So, what's a Doula anyway?

From Kellie: Here's another Guest post....I couldnt wait until monday to put it up because I felt like it went perfectly with our Mother Friendly theme this week!  I have another guest post for you on Monday and the Momma who wrote it said that she so wished she would have hired a Doula for the birth of her son....it could have very well changed the entire outcome of her birth and birth experience.  Meet Daijeri, she is a Doula in training and services our area locally!

So you're expecting a baby. You've thought about names,  nursery themes, and car seats. You've found a doctor, debated birth settings and maybe picked a birth class. So what is left to consider? A doula of course!   

Now, you may be thinking "a do-what?" Maybe you have heard of doulas, or maybe you are like my husband who proudly told everyone his wife was becoming a dow-la for weeks. (He has since figured it out, thankfully.)  

A doula can be your best friend in navigating the sometimes overwhelming world of childbirth. Before your birth, we help you write out a birth plan and work through any anxieties and worries you may have. We also help you prepare your body and mind for childbirth.   

In labor, one of our main jobs is to provide you with information that empowers you to have your ideal birth, and to help you reassess and navigate those times that ideal just isn't working out.  Our other main job is to basically mother the mother.  We make sure her needs are met, both big and small. We help her manage her pain by providing massage, guided relaxation, or distraction. We help her get into positions that she can labor the best in. We help make sure her wishes are met the best they can be and that her voice is heard. Maybe most importantly, we make sure she knows what an amazing rock star she is. Birth is hard work, and no one should do it unsupported. Your doula will stay with you from your initial "I think it's labor!" phone call, until a few hours after you've given birth. We massage, we motivate, we reposition, and we empower.   

You may be thinking "but what about the fathers? Won't they feel left out?" The answer is no! Doulas work to help the father support mom as much as possible. We help fathers remember what they may have learned in childbirth class when they just can't recall it. Dads can sometimes feel a lot of pressure to be a super birth coach when they just aren't prepared for it. We can take some of the pressure off. We give them breaks to eat, rest, recuperate. We may run small errands so that they can stay with their laboring partners. We provide them with information they may not have foreseen the need for. So no, we don't overpower the dads, we empower them.  

 There are some things that doulas don't do. We never perform medical procedures, or give medical advice. We also can't make decisions for you. We give you all the information you need to make your choice, and we will support whatever you decide with no judgment.   

So what about after the baby comes? Is a doula's job over? Nope! There are also postpartum doulas who help mom and dad adjust to life with a newborn. We can help with meal preparations, light housework, run some errands, and even provide infant care so that mom can shower, eat,  and get some rest. We can also help mom and baby with their breastfeeding relationship and help jump small hurdles along the way. When we can't help, we can also point mom in the direction of an IBCLC who can.   

Even after we've stopped regularly coming for postpartum visits, you can still call or email when you have questions or concerns about your baby.   

After going through something as intense and wonderful as the birth of a baby, a bond is formed. You just might find a connection for life in your doula.  

 -Daijeri

yourbeautifulbirth.com

I asked 15 women the same question...

I asked 15 women the same question....Do you think its important to change the way childbirth is viewed and managed in the United States? Why or Why not? Looking for different views and opinions...
Here were the responses I did receive:

• Yes I think it's important to change the way it's viewed. Labor should be something a woman feels she is in control of and has a voice during. It shouldn't be something that happens to her that is managed by hospital staff while she lays about helpless. I am not against pain medicine during labor to help a woman stay in the driver's seat with her body if she needs it, but I think birthing classes should be mandatory for ANY kind of birth. The power of knowledge is amazing. I think many women feel powerless during labor simply because they have no idea what to expect other than pain.
• I do believe it is important to change the way we view childbirth. Childbirth is not something that needs to be "managed" it is a natural process and should be viewed as such. Women who are healthy and low risk can normally grow and push out their baby with minimum interventions. In our culture, we are always trying to improve on nature but there's not a need. Our bodies were designed to grow babies, give birth, and feed our young. The vast majority of women are able to do this and should be empowered and educated to believe in their bodies and themselves.

