Thursday, December 10, 2009
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What is a Doula?
The word Doula comes from Greek and means servant. For this reason some birth workers shy away from the term Doula. Personally I think it is an apt description of what I offer my clients. It is my pleasure to serve you.
People often ask me what it is that a Doula does. Here is a clear definition from Wikipedia:
"A birth doula is a labor support person who attends to the emotional and physical comfort needs of laboring women to smooth the labor process. They use massage, positioning suggestions, etc., to help labor to progress as well as possible. A birth doula joins a laboring woman either at her home, birth center, or hospital and remains with her until a few hours after the birth.
In addition to emotional, physical and informational support, doulas work as advocates of their client’s wishes and may assist in communicating with medical staff to obtain information for the client to make informed decisions regarding medical procedures.
They are skilled in offering families evidence-based information and support on breastfeeding, emotional and physical recovery from childbirth, infant soothing, mother-baby bonding, and coping skills for new parents.
The doula is an ally and occasional mentor for the father or partner. Their respective roles are similar, but the differences are crucial. The father or partner typically has little actual experience in dealing with the often-subtle forces of the labor process, and may receive enormous benefit from the presence of a doula, who is familiar with the process of birth. Even more important, many fathers experience the birth as an emotional journey of their own and find it hard to be objective in such a situation, and a doula facilitates the family process. Studies have shown that fathers usually participate more actively during labor with the presence of a doula than without one. A responsible doula supports and encourages the father in his support style rather than replaces him."
The word Doula comes from Greek and means servant. For this reason some birth workers shy away from the term Doula. Personally I think it is an apt description of what I offer my clients. It is my pleasure to serve you.
People often ask me what it is that a Doula does. Here is a clear definition from Wikipedia:
"A birth doula is a labor support person who attends to the emotional and physical comfort needs of laboring women to smooth the labor process. They use massage, positioning suggestions, etc., to help labor to progress as well as possible. A birth doula joins a laboring woman either at her home, birth center, or hospital and remains with her until a few hours after the birth.
In addition to emotional, physical and informational support, doulas work as advocates of their client’s wishes and may assist in communicating with medical staff to obtain information for the client to make informed decisions regarding medical procedures.
They are skilled in offering families evidence-based information and support on breastfeeding, emotional and physical recovery from childbirth, infant soothing, mother-baby bonding, and coping skills for new parents.
The doula is an ally and occasional mentor for the father or partner. Their respective roles are similar, but the differences are crucial. The father or partner typically has little actual experience in dealing with the often-subtle forces of the labor process, and may receive enormous benefit from the presence of a doula, who is familiar with the process of birth. Even more important, many fathers experience the birth as an emotional journey of their own and find it hard to be objective in such a situation, and a doula facilitates the family process. Studies have shown that fathers usually participate more actively during labor with the presence of a doula than without one. A responsible doula supports and encourages the father in his support style rather than replaces him."
TESTIMONIALS:
Tracie,
Thank you so much for being my doula for the second time. You are amazing! I can’t even begin to explain how much more calm confident and relaxed I was during Savannah’s birth knowing that you were there for me and would make sure everything was okay! You came to my house at the perfect time and knew just what to do to alleviate my discomfort and keep me calm when things went differently than last time. Truly, I couldn’t have done it without you! I appreciate all the advice you gave me throughout my pregnancy whenever I had any questions or concerns. Thank you for taking pictures at the birth too. You took such wonderful pictures, now I have a beautiful record of the birth! Thank you for everything.
Lots of Love,
Monique Decker
*************************************************
Having Tracie as our doula was the best decision we could have made. Being a first time mom, I had a lot of questions and I felt no hesitation to call her anytime. She always had a fast understandable answer. When my water broke the first person I called was Tracie. She came over immediately and stayed with us through a very long (39 hours) labor. She massaged and comforted, and encouraged us when exhaustion set in and always reminded us of our ultimate goal of having a safe and natural birth. The pictures she took are a continual reminder of that amazing time when we finally held our little angel. After the birth she helped out doing chores and keeping the house nice and cooking us a delicious healthy dinner. She was truly a blessing to our family during the most incredible moments of our lives.
Shannan Randall
******************************************************
Tracie has been my dear friend for the past 18 years. For as long as I have known her she has been fascinated with childbirth. When I was expecting my first child in 1994, I naturally turned to her for help and advice. Looking back now I see just how instrumental she was in my successful birth experience. She helped me to prepare and better understand the birth process and she searched for answers to my questions and concerns. When my labor began, she provided physical relief through massage and counter pressure for my back pain. But I believe the greatest support was the calming influence of her constant presence. Her confidence and encouragement enabled me to stay focused and feel safe. I’ll be forever grateful that she was there for me then and also later during the births of my next two children.
