What is a Doula?

In this journey to become a certified doula, I’ve seen that women need a confident, knowledgeable woman to help nurture, coach and gently guide them through the duration of labor, pushing and post-partum care. Women in labor need continuous physical, emotional and mental support. A doula provides just that. Through statistics published on how doula’s can effect women positively in birth and my own experiences, I’ve come to see what a doula provides, why it is significant and why continuous support is necessary in the birthing process. I’ve been fascinated and encouraged about the answers revealed. I’m more confident now in what I want to be doing and how I can be effective in helping women achieve something that they want for their birth experience.

Let’s look at some studies documented about the benefits of having a doula present. Women were less likely to have pain relief administered, less likely to have a C-section and report having a better childbirth experience. Other statistical studies show that overall having a doula assist in a birth decreases cesarean rate by 50%, length of labor by 25%, the use of oxytocin by 40% and requests for an epidural by 60%. Still in other published findings there is 30% reduction in analgesic use and 40% reduction in forceps delivery. These are fantastic positive findings that help to prove the important role a doula can play in a birth experience!

So what is a doula and what exactly does she do? The simple definition is a women helping another women. It has now evolved more specifically to a doula being someone who attends a birth and provides encouragement and support to a laboring woman. There are three main ways to provide support and one is physical support. This is an important aspect of a doula’s role in the birth of a baby. Mom is working hard and will encounter discomfort, pain, agitation, etc. A doula offers suggestions of different positions that might help manage pain during contractions. Some examples might be sitting on a birthing ball, leaning on dad, a bath, swaying, squatting with support, etc. Physical support can also include massaging mom to help her relax or relieve pain to take some of the stress away. Offering mom ice-chips, assisting mom to and from the bed, grabbing extra pillows are other ways a doula can offer additional physical support.

Secondly, emotional support is a big need in a birthing situation as well. Birth is intense and can be draining not only for mom but dad as well. In one of the births I submitted, I realized how much the man feels the weight of becoming someone’s father. I had the opportunity to listen and allow a dad to express his disappointment with a doctor and the fear of a wrong choice being made. By my being there for him, he was able to process with me first and then go and be there for his wife during a C-section and enjoy his baby girl being born.

Finally, there is mental support that a doula can provide. As stated earlier, birth can be a long, drawn out, difficult and draining process. This takes it toll on both partners. When hours have gone by and progress is slow and mom is exhausted, couples can lose mental energy to keep going. What they need is to be reminded of what they’ve learned, their options and guided about the task at hand. A doula can keep the positive momentum going and allow them both to just relax and enjoy the process. Many couples don’t want to “do the wrong thing” and that weighs heavily on them as time goes on. When a doula is coaching mom during labor and she can trust her, then this can release mom to focus on her part - resting and breathing. I believe that each one - physical, emotional, and mental support - is invaluable.

A doula should be a person who has no trouble affirming and encouraging others. Encouragement is important to help strengthen mom with words and phrases that praise her of her efforts. Mom needs to hear that she is doing a fantastic job. She needs to hear how strong she is. She needs to know that she is listening well and doing what you’re coaching her to do. All of this positive reenforcement enables mom to continue her journey while knowing that SHE IS doing it! Encouragement also makes for a great experience for the birthing couple. Most women don’t know that their birth experience can be a positive and wonderful. When there is positive affirmation taking place, the atmosphere is a pleasant one.

As I’ve gotten feed back from my clients, naturally the most significant aspects offered to them are the support, affirmation and nurturing provided for them. There is something very vulnerable about birth. A women wants to feel protected and known. When other women are reassuring her insecurities and listening to her fears, a woman feels connected and responds positively to what is going on around her. In a sense, she feels taken care of. Even though she is the one doing all the work, she doesn’t feel alone and has a connectedness with a “team” effort. Again, labor techniques are very helpful. When there is a reliable, trusted person answering and guiding mom through contractions, there can be a peace and a rest for mom and even dad. As a doula offers suggestions of positions and leads mom in breathing techniques, mom is free of worry and concern about doing it right and can just relax and breath. Lastly, a key in labor for most of my clients has been the mental factor. A doula can be very present in the intentional focus of mom and her work. Women want to “stay in the game” and this can be hard to do. So, when she is being built up at a time when she feel weary then each contraction provides empowerment rather than defeat. Why? Because there is focus and that leaves no room for panic and chaos. These efforts have given the couples I’ve worked with great satisfaction with the births of their babies. It has given me absolute gratitude for the opportunity to aid someone in this amazing journey called “birth”.

