Hello, everyone! I'd like to start this blog post with a commitment to do more blogging here. I've been working through the Shining Life Workbooks in the hopes of better dreaming and planning for a shift away from full-time nanny work to full time birth work and through the process have decided that I need to be 100% focused on content in this space. If you've been reading all along, thank you! If this is the first time you're reading this blog, welcome and I hope you find some content that you enjoy and find to be helpful. And now, on to the blog.
Q. When is the right time to hire a birth doula?
A. Right now!
In my opinion, it doesn't matter if you've just found out you're having a baby or if you're in your 38th week and have decided that, "Yes! OKAY! I do want another support person by my side at my birth!" Whenever you make that decision is the best time. There are definitely some benefits to hiring a birth doula early on in your pregnancy; you can take your time to find the right doula for you and your family, you can take time to craft a birth vision and be thoroughly educated on what to expect during pregnancy, labor, birth and postpartum, and it allows you and your family to be completely comfortable with a person (your doula) who will be by your side at one of the most important days of your life.
On the other hand, a good doula is perfectly capable of providing you with consistent care and support if hired a week before or even the day of your birth. In fact, many hospitals are starting to hire doulas as staff and a lot of the time people may not have been introduced to the doula until the day of your birth.
If you have the time, I would add hiring a doula to your baby prep list. Just as you pencil in provider appointments, time to shop for your new wee human, etc.
If you live in the Seattle Metro area and are looking to hire a doula, I currently have availability for late May, June, and August births! Please call or email
It always feels great to get reviewed on my Birth Doula services! In the last month I've received two new reviews! You can check them out over on DoulaMatch or read them below!
I have openings for June and July Births so be sure to send me an email to schedule your consultation!
"Erika is one of those most competent, kind, emphatic and capable doulas I have ever met. She transformed every fear and anxiety we had into a reassuring, comforting thought to take with us into the birth. She visited with us in our home a couple times before the actual birth and always brought books, visuals and great stories. At the actual birth, she was unflappable and focused the entire time. I have no idea how but she never seemed to get tired or stressed! She was a great support for BOTH of us too - for my wife who was birthing our child and to myself as the birth partner. She was right there with us reminding us to drink water, eat a snack or take a break to breath. And she happily took photos at our request after our daughter was born. There is no one quite like Erika - her humor, her warmth, her energy are unlike any other doula out there. My wife and I both would recommend her without any reservations."
"Erika made me feel so supported and confident about my labor and birth. The birth plan she helped my partner and I craft, as well as discussions about what happens if things don't go according to plan, helped us make decisions easily during labor.
I would definitely hire her again and would recommend her services to anyone looking for an amazing birthing experience with a caring and competent doula."
The following snippet comes from a January 12th article about doulas from the Seattle Times. While I find some aspects of the piece problematic, particularly the assumption that doulas are women and that only women give birth, it does a great job at shedding a bit of light on the racial and ethnic disparities faced by people of color and the babies of those people.
"A week into my son’s life, he wouldn’t stop crying. I can still see his scarlet face and hear the alarm in his voice. Exhausted and new to motherhood, I was flummoxed and near panic myself.
Then my doula rang the bell. A no-nonsense woman, she swooped Malcolm up, whispered in his ear and massaged his little body. Identifying that he was hysterically hungry, she fed him a few fingers of formula — calming him down long enough to nurse.
She also asked me how I was doing and listened when I admitted: “Not great.” She was a lifeline in the chaos, and I still think of her with deep gratitude.
A person* is a woman who is trained to assist women during childbirth as well as in the pre- and postnatal period. It’s a tradition with roots around the world but a practice that has been resurrected in the U.S. as research increasingly shows doulas reduce C-section births and encourage successful breast-feeding."
Read the rest of the article here.
I remember my first tough postpartum visit like it was yesterday even though it was three years ago. It was one of my first births and it went beautifully. The mother labored at home all day and when we arrived at the hospital she was 10 cm dilated! She pushed out her baby girl and had skin-to-skin right away. It all went according to plan.
