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Thursday, 06 February 2014 22:04

With Woman

It has not been long that I've been a doula. My training is nearing completion with a few more births to be evaluated. I take great pride in my training efforts; read far more than required, watch every film and documentary, listen earnestly to other birth workers and other mothers like myself who have experienced a birth trauma, only to redeem their experience with a subsequent birth. I think I can confidently say "I know the basics" just as confidently as I can say "there is so much to be learned". 

As a training doula, I often focus my learning on techniques to be used: massage, Rebozo, essential oils, memorizing positions and their uses. Important stuff, as in most descriptions of a doula these are the highlights of our work. We know how to help you cope, physically. We know the process, and believe in the process, of natural childbirth. We also know about the interventions and how to work with them so they don't fall into the "cascade" we birth workers fear will take away from the childbirth experience. Ask any lay person what a doula does, and if they know anything about us at all, they will know that we can help you deal with the pain of labor. 

But despite all the wonderful uses and intentions of those techniques, I fear I have left out focus of a key factor of my work. As a doula can tell you, the most beneficial part of having a doula at your birth is the CONSTANT SUPPORT. I knew this. I believed this true. And yet I still didn't understand the extreme impact that statement has. 


Not "doing it with woman", not even "helping a girl out". WITH. With? Such a simple implication of a word. Defined easily, categorized simply.

Not until the last birth I attended did I truly understand the full weight of importance of "with" in my role as labor support.

Although, I should have as I experienced it in my own birth of my second child. In my personal experience of a rather quick labor/birth (6 hrs total), I did not want coping techniques to be used on me. I was fighting off the panic of how quickly my birth approached. I holed myself up in the smallest room of my house and made a small nesting area reminiscent of the way the dogs my family bred in my childhood did. I was offered a simple, and known to be quite effective, hot water bottle; but the presences of the gentle, loving, midwife's apprentice and the trying of that physical ease made me loose focus. I did not like either, and so I stayed alone in my safe place listening to the conversations of my husband and midwife, my mother crushing ice for me in the kitchen, my father retreating to another area of the house so not to disturb the process; alone and content working internally to handle my labor. 

And then, eventually, I came out of my nest because I honestly felt a little out of the loop. I wanted to be near the people. I entered the hardest of my labor there, with them. I needed them there. I did not need them to assist my labor and frankly they couldn't have anyway. No, I just needed them. After a unfavorable positional change I remember grabbing my midwife's knee suddenly as a heavy contraction hit before I was ready. Her face was shocked by my sudden grasp as I up until this point had labored within myself, not reaching out for help. And then her eyes told me what I needed to know:

"I know it's hard. I know you're working harder than you ever have. I know." 

After that moment I felt a new level of trust. Not because she helped ease my pain or even because she said some scholarly fact about transition being the hardest but shortest part, but because she empathized and validated my experience..... all in a look. 


Yes, a doula can offer you many helpful things to deal with your labor but not all who labor want a massage or a positional suggestion. Some just need you to be WITH them. To hear them when they cry out that they don't want to do this or that they don't think it can be done. To know they are suffering. To somehow with your presence tell them you understand. Perhaps a word of "but you are doing this" or "your work is paying off" or even "you are further than you realize and doing more wonderfully than you think" but mostly just WITH. 

The last birth I attended was a mother's 3rd and first attempt at a totally natural and un-augmented childbirth. Much like my own, quickly moving. She fought her labor until she couldn't fight anymore. She voiced her retreat of intent for this birth so I could hear it, not because she really meant she wanted to give up but because someone had to know how difficult it was. And I did. I knew. It was hard and it was fast and it wasn't exactly how she pictured herself laboring. Once she had told me and I agreed that it was hard, she stopped fighting it. She danced beautifully the dance of a laboring woman, drawing her baby further through the pelvis. And when her dance was sufficient she found herself a bed to rest in. And when her rest was sufficient, she pushed the baby out in 2 waves without voicing to anyone that it was happening (in fact, in that dark hospital room, we nearly missed that the baby was being born, let alone a doctor to be present for its entirety!). Her birth was beautiful and it was hers. She was strong, even when she tried to say she wasn't. I did not help her with counter pressure or positions as I so often do. No, instead I was simply "with". 