My hope is that in our birthing community we will have established the value of doulas. Every positive experience brings us closer to the support of women in birth. As couples continue to talk about how much they actually enjoyed their birth, more questions will arise and more answers can be given. I would love to see women doing what their bodies were created to do and partake in the awe of what a positive birth experience can accomplish in one’s life. It is empowering to bring a life into the world and to know that “I DID THAT!”

Fast and Furious

The Birth of My First Born Child

Today I am going down memory lane once again. Twenty-five years and some odd months ago, I gave birth to my first baby. The reasons of significance for this event are mostly obvious but I want to dive deeper into how this big event in my life transpired into my passion for being a doula.

After I got married, I had little time to think about being pregnant or what childbirth actually meant because, within months, I became pregnant.

My family lovingly joked that I was a hypochondriac. I was the girl who would get a papercut and that's all I could talk about at dinner time. So, when I mentioned that I was considering a natural home birth, I got a little push back from everyone. At the time, home births were common in my circle of friends, but my loved ones were unsure that I would be able to actually go through with it.

My husband, Michael, was very adamant that I have my way and encouraged me that I was strong enough to do it. He is not an alarmist, in fact, he is very laid back. He did not consider having our baby at the hospital a "have to". He has a degree in biology so birth actually interested him. Michael was obviously a wonderful partner for me as I went into the unknown of giving birth. My midwife was also great for me throughout my pregnancy even when we told her we did not want to know the sex of the baby until after we had a chance to bond with baby. My pregnancy went very smoothly and was uneventful.

I am now 39 weeks pregnant. It is a Sunday afternoon and I am at my mom's house. Everyone is hanging out. Some are watching TV. Some are working on a puzzle. I had been experiencing some Braxton Hicks contractions, and of course, thought every time I started getting that tightening sensation that "this is it." This particular afternoon, I notice that I am getting them more frequently than usual. The tightening turns to cramps and I find myself in the restroom several times. My mom begins timing and there is, in fact, a 3-4 minute pattern.

Michael and I decide to head home and we “Call the Midwife”. She comes to our house and checks me. I am dilated to 4 cm and my contractions are becoming stronger. She confirms that I am in active labor. I feel excited and nervous at the same time. I pretty much immediately get into my bathtub which doesn't really help much. But I just focus on my breathing and tell myself not to lose control. I reach a point while in the tub that is very intense and I stand up.

“I don't know about all of this, y’all...?”

My midwife checks me again and within one hour I have already progressed to 8 cm dilation. She encourages me that I am doing well. My mom and sister are at the house with me and take turns recording the birth. At one point right before a contraction, I hear, "Say hi!" The camera pointing straight at me. I reply back, "IIIII'm busy!" I have tunnel vision and I am focused more than ever now.

There is slow music in the background as I go through the most painful of my contractions. I never again play that tape because of what it reminds me of. It represents something hard. The hardest thing I have ever done. I feel vulnerable, I am in need and I have no control over the situation. I am, however, surrounded. I am not alone. I am being affirmed that I am strong, I am being comforted and heard. This is so vital in keeping me focused.

Less than an hour after being checked at an 8, I am now on the birthing stool. It's time to push. I had felt nerves throughout the process, now I'm scared. But I am determined as well. Michael is sitting behind me and I am leaning back on him. My midwife is on the floor watching and waiting. At this stage in my birth, I am loud through every

Early Labor

What to Expect & How to Respond

As a doula with experience in over 200 births, I get a lot of questions about early labor. So today I want to jump into a quick overview of what to expect and how to respond when faced with this part of your birth experience. There are a few things I want to share in order to help your early labor as peaceful and enjoyable as possible.

First things first. What is actually happening in early labor? There are three big things that are going on. 1- Dilation. The cervix begins to open and dilate from a 1 to a 10. 2- Effacement. This is simply the process of the cervix thinning until it disappears. 3- Position of baby. A “station” describes how the baby is progressing through the birth canal. A negative 3 (or -3) station would be a common place to start in early labor as the head is further up the canal. A woman can go into labor already dilated to 3cm and 80% effaced & at a -2 station. That may mean early labor will progress a little quicker. If the contractions aren’t strong enough for change, though, she may stay at 3cm, 80% and -2. It’s all about the combination of these three factors while having strong, effective contractions. Unfortunately, there’s no magic, no set way and no predicting how everything will go. Because of this, it is important to keep your mind clear and at peace in the last days of your pregnancy.