Johnell Jacobson
Tracie,
Thank you so much for being my doula for the second time. You are amazing! I can’t even begin to explain how much more calm confident and relaxed I was during Savannah’s birth knowing that you were there for me and would make sure everything was okay! You came to my house at the perfect time and knew just what to do to alleviate my discomfort and keep me calm when things went differently than last time. Truly, I couldn’t have done it without you! I appreciate all the advice you gave me throughout my pregnancy whenever I had any questions or concerns. Thank you for taking pictures at the birth too. You took such wonderful pictures, now I have a beautiful record of the birth! Thank you for everything.
Lots of Love,
Monique Decker
*************************************************
Having Tracie as our doula was the best decision we could have made. Being a first time mom, I had a lot of questions and I felt no hesitation to call her anytime. She always had a fast understandable answer. When my water broke the first person I called was Tracie. She came over immediately and stayed with us through a very long (39 hours) labor. She massaged and comforted, and encouraged us when exhaustion set in and always reminded us of our ultimate goal of having a safe and natural birth. The pictures she took are a continual reminder of that amazing time when we finally held our little angel. After the birth she helped out doing chores and keeping the house nice and cooking us a delicious healthy dinner. She was truly a blessing to our family during the most incredible moments of our lives.
Shannan Randall
******************************************************
Tracie has been my dear friend for the past 18 years. For as long as I have known her she has been fascinated with childbirth. When I was expecting my first child in 1994, I naturally turned to her for help and advice. Looking back now I see just how instrumental she was in my successful birth experience. She helped me to prepare and better understand the birth process and she searched for answers to my questions and concerns. When my labor began, she provided physical relief through massage and counter pressure for my back pain. But I believe the greatest support was the calming influence of her constant presence. Her confidence and encouragement enabled me to stay focused and feel safe. I’ll be forever grateful that she was there for me then and also later during the births of my next two children.
Johnell Jacobson
My role as your Doula
*Typically I meet with you as many times as necessary prior to the birth to discuss philosophies and develop a birth plan. This also gives us a chance to build the foundation for a friendly and relaxed relationship which will contribute to your comfort level at the birth.
*You can consider me your childbirth educator. I have materials, handouts and books for this purpose and we will discuss any questions/concerns during our meetings so that you are able to make informed choices at your labor and birth.
*Before your birth, you should feel free to call me any time with questions and concerns you may have; no matter how trivial they may seem; so that I can provide the support and education that I hope to. This casual communication is integral to building the trusting relationship that is necessary for me to be a good Doula for you. Please never hesitate on this point. I am always happy to talk to you or I would not have agreed to be your Doula.
*When you go into labor you can expect me to be available from the first contraction until several hours postpartum. I can help you determine pre-labor from true labor and early labor from active labor alleviating concerns about going to the hospital too early or too late.
*During labor I will provide continuous physical and emotional support to both you and your spouse. I am not there to replace the dad but to provide additional support. The support I provide includes encouraging you to eat and drink in early labor, suggesting helpful positions and comfort measures, explaining medical procedures and interventions and helping you understand what options you have. I am also there to advocate your birth plan and wishes with the hospital staff.
*Postpartum I will stay as long as you wish and until you are feeling settled and comfortable. I am familiar with breastfeeding and normal newborn physiology and behavior and have many resources that I can share should you experience any problems which are beyond my scope of education and experience.
*You can expect a follow up appt. at 2-3 days postpartum to review your labor and birth and so that I can answer any questions you may have. And of course you should feel free to call me with any questions or concerns you have in the interim.
*Typically I meet with you as many times as necessary prior to the birth to discuss philosophies and develop a birth plan. This also gives us a chance to build the foundation for a friendly and relaxed relationship which will contribute to your comfort level at the birth.
*You can consider me your childbirth educator. I have materials, handouts and books for this purpose and we will discuss any questions/concerns during our meetings so that you are able to make informed choices at your labor and birth.
*Before your birth, you should feel free to call me any time with questions and concerns you may have; no matter how trivial they may seem; so that I can provide the support and education that I hope to. This casual communication is integral to building the trusting relationship that is necessary for me to be a good Doula for you. Please never hesitate on this point. I am always happy to talk to you or I would not have agreed to be your Doula.
