I'm not sure... do I need a doula?

I'm not sure... do I need a doula?

do I need a doula

Parents who consider hiring a doula often ask some of the following questions. In response, we are exploring and clarifying the doula role and some of the reasons for hiring one. 

1. What exactly does a doula do? 

The “textbook” answer – that many of you have probably already heard – is that a doula provides continuous physical, emotional and informational support to a laboring mother and her partner throughout the labor and birth process.

But what this looks like in practice spans a very wide spectrum of scenarios. Since a mother doesn’t often know ahead of time exactly what will be most helpful to her in labor, probably the most important trait that a doula brings is the ability to be adaptable and adjust her style according to the individual needs of the mother and of the moment; to read the situation and act appropriately.

Sometimes, a mother needs to be left completely alone to feel safe and secure – any noise or touch creates more stimulation than she can handle in addition to her labor. Sometimes, a mother needs to have continuous eye contact with her partner. Sometimes the couple is doing well on their own and the doula can help carry bags, fetch water, and take care of other errands so that the parents never need to be separated for a moment. Sometimes a mother needs to be held, massaged, loved and encouraged by another woman who understands what she is going through. At times, labor support requires some trial and error for the doula to figure out what is most effective and as labor progresses, the doula may need to adjust her role, style or technique based on the mother’s changing needs.

2. Why would I need a doula when my partner/husband is prepared and wants to support me?

This can be a tough question to answer. It is true that the partner knows the mother well and has a very intimate connection with her and the baby; however the partner is also very emotionally involved, most likely not an experienced birth attendant and may benefit from some support, reassurance and guidance him/herself. Many parents have expressed concern that a doula will take away from the partner's role or experience. On the contrary, doulas want the partner to be intimately involved and work to keep the couple connected throughout the labor. Ideally, the partner and doula working together create the ultimate support team.

It is also important to realize that there are some unique elements that a doula can bring to the birth that may be difficult for a husband or partner:

    1. Experience. A seasoned doula has usually attended dozens, sometimes hundreds of births and can draw upon those experiences to guide her support. A newer doula has read countless books and websites, attended a training(s), and/or watched birth films and is knowledgeable and eager to help. For the partner, the birth is likely the first or one of a small number, so it may be difficult for him/her to establish a helpful frame of reference. Situations such as a baby in an awkward position, a mother battling nausea, a mother who panics, or other unexpected events, are likely situations that the doula has seen in the past and has learned various methods that can help.

    2. Instinct. Many doulas have had children of their own and have a love and passion for birth and helping other women have a positive experience. Attending many births and/or having given birth to her own children gives a doula a powerful personal experience from which to draw ideas and tools for support. Often, though not always, it is easier for women, especially those who have gone through it, to instinctively know how to support a laboring woman than it is for men.

    3. Objectivity. A doula will be able to maintain a bit more emotional distance in the midst of the passion and intensity of labor than a husband or partner. It’s not that she doesn’t care about the laboring mother, but rather that she is able to take a step back and look at the bigger picture, keeping a more objective viewpoint. This will help her provide the information that parents need to make a decision based on evidence and experience rather than out of emotions or fear. Parents who are given tools to be at the center of the decision-making at every step of the labor and birth process are more likely to come out on the other side feeling respected and cared for. This will create a joyful and positive experience and get the family off to a healthy start. 

If a mother does not have a partner or other support person, the doula’s role possibly becomes even more critical, ensuring that the laboring mother will never have a moment when she will face her labor alone.

3. I get the idea of labor support, but won’t my midwife or nurse do that?

Maybe. Some labor and delivery nurses and midwives provide wonderful labor support, while others do not consider that to be part of their role at all or are too busy to have much time with the mother in that capacity. The problem with counting on the nurse or midwife for labor support is that no matter how wonderful she may be and no matter how much she may want to support her patient or client, that cannot be her primary concern. She has a job to do that includes monitoring, paperwork, and protocol. Ultimately, ensuring baby and mother’s health and safety is her primary focus, not providing comfort, support and encouragement to the laboring mother.

4. I’m not sure about having some stranger at my birth; wouldn’t it be better to have someone I’m already close to for support? Like my mom or sister?

