Doulas are for Dad's, Too!

Yesterday we had a really good time celebrating Father's Day with Greg's family.  The weather was ideal, the kids were happy, and we just hung out at my in-laws doing nothing and being together.  (A day of doing nothing is bliss for this mama!)  It was also a good to to reflect on fatherhood; how my dad's love for me shaped me into the woman I am today and how my husband is such an awesome dad to our kids.  I also had fun reflecting on the proud new papas I have served as a doula!

It's always amusing to me that, at interviews, the dad is usually pretty apprehensive about hiring a doula, but after the birth he is almost more grateful than the mom!  I think that labor support, especially for first-time dads, is really hard.  They've typically never seen a birth before, so to see their wife or partner going through such an intense ordeal can be very taxing emotionally.  He often has a hard time knowing how to support her, especially if she starts asking for drugs when he knows that she really wants a natural birth!  I can't imagine what it must be like seeing the person you love most in the world experiencing the crazy ride that is childbirth.

This is why I love my job so much.  As a woman having gone through childbirth twice before, and as a trained birth professional, it is so rewarding for me to deduce what a laboring mom needs at a certain point, and gently instruct her loving partner to know how to best support her.

I remember at one of my very first births (this couple happened to be some of our best friends), they were working so well together, swaying and relaxing through some of her most intense contractions.  And I just stood in the corner, giving the dad an occasional calm smile letting him know that everything was going perfectly.  When she went into the bathroom by herself, I just gave him a little pep-talk on what to expect over the next hour or two (she was entering transition, so I told him she would probably get emotional and start having some self-doubt).  Within minutes after her coming out of the bathroom, she started crying and saying she couldn't do it anymore, and it was so beautiful to watch her husband calmly tell her that she could, and that she was doing great, and how they fell into their perfect rhythm together again.

And last week I was at a birth with a super sweet couple.  Young, newly-married, first-time parents, they hired me at the last minute because someone in their birthing class told them that they HAD to have a doula (yeah!).  The dad had been very quiet and reserved throughout our prenatal meetings, and continued to be so during the birth.  During her labor, I just did my thing, helping his wife, giving her words of encouragement and prompting him to do the same, telling them both what to expect through each stage of labor, and really just guiding them through the process.  Toward the end when things were getting quite intense, she really needed some eye-contact to keep her grounded.  So I did that for awhile and breathed with her.  Then she went to the bathroom, came back and was lying on her other side facing her husband, so I said, "During this next contraction, I want you to really focus on her eyes, and breathe with her in rhythm."  It think it was really hard for him--he was crying quietly from seeing his wife in such a state, and I could tell he wanted to withdraw from the situation because it was just so emotionally overwhelming.  But I gave him a tissue and prompted him to stay close to her.  And they both got into this amazing zone together, connecting in a deep and meaningful way.  What a privilege it was to have facilitated such a beautiful moment!  Afterwards, at their follow-up visit, she told me that her husband had been telling a pregnant relative of theirs how much of a help I was, and that they should hire a doula, too. :)

So as much as I am passionate about women and our amazing bodies and all things birth/mothering related, I think dads are pretty cool, too.  I love creating a space where a couple can really connect without worrying about outside distractions, assuring them of the normalcy of birth as they work together to bring their baby into the world.  Whether it's getting dad a coffee and a sandwich, or showing him how to put pressure on his wife's back in just the right way, my goal is to help him to be as integrated and as involved in the birth process as possible.


The Doula: A Hindrance to Family Bonding?

 

“Not only was it nice having someone familiar with the processes…in the thick of labor, I knew my wife felt so supported by Kim. It made all the difference, and I'm going to insist Kim be there for our next child.” ~Seth, on having a doula at his son's birth
I had a couple recently who expressed interest in having a doula, but were concerned that having another person there might take away from the intimacy of the experience. She said that they had been together for a long time, and had a very close relationship, and that was the one thing that made them a little bit hesitant about the whole doula thing.

