Wednesday, July 27, 2011

Why use a doula?

The following video has been circulating around some of the natural birthing online communities I like to visit, so I would like to share my two cents about it. As I was watching, while trying not to get upset, I thought, "A doula could have helped (fill in the blank)."

Without knowing what kind of birth this mom had, how long it was, who was there, her relationship with her doctor, whether this was her first baby, or even if she had a doula, I thought of a few ways a doula could have helped her in just this three minute clip.

I am assuming that this was your average, run-of-the-mill hospital birth in which the mother pushes her baby out, the doctor shows up to catch, shows the mom the baby and they pass the baby quickly off to the pediatric nurse for cleaning, weighing and other newborn procedures. Granted, they generally do not take very long, but to a mama that just gave birth to that precious little baby, those few minutes feel like eternity.

Assuming that mom and baby had no skin to skin contact, which is common for many hospital births, a doula could have asked mom in between pushes, "Would you like your baby placed directly on you when s/he comes out?" In this way, everyone, I mean EVERYONE, hears her answer. When a baby is nearly born, everyone is in the room already, and it gets crowded and exciting for the family. Even the staff hustles and bustles when FINALLY the baby is making an appearance in the world. During this time, mom is working hard, and most likely is not thinking about anything other than, "I need to get this baby out!" It is good to have a reminder, "Oh yeah! I wanted my baby on me immediately." Dad is generally preoccupied as well, so a doula, with her quiet assurance, can remind mom. Also, in this way, it is MOM making the decision to have the baby placed on her immediately after birth.

As the baby is sliding out, a doula can help remind and ask again, "You wanted your baby on your belly right after birth, right?" And she can lift up the mom's gown to help make room for baby directly on her skin. I borrowed this idea from a more experienced doula recently, and the baby was placed right on that space that I had made for it.

As you watch, that poor little baby is just crying and crying. If the baby is breathing fine right after the birth, is all that crying necessary? Why not ask to have the newborn procedures done directly on your belly? It is possible. A doula can help you even before the labor and delivery happens by reminding you to think about those postpartum plans to include in your birth plan. She can ask you while you are marveling at your baby, "Did you still want to have the newborn procedures done on your belly?" Also, you can consider having the procedures delayed. A doula can remind you about your wishes in this area.

I attended a birth recently that the baby came out, mom caught, and immediately started nursing. The baby was healthy and pink and didn't even cry. He fell right asleep! It's almost as if he didn't know he was born. The room was quiet, warm, reverent and peaceful. There was no extraneous chatter happening.  That was very different than the birth I attended earlier that same day. While the mom was pushing, the OB was sitting on a stool watching as a nurse coached her through pushing and massaged her perineum. The pediatric nurse walked in and started talking to the OB about her workouts and diet the previous week. Hello! What about the mom over there pushing! I couldn't help it, but I know I gave them an incredulous and dirty look. I just couldn't believe they were doing that! A new life was entering this world and they wanted to talk about how that nurse was able to lay off cheeseburgers for a week. Unbelievable. However, it happens more often than it should. The fact that it happened at all, even one time in this entire world, is more often than it should happen.

Much of what a doula can do for you happens during your prenatal visits. She can help you to think about those postpartum procedures, learn whether or not they really are required, encourage you to do your own research so you can make informed decisions, and empower you to find your voice. Many patients, not just in the birth world, are very intimidated by doctors and hospital staff. You do not have to be! A doula can help you find your voice with her quiet assurance and calming presence, guiding you as you have a memorable and empowering pregnancy, birth and postpartum experience.