So when I arrived to her apartment two days later I wasn't prepared for what I encountered. Her little one was wailing in her bassinet and the mama's face was streaked with her own tears.
"My breasts!" she exclaimed and threw open her shirt. They were large, bright red and painfully engorged. I wracked my new doula brain for what to do; we got her little one settled down and latched on, but it was at that moment that I realized that the entire birth process tends to be focused on labor and birth and not so much on the postpartum period.
We found that Mama an amazing Le Leche League Lactation Consultant and she nursed her Little One until she was almost 2. Since then I have been suggesting that all of my doula clients come up with a solid Postpartum Plan. These plans can include specific thing like rules for visiting the new family after the baby is born, a chores check lists guests can help with, and creating a meal train plan. I also encourage clients to create a list of resources including lactation consultants, postpartum doulas, new parent groups and more.
Your Postpartum Plan, like your Birth Plan, should be as specific and as personalized as possible. Think of everything you could need to make your transition into parenthood easier. Having a plan can take some of the surprise out of those first few weeks.
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.
Finding the right doula is all about finding a good match. Your doula should fit seamlessly into your life and the life of your family.
A lot of times you'll hear doulas say that we "hold space", which I think is pretty accurate. We're not there to be your cheerleader (although we will encourage you completely). We're not there to be your coach (although we'll make sure you have all of the tools you need to have the birth you envision). And we're not there to replace your partner.
Instead, we help you create, make and keep space. And finding someone who is able to do that in a way that is natural and feels comfortable is all about the Match.
Meeting a doula is sort of like going on a blind date. You have possibly scoped out their profile on a site like Doula Match. You were attracted to their skill set. You sent them an inquiry and they emailed back. The emails and the phone conversations felt wonderful and natural, and you got actual nervous butterflies in your stomach waiting for them to arrive to the initial consultation. And in the moment you met the chemistry just clicked.
I've had this feeling for all of my births and I can say honestly that it is one of the best feelings. And. Even after meeting with a couple or woman who is giving birth and even if everything feels amazing and we gel well as a team, I always encourage the couple or single person to go home and think about it.
Hiring a doula is not only a big financial decision, it's a big personal decision. Inviting another person into a birthing space is a big deal. That person, your doula, will bare witness to your birth and the expansion of your family. They will see you laugh and cry and roar. They will see you at your most vulnerable and your most powerful. I guess what I'm trying to say is that they will truly see you. Into the deepest parts of your soul.
Now think back to that initial meeting. Is that the person you want to share your soul space with?
For me, thankfully, the answer has always been yes. In fact, there has only been one time when it wasn't a good match between me and a mother. And it was me who decided that we didn't quite fit. She went on to have a lovely birth and found the right doula for her. And I went on to continue to do births as well and find clients who were a good match for me.
Like a good date, a good partner, a good melon - you just know.
One of my favorite births was a dear friend of mine. She had a hard labor that totally veered off of our Birth Vision. Low fluids followed by an induction and a strong reaction to Cervidil followed by epidural and Pitocin and a lovely, healthy baby boy. Through the hard times and the bliss that an epidural can sometimes bring, I felt like I was a witness to the birth, rather than a participant. Which sounds strange as a doula.
What I mean is that this mother and her husband were so connected, so in sync, so in their own world that much of my role was to support them.
A doula doesn't replace the role of husband or partner or birth partner, our role is to enhance and support. And yes, sometimes to stand watch while the partner takes a nap.
What About The Father’s Role When Using A Doula?
The role of the doula is never to take the place of husbands or partnersin labor, but to compliment and enhance their experience. Today, more husbandsare an active role in the birth process. However, some partners prefer toenjoy the delivery without having to stand in as the labor coach. By havinga doula as a part of the birth team, a father is free to do whatever hechooses. Doulas can encourage the father to use comfort measures and canstep in if he wants a break. Having a doula allows the father to support his partner emotionally during labor and birth and to also enjoy the experience without the added pressure of trying to remember everything he learned in child birth class!
Read the rest of this article outlining the benefits of having a doula.
So what is the evidence for doulas?
