By now, many people know and understand the way birth doulas support mothers in labor and how this support creates healthier births. While the research backs it up, it’s kind of just plain old common sense. Women need support on the biggest day of their life, performing the greatest physical and emotional feat they will ever accomplish – of course!
But what about doctors and midwives? For their patients that employ the service of birth doulas, what benefit is a doula to the care provider? It’s a sad reality that many people – physicians included – think of doulas and care providers as being opposing forces, always trying to “win” on the side of what they feel is best for the patient/client. A professional birth doula will do no such thing.
In fact, a well trained, professional, career doula will make every effort to be of service and support to the client while being a valuable member of the birth team. Professional doulas recognize and respect that they are working within a limited, yet extremely valuable scope of practice. Fully embracing that role, they can be of benefit to care providers in many ways.
A primary priority for birth doulas is making sure that their clients have all the information to make a fully informed decision. The care provider can rest assured that their patient is discussing at length the risks, benefits, and alternatives to their options. Patients are not alone in their rooms consorting with Google, but with someone who is knowledgeable. Furthermore, the birth doula is not emotionally or financially attached to the birth so the information they give is unbiased toward any particular path. Providers are busy in hospitals caring for several patients at a time and they don’t always have the time to have great, lengthy discussions with their patients. A doula’s job is to stay with the client through the whole birth. She is committed to being there anyway and she can take all the time needed for an informed decision to be made that satisfies the family.
Once a birth doula has spent time discussing options, she can help facilitate open communication between the provider and the laboring mother. Since she has a client relationship with the mother, the doula can make sure that the mother is fully understanding what the doctor is saying. Doulas do not speak on behalf of their clients. Rather, the doula’s priority is to facilitate an open conversation where fully informed consent can be made and this limits a provider’s liability if complications arise.
Research shows that women who hire birth doulas are much more likely to rate their birth with a high level of satisfaction, regardless of how the birth played out (http://evidencebasedbirth.com/the-evidence-for-doulas/). Patients are more satisfied with their natural birth, their induction, and their cesarean. Satisfaction with the overall birth experience naturally translates into higher satisfaction with the provider. This increases the likelihood that this patient will return to this provider and that they will recommend them to others.
Doctors and midwives can also rest assured that the patient is being monitored with trained eyes. For instance, if a woman spontaneously begins pushing, a doula can recognize that and notify the staff. A professional doula knows that her scope of practice does not include any clinical skills, including catching the baby. She can sometimes be the first line of defense in ensuring that everything happens as it should ensure a healthy birth.
Evidence also shows that births with doulas have lower intervention rates. This benefits the physician because it means lower complications associated with interventions. Patient satisfaction further increases and makes the birth with a doula more likely (but of course not guaranteed) to be straightforward and uncomplicated. These tend to be simpler births for physicians.
Doulas work primarily for women in labor. However, their unique expertise in the labor room is beneficial to all of the birth team, including the primary care provider. A doula is an advocate, a source of information, and a benefit to all involved in the birth.
Most women in pregnancy see one care and support provider, and in America that is usually an obstetrician. They attend their prenatal appointments, stay away from sushi and blue cheese and call it good. Unbeknownst to them, there is a whole world of additional care support available to women that they often times don’t even know about! They can see an OB, a Midwife or a Family Practitioner for their primary prenatal care. In addition, pregnant women can benefit from the services of a chiropractor, a prenatal massage therapist, a nutritionist, an acupuncturist, a naturopath, a monitrice, a doula or a prenatal yoga class. All specialists have something unique and valuable to offer women in their pregnancy.
Obstetrician. Obstetrics is a surgical specialty of medicine. OB’s specialize in high risk, abnormal, and pathological pregnancy and birth. They are perfect care providers for women with preeclampsia, diabetes, autoimmune conditions, cancers or other complications.
Midwife. A midwife is an expert in normal pregnancy and birth. The World Health Organization recommends that all women who are experiencing a low-risk pregnancy seek the care of a midwife. This is because low-risk birth with a midwife is known to be safer and less complicated. It also frees up obstetricians to focus more energy on the high risk and complicated cases that they are specialists for. Midwives are known for developing relationships with their clients and for providing personalized care rather than standard care. There are options for midwives; Certified Nurse Midwives who work within hospital settings and Certified Professional Midwives who support families in home birth.
Family Practitioner. Many women will choose a family practitioner for their primary pregnancy care. FP’s who care for pregnancy will generally have rights at a hospital. The care they give will be similar to that of a midwife. They do not generally do surgery, but they can manage all other aspects of pregnancy and birth.
