in undeveloped and developing countries (says the WHO) , and pit has had  great success in the prevention and treatment of PPH in low-resource countries.

 But here in the US and  in other  high-resource settings, AMTSL “ conferred no benefit other than a small absolute reduction in transfusion rates, but findings show that transfusion rates are not an objective measure”, (Goer/Romano p379), because of the biases found in decisions about  the administration of transfusion and the lack of standardization as to when to treat.   Here, where we have the best medical resources (badly used and badly distributed, no doubt), a pit shot for every woman is overkill, unnecessary for the healthy mother, takes the place of her own highest-ever levels of natural oxytocin, upsets the beneficent cocktail of post birth hormones  the high levels  that nature provides for the most successful and joyous first minutes and hours with her newborn.  

During a c-section,  the mother may lose as much as 1000ml of blood, and that’s not enough to make docs call for a transfusion, but the standard for vaginal birth is only 500ml, and one wonders how they can tell how much blood loss there really is, when much of what a woman loses may be absorbed in the chux pads under and around her.

The Cochrane  says” Women should be given information on the benefits and harms of both methods to support informed choice. Given the concerns about early cord clamping and the potential adverse effects of some uterotonics, it is critical now to look at the individual components of third-stage management.”

Active versus expectant management for women in the third stage of labour. Cochrane Database Syst Rev. 2011; 11:CD007412 (ISSN: 1469-493X) Begley CM ; Gyte GM ; Devane D ; McGuire W ; Weeks A
School of Nursing and Midwifery, Trinity College Dublin, 24, D’Olier Street, Dublin, Ireland, Dublin 2.


Baby Belly Bazaar March 29, 2014




   March 29, 2014; 11 am – 3 pm;

        Greensboro Cultural Center





 November, 2013


Baby Belly Bazaar


Triad Birth Doula is proud to present a FREE eclectic celebration for expectant moms who are interested in expanding their artistic & healthy prenatal experience. Belly casting, belly painting and belly dancing will be showcased in the Greensboro Cultural Center (200 N. Davie St) from 10am to 2pm on Sat, Nov. 9th, 2013. Massage, yoga and aroma therapy will enhance the ambiance while herbal teas and healthy lunches will be available for purchase.


 Learn about the most up to date research pertaining to birthing techniques Transform your beautiful belly into a canvas and let us capture your photo for posterity. If you are ripe with artistic potential or feel the urge to be pampered, this is a day for you. Bring your girlfriends and celebrate your bountiful belly.


Your baby will get a kick out of it, too.


For more information, call 336 312-4678 or email


How do you envision your baby’s first two hours of life?


Will it be peaceful and soothing? Maybe soft lighting, soft sounds, soft touches, and familiar smells that remind baby of where he has been? Will your baby lie safely and peacefully on your chest, staying warm with your body heat, regulating his heart beat with yours, gazing into your eyes, searching for his nourishment? Will it be a gentle welcome after such hard work to be born and then quickly adjust to this world of gravity and air?


Or will it be bright with fluorescent lights, loud voices with lots of people talking to vitamin K shotyou, to your baby, to each other, and too many people wanting to lay their hands on your baby, or even rub your baby down with a rough terry cloth towel.

Can you imagine after having been floating in warm water for all of your existence to only suddenly being roughly rubbed with stiff terry cloth??? Do you think that might feel like sandpaper?

And what of the ointment that goes into the newly used eyes that only caught a glimpse of the world? Need I even mention the prick of a needle?

How do you envision your baby’s first two hours of life? Consider this all important time. Then consider writing down what you envision so that after you describe it to your nurse and care provider, they have your vision and wishes in words to remind them.

How do you envision your baby’s first two hours of life?

The Everlasting Flu Shot Debate

It is that time of year again….the offering of flu shots!

You may ask yourself…….should I? Or is there a valid reason not to?

The following is a post from a mother, and pregnant, sister birth junkie, Ashley Snyder:

“Honestly, being a science chick I go back and fourth. Looking at the list of ingredients is obviously very scary. However, trying to balance that when you see studies that show a big increase in better outcomes for babe including a 50% reduction in flu transmission over their first year of life…. It is such a hard decision. I personally rarely get sick, except when pregnant, but when I do it tends to be really bad. I wasn’t able to get out of bed for nearly three weeks when I had the chicken pox. The last time I had the flu I wasn’t able to walk, was delirious at points and very close to being hospitalized. I am however leaning toward not doing it this time since I am so early during flu season. If i were later into my second trimester or if baby would be born during flu season I think I would be more inclined to. What is swaying your decision?”

I (Kenny) recently heard a  midwife say it is the newborn that you are most protecting with mom getting the shot. The vaccination is not guaranteed to prevent mom from getting flu. If mom gets flu, and new born then gets it, it is potentially very dangerous for that little, newborn. Not 100% protection, but at least some, even if it is only to help new born to have milder case of flu. Oh…..and that wonderful, healthy breastmilk, without the vaccination,  does not have nearly the same amount of protection.

What I feel is most important here, is that you research, learn pros and cons, and then make an informed decision!

So……what is swaying your decision? While you are restricted from posting here (those robots drive me bonkers) please feel free to post on my FaceBook page: Triad BirthDoula! Or email me:!


