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So What's a Doula? Answers to the top three questions about birth work

Often when someone hears that I am a doula, the first questions about my field are:

Is that like a midwife?

That's for home births, right?

But then what does the dad do?

 

Let me address these questions, then I'll share exactly what a doula does for her clients.

 

Is that like a midwife?

Nope. A midwife is a medical professional that oversees your and baby's medical care through pregnancy and birth. Midwives are typically low intervention, and are great advocates for natural birth. A midwife can practice in a hospital, birthing center, or private home birth practice depending on the state.

Midwife checking on baby. Midwives can serve births at hospitals, birth centers, and at home. If you are having a low risk, healthy pregnancy, midwifery care may be for you.

Midwife checking on baby. Midwives can serve births at hospitals, birth centers, and at home. If you are having a low risk, healthy pregnancy, midwifery care may be for you.

 

A doula does not dispense medical advice, and it's out of their scope of practice to perform any medical procedures (temperature, cervical checks, manually feeling your belly for fetal position, etc.) Instead, a doula is a wealth of resources and knowledge. If you are faced with a procedure during your pregnancy and you are unsure of your options, a doula can help you to research the procedure and suggest questions to bring to your provider. We don't want to make decisions for you, but help to empower you in your decisions. We offer resources and support both prenatally and during birth.

 

When you begin to labor, you can call your doula to be with you whenever you want her. A doula can help you to labor at home longer and more comfortably (A well trained doula knows the signs in labor to transfer to the birthing location. However, whenever mama wants to go, is when we head in. We can also make transferring more comfortable too!) We are equipped with birth balls, rebozos, essential oils, and massage techniques. We can help with positioning, counter pressure for back labor, grabbing snacks, and making suggestions for other coping strategies. We are also there to support you emotionally, and can help with any mental blocks. Labor can be a crazy, emotional, messy time, and we are there to protect that space and see you through it. I reassure clients that she can release on me in a way that maybe she couldn’t with her mother-in-law around.

Airlia is sitting on the birth ball while I help keep heat and pressure on her lower back. Even while being monitored, there are ways to keep moms comfortable and not just in bed.

Airlia is sitting on the birth ball while I help keep heat and pressure on her lower back. Even while being monitored, there are ways to keep moms comfortable and not just in bed.

 

A midwife will usually come as you are heading in to active labor if you are birthing at home. If you are at a hospital or birthing center, they will be around to check in with you, but won’t likely be with you the entire time. They will be with you during pushing, and can aide with protecting your perineum with stretching or counter pressure. Your midwife is the other half of the equation to your birth team.  Midwife + doula + partner = Fully Supported Mama

 

That’s for home births, right?

You may be hearing about doulas from your crunchier mamas. While I do support mamas that choose to birth at home, I also happily support families that birth at the hospital or birthing center. If you are planning a natural birth, opting for medication, or scheduled cesarean, I fully support you in your best birth. That looks different to different families, and no mama is the same in what she needs to birth with confidence. What matters to me is that you have options, and are fully supported in your choices.

 

But then what does the Dad do?

Doulas do not replace partners. Dads, partners, and other support people all have a role to play in supporting the mama. As a doula, I care about their needs as well. I can offer tons of support to Dad who may be nervous about how the labor is progressing, and pull him in with tips on how to offer counter pressure on a sore back, show him how to use a rebozo on mama’s belly to help a posterior baby turn, and I can be the one running to reheating the rice pack so he can be with you. It’s a team effort, and I am here for both of you! 

