I'll admit it, "Doula" is sort of a buzz word in birth now. Almost as common as "When's your due date?" is "Do you have a doula?" For some a doula seems like a bit of extravagance, an expensive accessory for the rich. And for others a doula is something that only hippie-dippy folks have.
Both can be true, and more.
Ill give you an example. I have a friend, let's call her Chana. She's a Type-A, badass lawyer. She's no nonsense and gives the best side eye of anyone on the planet. Period. When I told her that I wanted to move to the country to raise chickens I never thought I'd see her eyes again, she rolled them so hard. So when she got pregnant and asked for my help finding a doula I was shocked. And when I got an email from her of her requests I understood she was one of those people who wanted the support, but none of the other "hippie" things. She had no problem with pain meds, she wasn't going to try to do something natural if she couldn't handle it and wanted a doula who understood that. She just had her second baby with her second no-nonsense doula.
While having a doula may seem like a new thing, it's actually quite old, as old as it's Greek name, perhaps older. When people gave birth they would be traditionally and historically be joined by family. Grandmothers, sisters, aunts, cousins and close friends would join the birthing person, in many cases the birthing woman to give her the support she needed to bring her baby earthside based only on experience and instincts. As birth moved away from the home and into the hospital this tradition was lost, when we need it the most. And with hospital schedules that work on rotations and shifts giving birth can be a sea of unfamiliar faces. A doula is sometimes the only constant.
I've heard snide comments that doulas don't really stay for the entire birth, especially for long labors and I can say, in my personal experience as a doula, that I've never left a mother's side. The one exception was when my sister passed away during a birth. I've spent multiple evenings in hospitals, and my longest was just over 50 hours.
Check out this informational page over on Evidence Based Birth for more ways that Doulas can help in a birth.
Back in March the American Journal of Obstetrics and Gynecology released q study that confirmed what a lot of midwives and doulas (and yes many OBGYNs) have been saying for a while. Pregnant people need more time to push. In fact, the study proved that if women and pregnant people were given as little as one extra hour to push their rates of unplanned C-Section went down by roughly half. HALF!
According to the Huffington Post article about the study, while this information has he potential to radically change how people give birth in the U.S, it may not actually amount to concrete change. Author Catherine Pearson writes, while the study is small, it's "unlikely to fundamentally change medical norms any time soon, researchers say it offers a much-needed critique of potentially outdated standards."
Just how outdated are the standards you may ask, well the allotted time a woman is "allowed" to push was adopted in the late 1800s. “[The time recommendation] came from expert opinion from the 1800s,” said Dr. Alexis Gimovsky, a fellow in maternal fetal medicine at Thomas Jefferson University in Pennsylvania, and an author on the study. “Since then, there’s really only been retrospective data used to validate that guideline.” In the 1950s, researchers looked over earlier data and found that women who delivered their babies within two hours had lower rates of infection and serious postpartum bleeding, for example. In 1955, another team concluded that most women without anesthesia give birth within two hours."
So what does this all mean? In my opinion it goes back to the idea of B.R.A.I.N, being armed with knowledge, and being confident that your body knows how to give birth.
As a review B.R.A.I.N is an acronym I suggest pregnant folks and couples start to using during prenatal appointments with your caregiver.Using it early on in pregnancy and frequently helps you get accustomed to the process of coming to your care provider with questions and being ready with responses that are best for you and your baby. Frequently using B.R.A.I.N also is great so that when something is suggested during labor, you're ready to ask:
B: Benefits - What are the benefits of doing this?
R: Risk -What are the risks of doing this?
A: Alternatives -What alternatives do we have?
I: Intuition/Instinct - What's your gut say?
N: Nothing - What happens if we do nothing?
I will close by saying that there are many reasons that birth visions fall off track and interventions and potential c-sections are how some babies are born. I like to say that there is no "right" or "wrong" way to give birth. And this evidence-based information about not rushing into pushing and giving you, the person giving birth, time to ease into pushing and to let pushing happen can result in the birth you vision.
The topics of pregnancy and birth seem to be open season for anyone and everyone to give an expectant mother information; solicited or otherwise.