*When you go into labor you can expect me to be available from the first contraction until several hours postpartum. I can help you determine pre-labor from true labor and early labor from active labor alleviating concerns about going to the hospital too early or too late.
*During labor I will provide continuous physical and emotional support to both you and your spouse. I am not there to replace the dad but to provide additional support. The support I provide includes encouraging you to eat and drink in early labor, suggesting helpful positions and comfort measures, explaining medical procedures and interventions and helping you understand what options you have. I am also there to advocate your birth plan and wishes with the hospital staff.
*Postpartum I will stay as long as you wish and until you are feeling settled and comfortable. I am familiar with breastfeeding and normal newborn physiology and behavior and have many resources that I can share should you experience any problems which are beyond my scope of education and experience.
*You can expect a follow up appt. at 2-3 days postpartum to review your labor and birth and so that I can answer any questions you may have. And of course you should feel free to call me with any questions or concerns you have in the interim.
Continuous emotional support during labor in a US hospital. A randomized controlled trial.
J. Kennell, M. Klaus, S. McGrath, S. Robertson and C. HinkleyDepartment of Pediatrics, Case Western Reserve University, Cleveland, OH. JAMA, May 1991; 265: 2197 – 2201.
The continuous presence of a supportive companion (doula) during labor and delivery in two studies in Guatemala shortened labor and reduced the need for cesarean section and other interventions. In a US hospital with modern obstetric practices, 412 healthy nulliparous women in labor were randomly assigned to a supported group (n = 212) that received the continuous support of a doula or an observed group (n = 200) that was monitored by an inconspicuous observer. Two hundred four women were assigned to a control group after delivery. Continuous labor support significantly reduced the rate of cesarean section deliveries (supported group, 8%; observed group, 13%; and control group, 18%) and forceps deliveries. Epidural anesthesia for spontaneous vaginal deliveries varied across the three groups (supported group, 7.8%; observed group, 22.6%; and control group, 55.3%). Oxytocin use, duration of labor, prolonged infant hospitalization, and maternal fever followed a similar pattern. The beneficial effects of labor support underscore the need for a review of current obstetric practices.
J. Kennell, M. Klaus, S. McGrath, S. Robertson and C. HinkleyDepartment of Pediatrics, Case Western Reserve University, Cleveland, OH. JAMA, May 1991; 265: 2197 – 2201.
The continuous presence of a supportive companion (doula) during labor and delivery in two studies in Guatemala shortened labor and reduced the need for cesarean section and other interventions. In a US hospital with modern obstetric practices, 412 healthy nulliparous women in labor were randomly assigned to a supported group (n = 212) that received the continuous support of a doula or an observed group (n = 200) that was monitored by an inconspicuous observer. Two hundred four women were assigned to a control group after delivery. Continuous labor support significantly reduced the rate of cesarean section deliveries (supported group, 8%; observed group, 13%; and control group, 18%) and forceps deliveries. Epidural anesthesia for spontaneous vaginal deliveries varied across the three groups (supported group, 7.8%; observed group, 22.6%; and control group, 55.3%). Oxytocin use, duration of labor, prolonged infant hospitalization, and maternal fever followed a similar pattern. The beneficial effects of labor support underscore the need for a review of current obstetric practices.
Myths about Dads and Doulas by Penny Simkin
Myth 1- If a woman has her partner, the doula becomes redundant.
Reality-The doula may be the only person at the labor besides the partner who is there solely for the emotional well being of the woman. The nurse, the doctor, the midwife have other priorities that compete with the emotional care of the woman: for example, breaks, shift changes, clinical responsibilities, office hours and hospital policies. The doula has few or no other priorities. She stays through shift changes, and until after the baby is born. She is not just another stranger with the couple. She has the woman's needs as her sole priority. In some cases, the couple will bring several other friends of family members into labor with them. Sometimes these people can be uncertain of how to help which leads to confusion and actually adds to the woman's stress. The doula can direct and coordinate the efforts of a group of people, giving them all something useful to do, so they work as a team on the woman's behalf.
Myth 2- The doula "takes over", displacing the partner and interferes with their intimate experience.