Friends, moms, sisters, aunts, cousins and many other possibilities can make great labor support people. Anyone a mother chooses to invite to the birth that is going to enhance her experience, create a safe and secure space for her, and support her goals can make a great asset to the birth team. Doulas often work with family members to enhance their support or step in when they need a break. For a mother who finds companionship comforting, it is terrific to have a number of people nearby. With friends and family, it is important to keep in mind that some of the same limitations exist as with partners; it can be challenging for them to maintain objectivity, and without having attended many (or any) births, they may lack experience. In addition, your doula should not be a “stranger” by the time labor comes around. By then, she should have a well-established understanding of your goals, perspectives and personality, and the parents should be completely comfortable with her.

5. I plan to have an epidural or I may need a cesarean; is a doula still necessary?

No matter what your plans are for labor and delivery, it can be very beneficial to have an experienced, professional person with you whose primary task is to provide you with information and support. Sometimes suggestions, positions changes or a comforting face can make all the difference. 

These questions are great starting points for conversations that can help you decide what is best for your birth experience. If you agree, please share this with your friends! 

 Copyright 2012 © All Rights Reserved

Plumtree Baby, LLC

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Parents: Six Things Your Doula Wants You to Know

To the expectant parents out there considering hiring a doula, there are a few things that we as experienced doulas think you should know.

1. Our job begins long before labor does.

When people think “doula” they think support during labor. We will certainly be with you for labor, but a huge part of our role is to be available to you in the weeks and sometimes even months before labor. We will answer questions, lend support, encourage you, give you information and offer suggestions to help you become ready for labor. You should never hesitate to contact us with your concerns and questions, day or night, nor should you ever apologize for doing so. We juggle a lot of different things in our lives and we may not be as good as we should be about touching base with you, but we always want you to contact us whenever you feel the need. Having a baby is a big deal, and especially if you haven’t done it before, it’s hard to know where to turn for guidance. We love being involved in your journey leading up to labor, so please, use us!

2. This is about you. Not us.

We are here to support your birth experience and your choices. We want your family unit to be strengthened and bonded through our presence, and it is always our goal to be in the background making things better for your experience, not in the center or forefront. We are aware of your goals and choices and we are going to be there to remind you of them and help you achieve them. But if circumstances prevent this, or if you choose something different during your labor than you had originally planned on, our support for you will not waver. For example, if you wanted an intervention-free birth, but you change your mind and ask for an epidural during your labor, please don’t apologize to us or feel guilty. It’s not about us and we are going to be there for you with 100% of our love and support. No matter what.

3. Please understand our position.

You have hired us and we have no obligation, loyalty, or responsibility to anyone else. You’re our client and you’re the boss. We do not work for the nurses, the midwife, the doctor or the hospital. We work for you. However, please realize that we are professional labor support people, not bodyguards, decision-makers or medical care providers. We are there to support you, not protect you. Therefore, we cannot throw ourselves between you and your care providers, interfere with anyone trying to do his or her job, or speak to medical staff on your behalf. If we did, we would not be welcomed back to support the next laboring mother and long-term consequences would impact many more women, as well as the doula community. We need you to take responsibility for knowing the policies and procedures in the birth place you have chosen, and understand that some things come with the territory (and we will discuss these topics at length in our prenatal meetings so you are prepared). If there are things about the hospital that you do not want (i.e. continuous monitoring, mandatory IV, confined to bed), please do not expect our presence to “protect” you from these things. We can discuss your options privately, remind you of your preferences, and suggest alternatives, but it is up to you to refuse or accept these things.

4. Align your goals and choices.

It is challenging to serve clients who have certain goals and desires for their birth, then proceed to choose a hospital and/or care provider who do not support those goals and desires. If, for example, you want an intervention-free, mother-centered birth with the option of a water birth, choosing to go to the biggest, most impersonal hospital with a 60% cesarean rate that doesn’t have birth or bath tubs and hiring the doctor with the highest epidural rate, may lead to disappointment, since these choices do not necessarily set the stage for the most effective support for your goals. If, on the other hand, you are not all that concerned with rates of intervention or plan on an epidural in labor, this setting and care provider may be perfectly appropriate, especially if this is the choice you are most comfortable with and we completely support your choice. Just be aware that you will be better off if you align your goals and your choices.