• The health benefits for a child that passes through the birth canal are endless (granted, some c-sections are necessary; I discredit the elective procedures): 1. Populates baby's gut w/flora/fauna. 2. Squeezes excess fluid out of lungs & jump starts respiration. 3. Helps improve circulation. 4. Helps gets mom's milk flowing; etc etc etc... One thing that we're seeing in the medical field, in older patients, is the correlation between small bowel obstructions in women who had c-sections. Scar tissue forms & strangulated bowels. Docs don't think about later-in-life complications... Having to have your bowels removed and placed on tube/IV feedings the rest if your life is hardly worth it. The U.S. would have a healthier population of people of all ages if we could start encouraging more natural/vaginal births...... And hand the doctors a pair of balls in med school... Those chickens can't handle the heat.
• Doctors should view it more natural and people should too. Women get so wrapped up in " I want the OB I've been seeing this whole time to "deliver" my baby! And there's too many inductions are pushed by mother and Doctor.
• Yes.  There is too much fear associated with child birth in the US.  Birthing is not meant to be a traumatic experience - it should be a memorable and joyous occasion of bringing new life into the world.  There isn't enough support either of a woman's choice to birth how she wants to birth.  If women had regular access (and not just researching, but Dr.'s giving ALL the options to the patient) of the different methods of natural child birth that teach techniques to relax through the pain, then maybe things would change.  And not even just that, there's also the convenience factor of child birth.  Women that are tired of being pregnant and want to induce; Doctors who don't want to have to show up at the hospital on their day off so they induce (uh, you chose the wrong profession if you don't want to be inconvenienced during your day, just sayin'); women choose elective c-sections so as not to interfere with their career - or worse - they're body.  People just need to view child birth for what it is:  the means to bring your precious child into the world in the safest way possible for YOU.  Whatever way that may be, there is more than just ONE cookie cutter way.
• I can see both sides of the argument (as far as natural birth vs. modern medicine). I think that whatever it takes to bring in a health baby is most important. To get my daughter into the world, I would have died (and, maybe she would have, too) if not for modern medicine. At the same time, I really appreciate a natural birth - and would really like to try the experience of childbirth that way. Overall, I think it's important that people in society stop judging each other. People get too extreme (for me) -- whether it is scheduling a C-section for convenience (I'm not a big fan of that) or sharing too much information about the water-birth that took place in their home (TMI and stop making me feel guilty for not doing that). .... To each his (her!) own - just get that health baby here!

More on Mother Friendly Initiative

Why should you care? Because we're on each others team.... remember?
and you should care because I do! Haha, if only it were that easy to win people over to a cause. Maybe you had a wonderful birth in a hospital that went exactly the way you envisioned...I say good for you! That really is awesome!  But I have also talked to many women who have some deep emotional scars about how their birth went, saying they felt like they didn't have a voice, weren't consulted about the things going on with their birth...left in the dark so to say and then "required" a c-section and they weren't really sure why they needed one. I am working on getting these women to do a guest post for me but as you would think its a very sensitive subject for them, very emotional.  My heart hurts for these women....and from me to you- You are NOT a failure! The system failed you.  You should be able to go into any hospital to have a baby and trust that you will be catered to, cared for properly, respected, and consulted not instructed.  Sadly, a lot (not all) hospitals require you to be on the defense it seems.

If its not an important cause for you here's why I think it should be:

April 1st marks the beginning of Cesarean Awareness Month. "Our national cesarean rate of 1 in 3 women is a warning to us all. It’s not that providers should stop performing c-sections—it’s that they should stop pushing interventions and protocols that are known to lead to c-sections." -Cynthia Overgard

Visit http://pathwaystofamilywellness.org/Pregnancy-Birth/better-birthing-its-about-time.html to read "Better Birthing: It's About Time"

_________________

So right there it says 1 in 3 chance of a c-section if you go to a hospital, If we don't try to change something about the "system" in place what does that mean for your daughters and granddaughters? I know C-sections are not the end of the world, but at this rate will future generations even get a choice?

If you are curious about C-section rates by state, currently Texas (where I'm from) is pretty darn high at  35 %.  Louisiana has the highest rate at 40% and Utah the lowest at 22% according to the CDC.  Find out the Cesarean rate of each Hospital in Texas, (its the 2011 study so if your Hospital's name has changed since then it will be under the old name.)

If you plan to have a home birth your chance of needing a C-section is about 5.20% according to this study.  Maybe that's why after 37 years the highest percentage of home births occurred in 2012.  This is why the Mother Friendly Initiative is so important, there are a lot of women who would be more comfortable in a hospital setting but they don't want such a drastic increase in their chance of a c-section, and they don't want pressure to conform to all the hospital guidelines that aren't absolutely necessary.......

Here are 5 hospital procedures that aren't absolutely necessary (with legitimate sources)

I copied the info below from here

Here are the top five myths associated with hospital procedures that change your birth experience.

Myth 1: You need a monitor on your belly the whole time you're in labor.

Fact: You absolutely do not. Intermittent monitoring is shown to be just as effective, and actually allows the woman to focus on things other than her contractions. Consider that women are often made to lie down and stay relatively still with the monitors on as well, and you're put in a position where you have nothing to do but focus on and internalize any pain of contractions.

In fact, constant fetal monitoring often leads to unnecessary concern, and even intervention, including c-sections, so says the American Academy of Family Physicians, not some holistic home birth website, for those of you in doubt. In fact, only monitoring the baby's heart rate and your contractions every 30 minutes during early labor, and every 15 during transition and pushing is the current recommendation, but one that you almost never see actually practiced.

Myth 2: Lying on your back is a good position for pushing.