A lot of moms have trouble knowing the difference between “warming up” and active labor. Some feel as if their labor was extremely long because they mentally committed to having the baby too soon. The key is distraction. Do your day. Ignore the little voice inside your head saying “this might be it”. If you feel the need to time contractions and they are still a good 10 min apart or if there is no pattern at all, there is nothing to do at that point. By putting on your “binoculars” and dwelling on every single thing you are feeling, you can create a longer birth for yourself. It is easy to wear yourself out too early mentally. And it is important to conserve that energy for later in the birth when you will really need it.

If you are feeling symptoms during the day, finish the task at hand, do some laundry, go grocery shopping. Eat a healthy snack. Take a walk to encourage any contractions to get stronger. Remember, try not to focus on them. Having said that, if you are feeling some things happening at night, try to rest. There is no telling how long you are about to go without sleep once your true labor begins. Ask yourself- “Do I really want to have this baby in the middle of the night?” If you are able to go back to sleep, by all means, do it! I’m always encouraging my clients to stay in the comfort of their own home as long as possible. You will be more at ease not being hooked up to monitors and watched constantly. This is a marathon, not a sprint.

A good way to indicate if you are in active labor is to drink a big glass of water or two, and get into a relaxing bath tub. Put your feet up and try to nap. If it’s not labor, 9 times out of 10, your symptoms will stop. If you are in labor, doing these things may slow it down a little, but there is no stopping this locomotive. Once the body has agreed and said “yes” to labor, than it’s truly a runaway train going downhill. Trying to decide whether or not you’re in labor, or if it’s time to go to the hospital is almost always about a pattern and an increased intensity in your contractions.

You can shave time off of your birth if you focus on things other than early labor. But there will come a point where you cannot ignore your contractions anymore. They may be 3-5 minutes apart. You will move from discomfort to pain. And then it’s go time, baby!

Where it All Began

For my first blog post, I want to rewind 28 years to tell the story of how becoming a doula started long before I would ever actually become a certified birthing coach. At the time, I had no idea the impact that this life event would create. A beautiful part of my story would set up in me a passion for natural childbirth.

To set the stage for that time in my life: I am not married, have never been to a birth and have just been given a fresh start in life. I am a young woman and have recently moved back home from college after a few struggles. I am

living with my sister, Maranatha, who is a couple of years younger than I, who is married and expecting her first baby. She invites me to attend her birth, which she was doing at home, and I am very eager to be there with her and mostly to become an aunt!

Fast forward to the big day: everything starts slowly. The mood is peaceful, lights dim. She makes some hot tea in the kitchen, moves to the living room and sits in her rocking chair for a bit, then wanders to the bedroom. Lies down for a minute, then stands back up and keeps slowly moving. She is roaming around the house aimlessly like a cat. At some point, she decides she wants to move to her bathtub to relax for a while as the contractions begin to increase in intensity. My youngest sister, Amelia, and I are in the bathroom with her making conversation. Maranatha is overcome by a pretty strong contraction and unable to talk. I can tell she is trying to tell us something, so I encourage her to just breathe and to tell us when the contraction was over. Well, she is obviously struggling and starts pointing as she grimaces in pain so we get a little frantic trying to figure out what she needs. I'm thinking, "Oh, this is serious! Maybe the baby is coming?" The contraction finally ends and she blurts out- "Your shorts are on FIRE!" A candle had caught the side of my sister's shorts! So much for good coaching and just "breeeeathe through it, honey.” We all had a good laugh and could breathe again.

Throughout the rest of her labor, I just love and support my sister in whatever way I can. Giving her affirmation and telling her she is doing good, even though I am clueless about the whole thing. I don't remember every detail of this birth, I don't remember little things like how many hours she was in labor or how long she pushed. I do know that I was emotional as I watched my first nephew, Benjamin, be born. There were a lot of tears. I fell in love with the miracle of childbirth, the significance of it all. For me personally, Benjamin being born was a very significant moment in my life. It symbolized my re-birth and propelled me from my personal trials.

After watching my sister, I realized how good birth could actually be. And I knew I wanted it for myself one day. It was a positive experience and I liked that she had free will to walk around as she pleased, eat when she wanted to or get in the bath if she felt like it. Natural birth was important to me long before I became a doula because my sister's birth had such a big impact on my heart. The medical details about birth were not what drew me to it. It was the weight that the entire experience held, it was about what she, the mother, needed as she going through one of the most important events in her life.

Still, to this day, I have a very close, strong relationship with Benjamin. And I would say that is true for each of my children and every other baby I have seen be born. While I may not share everyday life with them, there is an undeniable connection there.

The true reason I am a doula is that I love seeing life come into this world and I love the process of it all. When I can help a mama not just get through her birth, but to experience it fully and then see the miracle she produced, that continues to inspire me and to empower others still to this day. I love my job!