Sweetwater Doula with Krista Cain

2013: Taught my first childbirth class
2014: Attended my first birth as doula
2023: Attended my final birth as a doula
2024: Announced big changes are coming to my childbirth classes and more!

1. Given that I am no longer offering hands-on doula support, I am rebranding my childbirth education under a new name. This page will soon become Next Level Birth.

2. I am excited to also be launching a doula mentoring program in 2024! It will be called Next Level Birth Pro and will give me a chance to pass along my decade of experience and expertise to small cohorts of doulas who have already trained / certified elsewhere and are ready to take their practice to, you guessed it, the Next Level.

There's more to come but that feels like a lot already so I'll save further details for another post (spoiler...there will be a party!)

It's been an amazing 10+ years serving individuals and families as they prepare to welcome their little ones.

Here's to many more years of learning and growing together!

Yours truly, Krista Cain

While I continue to update the website and get it back to full functioning, here's the link for those of you wishing to schedule an initial consultation / interview. I'm currently accepting clients for Placenta Encapsulation, Doula Support.

If we've already spoken, have a look in your inbox later today....I'm sending contracts & registration information your way this morning!

All my best, Krista

Schedule Appointment Schedule your appointment online

Parents-to-be: As you plan for baby's arrival, one excellent way to strengthen your connection with loved ones is to be very clear about your boundaries when it comes online etiquette and privacy.

Loved-ones: A terrific way to affirm that healthy connection is to abide by the parents' wishes.

Can amends me made? Yes. But it's nice when they aren't necessary.

xo, Krista (Sweetwater Doula)

Emma Roberts Shares Son's Face After Her Mom Posts 'Without Asking' Emma Roberts' days of hiding her son's face on social media might be over -- here's why.

My website isn't down but it's just kind of wild over there right now because of some major technical issues. If you need to get in touch with me, feel free to reach out via messenger while I figure things out over there. xo

Looking to get trained in pediatric CPR by Sherry at Great Lales CPR?

$75
Find the sign up link here:

https://www.greatlakescpr.com/join-a-course/

I get NO kickbacks for your participation. I'm simply sharing for anyone who might. E interested 🎉

Yours, Krista

Join a Course – Great Lakes CPR, LLC “Hands Only” CPR Demo/Practice Session This is a NON-CERTIFICATION course for community members who would like to learn “Hands Only” CPR for adults. (Child and Infant not included)

I was just talking with someone about whether or not home birth is becoming more popular and it turns out it is.

The vast majority of my doula clients have had their babies in the hospital but my birth classes are filled with a mix of folks preparing for home and hospital birth.

I'm curious, where did you give birth?
Home? 🏡
Hospital? 🏥
Birth center? 🏠

US home births reached highest level in 30 years in 2021 | CNN There were more than 50,000 home births in the United States in 2021, an increase of 12% over the year before and the highest level since at least 1990, according to a report released Thursday from the US Centers for Disease Control and Prevention's National Center for Health Statistics.

Malcolm... part nine.

I think it’s incredibly important to discuss how often the vision we form of what we hope our birth experience will look like through our pregnancy will differ from the way our birth actually looks and feels when we experience it.

I’m not just talking about birth trauma here, not at all.

When we are pregnant, one tool we have to prepare ourselves for an empowering birth experience is to spend a lot of time reading, watching and learning about positive, peaceful and ideal birth stories. We use this as a tool to help us trust our bodies, our babies and to train our brain to believe that we CAN have a birth experience like that.

But what happens when from the outside our birth actually does meet those hopes and expectations, but our lived experience isn’t peaceful and empowered but instead filled with a lot of disillusionment regarding our own strength or peace of mind?

The lived experience is different from the outsiders view and that can make it difficult for the birthing person to unpack the complexity of how they are feeling about their own birth story.

What happens when birth goes sideways and ends up needing intervention you felt desperate to avoid?

I always tell people that you can have a birth experience that ends up needing a ton of unwanted interventions and still leave that experience without trauma as long as you were educated on your options, apprised of what was happening the whole time, have a voice in your own story, and get to be part of the decision.

I fully believe that those things dramatically lesson the rate of birth trauma in undesired birth experiences. But just because there isn’t capital T trauma, does that mean that there isn’t a complexity of emotions, grief, loss, and confusion to process through in the end? No. Not at all. And that’s what I want to talk about today.