I really do think that theirs is a totally valid and legitimate concern. Giving birth to your baby is one of the most memorable things you will ever do, and it's something that you will remember for the rest of your life! Having a doula there, or anyone else besides your partner, is truly a big decision that requires a lot of thought.

While in the end, it is totally up to you to decide, I thought I’d blog a little about my thoughts on the topic.

If you are giving birth in a hospital, there will likely be many professionals buzzing about you. Some you choose, like your doctor (who is usually only with you for a fraction of the time you are in labor), and others you don’t, like your nurses. A doula is a professional, just like a nurse or doctor, who will be there for your birth. The differences are that you choose who your doula will be, and that her sole purpose is to make sure you are okay. She doesn’t work for the hospital—she works for you.

As a doula, I encourage laboring moms to stay at home in early labor, where they can relax in a familiar environment and work with their partner to get into the rhythm of labor together. I ask that each mom calls me when she thinks she is in labor, so I can start making arrangements for my family and be there when she needs me, but I will not come until the mom feels like labor is getting more intense and could use some extra support and encouragement. So if the mom is having a “textbook” labor, there will be plenty of time at home with just her and her partner.

When I do join the couple, at home or at the hospital, if they seem to be coping well and getting through the contractions just fine, I will gladly step back and let the dad continue supporting the laboring mom as he has been doing. I feel very strongly about not intruding on the bond that exists between the couple, and I strive to maintain a calm, peaceful, and reassuring presence throughout the labor and birth. Part of this is remaining calm and peaceful myself, and a big part of it is encouraging others in the room to respect the bond between the couple, and the intensity of the mother’s experience. I do this by speaking in a soft voice and encouraging the nurses to do the same, and asking the nurses to wait until the mom is not contracting to ask her questions or perform procedures when possible. This actually frees up the dad to give more of his attention to his lover, because he doesn’t have to worry about creating and sustaining that calm atmosphere, especially at a hospital birth.

If you are hoping for a natural, drug-free birth* in a hospital, I believe the role of a doula is vital. Sadly, most medical staff at the hospital are not very familiar with unmedicated birth, and don’t realize the importance of uninterrupted quiet and peacefulness so that the mother can maintain her focus to get through the contractions. When I was in active labor, I remember several times nurses bursting into the room, talking casually and loudly with one another and to me. It was a struggle to remain focused, to say the least. As I said earlier, Greg did a great job interacting with them—encouraging them to lower their voices and not to talk to me during contractions, but that did take his time and focus off of me. As a doula, one of my goals is to free up the dad to be available for the mom as much as possible.

Obviously, when labor is getting very intense and comfort measures or relaxation are not working as well as they did earlier, I will be available to offer new suggestions. I have been well-trained on a number of different positions and coping techniques. I can apply pressure in certain areas of the back that would feel especially good if she is having back labor, and I can show the dad how to do these techniques as well. It can actually be very exhausting to give constant pressure or massage if the mom needs it, so I can take turns with the dad, or we can work together to provide double the pressure.

There are countless benefits of having a doula, and I understand that a potential drawback could be having a "third wheel" along for the ride. I definitely respect couples who would prefer to work through the process of labor and birth alone. At the same time, though, I feel that I offer a level of service that would not detract from the most memorable day of their lives, but would enhance it.

 

 

The Doula: Who She is and How She Helps

"Doula" is Greek for "woman's servant." The term today has been adopted and changed a bit to mean someone who helps women in labor. She provides emotional support (caring words, encouragement), physical support (massage, gentle touch), and mental support (education) before and throughout labor and birth. She is well-educated about birth, natural pain-relief and comfort techniques, and how to make the laboring woman feel strong and in control of her body. Her calming presence during labor allows the parents to relax, knowing they have a caring friend who will not leave their side, and someone who will advocate for them throughout this new and often-times overwhelming event. She does not perform any medical tasks; her sole purpose is to be there for mom (and dad), and to make their birth experience as smooth and worry-free as possible.