 

Here’s the nitty gritty on what a doula does for you:

  •          Meets with you in the weeks before your due. Meetings are usually to go over any health issues, any problems from previous births, and any lingering anxieties or fears about the labor. This allows us to develop strategies to help you cope during labor, and to develop your birth plan. We want to get to know you, so we can better support you.
  •           Having your doula present can:

o   decrease pain

o    decrease the need for epidural or pain meds

o   Shorten labor

o   Improve parent-baby bonding

o   Lower rate of postpartum depression

o   Lower caesarian rate 

 

  • While we aren't birth photographers, we will happily snap photos and video of the birth if you'd like us to.
  •  Doulas can help with the first breastfeeding session, and can help support you in the early days as well. If you choose to bottle feed, we are happy to support you with that too!
  •  Once you are home from the hospital, your doula will check in with a postpartum visit. This visit is usually to go over the birth, discuss how you and baby are doing, and help with any issues you may be facing. Having a baby is life changing, and no one understands this more than your doula. Birth is beautiful, hard, emotional, transforming work.

 

So to recap, doulas offer non-medical support for birthing families, offering education and physical and emotional support through the birthing process. We support all kinds of birth, and can act as guide through the experience.

 

 I am honored I get to witness it. I am honored to serve the growing families in my community.

 

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Birth Balls, Best thing ever

Birth balls, commonly recognized as exercise balls, have been used for many purposes over the last ten years, including physical therapy, abdominal exercise, and most recently to aid pregnancy and labor. Its shape and durability allow it to be used by a variety of weights and heights, and in multiple positions. Birth balls can aide in pregnancy and labor to improve fetal positioning, fetal descent and maternal comfort.

Fetal positioning can make a huge difference in how labor develops. A baby facing in the posterior position in the womb may have a slow descent, and can also cause painful back labor (Spinning Babies). Poor fetal position can also cause very slow dilation, often resulting in unnecessary interventions. In some cases, the baby may have a difficult time turning and become stuck, requiring surgery or forceps delivery (Spinning Babies). Fetal positioning can be improved by having good posture. Often pregnant women are sitting on cushy couches or less than ergonomic driver seats, causing poor posture (Spinning Babies). By sitting and resting on the ball, the posture is upright and forward leaning, engaging abdominal muscles while relaxing the pelvis area. The back is comforted and strengthened by ball use, supporting the pelvis. With proper alignment and a relaxed pelvic area, the baby will have room to position properly, and begin to drop into the pelvis (Spinning Babies). It also encourages the baby to settle into an anterior position that is optimal for labor (Spinning Babies). Often a posterior baby can be encouraged to turn during labor by sitting on the ball.

Fetal descent is defined as entrance of the presenting portion (usually the head) into the birth canal. Descending takes time and hard work from both mom and baby.The use of gravity and squatting positions are helpful in this process, but can be taxing on the mother’s muscles over a long labor. The birth ball is a great tool in this scenario, as it allows mom to sit in a squatting position, allowing the use of gravity and an open pelvis to bring the baby down, but also allows for rest. The mother can also lean forward while sitting, and receive a massage or counter pressure. The ball can also be hugged while deeply squatting on the floor. It allows mom a greater balance and ease in the position, one that can be utilized in the pushing stage.

The birth ball is a great comfort tool for mothers in labor. It allows the mother to rest while still engaging an open pelvis. The birth ball can be a great break from walking, while still remaining active (Birth Arts Handbook p.187). It allows the mother to do pelvic circles and rhythmic movements that help her ease the pain of contractions. These movements often help the baby to navigate the turns in the pelvis before crowning (Birth Arts International p.187).  The birth ball also creates a counter pressure against the perineum and buttocks that can ease the sensations of early transition, which can be a difficult time for the mother. Having the birth ball as a comfort tool the mother can find a coping mechanism and rhythm through her contractions. By having support and a rhythm to help her cope, the mother can navigate her labor and have a mental place to return to when labor gets hard.

By utilizing the versatility of the birth ball, a mother can improve fetal position, while encouraging fetal descent and increasing comfort during labor. By improving these aspects of birth, unnecessary intervention can be avoided, as well as the use for drugs. This can greatly improve outcomes for mothers and babies, especially in a hospital setting where the mother is out of her comfort zone.

Works Cited

Birth Arts International, Certified Doula Education Program. Demetria Clark. 2000-2015. P.187

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