I don’t think there could be a person more prepared and accepting that our birth had a high possibility that it would end in a c-section than I was.

Logically, I felt super comfortable with the statistics and potential reasons we might have a belly birth from the start.

Emotionally I.did.the.work. To process my past experiences that were certainly coupled with a lot of trauma. To work through the what if’s and how comes as much as absolutely possible. To prepare myself, my partner, and my birth team that if it was needed, I was truly at peace with everything as long as I got to try.

Every single word of that is true. I couldn’t have been more prepared for however our birth was going to play out, and still... 13 days after delivery... we are unpacking pieces of the sadness I feel daily.

Here’s the thing, I feel 100% sure we did the right thing in our birth. We had a beautiful experience and a perfect outcome. But it still means the vision I created so strongly in my heart and mind of what this va**nal birth would look like, didn’t happen, and that’s something I have to work through.

I know plenty of people who fight for a VBAC, have a “beautiful and successful” va**nal birth and find themselves struggling in the aftermath because it was so different than their vision of what that birth would be that they wish they had just had a repeat c-section from the start.

I have worked with and witnessed parents who have to unpack feelings of disappointment, sadness and inferiority when they had hoped to have an unmedicated birth and ended up with an epidural. Those feelings are valid.

I have worked with and witnessed parents who have to unpack feelings of disappointment, sadness, and even anger when they had hoped for an epidural and ended up having such a fast delivery that they had no time. Those feelings are valid.

This is important because we need to acknowledge that we can be happy, content, empowered, and at peace with our birth experience while STILL having to grieve the loss of the vision.

Marnie and I spent a lot of time dreaming about our upcoming birth. In our vision, so strongly, marnie helped to catch Malcolm as he was born into the world and placed him directly on her own chest. To be honest, this is the only part of our birth vision that didn’t happen.

We got to experience labor together, we got to work through every single stage of labor over the course of five days time fulfilling every part of what I envisioned it would be to have Marnie by my side supporting me. The only part that changed, was the way he came into this world at the very end.

But in the realm of early postpartum days, where sleepless nights are met with unbalanced hormones, incredible amounts of love and the “baby blues”... missing that piece, that part of the vision that felt soooo important and incredible for all the months we dreamt of it... it feels sad to know that that opportunity and that vision are over.

And that’s had me thinking a lot about how much we need to validate the differences in our vision vs our lived experience and the vast complexity of emotions that occur because of it.

Malcolm... part seven.

Just before our favorite midwife was to leave for the day, we had her come in to check my progress since I was feeling all the indicators of being ready to deliver my baby with each contraction.

Tired and uncomfortable there was this part of me that felt so confident that everything we spent all of these days going through had worked and that the epidural was the ticket we needed. I was eager to get checked knowing we were so close to meeting him.

This other part of me went into the cervical exam feeling apathetic and emotionally removed because there was this corner of my heart that felt just as sure that something wasn’t right.

She checked me... I was waiting for “okay Kristin, your fully dilated, baby is nice and low, let’s try a few practice pushes”, but her face told me something else before she even spoke.

Nothing at all had changed.

I was still 4cm, 50%, and -1.

This isn’t normal. Something was wrong.

There isn’t a single other thing that we could have done to help me progress. I am confident both professionally and personally that we used all of the tools, preventative tools and aggressive intervention tools. I tried it all. I left nothing behind. I pushed myself all of the way. We did it all.

“I’m having a c-section”

I expected the midwife to say yes. I expected her to be the one to call it and tell me it was time to have surgery. But she didn’t. She assured me that no one was medically ready to make that call. That Malcolm was picture perfect through it all. That I was healthy and not in any kind of danger at this time.

She checked one more time and then assured me that the baby was well applied and his position and station were not the issue.

She was as surprised and confused as the rest of us, the big question now was WHY?

Earlier in the labor WHY did he go from low and engaged to floating back up to a ballotable position?!?

Ballotable means that the head can be moved around, that it bounced up and down or is able to be moved side to side because it is not engaged in the pelvis.

It’s very strange, almost unseen that a baby will be well engaged in the pelvis for weeks and then DURING induction of contractions disengage and go high... there was a reason for this.

