Posts Tagged ‘doulas’

5 Reasons Your Midwife Wants You to Hire a Doula

Wednesday, May 1st, 2019

partner supporting laboring woman in birth pool

Not only does evidence tell us a doula can have measurable benefits for both mothers and their babies, but their intangible benefits are also felt every day by those who hire them for their expert support.

Doulas are fast becoming standard-of-care, as they should. Women have always surrounded women in their childbearing year, from girlhood on up. We know that new mothers in America are too isolated. Society leaves us alone to manage a never-ending list of “shoulds” between hectic schedules, separation of families, and age segregation. 

People often ask me if home birthing families really need a doula. My answer is nuanced. I don’t believe every family “needs” a doula. Some families have support and help. Their own extended family, their religious community, or a close-knit community of friends may provide the needed community. Those families may not “need” a doula.

However, I do believe that every family would benefit from a doula. This is because a good doula will always add to the experience what is needed, and guard the space from that which is not. Even in a home birth setting. 

Additionally, if a family lacks anything in the way of support, then a doula is absolutely a necessity! She is worth every penny you pay her, and more. A doula’s positive influence cannot be overstated. I am overjoyed when I hear that a mother has chosen to add a doula to her support network.

Here are 5 good reasons to hire a doula if you are planning a midwife-attended home birth:

 

1: You are a first-time parent or a VBAC client.

A first-time mom’s labor is likely to take longer than a woman has labored before. If you have had a cesarean, there may be some additional emotional blockages related to your prior experience that you need to overcome in labor. There is nothing wrong with either of those things. We don’t worry a bit about longish labors. As long as you and your baby are laboring well together, we are content to wait.

However, we often will not come to stay until active labor is well-established. There are a couple of reasons for this. One is because we need to be as well-rested as possible in order to maintain you and your baby’s health and safety during the labor and birth process. Our choice will often be to sleep while we can. This allows us to maintain our ability to make critical decisions that require a clear head. 

The other reason we don’t want to arrive too early in labor is that your uterus may not want us there! Your body knows when your care provider is watching, and it may get very shy–slowing or even stopping the process until the nosy midwife is out of sight and mind. I have seen it several times, both in my years as a doula and as a midwife. 

This is where doulas save the day! They are much more able to come in early labor and stay. They will help you relax, rest, eat, drink, stay distracted and let your labor unfold in its own good time. Doulas are experts in peer support, and as such, their presence rarely interferes with the natural labor process, and we often see much more efficient early labors in mothers who have doulas. 

 

2: Doulas are kind of a birth fairy.

They come into the birth space, read the room, and are able to fit themselves in wherever they are needed. Perhaps your partner feels bit overwhelmed trying to get the pool set up while supporting you, so your doula takes over pool duty so your partner can focus on you. One of the kids wakes up, so your doula is able to stay with you while your partner comforts a child and puts them back to sleep (or vice versa). You and your partner are rocking your labor just fine, and your doula snaps a few intimate photos. Sometimes, she walks the dog, feeds a child, updates the family phone chain, and updates the midwife. Whatever the need is, your doula will have a magical ability to fill it intuitively. 

 

3: Doulas can read your labor like a book.

Sometimes parents have a hard time deciding when to call the midwife to come in labor. Especially if they are first-time parents, have had a previous hospital birth (or cesarean), or were induced in a previous labor. No matter how much we discuss those “when to call” moments prenatally, some parents will doubt their ability to assess what warrants a phone call or will be so absorbed in labor, they no longer think about it. You can assign your doula the task of updating the midwife as needed, so you don’t have to break your concentration to do it. Plus, doulas know the clinical lingo and can communicate in concrete terms that your midwife will easily understand and acknowledge.

 

4: Comfort. Comfort. Comfort.

As a midwife, I do care about your comfort in labor, because I understand its correlation with health, well-being, and safety on multiple levels. However, I think more about how long it’s been since I listened to heart tones, rather than whether or not you need your hips squeezed. Not to mention charting. (Oh! the paperwork! *dramatic faint*) Midwives offer as much comfort as we can in the context of our primary responsibilities, but doulas are all about comfort. All the comfort. All the time. Comfort for the sake of comfort, in a very uncomfortable process! Comfort is a doula’s primary responsibility. You really can’t beat that.