When I was pregnant, I had a general idea about what a doula was, but I didn't feel like I needed one. None of our friends had had one, and I felt like Greg and I could do it on our own. Which we did, and it was amazing (see my birth story). BUT, looking back, I realize it could have been a lot better if we would have had that extra support-person. Greg was really busy while I was in labor, packing our bags, calling people to let them know this was the day, and dealing with hospital staff/procedures. Not to mention he was super nervous and--dare I say it--a little bit scared. I feel like it would have been a lot less hectic had a doula been there working with Greg to make sure everything got done and that I was being taken care of continuously (I spent a lot of time laboring by myself). Also, since we were only at the hospital for a few hours before Lucy's birth, we had the same nurse with us the whole time. Most of my friends, though, have spent many, many hours at the hospital and have had several different nurses who left them alone in the room so she could take care of other patients. One benefit of the doula is that she is always there, by mom's side.

There are also many very real, tangible, and actually quite astounding statistical benefits to having a doula. Studies have shown that doula supported women have:

Overall, a 25% decrease in the length of labor
50 % decrease in cesarean births
60 % decrease in epidurals
40 % decrease in the use of pitocin
30% decrease in the use of narcotics
30% decrease in the use of forceps*

Can you believe it?! I think that is just plain amazing.

Long-term, mothers with doulas breastfeed longer and with fewer problems, are less likely to suffer from post-partum depression, and in general have better feelings about themselves, their birth experience, and their new family. AND, their babies are more likely to have a greater appetite and fewer health problems at six weeks than their non-doula counterparts.**


*Mothering the Mother, How a Doula Can Help You Have a Shorter, Easier and Healthier Birth by Marshall H. Klaus, John H. Kennell, Phyllis H. Klaus
**The Doula Book by Marshall H. Klaus, John H. Kennell, Phyllis H. Klaus

What's a Doula?

(This is Chrissy, smiling and 5cm dilated, as we arrive at the hospital.)

Back in ancient times, a royal woman had many servants who all attended to her in different ways. But there was one servant who knew her inside and out, talked her through her problems, comforted her when she was distressed, and was there whenever she needed her. This special servant was called her "doula."

The specific translation for the word "doula" is "woman's servant." It has been adopted today to mean "a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth" (from DONA's website). Let me just touch on those three points...

Physical.

Ever wonder why they call it "labor?" Because it's just that: physical labor. It is tough work! The closest thing I could compare it to would be running a really long race, only ten times harder. As a doula, I stay with the laboring mom from the time I arrive (either at home or hospital), until her baby is born and they have successfully breastfed. Throughout that time I encourage relaxation with my voice, soft touch, or massage. I suggest positions that are helpful, encouraging the baby to descend or to relieve back pain. I can also instruct the dad in different techniques, so he can play an active role in supporting his partner. And I'm there for support if mom needs someone to lean on or just a hand to hold.

Emotional.

Pregnancy and birth can be a very emotional time, especially for first-time mothers. Having been there myself, I can relate very closely with what each new mom is going through. I offer continuous emotional support throughout the pregnancy, and especially during the birth.

Informational.

There is so much to know about pregnancy and birth! There is way more information out there than can be soaked up in the short nine months of pregnancy. I have had extensive training and education about the birth process, and am equipped to answer your questions. I can make book recommendations based on your specific situation and desire for your birth. I also have a network of childbirth professionals to refer you to if need be. The more informed you are going into labor, the less fear you will have, and the better your experience will be!

If you're still not convinced about the helpfulness of a doula, check out these statistics:

Studies have shown that women supported by a doula during labor have:

~50% reduction in the cesarean rate

~25% shorter labor

~60% reduction in epidural requests

~40% reduction in pitocin use

~30% reduction in analgesia use

~40% reduction in forceps delivery

Long-term benefits:

~improved breastfeeding

~greater interaction between mothers and babies

~decreased postpartum depression

(Statistics from Mothering the Mother by Klaus, Kennel, and Klaus)