WHY did my cervix stop dilating and effacing after 4cm and 50%?!?! Labor was not false, the contractions were powerful and strong enough to make change. Baby was well applied to the cervix again... there was a reason that labor continued and my cervix did not.

I had zero pressure from my medical team to stop my attempt of a VBA2C. After the cervical exam was done, and we spoke with our trusted provider for a short time we asked for some space to talk alone.

It wasn’t a hard decision at this point, something inside me knew clearly that it was time. I told Marnie that even though we were both very strong and healthy still, I just knew that if we continued to labor and put more stress on my body and on Malcolm that something was going to happen..

Babies are very wise. They are intuitive creatures who make decision in the womb to help protect themselves. It was time to listen to what he was trying to tell us before anything became emergent.

We called our team back in and shifted gears to prepare ourselves to meet our baby very soon and very differently than we had hoped...

(I’d encourage you to not stop reading here... the next chapters are very important parts of our story)

If you only read one of these installments, read this one.

Consent.
Informed decision making.
Trauma-informed care.

These are major concepts and skill areas I help my own clients strengthen. But care providers have a major hand in these, too.

This part of Kristin & Marnie’s stories sheds light on how it could and should be in any birthing location and with every care provider.

xo, Krista

Malcolm... part five.

Rest and reset, that was the plan. After a good cry and the redirection to surrender to whatever needed to happen next, I found myself doing big figure eights with my hips leaning over the bed while we “watched” Mrs. Doubtfire to distract from the focus of labor.

At one point I felt the shift and all of the sudden we needed to move the monitors far down on my belly again. I knew I had managed to move him out of the way and give him room to find a better position, he was re-engaged and things started to pick back up a little more intensely.

One of the doctors and residents who had checked on us earlier came in to see if things had changed enough to break my water...

I want to explain to you what happens during a cervical check if you are pregnant before you go into labor or when you are already in labor.

Every time a doctor, midwife, or nurse does a cervical exam they are measuring three things.

1: they are checking to see how effaced your cervix is. This is a measurement of how soft and thin the cervical band is. Before you are in labor this is thick and hard (0% effaced) throughout the process of labor the cervix will soften and thin to about the width of a piece of paper (100% effaced).

2: they are checking for cervical dilation. This is the opening into your cervix. During your pregnancy you will be 0cm dilated, the cervix is fully closed to keep your baby protected while they grow. As labor progresses your cervix will continue to open, 1cm is usually measured as one finger width open... in order to deliver a baby va**nally the cervix must open all the way to 10cm or “fully dilated”.

3: they are checking the station of the baby. The station of the baby is the measurement of where the babies head is in the birth canal. -4 station is when you baby is floating high in the pelvis and not well engaged. 0 station the baby has reached the pelvic brim... +3 your baby is crowning. The baby had about 8 stations to transcend down the pelvis through the birth process.

Before labor begins, and in the earlier stages of labor, the cervix is typically in a posterior position... this means that the cervix is tipped towards the spine and behind the babies head, if you can imagine this means for the provider to reach the cervix to assess effacement, dilation and station they must reach far up and back into your va**na. As labor progresses, one of the markers we see change throughout labor is that the cervix will move forward towards the front of the body, making it far easier and less painful to check.

And this is where we are going to talk about trauma informed care and consent.

Pay attention here, because this alone made it worth it to drive 4 hours to have our baby.

Every single time someone touches your body they should be asking for consent to do so. Every. Single. Time.

If this isn’t the standard of practice, (which it sadly isn’t in most places) and they haven’t been trained in informed consent and trauma care, then I know how awkward it can feel as the care provider to ask so frequently for “silly” things like taking a blood pressure or checking an IV. I promise you that the more you practice this model of care the more natural in becomes and the less awkward it feels for everyone.

Whether or not someone has a history of trauma, (physical, emotional, sexual, etc) or not, we should be practicing the model of care that assumes we never know what someone has experienced.

The 2021 CDC statistics states that “Nearly 1 in 5 women have experienced completed or attempted r**e during their lifetime.” Most of which occurs in adolescence or young adulthood. This doesn’t even count other acts of moleststion or other sexual trauma. This is an incredible number to consider.

Every time BEFORE my body was touched by ANYONE I was asked “is it okay if I...”, “may I touch your...”, even if I told them they didn’t need to ask, they asked. That’s how this should work.