Chiropractor. Chiropractors are a must for pregnancy. Many people mistakenly believe that chiropractors only work on the back, when in reality chiropractors are specialists in the skeletal balance of all kinds. When the relaxin is flowing during pregnancy, it doesn’t take much for joints to become out of balance. This can lead to all sorts of discomfort, especially in the hips. A chiropractor can be a tremendous help in keeping women comfortable. Chiropractic care is safe through all of the pregnancy.
Prenatal Massage. A compliment to chiropractic, prenatal massage can help keep pregnancy comfortable. As joints stretch, muscles stretch and discomfort increases, prenatal massage can help loosen and balance all the growing parts of a woman’s body. When combined with chiropractic care, prenatal massage can really help women feel as normal as possible as they progress in pregnancy.
Nutritionist. A woman’s body is growing a human! It makes sense that the building blocks to accomplish this feat could use some gentle guidance. Proper pregnancy nutrition can help prevent a myriad of pregnancy related complications. Your body needs ongoing nourishment for itself as well as your baby! Furthermore, a pregnant woman’s physiology is different than that of a non-pregnant body. A nutritionist who is trained in pregnancy can help your pregnancy to be as healthy and uncomplicated as possible.
Acupuncturist. Acupuncture is a branch of eastern medicine that is not widely understood in the western world. Nonetheless, its effectiveness cannot be argued. Acupuncture is based on the theory that your Qi (pronounced chee) must be balanced for optimal health. We now understand Qi to be electromagnetic energy in a body, so it’s not all fantasy. Many health problems are thought to be the result of unbalanced Qi. Acupuncture is safe in pregnancy. At the end of pregnancy, it is a very effective form of natural induction.
Naturopath. A naturopath is a practitioner that uses many natural types of healing and nutrition to bring balance to the body. Their healing approach is generally holistic – seeing the body as one whole functioning organism where all parts are connected. Some naturopaths specialize in varying types of natural health. Some may include nutrition counseling, homeopathic remedies, herbal remedies, etc.
Doula. A birth doula is a specialist in pregnancy and birth support. A doula is an expert in connecting a pregnant woman with all the resources she may need in her pregnancy to be fully informed. During labor, a birth doula will stay with a laboring couple throughout the course of labor to provide physical and emotional support throughout the birth. A doula is not a medical care provider, so she does not use clinical skills that nurses, midwives, and OB’s employ.
Montrice. A monitrice is similar to a doula in the way she works to offer prenatal education, support, and physical comfort, but is also trained to perform a limited amount of clinical skills such as maternal blood pressure, fetal heart tones, cervical exams for dilation, and abdominal palpation to assess the position of your baby. A monitrice will offer these services while laboring at home, but once she accompanies you to the hospital, her role becomes strictly non-medical by offering doula support.
Prenatal Yoga. One of the best and most effective ways to prepare for labor is through prenatal yoga. While most forms of exercise tend to be safe throughout all of the pregnancy, yoga is particularly good for pregnancy because it combines deep focused concentration, relaxation, and physical exertion. A prenatal yoga instructor will usually do a mental and physical exercise as a practice for labor during their class. This practice is of tremendous benefit as a woman prepares for labor.
A pregnant woman has many options for pregnancy specialized care. Making use of the many available options can bring balance, comfort, health, and support to a pregnancy and birth.
We are celebrating my son’s 5th birthday this week! Merrick’s birth plays a large part in why I am where I am today.
Now bear with me… my mind may be a little fuzzy on all the events, and I hope I’m telling the story accurately and clearly, as this story is pieced together from past Social media posts. But of course, my birthing memory may be a bit skewed… I WAS IN LABOR LAND!
When I found out I was expecting in late August of 2010, I was utterly surprised. I had previously been diagnosed with PCOS, Polycystic Ovarian Syndrome, and had tried a gamut of medications to help my natural system take over, but was told that having biological children was nearly impossible and my insurance wouldn’t likely cover the next stages of medical intervention had I wanted to have children. I remember my mother vividly when she said, “Don’t cry. God gives us the truest desires of our hearts,” so it was common sense to call her first from the bathroom of my apartment at midnight, gripping the test in hand.
Is this real??
That’s also what I said when labor began.
5 years ago at 2 am, I looked up from my bed at my midwife and said,
" Tell me this is real."
I had been experiencing contractions since yesterday AM and was praying these were not Braxton Hicks as I had not noticed any previously in my pregnancy. She smiled and confirmed they were real labor contractions. My son’s “due date” was today. She tucked me in and said she’d be back around 10 am, but call if things changed.
