Wednesday, September 21, 2011

What do you do during labor?

Short Answer: Whatever you need me to do!

Long Answer: You may be wondering, "Is it really worth it? Do I really need a doula? I know what a doula is, but what does a doula do? What do you do? Can you really help me? After all, you're new at this."

Ultimately, only you can answer those questions, and sometimes it isn't until after the fact that you find out whether or not you really need a doula. Hopefully it's a good response of, "Man! I am so glad I had a doula!" And yes, I really can help you- even though I am new. I am learning all the time, and I learn and improve at each and every birth I attend. Yes, experience is very helpful in a doula, but it really is about having a person there with whom you feel a connection. You want your doula to be someone that you feel comfortable sharing this experience with and someone you feel good about. Of course, it never hurts that most newer doulas charge a significantly lower fee than more experienced doulas.

So, back to the question, "What do you do?" Most of our preparation for labor occurs at our prenatal visits. At the second prenatal visit, I show clients everything that I have in my doula bag that we could possibly use during labor. We also practice labor positions, and in the course of our journey together prenatally, I try to get a general sense of the family's ideal birth. One of the homework assignments (yes, I give out homework) I give to Mom is to have her ponder how she would like her birth to go, i.e. what location, what positions, what time of day, who would she like present, what tools would she like to use, etc. Usually when I ask, "How would you like your birth to go?" I get the response, "FAST!" Well, there is more to it than that! Although one of the perks of having a doula present is a shorter labor, I can't guarantee that your labor will go as fast as you would like. Also, just because a labor is FAST doesn't mean it is easier. But that is another story for another day.

I like to have mom get an image in her head. Of course we don't have control over every aspect of how our labors will go, but I still like to have her imagine her dream birth as if she could hand pick the experience. For example, a mom may ideally want to give birth in the ocean at night, but she may have a hospital birth in the middle of the day. However, having that image in her head can give her a scene to focus on while she is in labor. Even though I may not be able to bring the ocean to her, we can make sure that she has access to water. If she really likes the dark, we can make sure to turn the lights out. If she wants a cozy, quiet, intimate environment, we can accommodate her wishes. My goal is to try to help mom get as close to her ideal birth as possible, and we discuss ways we can make it work in the setting in which she wishes to give birth, whether it is home, birth center or hospital.

I tell my moms that, so far, typically, the only tools I have used are my hands, my voice and a cool washcloth. I have many more items in my bag than that, but the births I have attended have gone by so quickly, I never had a chance to use most of my tools.

One mom enjoyed sitting on the birth ball and talking with her family during early labor. At that time, I participated in their light-hearted conversations as much as they seemed to want me to. When labor started to pick up and take her attention, most of the family left the room and/or slept (I don't know how they did) through her contractions. It was just me and mom. We vocalized together, I rubbed her back where she was feeling pain, I held her tightly when she wanted that and when she called out for her family members that were in the room, I woke them up for her.

Another mom had a beautiful home birth and I tried to do all the "little things" that needed to be done so that her husband could be her main source of support like they both wanted. At one point, every time she would begin a contraction, the husband would run off to try to do something. As her contraction would begin I would say, "Here comes another one." After a few contractions, he realized that he needed to stay where he was when I said that. After that, he never left her side and I fetched all the things that he needed to comfort her.

Another mom liked using the rebozo around her belly during contractions while we labored at home. She liked the feeling of having that secure pressure around her belly. After awhile she used the birth ball while I provided counter pressure to her back. At some point she really wanted some mood music. Immediately upon her request, I opened my Pandora app and provided some mood music. Yes, I even have a folder on my iPhone called "Doula Bag" with various apps to help comfort mom. For awhile it was just me and mom as dad bustled around trying to get everything ready for the trip to the hospital. Once we arrived at the hospital, she used the birth tub and I would provide sips of water as needed and vocalize with her. Dad sometimes needed to walk away during the birth, so I was there to provide him relief.

Last example, I had a mom who merely wanted my presence. I provided her with a cool cloth and waved it over her face with some essential oils dabbed on the cloth to provide a little aromatherapy. She was the first mom who wanted me to do that and I was excited to try it. Her birth was a classic example of a doula's presence being a calming influence to the birth environment. Once I arrived, both she and her husband relaxed into the task of giving birth to their baby. It was wonderful.

As you can see, all the moms wanted and needed something a little different to help them throughout their labors. However, each mom had something in common, and that is, they all had me as their doula and I never left them. They were never left alone. Even if I had to step out for a minute, it was only when their husbands, partners or other family members were present. A couple of the moms would have been completely alone for a good portion of their labors had I not been present, and for the others, I helped relieve the dads so they could focus more on their partners. For these moms, they were happy with their decision to have a doula present.

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