The doctor came in and asked me to tell her a bit about my other births. During that conversation I explained that I could not tolerate cervical checks at all in my past.

Without any other explanation needed the response from the doctor was, “what can I do to help make the exam better for you? Is there anything specific you need for me to do or not do? You are in complete control here”.

I want you to read that again.

This is trauma informed care. To treat each person without shame, shock, or assumption while giving them the tools to speak up for their own needs as part of the shared decision model.

It makes all the difference.

Never was I touched without my consent. Every step of every procedure, blood pressure check, cervical exam, etc. was a conversation where I was asked if it was okay, they waited until consent was given, continued to inform me of what was happening along the way, and made sure I understood each step.

“May I touch your belly”
“You’re going to feel my hand”
“Is the pressure I’m using okay”
“If you want me to pause say stop, if you want me to stop all together say done”
“You are in charge”

It was time to see if I had made change, would they be able to break my water?

The resident checked me first and “couldn’t hardly reach my cervix”, it was painful and discouraging and I felt more confused than ever. I explained in detail what I knew about the shape and placement of where my cervix was positioned from prior checks and the doctor asked if she could try one more time.

In a matter of seconds the conversation had shifted from “I can’t reach it”, to “oh you’ve made great progress and I can break your bag of water now if you’d like”. As soon as I gave consent she broke my water.

The entire room cheered. Marnie and I both wept in excitement and relief, the doctor exclaimed “I’ve never been SO thrilled to break someone’s water”, laughter and tears filled the room and immediately things intensified.

Our doula returned, contractions were every couple of minutes, and grit and determination took over. The surrender worked and our baby was on his way...

If you’re just joining this feed we’re following along as local doula and brand-new (again) mama Kristin Jardine and wife Marnie Duse share the story of their baby’s birth. Like all births, it is an epic tale!

Kristin’s personal experience paired with her professional expertise provide a powerful look at their baby’s birth and birth in Michigan.

Malcolm... part four.

When I labored during my first induction for Hayden over 11 years ago, I had Pitocin for going on 36 hours, I felt some contractions, but all were very minimal and manageable and I never made any progress before a c-section was called.

For Britton, a completely unnecessary repeat c-section was scheduled which meant I experienced no labor at all before walking my self back to the OR to meet him.

This time, my body was ready and fully responding. Induction with Pitocin typically means contractions that can come on strong and hard without the gradual climb of unmedicated spontaneous labor. To be honest, I was ready for it and excited to feel such discomfort right from the start (even if that meant many many hours of intensity). I knew my body was making changes and Malcolm was a picture of health the entire time.

About ten hours into Pitocin with the foley catheter I was sure it was ready to come out, the pressure was intense, I was working hard through each contraction. At 7pm our favorite midwife Sarah came on shift and immediate gave a pull to the catheter that came right out.

A Foley catheter is a small thin rubber tube that is inserted through the cervix and inflated with 60cc of fluid to create a balloon that then sits internally on top of your cervix, applying pressure to mimic the babies head doing the same. This is a way to manually help dilate the cervix and it usually comes out when you are around 3-4 centimeters dilated. This is a technique often used for less chemical inductions.

Interestingly in almost ten years I have never seen or heard of our two most local hospitals using this option as part of their induction. I can’t say that it’s completely not an option because I haven’t had a situation where we have inquired about using this tool recently, but in many other hospitals, Traverse City and UofM alike, this is a very common and effective way to help induce labor.

We were hoping to be able to rupture my membranes (break my bag of water) and try to allow my body to take over labor on its own.

I was now 4cm dilated, still 50% effaced, but this little one swam back up high and turned into a not ideal position where his head was a little bit posterior (he was facing my belly instead of my back) and asynclitic. This means the head of the baby is down but is tilted to the shoulder, causing him to be malpositioned for the birth canal. He was now -3 station and no longer in a good place to break my water.

When you manually break through the amniotic sack it’s very important that the head is well applied to the cervix (low down in the pelvis) to make sure the umbilical cord doesn’t slide down in front of the babies head causing what is called a cord prolapse, where the head can then come down on top of the cord, compressing the flow of blood to and from baby creating a very grave emergency situation.

