Benefits of a Birth Doula before and after

What is a doula?

Doula is the Greek word to mean women’s servant; however, the definition has come to be known as a women who is experienced in child birth. She provides continuous physical and emotional support during and after labor.

What does a doula do?

A doula has many jobs that she does for the family. First we ensure that her care is individual and focused on her needs and wants. Doulas help in education and decision making process of where a woman will birth; hospital, home, birth center, or other. Doulas assist in helping in creating a birth vision/plan by providing education and information on the questions that the family has. Usually a doula meets with the family a couple times before delivery to establish a relationship; this way the family can gain confidence in her to ask questions that mom needs answered.

Before labor begins a doula is usually available to the mother by phone, text and email as much as the mother needs it. When in labor, a doula can help the mother determine if they are in-fact in labor. Doulas support the mother in staying home longer or going to the hospital. During your labor, the goal of a doula is to help the mother experience a positive and safe birth (American Pregnancy Association; is a doula for me? retrieved from americanpregnacy.org). Doulas help advocate on behalf of the mother; providing her with information about what is going on with her and her body, medication, and achieving a positive outcome determined by her birth plan. If the birth does not go as planned, a doula can provide information on what is going on and encourage the couple to ask questions and take the time needed to make an informed decision about proposed interventions. Even though your delivery did not go as planned, it was still the best possible delivery for the mother. Throughout the birthing process, a doula provides continuous emotional, physical and informational support. Doulas will often stay for some time after the birth as well to help with breastfeeding support. Doulas can offer coping techniques such as breathing, guided-relaxation, position changes and massage. Touch massage has been proven to reduce stress and anxiety during birth, quotes the American Pregnancy Association. Marshal Klaus and John Kennell wrote that massage helps stimulate the production of natural oxytocin. The pituitary gland secrets natural oxytocin to the bloodstream, causing uterine contractions, and to the brain resulting in a feeling of well-being, drowsiness and higher pain threshold. By contrast, because synthetic IV oxytocin cannot cross into both the blood stream and the brain, it increases contractions without positive psychological benefits of natural oxytocin.

Help During Labor

A doula will come to the family home at the beginning of labor, or whenever the family is ready for her in early labor and stay with her throughout; offering physical support such as, counter pressure, massage, walking, bathing or showering. A doula also provides the following emotional support; encouragement, confidence, and reassurance. A doula will support the mother in her choices such as if she wishes for a natural medication free labor, she will help the family in achieving their birth plan, and calm your fears. Fathers are a large part of the birthing process offering emotional support; however, fathers may struggle seeing his wife in so much pain, a doula can support the father by alleviating the burden place on him during delivery. A doula’s role is not to take the place of the father but to enhance and improve their experience. Fathers are free to help and be involved as much as they can, while doulas encourage the use of comfort measures and step in if he needs a break. While interviewing fathers Scott, Klaus and Klaus (1999) had one physician-father note, “I’ve run a number of marathons, I’ve done a lot of hiking with a heavy backpack, and I’ve worked for 40 hours straight on-call, but going through labor with my wife was more exhausting than any of these experiences. After delivery, a doula will stay approximately 2 hours to help with questions on breastfeeding, care and skin to skin contact.

STATS

During labor

• 50% reduction in caesarean delivery
• 25% shorter labor
• 60% reduction in epidural requests
• 30-40% reduction in forceps
• 40% reduction in oxytocin
• In a study, of women whom gave birth with just her partner there was a rate of 22.5% caesarean, compared to 12.2 with a father doula team.

Right After Delivery

• Mom was observed through a 2 way mirror doing more stroking, cuddling, Kissing and petting of her baby.

6 Weeks After Delivery

• 51% of women who had a doula were still breastfeeding compared to 29% of women without a doula
• Women reported reduced anxiety and depression
• Increased levels of self esteem
• Rated their baby better than a standard baby
• Rated their baby as more beautiful and cleaver
• Reported that their baby as easier to manage.

(The Obstetrical and Postpartum Benefits of Continuous support during Childbirth; Scott, Klaus and Klaus., 1999)

Questions to Ask A Doula:

The most important thing is to choose a doula that you are comfortable with and feel a connection too. Interviewing a doula in no way obligates you to hire them. Interview until you find a doula that best serves your needs.

