Pain Management

Search Our Site

Saturday, 16 August 2014 05:46

Celebrating Doulas

Aztec elders taught that women who died in childbirth go to the same level of paradise as men who died in battle. After attending over forty births, I fully understood why. Men die in battle from intense wounds. They bleed as they sacrifice for a greater cause. The same holds true for women who die in childbirth. They bleed as they open to life. The juxtaposition of beauty and pain in each birth astounds me. Each story lives in me.

 

Amy Wright Glenn in “Birth, Breath, and Death—Meditations on Motherhood, Chaplaincy, and Life as a Doula”

Birth

At 9:35pm, my first doula client called me in active labor.

“I’ll see you soon,” I told her. “You can do this Amanda. Just one breath at a time.”

Thirty minutes later, I had everything I needed to begin my doula career. I kissed my husband good-bye. “I’m not sure how long I’ll be gone,” I said holding him close. “Wish me luck.”

It was December and the New Jersey winter air filled my lungs. I drove to Amanda’s address. After parking the car, I looked up at the stars and prayed. I vividly remember walking to her apartment door.

I had successfully completed my doula-training workshop, read many birth books, and seen a multitude of videos and images of birth. Yet, nothing compared to the honor of being asked to support a woman through labor and delivery.

Over the course of the next 17 hours, I held Amanda’s hands, massaged her back, shared encouraging words, kept silent vigil, and even at points laughed with her as she rested between the waves of contractions transforming her being. Then, the time came. Amanda stood up, fiercely held onto her loving husband, and pushed her daughter into this world. The midwife joyfully caught the infant from below. I marveled at the wonder of birth.

My first birth as a doula transformed me as did the dozens more that followed – each unique and beautiful, each a testament to a mother’s courage.

I’m deeply drawn to the doula path. I love offering my time to women as they open their hearts, souls, and bodies in childbirth. As a doula, I stay up for hours on end holding, nurturing, and making space for a laboring woman to find her strength. As a doula, I hold the hands of women as the next generation enters our world.

The word “doula” comes from a Greek term meaning “woman servant.” Historically, doulas were servants skilled at attending women in labor. Today, doulas continue to serve birthing women.

Doulas are not midwives, OBs, or nurses. But together with these professionals, doulas work to support a woman through birth. While the focus of the medical team involves analyzing data and safeguarding the physical health of both mother and child, a doula focuses on the holistic wellbeing of the mother. Doulas teach comfort measures, offer loving touch, speak encouraging words, and serve as a spiritual support at a most transformative time in life. In today’s hospitals, doulas work from a place of softness in an obstetrical world of hard edges.

Most modern women have never personally witnessed a birth. So often, the first birth they experience is their own. When contractions begin, the majority of pregnant women embark upon one of the most transformative experiences of their lives without first hand knowledge of what awaits them. This fact stands in stark contrast to the birthing practices of our ancestors.  For the vast majority of human history, women have always surrounded each other in labor and delivery. This aids birthing women and emboldens future mothers with the first-hand knowledge of female strength. Today, doulas reconnect birthing women to the powerful legacy of female support in birth. A doula’s presence also impacts the quality of the birth itself.

According to Christine Morton, a Stanford-based research sociologist and co-author of “Birth Ambassadors: Doulas and the Re-Emergence of Women-Supported Birth in America,” more and more American couples are hiring doulas. Morton argues that this is because midwifery care isn’t widely available and a doula’s presence at birth can lead to many of the same benefits found in a midwifery-based model. Morton writes, “Doulas are the birth ambassadors for the midwifery model of care in the US.” Such a model empowers women to be fully involved in the birth experience. Many studies confirm that the presence of trained labor support shortens the length of labor, minimizes the use of interventions, and reduces the use of pain relieving medicine. As Dr. John H. Kennell famously stated, "If a doula were a drug it would be unethical not to use it."

But, what about the husband or partner? Does a doula replace the birthing mother’s most intimate labor companion? No. While a doula “mothers the mother” through the birth process, the husband or partner also deeply benefits from her presence. Often husbands or partners become more involved in supporting a birthing woman as they learn and adopt many of the doula’s comforting techniques. A doula’s presence frees the husband or partner from feeling like s/he must be an expert support in an entirely new and challenging situation. If the labor is particularly trying, difficult, or emotionally charged, a doula’s presence soothes scared nerves and buoys a birthing couple’s confidence.

The Practical Level

There are two kinds of doulas: birth and postpartum doulas. A birth doula meets with a pregnant woman, is present throughout the birth, and helps the couple process the experience in a postpartum visit. A mother doesn’t need to be planning for a natural birth to hire a doula. Indeed, the majority of woman delivering in a modern day hospital setting would benefit greatly from the continuous labor support that a doula provides. For women birthing at home, a doula’s presence offers added support and loving energy to the wisdom that skilled homebirth midwives bring to the table. Birth doulas usually charge a flat rate and often ask for a portion of their fee to be paid prior to the birth.

In contrast, postpartum doulas help new mothers with breastfeeding and responding empathetically to a newborn’s needs. They understand a mother’s need for rest and support in the postpartum period. In a world where families are often separated by days of travel, the presence of a postpartum doula can provide a new mother with essential loving kindness and insight. Postpartum doulas charge per diem.

When seeking out a doula, I suggest interviewing at least two women. An expectant couple needs to find the right fit. Some doulas are closer to the mother’s age and bring a sister-like energy to the birth experience. Other doulas are older and bring a matronly energy to the birth or postpartum care. Most importantly, an expectant couple should feel very comfortable with the doula’s presence. After all, birth is one of the most intimate experiences one can share with another human being. Deep emotions and a great deal of physical touch are involved in most births – and much of this carries over into the postpartum period. A couple needs to feel confident that the doula will be a trusted, nonjudgmental and compassionate presence as they undergo the crucible experience of birth and welcome their little one to this world.