I was very confused and surprised to hear about the presentation that Malcolm had gotten himself in, he’d been so well engaged and low down for weeks and my labor wasn’t presenting with signs of a malpositioned baby... for example, we often see what is called “back labor” when a baby is turned in a poor direction, this is where you feel the contractions with extreme discomfort in your back instead of the front of your abdomen. My contractions were staying a steady and consistent pattern instead of spreading out or coupling on top of each other. None of the typical signs were present and I was discouraged and confused by how much this didn’t line up with what I know and how I felt.

Without the ability to break my water, my job became “move the baby”. We took a Pitocin break, sent our doula home for a while, had a nice shower and a walk. And began to use all the spinning baby positions and repositioning dance moves to help Malcolm turn and reengage in a better way. At some point, after a good cry and a lot of work it was clear that we just needed to surrender into the process and let Malcolm figure some things out for himself.

The focus shifted to rest... rest and reset. Trying hard to allow my body to stop fighting for progress and just sink into rest. We were now ready to wait and see...

(This image is of the Foley catheter still inflated after it came out, to give you a visual of how big 4cm dilated actually is)

Malcolm... part three.

Did you know that up to date research shows that a medical induction for a trial of labor after cesarean (TOLAC) is evidence based and supported for up to two prior c-sections?

I would venture to guess that most people are not aware of this, because so many providers do not “allow” a TOLAC let alone a medical induction for one.

There are obviously situations where additional risk factors change the recommendation here, as with everything there is no one mold that fits all birthing people.

There are also many restrictions to maintain safety throughout an induction when there have been prior surgical deliveries. This makes a lot of sense because some of the methods we use to medically induce people for labor include things like cervadil and cytotec both of which are designed to soften the cervix and are contraindicated for inductions where there is a uterine scar that may then also “soften” creating a greater risk for uterine rupture.

There are many reasons why someone who is hoping to have a VBAC might need to have a medical induction of labor, for me the decision was made to help start labor early because of gestational hypertension that was increasing at the end of my pregnancy.

We were an active part of this decision and conversation every single step of the way with our OB and MFM (maternal fetal medicine doctor) at UofM.

Never once did they place harsh limits or restrictions based solely on “hospital policy”, the language used was consistently “this is what we are seeing... here are your options... how do you feel about that?”. Shared decision making creates a profoundly empowering experience for the birthing person and their partner.

In fact... it was us who ended up pushing forward with an induction as early as we did, they were still feeling comfortable letting us wait longer. It was my own knowledge and internal feeling that made me more comfortable starting earlier instead of waiting, a decision the whole team got behind and fully supported.

Malcolm was already giving me a lot of signs that he was ready, my body was prepping for birth for a couple weeks prior to his delivery.

He was well engaged, head down and low. I was having random contractions and cramping that were certainly “new”, he was working with me to help me know when it was time.

Marnie and I did a lot of things to help my body prepare, exercising regularly, walking, squatting, dancing, using the birth ball, etc.

I saw a chiropractor regularly, weekly prenatal massages and had acupuncture done the last two weeks. We practiced impeccable posture and positioning to keep him in good alignment for birth.

My body and my baby were making the call of when it was time. Ultimately my blood pressure made the final decision and our induction was scheduled for May 7th.

I think the hardest part about inductions for most people is the time it takes, in my experience it’s what surprises people the most and wears them down the quickest.

Inductions are long, when they are done well, they go slowly for most people. We are talking about many days of slow and hard work to help make your body do something it probably wasn’t fully ready to do. We knew this going in and tried to get as much rest and nutrition in before we began as possible.

From the moment we walked into the hospital we had a staff of cheerleaders supporting us so fully in our hopes for a va**nal birth. We also brought with us a detailed write up of our birth preferences, explicitly saying that our actual goal was to have the CHANCE to TOLAC and to be a part of shared decision making in an evidence based care model. We understood going in that this birth could end up going many different directions and were open to any and all interventions that may be beneficial and/or needed.

After one 12 hr round of a Foley catheter that gave us a more favorable cervix but no dilation we did a low and slow 6 hours of Pitocin to help “ripen” things a little bit more. At 3:30 in the morning we were 1cm dilated, 50% effaced, with a nice low baby at -1 station. Our second foley was placed with Pitocin consistently being upped over the next 15 hours.