With woman.

To sum up the whole, the best part, the most important part, is that I, and all the striving birth workers in our present, past and future, are WITH you, woman. Every mother that has ever been is WITH you, birthing goddess. And if you need to be validated while you work to bring your baby earth-side, just look to the woman at your birth-she is WITH you in this momentous right of passage and that, I hope, will sooth your soul. 

Published in Birthing Assistance
Tuesday, 13 December 2011 22:50

Hospital Birth Step #2: Establishing Support

Once you have chosen a care provider, the next step in planning a hospital birth is establishing your support system.  I would argue that this is possibly the single most important thing you can do for both you and your baby to ensure you have the birth you desire.  Having a solid support system to guide you through pregnancy, labor and delivery has been shown to increase women’s reports of satisfaction and happy memories of their labor and birth.  This can also be the most challenging aspect of planning a birth.  

The process of establishing a support system can be difficult because it requires you to be familiar with what you want out of the experience (preferences for interventions such as induction or pain medications,) and that you find people who will support your decisions without question.  You likely have already been barraged with people who have unsolicited advice for you.  While it can be beneficial to hear many different views and opinions on what helps and what doesn’t, the choice is ultimately yours.  

When I gave birth to my first son, I was astonished at how unprepared I was to handle labor.  I had a very supportive husband, but we were not as informed about the process as we should have been.  During the end of my second pregnancy I started reading and discovered an amazing amount of information that helped me get through labor much easier the second time around.  I discovered a number of sources of great information about handling labor and delivery in a naturalistic and intervention free way.  Unfortunately, I was less than a month away from my EDD and I did not have enough time to thoroughly educate both myself and my husband properly to get through transition and I ultimately asked for an epidural.  When I continued to read after the birth of my second son, I found even more information and confidence that I know will help me get through a third labor and delivery, drug free.  

I have outlined  two of what I think are “essential roles” to help you through labor and delivery.  These roles can be played by anyone you chose, as long as you know that these people will trust in your beliefs about what you want, and will support you 100%.  The process of assigning these roles to people in your life does not have to be done at one time or another, but should be ongoing throughout your pregnancy.  You may discover that people are supportive at first, but as you discuss your wishes for labor and delivery, they try to impose their own opinions and values on you.  You may want to wait to officially assign people to play these roles until you are nearing your due date so that you can be sure that they will support you the way you want them to.  

Your Partner: This person is usually the husband, boyfriend, lover or life partner.  Your partner loves you, trusts you, and is definitely going to be there for the big moment.  If you do not have this person in your life now, consider a close friend who shares your values.  If this person does not share your values and beliefs about labor and delivery, you may try to educate them with information you have found that supports your decisions.  It may also be the case that this person will still support you even if they do not understand your decisions or would do things differently.  Either way, it is essential that you trust this person to fully support you during labor and delivery.  If you do not have someone close that you feel you can count on, you should consider a doula.

A Doula: A doula is a trained professional, typically a woman who is knowledgeable about all aspects of pregnancy, labor and delivery.  Doulas are typically paid (though some utilize a sliding scale rate, and many in training work for free while they gain experience towards certification.)  A Doula essentially acts as a secondary support system for both you and your partner, and ensures that your wishes about labor and delivery are adhered to.  A Doula is an excellent resource to have if you are planning a natural birth in a hospital because she will be able to ensure that the hospital staff does not try to influence you to agree to unnecessary interventions such as pain medication or monitoring.  You can read more about what a Doula does here on the DONA International website.  You can also use the DONA site to find a doula. The presence of a Doula can help your partner feel supported so that he or she can better support you.  Doulas do not replace your partner, they are a compliment to the partner.

Birthing classes are also a form of support for you and your partner for labor and delivery.  There are a number of classes and methods that you can choose from.  I have outlined some of the most common and familiar methods here.