5. We cannot do this for you, but we can help.

Having a doula with you for your birth will help you be encouraged, empowered and will ensure that you have continuous support at every moment. We will make sure you are well cared for and that you have the information you need to make the best choices for yourself and your baby. But having a doula in no way guarantees you a birth without complications, and we cannot do the work for you. Labor is hard with or without a doula. We will do everything we can to keep you as comfortable as possible. We will suggest positions, use massage, heat, encourage you to use the shower and the tub, employ counter-pressure, squeeze your hips, have lip balm ready, keep cool washcloths on your forehead, and remind you that you are strong and capable. All of these things will not necessarily make your birth pain-free or easy. They will help, but ultimately, this is your body, your baby, your experience, and your mountain to climb and you can do it! You will look back on this experienced and be amazed by your ability. This is a gift that we want for you so much.

6. Our relationship is for a defined set of time.

It is not unusual for us to form strong bonds with our clients. By the time baby arrives we have a solid relationship and care deeply for one another. But please understand that we serve a lot of clients and it is very difficult to maintain a long-standing relationship with each one. Sometimes our good friends develop out of a doula-client relationship, but please don't take it personally if we neglect to stay in touch or cannot make it to a birthday party that you invite us to. We care deeply about you and your family, but this is a result of the time constraints of our line of work and the nature of the job.

Finally, we are honored to be with you for your birth and have a deep respect for the work you will do to bring your little one safely into this world. There is nothing more sacred and special than witnessing the birth of a child and we thank you for trusting us and hiring us. Happy birthing!

If you agree, please pin this image on Pinterest and share it with other.

Updated 9/6/12

Copyright 2012 © All Rights Reserved 

Plumtree Baby, LLC

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Offbeat Parenting Milestones

Offbeat Parenting Milestones

We cover a variety of serious topics on our blog, but every once in a while it is nice to lighten the mood. Today we are exploring the humorous and real side of parenting. It is wonderful when you hear your baby giggle for the first time, when she takes her first step, or utters her first words, but here are 12 milestones that you never knew you would LOVE: 

  1. When he wipes his own bottom. Sure, it is exciting when your little guy shows interest in the potty, and even better when he starts using it consistently, but did you realize you’d continue to accompany him on those trips for a long time to come? The day he can successfully tackle that task independently from start to finish is party-worthy.
  2. When she learns to pump on the swing. When this clicks for your little one, you get to say goodbye to hours of standing there pushing her back and forth, over and over and over. You just may hear music from the heavens and feel like jumping onto your own swing beside her to celebrate.
  3. When he can buckle and unbuckle his own seat belt. You’ll recall how fun it is to mess with straps and buckles (sometimes for two or three kids) every single time you stop to run into the store, or post office, or library. And then do it all over again when you get back out. Well, no more! He’s got this now! Your errand-running just became a thousand times easier.
  4. When she can get her own breakfast without waking you. Even though you are thrilled to wake up to: “Moooom! Daaaaaad! I’m huuuuuungry!” the day will come when you’ll wake up all on your own, rub your eyes, and wonder why she is sleeping in, only to find her happily munching on breakfast that she got all by herself. Yes, there may be some cereal scattered on the floor or some milk on the counter, but you’ll still want to do a cartwheel.
  5. When he can get across the monkey bars all by himself. No more holding his weight as he struggles, trying not to get kicked in the stomach. Your little monkey is growing up!
  6. When life no longer depends on the blankie. Or pacifier, or beloved stuffed animal. She has that one thing that is her lifeline, and if you’ve ever misplaced it, you know you’re in a world of trouble, and there will be no peace until it is found. The day will come when it is still loved, but it’s not critical.
  7. When she can handle her own bath or shower, and actually get clean, including washing her hair. Yes, she may flood the bathroom for the first little while, but eventually, she’ll be able to get the water started, suds up, rinse off, get a towel and dry off without any help from anyone. Oh the rejoicing!
  8. When he gets up in the middle of the night to go potty without waking you. The night will come when you’ll half-way wake up and think you hear feet, then hear a flush and little steps heading back to bed. In the morning, when the fog clears and you realize what happened, give that kid a high-five and some stickers.  
  9. kid painting self portrait messTheir first self portrait. You have never seen a more perfect and beautiful stick figure in your life. Your heart will melt when you see her fingers are as long as their arms, her smiling face has no nose and her spaghetti string hair looks almost like hers does when she wakes up on the morning.
  10. When he realizes the toilet is not a garbage can or useful for storing toys. It’ll suddenly dawn on you one day that you haven’t fished anything out of there for some time. At last, the phase has passed. Breathe easier.
  11. When she names her first boyfriend. There are fewer things cuter than a 3-year-old preschooler letting you know she has a boyfriend, or better yet, pointing out the boy she plans to marry (in about 30 years, your brain will add). Of course, the next day she may want to marry her grandpa, but it’s still a fun day. 
  12. When he shows you that he is clearly growing up. This can come in many forms: his first basket, goal, cartwheel, the first time he sounds out a word, or the first time he writes his complete name and it is readable. Perhaps he will reach out to a friend who is hurting, or stand up for someone at school who is being picked on. He may show you that he can be trusted alone for a while, or get up and let the dog out without being asked. Whatever this looks like, you’ll have a moment when you realize your baby isn’t a baby any more. When that happens, cry, laugh, and give him a big hug (while he will still let you).

