Archive | December 2011

Oh Baby Magazine article on Doulas

Just another of the many articles and videos on how useful it is to have a doula at your birth.

“Looking for a way to decrease the length of your labour, reduce your need for pain medication, decrease your chances of needing a forceps delivery or a Caesarean, and leave you feeling satisfied about your birth experience? What you need is a doula—the birthing world’s equivalent of a fairy godmother.

Think I’m exaggerating? Consider the evidence for yourself. There’s a growing body of research proving that doulas (experienced non-medical female companions who provide continuous labour support) can help to improve the birth and postpartum outcomes for both mother and baby…“

To read the rest of the article you can go to Why Doulas are a Mom`s Best Friend at Oh Baby Magazine.

doulas

The question is not, “Will it be worthwhile to hire a doula?“

The question is, “Why don`t more women hire a doula?“

Doulas are a relatively new and growing profession, although the roots of it stretch back to the beginning of humankind. Since women have been giving birth, other women have attended to the mom in labor, providing physical and emotional support so that she can get through labor feeling calmer. In the past, the role of the midwife and the doula was the same.

Now the differences in the roles are more clearly defined, although there is some overlap. Midwives are responsible for medical tasks and for catching the baby, while doulas focus on the emotional and comfort needs of the mom. Also they provide continuous labor support, from the beginning of active labor in the home through to birth and breastfeeding. Nurses, midwives and doctors may have other moms to attend to and have other technical tasks to do.

The research by Klaus and Kennel reveals something very interesting – that women have easier labors when someone is giving them undivided attention. The thing is, this is difficult for people to wrap their minds around. It is difficult for most people to understand how a doula can help them in labor. Those who do, are glad they did hire a doula and can`t imagine how other women manage through without one. There is a quote that says, “If a doula were a drug, it would be unethical not to use one.“ I think in the future, the majority of women who want a natural birth will automatically hire a doula.

Even in the animal world, there are doulas. Most animals like to birth in complete privacy, but some social animals don`t labor alone. They need other females around them. Dolphin females swim around the dolphin mom in labor, nuzzling her with their noses. Elephants as well, which are highly intelligent and social animals need other females around, stroking them with their noses.

There was an elephant in a zoo who was in labor. The zookeepers moved her to another enclosure because they thought the other elephants would disturb her or the baby. What they found was that when she was separated, she went into distress, stomping around and wailing, banging herself on the fence. The zookeepers called another zoo that had experience with elephant birth. They said to put the elephant back with the other females. When she went back, her elephant doula friends stroked her with their noses and she immediately calmed down and had her baby smoothly.

Humans can learn from other social mammals because we have forgotten how the natural process of birth works.

Where I am, here in Surrey, BC, I hear some of the more common reasons women don`t hire a doula, even though they want a natural birth. One is that they think it will be too expensive. They`re usually shocked when they find out how reasonable rates are considering the time and benefit. Doulas are committed to helping all moms who want a doula. We don`t believe finances should be a reason not to have one. Some doulas, especially newer ones, even volunteer their services for moms who cannot afford even a basic fee. To find volunteer doulas go to BC Doula Services Association.

Another reason is that they feel that they have enough support because they either have a midwife, or have family support. Those are awesome, however, the role of a doula is quite different. I know from my own experience at the birth of my first child, the midwife is not going to be with you all through labor. She has other things to attend to, and is responsible for all the medical tasks.

Family or friends are great supports, but they don`t have the training, and the experience of learning from hundreds of other births what to do in different situations. The doula does not replace husbands or family, because they are the ones you have a relationship with, but they bring so much more knowledge and skills. Doulas involve the dad`s and other family members and teach them comfort measures that help the mom. Dad`s are always glad to have a doula there so the pressure to know and do everything is taken off him.

Do you have a story or a question about doulas? If so, I`d love to hear your comments.

For more info about hiring a doula in Surrey, Langley or anywhere in the Lower Mainland, BC, call 604 809 3288 or email info@prenataljourney.ca

 

 

 

 

Do I need to write a Birth Plan and what should I put in it?

Q : “I had a cesarean with my first birth, which I didn’t think was really necessary. The doctor didn’t want to wait. I’m having my second child and I would really like a normal birth this time. I have a midwife who is very encouraging of VBAC. I’m wondering if I should write a birth plan so that I don’t end up with an unnecessary c-section again.”

A : A birth plan is not always necessary, although it is useful as a communication tool and also the process of thinking about and clarifying what you want can be invaluable. You can’t just copy someone else’s birth plan because every woman is different in what they find important to them. Some women are totally happy with sections are some are disappointed.

It’s awesome that you know what you want and are committed enough to seek out a midwife. Good for you! The most important factor in helping you have a VBAC is choosing a caregiver, whether it is a doctor or a midwife, who has lots of experience successfully supporting VBACs.

Another very important factor is feeling clear yourself about what you want and why, and educating yourself on the evidence to support your preferences. For example, many doctors are not comfortable with VBAC’s because of the small risk of uterine rupture. If you understand the evidence based research, you can dispel your fears because overwhelmingly the evidence states that VBAC is safer than another section. There are far more risks associated with sections than VBACs. Uterine rupture occurs in less than 1% of vbacs, and of those, they tend to mainly occur only when pitocin (artificial oxytocin) or cervadil (prostaglandin) is administered because they can cause unnaturally strong contractions.

The third factor to increase your chances of having a VBAC is to hire a Doula. At my first birth, I made the mistake of thinking I didn’t need a doula because I had a midwife, but what I found was that the role of a doula and a midwife, although overlapping, are quite different.

Research shows that having a doula can reduce cesarean rates by 50%, as well as reduce the need for epidurals, instrumental deliveries, inductions etc. A doula provides continuous support, while a midwife may have other clients to attend to. Doulas provide emotional, physical and informational support. The doula goes to your home before you go to the hospital. This in itself helps moms stay home longer so they don’t show up at the hospital too early. The reality is that when you get to the hospital, you are on the clock. We don’t live in utopia. Doctors have other patients, hospital beds may be full etc. If a mom is in labor too long, there may be a lot of pressure to speed things up, whether or not there is a medical reason for it. And some women are glad to speed things up, but some are not. This is where knowing yourself is important and communicating with your caregiver about what’s important to you. There are many grey areas in labor where there is room for negotiation.

If you do decide to hire a doula, find one who connects with you and listens to your needs. Besides having three kids, I am also a doula and prenatal teacher in Surrey, BC, Canada. I also do birth plan consultations to help moms create plans that are individualized. You can contact me or find another doula who is local to you.

Have a great day, and have a wonderful birth!