The Bradley Method: This method underscores natural techniques combined with viewing the pregnancy, labor, and delivery process as being a partnership between mother and her partner.  It is an experience that both people share, and this method focuses on educating both the mother and her partner about pregnancy, labor and birth so that the partner is better able to understand the process and thus better able to support the mother.  The Bradley Method involves a 12 week course that both the mother and her partner attend, and is taught by certified instructors.  Class sizes are small (3-6 couples), so that the instructor can provide one on one instruction. Click here to view more information on The Bradley Method.

Lamaze: is slightly more focused on labor and birth specifically, though it does encourage healthy and informed pregnancy choices as well.  Lamaze is not simply breathing techniques anymore.  It teaches the “6 Healthy Birth Practices” that focus on the choices a laboring mother has about her labor and delivery.  It educates women about why avoiding interventions is helpful and offers naturalistic ways to manage labor.  While its naturalistic views are similar to that of Bradley, there is less emphasis on the partner.</p>

HypnoBirthing: Also known as the Mongan Method, focuses on relaxation techniques and utilizes self hypnosis to help the birthing mother work with her body throughout the labor and birth process.  It educates women and their partners about the natural process of labor and birth with strong emphasis on a variety of relaxation techniques including breathing exercises, and deep relaxation techniques that can be practiced throughout pregnancy.  HypnoBirthing also emphasizes healthy pregnancy practices and provides women with lots of information to take home including a work book and relaxation scripts.  Class sizes are small and private instruction is available.  You can find a HypnoBirthing class for more information on Hypnobirthing.

There are also a number of books and authors that are I highly recommend.  I have only read a few of these, but they have been recommended by a number of people I trust in the birthing community.  If you would like to locate a book at a low cost, check out Amazon.  You can often find books used at significantly below the retail cost in a store.

  • Husband-Coached Childbirth by Robert A. Bradley, M.D., Marjie Hathaway, Jay Hathaway, James Hathaway
  • Natural Childbirth The Bradley Way by Susan Mc Cutcheon, AAHCC
  • The Womanly Art of Breastfeeding distributed by La Leche League International
  • Children at Birth by Marjie and Jay Hathaway, AAHCC
  • Assistant Coach's Manual Susan Hathaway Bek, Marjie Hathaway, AAHCC
  • The Birth Partner  Penny Simkin
  • Ina May’s Guide to Childbirth Ina May Gaskin
  • Birth Matters: A Midwife’s Manifesta Ina May Gaskin

 Also there are a number of Facebook Pages that I absolutely love including Birth Without Fear, Mamas and Babies, Mama Birth, and Breastfeeding Arts that are personal blogs by naturalistic mothers who share research information and personal stories to help mothers make informed choices.  These pages offer a community of women who have experienced all different kinds of births and share their experiences and support for women looking for information to make informed decisions.  

 As you can see, there is a ton of information out there at your disposal.  The key is finding it and figuring out what fits with your values and desires best.  Even if you have only heard stories from women who said that labor is painful and you are expecting the worst, (which I was for my first birth), you will find a lot of great information in these resources that may help to reduce the chances that you will ask for pain medication and the need for other unnecessary interventions.  I know I sound repetitive, but knowledge is POWER!  Empower yourself to make the best choices for you and your baby so that you may have the best birth possible!

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Go ahead to: Step #3: Selecting Tests and Procedures for Prenatal Care

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Published in Birthing Assistance

 This could be a doula, your partner, a family member, friend, or absolutely no one.  Who attends or doesn't attend your birth can make all the difference to you. 

This is a personal choice you have to make and not factor in what other people may think. Also, if you change your mind at last minute, that is fine too. It is a good idea to have a back plan in case you decide you want certain individuals there after all or want no one. Surround yourself with people who will truly support you in your unassisted birth.

Here are a few suggested readings:

Do I Need a Doula?

Support in Labour

 Here is the story my unassisted birth with my twin girls.


Go back to Step #4: Educate Yourself Then Educate Yourself Some More

Go to the next step Step #6: Visualizing Your Perfect Birth

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Published in Birthing Assistance

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