In 2012, Hodnett et al. published an updated Cochrane review on the use of continuous support for women during childbirth. They pooled the results of 22 trials that included more than 15,000 women. These women were randomized to either receive continuous, one-on-one support during labor or “usual care.” The quality of the studies was good.Continuous support was provided either by a member of the hospital staff, such as a midwife or nurse (9 studies), women who were not part of the woman’s social network and not part of hospital staff (doula 5 studies; childbirth educators 1 study, retired nurses 1 study), or a companion of the woman’s social network such as a female relative or the woman’s partner (6 studies). In 11 studies, the husband/partner was not allowed to be present at birth, and so continuous support was compared to no support at all. In all the other studies, the husband or partner was allowed to be present in addition to the person providing continuous labor support.
Overall, women who received continuous support were more likely to have spontaneous vaginal births and less likely to have any pain medication, epidurals, negative feelings about childbirth, vacuum or forceps-assisted births, and C-sections. In addition, their labors were shorter by about 40 minutes and their babies were less likely to have low Apgar scores at birth.
What does this mean?
It means that if you have continuous labor support (that is, someone who never leaves your side), you are statistically more likely to have better outcomes and your baby is more likely to have better outcomes! How did doulas compare to the other types of continuous support?
The researchers also looked to see if the type of support made a difference. They wanted to know—does it matter who you choose for your continuous support? Does it matter if you choose a midwife, doula, or partner for your continuous support? They were able to look at this question for 6 outcomes: use of any pain medication, use of Pitocin during labor, spontaneous vaginal birth, C-section, admission to special care nursery after birth, and negative ratings of birth experience.
For most of these outcomes,* the best results occurred when woman had continuous labor support from a doula– someone who was NOT a staff member at the hospital and who was NOT part of the woman’s social network. When continuous labor support was provided by a doula, women experienced a:
Why are doulas so effective?
A doula can act as a buffer in a harsh environment.
There are 3 main reasons why we think doulas are so effective. The first reason is the “harsh environment” theory. In most developed countries, ever since birth moved out of the home and into the hospital, women have been giving birth in conditions that can often be described as harsh. In the hospital, laboring women are frequently submitted to institutional routines, high intervention rates, personnel who are strangers, lack of privacy, bright lighting, and needles. Most of us would have a hard time dealing with these conditions when we’re feeling our best. But women in labor to deal with these harsh conditions when they are in their most vulnerable state. These harsh conditions may slow down a woman’s labor and decrease the woman’s self-confidence. It is thought that a doula “buffers” this harsh environment by providing continuous support and companionship which promotes the mother’s self-esteem (Hofmeyr, Nikodem et al. 1991).
A dad says: “My experience has shown me that, whether you’re giving birth in the hospital, birth center, or at home, your impact and ability to connect and support your wife during the birth process is both supported and maximized by having a doula there on your team.” Credit: www.yourbirthjourney.net and Seattle Birth Photography
The third reason that doulas are effective is becausedoulas are a form of pain relief (Hofmeyr, 1991). With continuous support, women are less likely to request epidurals or pain medication (Hodnett, 2011). Why are women with doulas less likely to request pain medications? Well, women are less likely to request pain medications when they have a doula because they just don’t need an epidural as much! Women who have a doula are statistically more likely to feel less pain when a doula is present.Furthermore, by avoiding epidural anesthesia, women may avoid many medical interventions that often go along with an epidural, including Pitocin augmentation and continuous electronic fetal monitoring (Caton, Corry et al. 2002).
Read the entire article here.
02/5/14 by Crystal Azul
I grew up hearing stories about births and deaths from my mom, who was raised in a poor, evangelical home in Mexico. My mom would tell me the story of her nephew Esteban’s birth. It happened during the middle of a hurricane, the water had risen a foot into the tiny house, and my mom’s cousin was in active labor. Baby Esteban, nearly having a water birth, came out of his squatting mother like a slippery fish, caught by my mom’s capable hands.