We could go on and on, but you get the idea. Now it is your turn: what are some of your favorite parenting milestones?

Copyright 2012 © All Rights Reserved

Plumtree Baby, LLC

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Why do I even need to take a Childbirth class? I’m just going to get an epidural...

Why do I even need to take a Childbirth class? I’m just going to get an epidural...

do i need a childbirth class plan epidural birthWe know that the majority of parents do not take a childbirth preparation course and there are many possible reasons for this (too costly, too time-consuming), but overall, the general consensus is that mothers-to-be are just planning to check into the hospital, let their doctor or midwife “get them through it” and to have an anesthesiologist at the ready to ensure a pain-free birthing experience. With this being a common view on birth, why even bother with a childbirth education class?

Well, we can suggest several reasons that pregnant women and their partners should take a childbirth preparation course.

  1. To become aware of the processes, whether medicated or not, that a woman’s body will go through in the course of labor and birth. Learning about the anatomy and physiology of birth makes a woman more aware, and thus more in-tune, with what her body is doing and how she may feel while her labor starts and progresses. Her understanding will help her feel calmer, more in control and less frightened.
  2. A woman that spontaneously goes into labor is going to have to manage her labor, at the very least, until she can get to the hospital, get through triage, be admitted, be examined and then have the anesthesiologist called (which can take 30-60 minutes or more depending on the time of day and how busy the labor and delivery ward is). She may also be advised to wait to get an epidural until her labor has progressed further. A mother (and her support partner) who has no idea of what is occurring in her body or how to cope with and mentally process her sensations is likely to experience a heightened sense of fear, tension and pain. This is something that is rarely discussed during the course of prenatal visits with care providers and can often come as a shock to mothers when labor begins and they find themselves without resources or coping techniques.
  3. Pain levels have little to do with a woman’s satisfaction with her birth! As stated in this article, “Remember that labor pain is more than a physiological process; coping with labor pain is emotional and complex and results in feelings of fulfillment and achievement for women. Therefore, satisfaction with labor is not necessarily related to the efficacy of pain relief.” A woman is more likely to feel satisfied with her labor if she is supported, feels “in control,” respected and cared for, regardless of the pain she may experience during the process.
  4. To understand what interventions may be suggested or administered and to become aware of the benefits and drawbacks of each one. Even if a woman fully intends to have an epidural, it (as with all other interventions) does not happen in a bubble. There are IV’s to be administered, continuous fetal monitoring for the remainder of labor, the loss of mobility, an injection into the spine to be considered, and several side effects that could, and commonly do, occur. It is not simply the skilled anesthesiologist that will breeze into the room to rescue a woman from her discomfort, or the possibility of experiencing it.

We don’t expect that all women who take a childbirth course and learn about their options will choose to have an unmedicated, natural birth, but we do believe that helping them become aware and informed, will help them feel powerful and more satisfied with their birth experience regardless of their choice of pain management. And we know that this information, and so much more, can be conveyed and discussed during thoughtful, evidence-based childbirth education classes.

Now it’s your turn...

Should expectant women and their partners take a childbirth preparation course? If no, why not? What are the benefits of a childbirth class? Share your comments below and if you would like to share this article with parents, pin the image about on Pinterest.

Copyright 2011 © All Rights Reserved

Plumtree Baby, LLC

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