Fact: It sucks, big time. The only reason women end up on their backs is to make it easier for doctors to get in there. So, really, unless they NEED to be in there, it's a bad move. It's not only shown to reduce the size of the pelvis significantly, but it puts pressure on the vena cava, which reduces blood flow to the baby and your lower body -- why is it not okay during pregnancy, but they tell you to do it for hours on end during labor, and then are surprised at reduced blood flow to the baby?

The National Center for Biotechnology Information states that being upright, in addition to increasing blood flow also makes contractions and labor less painful, faster, easier, with a lot less trauma to the mother's birth canal, minimal to no tearing, and less trauma to the infant as well. It also makes for less postpartum complications, damage to the pelvic floor, incontinence, and in general, a much better, faster, less painful birth.

Also, if you opt for an epidural and can't feel your legs, you can't walk or kneel. So consider that you might not need that if you actually get up off the bed, and that just because you can't feel the pain with an epidural, your baby can, and you will once the drugs wear off. I wish I'd known as much about epidurals as I do now 15 months ago when I had my daughter. I was ashamed of myself for getting it then, but now I really, really wish I hadn't.

So why are 75 percent of births still done with the woman flat on her back? Back to the beginning of this point -- to make it easier for the doctor.

Myth 3: You can't eat or you'll barf it up and aspirate the vomit.

Fact: You wouldn't tell a marathon runner to skip breakfast, would you? Telling a woman about to engage in major physical work not to eat is almost as bad -- except what is at risk here isn't just a race, but two lives. Yes, there has been some concern that with intubation before anesthesia would come vomit, and then aspiration of said vomit.

MedScape discusses a study on the matter that says:

"Aspiration pneumonitis/pneumonia is significantly associated with intubation and ventilation," the study authors conclude. "In modern obstetric practice it is the use of regional anaesthesia, thereby avoiding intubation, rather [than] fasting regimens that is likely to have reduced mortality from aspiration. Although the National Institute for Health and Clinical Excellence has recommended, on the basis of consensus opinion, that women in normal labor may eat/drink in labor, our trial shows that this will not improve their obstetric and neonatal outcomes."

In other words, forcing women not to eat hasn't reduced aspiration -- not shoving tubes down their throats has. In their study, women who ate light meals showed absolutely no difference in anything -- no more vomiting, no more risk than women who were only allowed ice chips or water.

Myth 4: You need to be told when to push.

Fact: Do you need to be told when to poop? You no more need permission and direction to push out your baby than you do to push out a bowel movement. Just as your body uses contractions to move the baby towards the cervix and through it, it moves the baby down the birth canal, too. Your body will tell you what to do. You will feel when you need to push, and you will just work with it. When you feel the need to relax, do it. Push as hard as YOU are comfortable and if someone is yelling to you to push harder or longer than you feel you should, yell at them to shut up.

Pushing to the point of shaking, not breathing (called 'purple pushing' for the color your face turns) and breaking blood vessels in your face is not going to help you. In fact, it can cause the cervix to swell if you're not ready, it can make you exhausted, it can create much more severe tears, and is just a bad idea in general, even according to the World Health Organization.

Drugs can inhibit the feeling of needing to push (or the ability to know if you need to stop), though, but that's a whole 'nother topic all on it's own.

Myth 5: A break in contractions/labor stalling is a bad sign.

Fact: Women can get fully dilated and have the baby ready to go ... and then have a period that has been appropriately nicknamed the "Rest and Be Thankful" stage. It is nature's way of giving you a break after all the work to get your body ready, before the final hurrah. You can also have a break like this earlier in labor as well. Sometimes you can even be in early labor for what ends up being days, often called prodromal labor. We are mammals, first and foremost, and our bodies aren't stupid -- if a woman gets really stressed or really exhausted, often her body will sense that she doesn't have the energy for birth, or deems that it's an unsafe situation and halt labor until mom is rested or calmed. Think of a mother rabbit in labor realizing a predator is nearby -- she NEEDS to get safe before she can birth the babies.

Doctors often start up pitocin here, when the recommended things are anything but that -- squatting, moving around, getting in a bath all are proven safe methods to help the mother relax and get her contractions going in a normal pattern again. In fact, my midwife told me that studies show nipple stimulation and relaxing in water had been shown to be as effective, if not more so, than pitocin. Considering that pitocin is an artificial chemical designed to mock those from things like nipple contraction, it's not exactly a far leap in logic.

If your labor stalls, don't rush for the meds -- relax, move around, have a light meal for energy, try to take a nap. In and of it's own, it is NOT an emergency.

________

Tomorrow I will post responses from a question I asked to some Moms last week- Do you think its important to change the way childbirth is viewed and managed in the United States? Why or Why not? Looking for different views and opinions... If you would like to voice your opinion in this matter you can email your response to 1babybeborn@gmail.com, I would be happy to include your opinion (Even if it differs from mine, lol). ~Kellie