All of a sudden your mother, mother-in-law, Great Aunt Mildred, your barista, cashier at Whole Foods, and yes, your doctors and nurses and doulas have become experts on what kind of birth is best for you.
"Both you and your sister were big babies, it's genetic, you'll need a c-section too."
"I wanted a natural birth, too. But after 5 hours of labor, I bet you'll be screaming for an epidural."
"An epidural is safe, and it allows you to rest during your labor."
"The drugs are there for a reason!"
"Don't be a hero, you don't have to have a natural birth!."
With so many choices, how are you supposed to decide what's right and what's wrong? You use your B.R.A.I.N.
I've often seen the B.R.A.I.N acronym used in relation to the labor process when interventions are offered to a birthing mother, but I think it has merit in pregnancy as well.
So what is B.R.A.I.N anyway? I'm glad you asked :) When someone (anyone from your neighbor to your provider) brings a suggestion for your birth or pregnancy ask yourself the following questions:
B-What are the Benefits
R-What are the Risks
A-What are the alternatives?
I-What does your Intuition say?
N-What happens if you do Nothing.
It's my opinion that no one is trying to scare you or deter you from your wishes when you are pregnant. Most unsolicted suggestions come because some cares, or they want to share their story. It can get pretty loud with all of these suggestions coming at you at once. So, this Tuesday Tip is to use your B.R.A.I.N
What more information that's Evidence Based. Check out one of my favorite resources, Evidence Based Birth.
fThis year I'd like to try something new. I'd like to share an article or blog post that I think is interesting, has important information for birthing families to consider, or is just plan awesome. I think this one falls into the important information range. Birth Stories.
As a part of the generation that grew up watching shows like "A Birth Story" on TLC I seriously FEARED childbirth. My own birth story was one of a long (50+) labor that ended in an emergency cesarean. To add a bit more drama, my mother often tells of looking over at me from the operating table and watching my little body heave, trying to catch my first breath, and then stop. And in her words, I was "whisked away."
When I look back at my first pictures, I see a fragile baby with tubes attached to it's body, flushed palms and feet with pale skin.
I determined that when I got pregnant that I would avoid all of that drama and go straight into the OR for a beautiful, forgettable cesarean birth resulting in a nice, round headed child.
It wasn't until much later that I realized that a cesarean section wasn't "easy", but that it was major surgery. Basic knowledge of anatomy teaches us that! So I learned about birth, considered becoming a midwife and decided that I wanted to be a doula.
One of the first questions I ask my clients is to tell me birth stories they've heard. And while some of them tell stories of cesarean births and others of blissed out natural births, it's how we tell stories that it's important. And the understanding that no two births are the same.
There are benefits to hearing "good" birth stories where mothers feel empowered and partners are connected. Hearing more of these stories, I think, over stories of panic, pain, and fear, are a vital step to creating the births moms and birthing people want. Life happens, births can veer off course, but in the span of human existence it's only been in the past few decades that we've dis-empowered women and our ability to give birth. Let's take our power back, trust our bodies and trust birth.
I'm thrilled to share a site I recently found called Good Birth Stories. Below is a snippet from a positive birth story. I hope you enjoy.
Vanessa’s story – Matheo’s birthThe Spanish phrase for ‘give birth’ is, brilliantly, ‘dar a luz’ (give light to). I gave light to Mathéo Zen at 7.30pm on a late May evening in St George’s hospital in Tooting, London.
The room on the delivery ward was luminous with mellow evening sun and crackling with energy; the air iron heavy with the raw smell of blood. I’d used hypnotherapy and my sheer bloody-mindedness to achieve a birth of my first baby that was natural, vaginal, drug-free (except gas and air – woohoo!) and seeing our miniature creature on the outside for the first time was mind-blowing.
He was the softest thing I’d ever touched; a tiny peach; deliciously creamy and a little bit fuzzy all over. He had come in his own sweet time and was very pleased with himself indeed. He was calm, bright as a button, and he seemed to suckle contentedly – if painfully, but that’s another story – when I put him to the breast.
Hi there! I'm Erika Davis and I'm a doula working in the Seattle and South Puget Sound area.