Doula or Don’t Ya?

That is the question. Of course you do-la! Once you know the importance and significance of having a labor support doula present at your labor and delivery, I am sure you will at least consider the option.

Consider this: having a doula at labor can cut your labor time almost in half!

My last four hospital deliveries included three first time mommies and a second timer who chose to use a doula and opted for a non medicated delivery this time. All four of these women delivered within six hours of getting to the hospital. This is excellent for first timers and all were able to labor naturally, quietly, feeling nurtured (very important word here) controlled, relaxed and empowered.

After they put the baby in new mommy Niki’s arms, she turned to me and said, “I can’t wait to do this again!” I knew it was the endorphin rush talking, but it truly was an amazing birth, quiet and comfortable. As her doula, I had Niki, her partner Bill and myself in a kind of zone; when it was all over I told her I thought Tom Cruise would have been very proud of her as she hardly made a sound during the whole labor (you know, scientologists are supposed to have silent births… I need to do research and find out if they use doulas? Or duct tape? J ) Niki and Bill had such an amazing experience because the doula pulled everyone together giving Bill a role that he would not have known otherwise.

Common Misconceptions

I have often heard woman say that they feel that by having a doula it will take away from your partner’s role in helping to support you through this process and one of the first questions I am asked by the partner in a consultation is “Well, if you are there, what is my role?” These are reasonable concerns but there is plenty for both a doula and your partner to do at the birth.

What many of you first time mommies don’t understand is that never having had this very unique experience you have no clue as to what condition you will be in when you arrive to the delivery and there are many factors that can work with you or against you:

• Amount of sleep immediately prior to going into labor
• Time of day
• Current energy level
• How long ago you ate (don’t show up hungry! If you’re delivering at a hospital, they will only give you ice chips until you deliver!)
• Fear level
• Is your partner helping you to get a grip or just pissing you off?
• Is your partner scared or feeling awkward? They get scared too and that’s OK. But they might be afraid of you and then shut down because they don’t know what to do.  (I have walked into a few situations where the fear on the dads face was more obvious then on the new mom’s face.)

Having a doula present at your labor and delivery can really help you to overcome some of the factors that might be working against you.

Another big misconception about labor and delivery, especially for first time moms, is that you are going to show up at the hospital and everyone there is just so happy to see you and so excited about you having your first baby, and nurses and doctors will just be gushing to say “Oh how wonderful!”, “What a miracle!” and “We are all so happy to be a part of this and helping you through your process.” While I believe this is how it should be, unfortunately this is almost never how it looks. (Click over to read Heather’s birth story on massageamom.com as I hear this type of story more times than a positive experience with the nursing staff. Nurses work twelve hour shifts, are overworked, and for most of them it’s just another day at the office so lending you an empathetic ear is not the first thing on their minds!)

In Henci Goer’s book, The Thinking Women’s Guide to a Better Birth (a must read) she states, “…studies show that the average labor and delivery nurse spends fifteen minutes of her eight hour shift (nowadays twelve hour shifts with even more patients and more work) offering physical comfort measures, providing emotional support or advocating for her patients.” In all the years I have been doing labor support there has been only one nurse who was truly amazing as her compassion and her willingness to nurture and support the laboring women was amazing. With a nurse like that being a part of and working with the birthmother, it usually makes for a better outcome and shorter labor time. Unfortunately, more often than not, there is almost NO compassion for a first time mother.

Is this how our first experience of birthing a child should feel like? In Naomi Wolf’s book, Misconceptions (another must read), Naomi states that “…but when you listen to women talk about birth, their horror stories about the medical profession are about something deeper and more fundamental than too much intervention: the thread that unites many is a telling, subtle, but distinctive lack of compassion”. She goes on to say, “As I discovered later, this lack of compassion actually has a medical impact. Your doctor’s or midwife’s or medical institution’s level of compassion, and the amount of control you feel you have as a pregnant woman can directly affect the physical outcome of your birth and your recovery from it. Your caregivers’ emotional support and compassion can be as important as the right choice of instruments or medication in terms of a good outcome.” Please read that statement again.

Non-medicated Births

This lack of compassion is felt even more if you show up hoping to have a non-medicated birth. Most nurses don’t even hide the rolling of the eyes and volunteering their opinion about your “crazy” decision not to have an epidural!

I always forewarn my clients of this and to pay no attention to any negative reaction by the staff because it is more about them than it is about you. Here’s a little secret: the nurses love you epidural girls because it makes their job so much easier. They put in a catheter so you can pee, your numb from the waist down, and in no pain, so how much trouble can you be? Everybody is happy, right? Well, maybe not! What happens if your epidural is not working properly and all that pitocin is kicking your ass big time? And unfortunately, this happens more times than you would like to think.

Where is my doctor?