 

5: Community Support.

As another midwife so aptly pointed out, your choices in midwives may be much more limited than your choices in doulas. Whether you are a woman of color, from a faith community, LGBT, or some other minority group, finding a doula who aligns more closely with your values and needs can help round out your care and make your experience much better than it otherwise would have been.

Pretty much any experienced midwife is going to have the skill set and competence you need in order to stay low-risk, healthy, empowered, and safe. Your community doula can help you create a beautiful, meaningful experience around your childbearing year through comfort, education, and learning to speak your needs effectively to your midwife (who will be learning right alongside you). The more trust that can be built among the members of your chosen support network, the better off you and your baby will be, and community doulas are key to this for many families.

Birth local. Hire a midwife. Then, hire a doula

You won’t regret it.

 

Did you hire a doula for your home birth? Why or why not? What was your experience?

 

In Honor of International Doula Month

Monday, May 11th, 2015
May Is International Doula Month!
 Not only were we able to celebrate World Doula Week recently, I found out that there is an entire month to celebrate doulas! Now, I could re-state all the facts about professional labor support. I could share famous doula quotes. I could toot my own horn, as it were.
However, I don’t want to do this. I would really prefer to sing the praises of my excellent clients, and what a joy it has been to serve every one of them over the past seven-plus years. Doulas would not be doulas without the need for it, and that starts with birthing women reaching out for the help a doula can offer.
So, this goes out to my clients.

Thank you.

Thank you for choosing me to walk with you, whatever your journey.

Thank you for asking questions.

Thank you for learning and growing, and letting me be a part of that.

Thank you for sharing your strength, dignity, and unique experiences with me.

You are amazing. You are the reason I love this work.

Grace & Peace,
Tiffany

This is where your pregnancy comes in!

Monday, May 4th, 2015

childbirth classes
We at Preparing for Birth are always striving to be more and more relevant to our clients and students, and we cannot do that without input from you! We are starting up the ol’ blog again, but we would rather not write about anything that you are not interested in. Of course, we want to cover new ground as more and more new evidence and information come to light, but it’s always nice to revisit topics that are key to you, our readers.

So, would you be so kind as to share in the comments what topics you are most interested in reading more about? Here are some ideas to get you started:

 

  • Doulas: Labor, antepartum, postpartum, and more.
  • Informed consent and conscious agreement.
  • Pregnancy myths debunked.
  • Home birth and midwifery.
  • Client and student birth stories.
  • Photos and videos.
  • Podcasts.
  • Book and product reviews.
  • Birth art/poetry/music.
  • Childbirth education.
  • Tips, tricks, and hacks for pregnancy, labor, birth, postpartum, and newborns.
  • Babywearing.
  • Breastfeeding myths.
  • Pregnancy fitness.
  • Pregnancy & special food needs (vegan, paleo, etc).

What else would you add? This is where you come in! Leave a comment, and share what you would like to read about here!

It’s World Doula Week!

Sunday, March 22nd, 2015

How are you celebrating?! Share your own video response in the comments on YouTube! Who are the doulas in your life?

Preparing For Birth Has Moved!

Monday, May 12th, 2014

We are still at the same address, but we have moved upstairs into a new, more spacious office suite. We are now in Suite 201, just at the top of the stairs. The very first door. We now have three midwives working out of this office, and five doulas, all of whom are a joy to work with. Classroom space is bigger, too, which excites me to no end!

As I grow in my business, I am learning so much, and I am grateful to be a part of Preparing For Birth as it grows to better serve our community with more options for women during the perinatal period. From Early Pregnancy classes, to Essentials for Childbirth, to Life With Baby, Pregnancy Fitness, and Breastfeeding classes, we really are covering a wider range of needs at an affordable price.

Stay tuned for more information!

Grace & Peace,
Tiffany

Doulas Benefit Care Providers, Too.

Monday, October 28th, 2013

Image credit: apperson.com/support

I’ve written a lot about the measurable benefits of trained labor support for women and their families, which is important. However, I believe firmly that doulas have great potential to benefit care providers and staff as well. As one more important piece of the birthing puzzle, doulas can either add to or detract from the big picture of any birth they attend.