Reality- The doula can actually bring the couple closer. By making sure that the partner's needs are met (food, drink, occasional back rubs, and reassurance), the woman and partner can work more closely together. The doula allows for the partner to participate at his own comfort level. Some partners prefer to be there only to witness the birth of their child and to share this experience with the woman they love. They may not want to play an active role and do not want to be responsible for the woman's comfort and emotional security. The doula can fill in and allow the partner to particpate as he wishes, without leaving the woman's needs unmet. When the partner chooses to be the major source of emotional support, the doula can supplement his efforts by running errands, making suggestions for comfort measures and offering words of reassurance and comfort. During a long tiring labor, she can give the patner a break for a brief rest or change of scene. While the doula probably knows more than the partner about birth, hospitals, and maternity care, the partner knows more about the woman's personality, likes and dislikes and needs. Moreover, he loves the woman more than anyone else there. The combined contributions of partner and doula, along with a competent, considerate and caring staff gives the woman the best chance of an optimal outcome.
Myth 3- The doula has her own beliefs about how the birth should go, and imposes it on the woman or couple.
Reality- The doula's true agenda is to help ensure that the woman's or couple's agenda is acknowledged and followed as much as possible. If the doula is thoroughly familiar with the couple's wishes and their birth plan, she may actually think more about it than the couple, especially when labor is intense and things are happening rapidly. The doula can remind the staff or the couple of some items on the birth plan that are forgotten, but which later might be important. Sometimes if a birth plan is not followed, the couple later look back with regret or disappointment. The doula helps with decision-making by asking questions that will ensure that the right information is given to the woman or couple so that they can make an informed decision. She may also suggest alternatives for the couple to consider. She does not, however, make decisions for the couple.
In summary, the doula helps make the birth experience to be as rewarding and satisfying as possible. As one father said, "I heaved a big sigh of relief when she (the doula) walked in. I hadn't realized how much pressure I had been feeling. She not only calmed my wife, she calmed me down."
Myth 1- If a woman has her partner, the doula becomes redundant.
Reality-The doula may be the only person at the labor besides the partner who is there solely for the emotional well being of the woman. The nurse, the doctor, the midwife have other priorities that compete with the emotional care of the woman: for example, breaks, shift changes, clinical responsibilities, office hours and hospital policies. The doula has few or no other priorities. She stays through shift changes, and until after the baby is born. She is not just another stranger with the couple. She has the woman's needs as her sole priority. In some cases, the couple will bring several other friends of family members into labor with them. Sometimes these people can be uncertain of how to help which leads to confusion and actually adds to the woman's stress. The doula can direct and coordinate the efforts of a group of people, giving them all something useful to do, so they work as a team on the woman's behalf.
Myth 2- The doula "takes over", displacing the partner and interferes with their intimate experience.
Reality- The doula can actually bring the couple closer. By making sure that the partner's needs are met (food, drink, occasional back rubs, and reassurance), the woman and partner can work more closely together. The doula allows for the partner to participate at his own comfort level. Some partners prefer to be there only to witness the birth of their child and to share this experience with the woman they love. They may not want to play an active role and do not want to be responsible for the woman's comfort and emotional security. The doula can fill in and allow the partner to particpate as he wishes, without leaving the woman's needs unmet. When the partner chooses to be the major source of emotional support, the doula can supplement his efforts by running errands, making suggestions for comfort measures and offering words of reassurance and comfort. During a long tiring labor, she can give the patner a break for a brief rest or change of scene. While the doula probably knows more than the partner about birth, hospitals, and maternity care, the partner knows more about the woman's personality, likes and dislikes and needs. Moreover, he loves the woman more than anyone else there. The combined contributions of partner and doula, along with a competent, considerate and caring staff gives the woman the best chance of an optimal outcome.
Myth 3- The doula has her own beliefs about how the birth should go, and imposes it on the woman or couple.
Reality- The doula's true agenda is to help ensure that the woman's or couple's agenda is acknowledged and followed as much as possible. If the doula is thoroughly familiar with the couple's wishes and their birth plan, she may actually think more about it than the couple, especially when labor is intense and things are happening rapidly. The doula can remind the staff or the couple of some items on the birth plan that are forgotten, but which later might be important. Sometimes if a birth plan is not followed, the couple later look back with regret or disappointment. The doula helps with decision-making by asking questions that will ensure that the right information is given to the woman or couple so that they can make an informed decision. She may also suggest alternatives for the couple to consider. She does not, however, make decisions for the couple.
In summary, the doula helps make the birth experience to be as rewarding and satisfying as possible. As one father said, "I heaved a big sigh of relief when she (the doula) walked in. I hadn't realized how much pressure I had been feeling. She not only calmed my wife, she calmed me down."