A doula holds the memory of each birth as precious. While she protects the confidentiality of her clients, her very presence also helps protect the mother’s own memories of birth. This matters.

Protecting a Mother’s Memory

“I am a protector of birth memories,” I often tell my clients. “I want you to look back on this experience and remember being supported, heard, and loved. I want you to feel proud of yourself.”

When women feel silenced, helpless, and dismissed in the birthing experience, their trust in both their own body’s wisdom and in their baby’s instinctive energy is eroded. This is true even if the birth experience fits the classic, textbook rendition of “normal.” If the emotional tone and energy surrounding the birth is negative, an unnecessary harm has been done. The impact of a negative birth experience -- sometimes called birth trauma -- can disrupt the secure attachment bonds linking generations and deeply impact a woman’s sense of self.

When women feel emboldened and supported through the birth experience, their abilities to trust their maternal instincts and bond with their newborn are deeply enhanced. This is true even when birthing preferences or plans unfold in ways unexpected. If the energy surrounding a birthing woman is positive, inspiring, and kind the mother internalizes these qualities as she nurtures her child.

In Conclusion

The way we approach birth as a society can either empower or disempower women. According to Aviva Romm, a Yale trained medical doctor and former homebirth midwife, “Women can be partners in their care, not subjects of it.” Doulas support women to be fully informed and empowered in their birth experience. Doulas are the ambassadors of change in a culture bereft of the birth’s wisdom present in ages past. Doulas help protect a birthing woman’s memory of her strength, struggle, and accomplishment.

I’ll always remember my first birth as a doula. When the time comes for me to leave this world, I take with me many treasured memories. Some of the most precious involve being present for the wonder, pain, love, and beauty of birth.

In celebration of doulas, I bow.

Originally published in Holistic Parenting Magazine, Issue #3 May-June 2014

Monday, 24 February 2014 09:31

Birth Partner No-No's

As a doula, I have had the privilege of witnessing so many beautiful moments during labor. From loving embraces to funny (but appropriate) jokes to lighten the mood, a woman’s birth partner can most certainly be her rock during labor. But I have also observed those moments where someone says the wrong thing or eats the wrong food that people in the Twitterverse like to call #epicfails.

It really doesn’t take much to anger or upset a laboring mama, so here are some tips to help you stay on her good side:

  1. This first one is a biggie, but it can be a tough one to master, especially for all you men out there (sorry, but it’s true). Try not to say anything stupid. In case you don’t know what would constitute a stupid thing to say, here are some examples: “does it hurt?”, “are you okay?”, “how long is this going to take?” or “I can’t believe I am missing the big game”. Do not say any of these things. And keep in mind that these examples are far from extensive, so think before you speak.
  2. General complaining is also a BIG faux pas. I do understand that it has been a long night/day/days. You have every right to be tired, hungry, sore and anxious. But for the love of bananas, act like you are perfectly fine! Your partner doesn’t need to hear you whine. Nothing you are experiencing is as uncomfortable as what the laboring mom is going through, so suck it up, buttercup.
  3. A laboring woman (or women in general, really) can quickly tune into how others are feeling and acting, so if you think you aren’t coping well don’t let her see it. If you can, leave the room until you feel more composed.
  4. If you are having a hospital birth it may be hard to turn away from the super cool mountain drawing machine (AKA contraction monitor). Those things are borderline hypnotic, but ignore that pesky monitor! All of those beeps and buzzes mean nothing of consequence and distract you from mom. In fact, I feel like they give partners a false sense of understanding what the laboring woman is going through. Avoid comparing the monitor to her pain level, and steer clear of phrases such as “these contractions aren’t nearly as big as they were two hours ago” or “here comes a contraction”. Trust me, mama knows what’s going on with her body way better than the machine attached to her does.
  5. Don’t interrupt a woman who is coping well with a technique or idea. Encourage what is working for her instead of trying to introduce new ideas or tips.
  6. Sense of smell is heightened during labor and many women become nauseated. Avoid eating in front of her (unless she is okay with it) as the smell of food might be a big turn off. And you never know what smell mama may find offensive…during the birth of my first son I became very agitated when the smell of cucumber wafted in my direction. If you do step out for a bite to eat then brush your teeth before you return. And most importantly, if mom has medical circumstances that do not allow her to eat food, then eating in front of her would constitute cruel and unusual punishment.
  7. Try not to be preoccupied with other thoughts such as getting the car seat installed, getting to the coffee shop before it closes or calling your mom. Your partner is your main focus, and being overly concerned with anything else will earn you some evil stares.
  8. As labor progresses, mom will likely want the chatter toned down a bit. Follow her lead. Be silent if she is being silent. Bring a book to read in the corner or nap if you can. Don’t ask open ended questions, especially late in labor. Stick to ‘yes’ or ‘no’ questions. And most certainly do not ask any questions during a contraction. I’ve witnessed this occurrence on several occasions and it is never pretty.
  9. Do not encourage mom to do things that do not fit into her birth plan. For example, if mom desires to avoid pain medication do not suggest it because it is hard to see her in pain.
  10. Don’t ask her what you can do to help. She is likely too exhausted to come up with an answer, or she simply just doesn’t know. Instead, just try things that you think might help. She’ll let you know if she doesn’t like it and if she does let you know, don’t take it personally.

Above all, women in labor need love and support. When all is said and done, even if you make one thousand “mistakes,” she will remember that you supported her, and that is all that matters.

Stay Notified

Keep up to date with changes and updates with newsletter via email . Contests, new articles and much more!