1. What training have you had?
2. What services do you provide?
3. What are your fees?
4. Are you available for my due date?
5. What made you become a doula?
6. What is your philosophy regarding child birth?
7. Would you be available to meet me before the birth to discuss my birth plan?
8. What happens if for some reason you are not available at the time of my birth?

Questions taken from; Is a Doula For Me; www.americanpregnacy.org

HAPPY BIRTHING

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WELL…IS IT?

How do I know when I am really in labor? In my experience, it was hard to know the difference from practice to real. A third time veteran and I was still tricked. I bring help in hopes of deciphering the code of pre-labor (Braxton-Hicks) and real labor (baby producing).

I want too quickly touch on the physiological change that occurs in your body while getting ready for delivery and true labor. As your body prepares for delivery, your cervix will begin to ripen as your body releases a hormone prostaglandin (also found in sperm). Your cervix will come forward (anterior) from where it has been all pregnancy (posterior). The cervix shortens (effaces) and then opens (Dilates).

At the beginning part of the birthing process, the most active part of your body is the primitive (limbic) part of the brain (Spatafora, 2009. 161). This part of the brain releases the hormones that queue your uterine muscles to open and help move the baby down.

Pre-labor is often a confusing and frustrating event that can leave a women worried that she will not know when her labor really hits. As seen on TV, go into labor and immediately fall to the ground, start rolling around, just out of reach of the phone, while screaming. Bum bum buuuum. This is untrue of labor, and this fear factor is just not helpful for us women. Often times the transition from pre-labor to active labor is subtle and gradual. For few women, this shift is obvious if their membranes rupture, or if there contractions begin suddenly and intensely (Simkin et al. 2010)

According to Ina Mae Gaskin, Midwife and author of Spiritual Midwifery says that signs of impending labor are; baby drops further down into mother’s pelvis also called lightening. This happens 2-3 weeks before delivery, increase of vaginal discharge or juices are present. Mothers often have to wear liners. Mucus plug will be released. This means the cervix has dilated enough to let it go. Most women don’t see there mucus plug because they lose it in chunks in the toilet, at night, or just wipe it away after they urinate. When the mucus plug is seen, it can be streaked with blood “Show” because of the capillaries breaking in dilation.

Signs and Symptoms

Possible Signs (late pregnancy changes)

Vague nagging back ache causing restlessness- a need to keep changing positions (different from the fatigue back ache).

Several soft bowel movements- sometimes accompanied by flu-like sick feelings.

Cramps, similar to menstrual cramps that come and go; the discomfort may extend to the thighs (may go away several times over the weeks and gradually become positive signs).

Unusual burst of energy resulting in great activity, this is termed as nesting. (Careful here not to overdo it, you’re going to need this energy for the real thing.)

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Preliminary or pre-labor signs

Blood-tinged mucus discharge (show or mucus plug) released from the vagina; mother continues passing this discharge off and on throughout labor

Bag of water leaks, resulting in a trickle (not a gush) of fluid from the vagina.

Continuous non progressing contractions- that is, they do not become longer, stronger and closer together over a period of time. These are termed pre-labor or Braxton-Hicks

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Positive signs

Progressing contractions- that is, contractions that become longer, stronger and closer together. These usually continue until it’s time to push.

Spontaneous breaking of the bag of waters with a pop or a gush of fluid followed by progressing contractions within hours.

CLOSING

When you believe you are or may be in labor, time your contractions. No need to sit there for hours timing, time a few like 5 or 6 then wait a few hours then time again. This should give you an indicator of how much closer they are, and if they are real or not. If you are in pre-labor drinking a big glass of water, changing positions or a bath often relives you of the discomfort. You can also call your doula for some tips on comfort measures.

I hope this helps, but if you are still unsure you can always contact your doula or care provider.

Please see my printable section for how to time contractions.

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HAPPY BIRTHING

Postpartum

10 to 15% of women suffer from postpartum. It is no joke and it is serious. Postpartum is nothing to be ashamed of, or embarrassed about. If you or someone else may be suffering from this disorder seek medical attention or find someone in your area to reach out to.

A good resource is Pacific Postpartum Support Society (604)-255-7999 or toll-free BC (855)-255-7999

Or you nurses help line 811, can offer valuable resources in your area. Information is confidential