She came back as promised and my home slowly filled with birth workers – Kim, Alexis – the other midwives – and Sarah, my doula. And even for a short time Angela, a doula I had met along my travels. I was excited, but I knew I had some time when my midwives went to lunch. I felt as if my contractions spaced and were not as strong, but my back hurt a bit more so my husband and I got in the “birth pool” which at that time was an Aquarium kiddie pool splashed with colorful fish all around it and a waterbed heating pad underneath which scorched my bottom if I sat too long.
The pool I LIKED! Leave me there for the duration of labor and I’d be one happy mama! My midwives returned and after a few more hours I began to hear little blips in my baby’s heart tones. I looked to read their faces, but they all held poker face – not one gave anything away. Joyce spent some extra time to listen the next time with the doppler. When I began presenting a low-grade fever, I went to labor in the living room, out of the warm air from the pool and onto my awesome birth ball. This is where the next heart tones were heard and my midwife laid it out; his heart tones were “fluky” and mine were beginning to mimic, along with an elevated temp.
She was talking transport, and it was previously set in my mind, if she ever considered it, I’d just go.
As the sun went down, we began preparing to transport from home to hospital. I set aside my desires for a home birth to be sure Merrick made his debut without incident. His heart had made some “wonky” blips of sound and it seemed my heart was conducting Heart Math with Merrick’s. I called my mom and told her it was just taking too long and we were transporting for a change of scenery — my little white fib to save her from worry.
We jumped, or rather slowly got in the car. I held on to the “oh sh*t” handle and I cringed while Brendon drove through the potholed streets of Worcester, following my midwife, and cracking jokes. I don’t really remember arriving – I mean, AT ALL. The next thing I really remember is my midwife-turned-doula, Joyce, saying, “I’m so sorry, I know it’s uncomfortable,” but it would be in my best interest to get on hands and knees. I remember thinking that meant Merrick was probably posterior… Boy, did I have a whole internal dialog!
Now I know I still had about 9 hrs ahead of me after arriving at the hospital, but then I assumed I’d be in labor for at least another 3 hours. I needed a break. However small it would be. I made the decision to have Nubain which gave me a 20 min “reprieve”. I remember trying to rest though the contractions in that 20-minute span. Brendon fell asleep in the cot next to me. Joyce had already been with me about 15 hrs and had seen me in the wee hrs earlier that morning… She laid her hand on me and gently rested her weary head beside me as I tried to snooze on my left side between contractions. Each time a contraction would envelop me, Joyce could feel me tense with her hand, would lift her head, and quietly remind me to relax. I remember thinking if she ONLY did THIS alone, she was worth her weight in Gold! But she did so much more! The contractions came and went and so did the 20 minutes rest! Somewhere around this time, I was told by the midwife on duty that they would break my amniotic sac. I don’t even remember consenting to it, but am pretty sure I did… I don’t know why they even suggested it. Suddenly, in my stupor, I felt the wetness and realization set in that it indeed had been broken.
Eventually, I couldn’t stay in bed any longer. I don’t remember getting naked, but I was. I don’t remember getting in the shower, but I had and was soaking wet. I sat on the toilet and remember being urged to my bed to be examined as I was feeling pressure. Low and behold, I was 10 cm dilated. It was time to push and meet my baby.
At some point in the early hours of April 23, 2011, my doula Sarah had returned and grabbed the camera – which I am so thankful for. For almost a full hour I fell asleep between contractions and pushed each time one came. I think I even SNORED! LOL!
When my baby crowned, I was reminded to touch his head, but I just couldn’t get the energy to lift my hand. Instead, I pulled it all together for one final push. “No, he’s coming out NOW!”
Finally! I met my son. “Vanessa, take your baby”. I was stunned…
My exact thought was, “Oh shit! There’s a baby!”
I looked down and lifted my son. And the realization that this little being was given to me to protect, love, and nurture changed my whole perspective on life.
I don’t remember hearing him cry. I don’t think he did much. But when I held him, I sang, “Around the world, I searched for you…” He just blinked and at that moment, my definition of love died and was reborn into something so much more magnificent!
My dear Merrick James is now in preschool and registering for Kindergarten. He breaks dances in our living room, adores listening to scores from The Lion Guard, tells me all about Professor Xavier and his X-Men, and gives me updates on his Batman video game. He’s a little obsessed with Minecraft and can do a hundred things on a tablet that I can’t. He loves digging in the yard and watering the flowers. He’s so proud to teach his swinging skills to his sister and that he can read a lot of words all on his own.
He’s everything I wished for and more!
He’s a boy through and through – dirt, dinosaurs, and DC Comics, but still a gentle and compassionate soul.
And today he is 5 years old.