When a doula is at her best, when she understands her role and her scope of practice, she brings freedom, communication, and peace to the place of birth.

Part of my Scope of Practice as a CAPPA-certified Labor Doula reads as follows:

During labor and birth, the labor doula provides the mother and her partner with physical, emotional, and informational support. She facilitates and promotes self-advocacy, informed choice, and effective communication between the family and care providers. She seeks to foster a cooperative, respectful, and positive atmosphere with all members of the birth team so that the mother can birth with confidence. (emphasis mine)

What does “effective communication” look like at a birth?

It looks like a bridge. A sturdy, well-built bridge that begins with openness, humility, and an extended hand from the doula to the staff member or care provider that does not interrupt their conversation with the client.

It’s remembering that the client chose her care providers just as much as she chose her doula.* That fact alone should elicit basic human respect from the doula toward those caring for her client. Period. Regardless if that respect is returned or not. Doulas do no one any good unless we do our best to leave those chips on our shoulders at home. We do best when we take the high road, and treat everyone on the birth team with dignity and respect.

Side note: respect doesn’t mean agreement or likeability. It simply means getting along, and choosing to work together toward a common goal: The safety and health (physical, mental, and emotional) of both mother and baby.

When a doula sees herself as an integral part of the birth team, and understands that everyone else there has their place (as long as her client chose them), there are a lot of benefits she has to offer to the care provider and staff she is working with.

Among those benefits:

  • Added perspective–Doulas can often get very creative when coming up with ways to help a labor progress effectively before medical interventions are truly needed. Care providers often appreciate suggestions that don’t interfere with safety, and that seem to help the mother.
  • Someone labor-sitting–Care providers are rarely available to labor sit as long as a doula can. Even home birth midwives may not have as much opportunity to do so, and usually arrive later in labor than a doula would. This means that a doula can fill in the provider and staff on what has been going on, what tricks have been tried, and things that may be relevant to improving her client’s care. The doula can often provide clarification where the mother’s or partner’s recollection is fuzzy. This helps the care provider have a more accurate picture of how labor is going.
  • Continuity of care for patient–This is one of the hardest things to provide as a care provider. Nurses, doctors, and hospital-based CNM’s change shifts–no matter what. Even home birth midwives may have to send a backup if two births are happening simultaneously. The doula provides one continuous thread of care, and we all know that this works out to better quality care in general. Also, can bond more quickly with the new people on shift, making her care easier for the staff and/or care provider, as they have to spend less time establishing trust.
  • Bridge of communication with patient–Doulas teach their clients to ask good questions, relevant to their own care, and how to understand the answers they’re given. This helps the client to build trust in her chosen provider, which makes caring for her easier for the care provider. A doula’s presence should facilitate togetherness at a birth, not a sense of “us vs. them.”
  • Extra set of hands–As much as care providers love to do hands-on care, many times they are simply not able to do so. Doctors, nurses, and even home birth midwives and their assistants, can easily get bogged down by charting, checking and setting up needed equipment, and (in hospitals) caring for other patients. This is as it should be, since the safety and health of the mother-baby dyad rests on their shoulders. Any non-clinical care they get to do is icing on the cake. Doulas have no such worries impeding their care. Non-clinical care is their only focus.Therefore, care providers are able to focus solely on their number one priority: the health and safety of mom and her baby.

I know that the above benefits are really more indirectly beneficial to the care provider. However, when there is benefit to the birthing woman, there is benefit to her care provider as well. The patient load of most OB’s is such that it can be extremely difficult for them to individualize care. After all, the care provider has as little time, per appointment, to get to know their patient as the patient has to get to know them.

Therefore, if there is any way for a doula to help build bridges, encourage their client to ask good questions, and utilize whatever time they have with their care provider, it enables and empowers the care provider to do what they want to do most: Provide evidence-based, individualized, humane care to their patients. This results in good feedback for them, and encourages them to be more open to the next client asking questions or wanting something different than the basic standard of care.