Oh, and one more misconception a lot of first time moms have (and this one I really get a kick out of): some of you believe that when you get to the hospital so does your OB, like he or she will be there to hold your hand, supporting you through this process. Well he will show up when you do….if you happen to be married to him! No sister, the docs show up just as you are starting to crown…that’s right they show up just in time for the final curtain call. Most times they cut you (remember you chose a surgeon to deliver your baby – this is what they went to school to learn to do), they maneuver the baby right out of you, sew you up, take a bow and leave as the hero, when you did all the work. God Love Them! Oh and just for babyshits and giggles, to say something nice about the nurses, two times I had a client that delivered so quickly the OB didn’t make it in time for the delivery, so the nurses had to do the delivery and both times I witnessed these nurses transform themselves into just the nurturing caregivers that that mom needed them to be and how you could see that they actually enjoyed doing the delivery and most importantly what I noticed was how their delivery seemed so much gentler, almost like a midwifery delivery, than most OB deliveries I witnessed.

Sometimes I would be shocked at the measures that some OBs (usually the males) would take in what looked like yanking the baby out. To those mothers I would always recommend that the baby have some Cranio-sacral treatments to release tension or restrictions the baby might have encountered during the delivery process. I also use Cranio-sacral therapy during labor support as I believe that is a tool I have to use to help the mom relax and dilate at a quicker rate. For more information on and the benefits of Cranio-sacral therapies, visit Upledger.com.

Getting the Epidural

Having a doula does not mean that you can’t opt for the epidural if you feel like this is what you need to do because everyone knows their own end point and if you get there and say, “Screw this! I need me some drugs…I have done all I can do I need to rest or something”, then I’m the first one to call the nurse. But there are things you need to know in advance….read on.

Certain hospitals make you sign up for the epidural and if you don’t sign up beforehand you’re not getting it. I always suggest to my preggos that they for sure sign up, even if you want to labor naturally without drugs. It is more than likely that the higher percentage of you will and do have the experience you’ve imagined, but again just for babyshits and giggles, just in case because you never know how you’re really going to feel that day, Sign Up! It’s just another tool in your labor and delivery tool belt. Think back to the beginning of this article where we talked about how you arrived for your delivery; maybe things aren’t going as you had planned and just can’t calm down and relax enough to do it naturally. By signing up, at least you have the option to get the epidural. But if you do want to go naturally, calming down and relaxing into this adventure is a big part of what a doula helps you and your partner to do.

In some cases, I’ve seen the epidural work wonders. You can always ask for a low dose epidural just enough to relax, then throw everyone out of the room, turn off the lights, sleep for two hours or so and wake up rejuvenated with a little more energy to push. This has always worked well for my clients that were really struggling with doing it drug-free.

Opting FOR the Doula

Because I love being a doula, and know firsthand how having that type of support (key word support) enhances the experience and how it pulls your partner into the process, I firmly believe you doula! I haven’t had one labor experience where the partner couldn’t thank me enough, almost as much as the mom! The partner and the doula play an equal part in nurturing the mom and helping her to get the baby born.

We are always better off in life no matter what the experience is when we know we are being supported. Here is the biggest thing you are ever going to do, push out a kid! Nothing has topped that one for me so far and I don’t believe anything will. To go into this new experience without trained support makes absolutely no sense to me. It’s all about preparing for the big event, taking care of yourself during the pregnancy, doing the exercising on the ball, doing the yoga, having the massages, learning how to relax, breathing techniques and of course hiring the doula.

If you were an Olympic athlete you would not just show up at the Olympics without your coach, would you? I think not! So, here you are going for the gold and you have no trained coach/supporter along for the ride. Girl you must be crazy! It’s up to you new preggos to start a new trend that is actually pretty old – women have been helping women deliver their babies for, oh I don’t know, since the beginning of time!!!!

I had never even heard of a doula twenty four years ago when I delivered, or prenatal massage for that matter. It was a lot different than with less testing and sonograms, and generally much less craziness surrounding pregnancy than there is today. I went in knowing nothing except that this kid has to come out so I didn’t do birthing classes, or the hospital tour. I didn’t want to know anything that would scare me. I just figured that I would more than likely know when to show up and I would be ready to see what happens when I got there. To this day I don’t know where my fearlessness came from! Maybe I channeled my inner doula but it sure seemed to work for me! I had two hours of what is known as hard labor and that was it and then Aja-Lee was born.

Actually my heartburn was more intense then my damn labor. And no epidural because I didn’t know I had to sign up for it!

My hope is that you will at least explore your options. Some hospitals even have doula services on staff and they are usually the most affordable. I recommend that you interview a few doulas before selecting one. You want to get a good feeling and have a connection with this person. You might not click with everyone and that’s ok. I once did a labor having never met the women before she called us from triage when she realized her baby’s daddy was going to be useless (and the poor thing was right!). We bonded immediately. I know my being there helped her to have a more positive experience. Having and asking for support in life is not a sign of weakness – it is a sign of strength.

Your birthing experience is a story that will stay with you for the rest of your life. I believe I read somewhere that you can be old and crazy from dementia, (probably from having kids – LOL) and yet still talk about your birthing experience. Ensure that your needs are met and create the personal and positive birthing experience you and your baby deserve.

Having a doula at your delivery not only lessens the chances of medical interventions and a possible c-section, but it enhances the whole experience for everyone, bringing a more positive energy into the process which has both physical and psychological benefits, there in the moment and long term as well.

So the question goes back to well, Doula or Don’t Ya?

Wishing you the best possible birthing experience,

MaryLou
a.k.a. Massage a Mom