Most women do not wish to have a cesarean but sometimes it is necessary.
When this happens, a woman can still have choices. She can choose to have a “Friendly Cesarean” with the help of her care provider and hospital personnel.
The following is the story of one woman who not to long ago had a “Friendly Cesarean”!

Hello Kenny.. You are welcome to share my story with anyone you like.

My birth experience was very positive but it took a partnership between us and Women’s Hospital.

During my Cesarean everyone around me was very considerate and encouraging. They even had a mirror there so I was able to see my baby when he was delivered right from my belly. After which they handed him to me and helped me remove my robe. My husband and I were then able to hold him and the nurse was kind enough to make a makeshift tent over our heads so the operating room lights wouldn’t bother or deter my son from opening his eyes. We spent close to 15 minutes like this and it was wonderful.

I was taken to the recovery room after and my son was brought to me within a few minutes.

One of the things we made sure to request was that my husband be with our son whenever he had to be taken away from me. Luckily , with the exception of a couple of times, the hospital was able to help us make this happen.

My son stayed with me the entire time from there on out and I even got to give him his first bath. We requested for the staff not to do this immediately after birth and for me to be involve when it happened. It was wonderful that they complied.

As for nursing, I nursed as soon as he was born as I already had my colostrum/milk come in. Our birth plan clearly stated no bottles/formula or water and therefore we were never asked or offered any of these things.

The staff was very considerate of our wishes and tried to comply and find me alternatives to make the experience positive for us. The only thing that I absolutely hated was when they had to prick his heel to collect blood for tests. The only good part about this was that they let me hold him while this happened. I continued to nurse him but he was still pretty upset so we could have done without it.

One thing I would recommend to all mothers going through a cesarean is that don’t be afraid to ask and communicate how you want your experience to be. The staff at Women’s is very accommodating and I am sure if thy can’t fulfill your request as is they will find an alternative.

Good luck to all you momma’s out there and happy birthing.

Thank you, my friend, for sharing your story!
You will not believe how many women you have impacted by doing so!
You are a beautiful and brave woman!!!
(Obviously, these are stock pictures not of my friend.)

When mom smokes marijuana, is her baby flying high?


What do you think about smoking marijuana while pregnant?

How about while breast feeding?


There are many experts who believe this is harmful in many different ways. Some site low birth weight, poor physical  development, impaired nervous system development, problems with short term memory, concentration and judgement, and the list continues. But there seems to be no conclusive evidence or studies at this time.


However, this much is a fact……when a mother smokes marijuana,

THC WILL show up in her lab work


If mom is smoking weed and feeling high because of this THC,

then isn’t her baby feeling high, too???

THC does mess with the brain…we all know that. But do you want it messing with your baby’s brain?

THC crosses the placenta to the unborn child.

THC crosses to breast milk to the nursing baby.

And here is another fact…

if THC is discovered in the lab work of mother and baby at Women’s Hospital of Greensboro, NC,

Child Protection Services of the Department of Social Services


So what do you think? Is it worth it???

You just may be harming your child!!!

Birth Doulas are for ANY kind of childbirth!!!

More and more people seem to understand the benefits a birth doula has to offer to a woman and her family, when that woman wishes to have a natural childbirth experience.

But how many people realize what benefits a doula offers when a woman chooses to use an epidural? Or how about the comfort a doula is able to give when there is a cesarean?

When a women tells me she wishes to have an epidural as soon as possible, I smile and assure her that I understand her wishes, which are absolutely her right.

I then explain how our local hospital does not typically admit a woman until she is in active labor. I suggest we work  on ways of coping until she is admitted, even how to stay active in triage. I then move on to the realities and mechanics of having an epidural. After this, I discuss her second stage of labor…actually giving birth. Then her wishes for her new born baby should be planned for, such as skin-to-skin, bonding, breastfeeding, having the nursery staff come to her and her baby.

Every time I am with a woman who suddenly finds she is going to have a cesarean, there is disbelief, deep regret, confusion… overall feeling of being a failure in some way. Her family is usually at a lost, feeling much the same way. And did I mention fear? I, as a doula, am there to help qualm these rampant and sudden emotions. I guess my job is to help restore peacefulness. I work fast and furious to try to accomplish this, assuring the woman that I will still be there for her. After all, there is still much work for me after the baby is delivered.

My point with these ramblings…a birth doula is there to provide physical, emotional, and informational support to the mother and her partner before, during, and just after birth…



Did you know that if everything is okay with your newborn, he does not need, or have to, go to the nursery???

Women’s Hospital of Greensboro, NC is beginning to follow the model of bringing everything to mom and baby, right on the L&D floor. And I say congratulations to Women’s Hospital!!!

What does this mean for you and your baby???

This means that you are able to continue skin to skin.

This means that there is no rush to initiate breastfeeding but you can follow a much more natural, calmer path.

This means that there is all the time in the world to cuddle, bond, nuzzle.

This means that there is ample time for your hormones, and your baby’s, to rage through your bodies and do so many beautiful things for you both.

This means that you get to give your baby his first bath.

This means that you are there to comfort when all of these new, some unpleasant, things are being done to your baby.

This means that you have the advantage of learning valuable information from the nursery nurse.

This means that after 40 weeks, plus labor, no one is going to try to remove your baby from your loving arms.

This means that you can relax and allow your new love to flow to your new baby!


Of course, this is all predicated on your baby, and you, having no medical issues.