In short, the presence of a doula can mean heightened communication, empowerment, and a positive experience for everyone on the birth team, not just the mother.

*I understand that many women only have very limited, or no choice, when it comes to their care provider, due to geography, local/state laws, financial constraints, or other factors. Still – they ultimately still have chosen their care provider, rather than birthing unassisted at home. Therefore, they are placing some modicum of trust in that care provider. I appreciate feedback on this.*

Care providers: How often do you work with doulas? What do you appreciate most about good doulas? What tips might you offer to doulas who are still learning, or who need to understand your perspective better? What ideas do you have to foster better relationships between clinical and non-clinical professionals?

Thanks for reading!

Grace & Peace,
Tiffany

At Preparing for Birth: A new blog post for dads!

Monday, September 30th, 2013

Beso-EmbarazadaI wrote my first post for the blog at Preparing for Birth, and it’s up today! Go check it out, and come back for more when you can!

“Many men in our culture are fairly apprehensive about birth. Most have never seen a real birth, or talked about it outside of sex ed. They are often nervous about birth itself, seeing their partner in pain, the what-ifs, and all that may come after. They doubt their ability to support their partner in her journey, and wonder if they’ll be strong enough.”

CLICK HERE to read more at the Preparing for Birth blog.

Grace & Peace,
Tiffany

Birthy Weekend Links

Saturday, September 7th, 2013

This weekend is coming up fast! What plans do you have? I have family coming in for a five-day visit, I’m on call for a midwife, and I’m trying to put together some bouquets for my sister’s upcoming wedding. In the meantime, here are a few things worth reading this weekend.

Interested in reading more? “Like” my Facebook page, since I tend to share a lot more of these on my Facebook page, almost daily!

Happy weekending to you!

Grace & Peace,
Tiffany

Do Moms Planning an Epidural Need a Doula?

Friday, May 25th, 2012

This question was posed on her facebook wall by my mentor, Desirre Andrews. I appreciate the thought that her questions provoke, and the way she challenges me to dig a little deeper and search out what my answer would be to this question.

I think, overall, there is an assumption in our country that an epidural is a panacea. The concept of labor with an epidural on board is one of passivity and a desire for separation from the experience because of fears about the process of labor. Whether those fears are well-founded or not really does depend on the individual, and is not the subject of this post. I would very much like to see a more realistic, knowledgeable view of epidurals begin to take prevalence in my community, and the world at large.

As a doula, I know that I can bring my community closer to that vision, one mother at a time. So, here is my answer to the question posed in the title of this post:

I usually tell someone that they don’t “need” a doula (if they want to get all technical), in that they can definitely have their baby without one. Yet, I would never say that a doula is a luxury, either. There is too much benefit to the presence of a doula, supported by scientific evidence, to label them luxuries. Not to mention the fact that women, for all of our world’s history, have always supported women during birth. Women need women who believe in them at their births. Period. Again – a subject for another lengthy post.

Moving on.

In the specific case of a mom planning an epidural, a doula can really help to optimize the use of this particular tool — maximizing its benefits, and minimizing the risks associated with it — if that’s what she wants.

A doula can help a mother stay calm through the procedure, and prepare her ahead of time to have realistic expectations of what epidurals do and do not do. Contrary to popular belief, epidurals are not a panacea. They vary in effectiveness for many women, and come with some side effects that are common enough that every woman who wants one should know about them.

A woman with a doula who has educated her ahead of time who experiences, for example, the drastic drop in blood pressure that can go along with an epidural, will know that the nurse will come in, place her on her side, put an oxygen mask on her face, and give her medication to raise her blood pressure immediately. The nurse will act, she will not ask. This prepared woman will be less susceptible to fear as the nurse takes quick action. The unprepared woman may end up scared out of her wits, and experience fear for her baby because of this process, if she did not know ahead of time that it could happen. A doula can prevent the latter circumstance. Doulas can help take fear out of the equation for women.

Along the same lines, a doula can assuage the fears of a woman’s partner, and reassure him/her that what’s going on is common, normal, and that mom and baby are likely to be okay. Partners who love these women so much often forget all they learned, as their gut takes over, and having a doula there for reassurance can really bring a sense of peace to the partners, freeing them to be fully present in their relationship to the laboring mother.

