And as far as preparations what would you again you know to advise your your patients to who are preparing for a natural childbirth sure that’s a also an important question I have patients come to me at the end of their pregnancy and say oh what can I do now to prepare for a vaginal delivery and I say you know this is something you should be preparing for from day one exercise is a huge benefit to pregnancy it helps to keep your posture your stamina your strength it really we see the difference in women who exercise and they’re they’re smooth and easy vaginal deliveries the other thing is to minimize weight gain the Institute’s of medicine recommend no more than 25 to 35 pound weight gain for women especially if they’re if they’re a normal BMI our normal weight to start with and we see unfortunately sometimes women gain a little bit too much weight and that can translate to a bigger baby which is certainly harder to deliver okay that makes sense now doctor I also know a lot of women turn to support if they are going to go through a natural childbirth though we hear the term doula someone who is in one on one support so tell us what is a doula and I also know that there is a nurse midwife that may also be an option for some of these women this is a very good question a doula is a labor support person they are not medical professionals they don’t have training in them the science or art of Medicine but they are wonderful support systems for our patients I also believe that women can use a sister a mother a friend as a doula anyone who has been through a delivery and even a partner can can be a great support person the the purpose of the doula is physically to help support you through labor by giving you massage rubbing your feet essential oils making it as pleasant and as as a nice situation as possible and also to support your desires for what you want for your delivery if you don’t want medications if you don’t want many interventions they are there to support you and to help keep you on track when sometimes in the middle of the moment and the emotions and the physical intensity of it all it you kind of lose focus they’re there to refocus you to what you wanted and what you always said you wanted for your delivery.