When my friends started having babies, I became actively interested in birth justice work, especially after hearing their stories of unnecessary interventions, lack of communication from hospital staff about procedures, and the feelings of being too overwhelmed to make an informed decision during labor. As a feminist, womanist, and queer POC, I understood all too well the importance of advocacy during times of medical vulnerability. In 2011, I finally trained as a doula in Arcata (Humboldt County) and had my first client – a 17 year old woman who found me on a volunteer doula list through the Family Practice Nurses who worked with mothers on WIC. After this first experience of working for my client and representing her wishes, I knew that would never want to work for a hospital or similar institution and began searching for ways to be a doula in community.
Last August, I attended SQUATfest, a conference for people working in birth/reproductive justice and held at the Women’s Building in SF. As can be expected, the conference was predominantly white and cis, though some effort had been made to offer scholarships for low-income/POC birth workers. For many (qt)poc folks, accessibility with regards to affordability is one of the biggest obstacles to becoming a doula or hiring a doula. (There is a movement to include doula services through Medi-Cal, and there are volunteer doula programs in select hospitals that provide doulas for those who qualify as low-income.) During SQUATfest, I spent time in the Doulas & Midwives of color circle. There were many conversations about working in mostly white and privileged spaces, bringing services and support to communities of color, and burn-out being a major issue for (qt) POC birth workers. Some of the newer birthworkers discussed finding it challenging to “connect with birthworkers of color for mentorship because they are too done, tired and are moving on, have too much risk/responsibility already on their plate, or are homophobic/transphobic.” I had the privilege of hearing the wisdom of such birth justice workers as Midwives Makeda Kamara, Claudia Booker, and our local Certified Professional Midwife Laura Perez from Sacred Birth Place in Oakland.
A few in late 2013 three articles emerged about the dangers of a common occurrence in American births-augmentation, Pitocin.
Augmentation can happen for a variety of reasons, both medically "warranted" and for the sake of convenience for either a busy doctor or mother. Augmentation is usually done by administering pitocin, a synthetic form of naturally occurring oxytocin, through an IV. While pitocin usually has the same effects of oxytocin (uterine contractions) there are certain other risks. The pitocin can sometimes cause fetal distress because the contractions come on stronger, more closely together and for longer periods of time than naturally produced oxytocin. And, as some of the studies have seemed to find, pitocin may be linked to Autism.
One of the most lasting impressions of The Business of Being Born was when one of the doctors said just this. Pitocin is a rather new drug with, until now, not much research into the long-term effects of its use. Am I against inductions? Do I think that mothers are "bad" for having their labors induced? Do I think that mothers who have inductions are some how putting their children in harm's way? No. Not at all. What I am saying is that we as women have to remember our voices and not be afraid to use them.
Throughout history women's voice has been stifled and throughout history women fight to make it heard. Educate yourself on the procedures that are often suggested or offered as normal and regular and ask questions.
Why do we need to do this procedure?
What will happen if we don't?
Is that bad?
Why is it bad?
What are the alternatives to this procedure?
I'd like to get a second opinion on this.
In terms of speeding along labor or inducing labor there are natural alternatives. Raspberry leaf tea and Thyme tea will both bring on contractions. Clary Sage, an active ingredient in my Birthing Sprays, is also thought to bring on contractions. Walking or other types of exercise can bring on contractions as well as boy-girl sex (chemical reaction of the sperm) as well as any sexual activity that brings orgasm. Nipple stimulation can also help bring on contractions.
I say all of this because while pitocin has become a regular fixture in hospital births, it doesn't need to be. In fact, if you're able to move around, change positions, squat, take a shower, enjoy uninterrupted laboring and are surrounded by positive energy labor can move along more quickly without the use of drugs because the hormones are able to better flow throughout your body.
I'm linking the articles below not to shake a finger, but so that we read, learn and research our options and alternatives.
From the American Congress of OBGs: New Study Finds Adverse Effects of Pitocin in Newborns
From the BBC News Induced Labor Linked to Autism
From MedPage Today Induced Labor Linked to Higher Autism Rate
Hi there! I'm Erika Davis and I'm a doula working in the Seattle and South Puget Sound area.