Doulas can also give women tools to cope with labor up until the time the epidural is placed. Mom is having a natural birth up to the point the epidural is in place, after all! A woman and partner equipped with basic labor coping skills and techniques will be able to handle whatever their labor throws at them up to the point the epidural can be placed.

Many moms, without the presence and preparation of a doula, may not know that the timing of an epidural is critical in avoiding some of the risks (both for herself and her baby), and maximizing its benefits. For one thing, an epidural placed too early can cause labor to slow down enough that Pitocin will be needed, beginning the lovely “Cascade of Interventions” all of us in the birth community are familiar with.

Without a doula, a mom may not have the confidence to believe she can handle labor beautifully until the time comes that an epidural would be more to her and her baby’s benefit than a risk. A doula can bring a strong sense of “I can do it” to the labor room, and help a mother to gauge when the time is right for her epidural.

Once the epidural is in, a doula will help a mother assume multiple positions that can keep it working well, keep her pelvis moving, and encourage progress. Progress in labor is directly linked to the amount of movement mom is able to do, and a doula knows this. She can help a mother and her partner work to keep an active role in her labor by maneuvering mom into alternating positions. Since epidurals are gravity-based, this also helps keep the pain relief on a more even keel, and minimizes uneven sensation.

A doula can also walk moms through what pushing with an epidural might be like, and teach them about different options for that stage. She is equipped to help them advocate for the option to “labor down” (a technique that can help preserve mom’s energy for more active pushing when baby is much further into the pelvis/birth canal), instead of beginning active, hard pushing as soon as she reaches full dilation. She can help mom assume different positions every few contractions, to maximize baby’s ability to descend and rotate well. This can also minimize the risk for forceps or vacuum extraction being needed.

After the birth, during the postpartum visits, a doula can help walk moms through any after effects she may be experiencing. She will have prepared the mother to recognize signs of a spinal headache (one possible side effect that is fairly common, but not overly so), and to get help quickly for it. She can help moms understand the back pain that may come along with it; the longer recovery time often associated with it; and – if it was on board for more than four hours – the side effects that her baby may experience. Usually, a baby might be sleepy, and have trouble latching on for the first time.

Once a mom is fully equipped with all the information about an epidural, she is equipped to take any side effects in stride, without fear. She knows that they may happen, and she accepts and owns her decision. She can come out on the other end still satisfied with her experience, even if she has experienced some negative side effects, when she is fully informed and fully supported in the way that only a doula can really do.

So, do moms planning an epidural need a doula?

You tell me.

This is just the tip of the iceberg regarding the knowledge a doula can bring to an epidural birth. If you are a birth professional, what would you add to this? If you are a mother who chose an epidural: Did you have a doula? If so, how did she help you? If not, would you want a doula the next time? What was your experience – doula or no doula?

This is a safe place for you to share – so, please do!

Grace & Peace,
Tiffany

A Glimpse of the Homebirth Difference

Tuesday, May 1st, 2012

A client of mine had her home visit from me this morning. It coincided, on purpose, with the 36 week homebirth visit from her midwife. I cannot say enough how lovely the experience really is.

My client was asked many pertinent questions about her physical and emotional health; her stress levels and what she’s doing to cope; her nutrition, hydration, and rest; and what she was hoping to have on hand at the birth for her comfort. Everything from essential oils, to where the birthing pool would be, to checking the availability of all of her supplies was covered. Then, oh joy! the midwife listened to the baby, and we got to stand in silence and awe of the precious sound.

I was delighted when my client allowed me to palpate her belly, under the supervision of the midwife and intern midwife, to get an idea of baby’s position.

Everything about this appointment was professional, warm, friendly, thorough, and centered on the mother – my client.

For a whole hour of her day, my client got to experience attention and love being centered on her and her baby. She got to be loved at the beginning of her busy day.

It was beautiful, and I can’t think of a single hospital experience — no matter how kind and warm the nurses are — that equals the time devoted to my homebirth clients. What a privilege to be a part of the journey of those who choose this “road less traveled.”

Grace & Peace,
Tiffany