Game on. Contractions were 3-4 minutes apart pretty much immediately, intense and certainly making change, things felt like they were really moving along and taking the support of my wife, our doula, and nitrous oxide (ohhhh more on this magic later) to cope through each contraction.

Labor for Malcolm, with my wife by my side, was one of the hardest and most beautiful things I’ve ever experienced...

Malcolm... part two.

I mentioned last time that I was the healthiest and strongest I’ve been during any pregnancy even with more “complications” than ever, I want to explain what I mean here...

1: I began this pregnancy 30lbs heavier than my other two, placing me in the “morbidly obese” BMI category. I could give a whole Ted Talk about what utter bu****it the BMI scale is and how detrimental it can be in our healthcare system, but for now I’ll keep it simple. When there is a focus placed on limiting weight gain during pregnancy because of a BMI number we are causing so much harm. You should know that you ALWAYS have the right to decline weight checks during your pregnancy and that you can ask that your provider not mention or focus on BMI at all.

2: I’m a mom of “advanced maternal age” (AMA), this was considered a “geriatric pregnancy”, lol. The terminology is asinine but it means that there can be increased risk factors for people who deliver babies over the age of 35.

3: I have a history of developing hypertension through my pregnancies, even if mild and controlled with low dose medication, hypertension in pregnancy is a real problem that needs to be addressed by your medical care team.

4: this time around I had severe pregnancy enhanced sleep apnea (expect a whole lot more about this topic in the future). This is a big deal y’all, it’s significantly undiagnosed and untreated. It’s far more prevalent than you could imagine and almost never considered or talked about. The symptoms, the impact, and the outcomes from sleep apnea while pregnant, are startling. For example, it severely increases the risk of high blood pressure, blood sugar issues and preeclampsia just to start. After a really rough first 24 weeks and the onset of both hypertension and gestational diabetes I called the sleep doctor myself to get a study done. 2 days after using the c-pap machine my hypertension dropped, my sugars balanced out and my entire existence changed.

5: for the first time In my life I developed gestational diabetes. Very likely impacted by my sleep apnea, diet controlled until the very end when my fasting numbers needed some overnight insulin to help a bit.

6: both of my first born sons where delivered via Caesarian sections after nearly a month of hospital bedrest for both of them.

That sure paints a pretty grim picture in the scheme of “risk factors”. It also meant that during my first months of care in northern Michigan we were already talking about how likely it would be that I’d need to transfer to Traverse City because I was going to have such a “high risk” and problematic pregnancy.

The thing of it is, I was actually very well managed, incredibly motivated and dedicated and overall... very very healthy.

I walked 4 miles almost every day.

I ate an incredibly healthy diet and drank my weight in water daily.

With the support of my wife, my body was strong and my “complications” did not need to lead us down a path of a fear based pregnancy.

We realized this especially once switching care to UofM. All of the sudden both our low risk OB and our high risk MFM were completely un-phased by the same exact things that struck panic alarms up north. It’s a marked difference in up-to-date information and evidence based care.

No doubt about it, I have special risk factors that need to be monitored, that’s why we took the needed precautions and did just that.

Twice weekly starting at just 32 weeks pregnant we had non-stress tests (NST) done to continually make sure that Malcolm was thriving.

One huge issue that the birthing community faces in northern Michigan is the barrier to co-care between Obstetricians and Midwives. Currently our local OB practices will not provide co-care for people who are working with midwives, it’s a really unfortunate divide that prevents both the care team and the patient from the opportunity to have amazing and cohesive evidence based care.

We were so thankful that our UofM team were totally on board to allow us to utilize my local midwives to provide my co-care.

In our birth center we have the same exact NST machine as we have in the hospitals. Our midwives are fully skilled and educated to provide this service. The comfort and peace I was able to receive while having this necessary monitoring done was such a benefit to my health and having my care providers on board to share this care made a huge difference.

We desperately need the relationship of licensed and skilled midwives, (who are providing low risk people excellent evidence based care) and our local OB practices to change. There are such amazing things that could come from a cohesive working relationship for the birthing world.

With so much gratitude for our entire team we continued with regular prenatal care via the birth center of northern Michigan while also receiving virtual prenatal care from UofM until it was decided that it was time to meet our baby...