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What research has been done on the effectiveness of doulas and what have the outcomes been? Doula Benefits Numerous medical studies have been performed to discover the benefits of doulas. The results of these studies have been published and subjected to scientific review in such journals as the Journal of the American Medical Association, the New England Journal of Medicine, the British Medical Journal, and the British Journal of Obstetrics and Gynecology. A meta-analysis is a technique that collects the results of different studies on related research. A meta-analysis of the doula studies showed that the continuous presence of a doula:
Insurance companies are also realizing that there are proven benefits and some providers have started to reimburse for doula care. If your company health care plan covers in-home care, nursing care, lactation consulting, or similar fields, doula care/professional labor support may also be covered. For more information on these studies, see the book Mothering The Mother by Klaus, Kennell, and Klaus or visit http://www.dona.org. Are there any books you recommend in terms of parental education? Yes. Here are a few that I have found really helpful:
What do you recommend in terms of Childbirth Education Classes? There is wide variety of choices these days. I recommend taking something and giving as much time to it as possible. It can be a great way to make sure you are taking some time to focus on your pregnancy and cherish it. I like to let my clients know about Realbirth on 22nd Street in the New York City (http://www.realbirth.com). They have excellent childbirth education classes through the Childbirth Education Association of NY and they also offer yoga and have great playgroup and support groups, etc. I am in a certification program and will begin teaching classes soon. I do incorporate a lot of my developing curriculum in my prenatal visits with doula clients. Why are birth balls such a rage these days? Birth balls are great for a variety of reasons. During labor you can use a birth ball to sit on to help open up the pelvis. When weight is put on a birth ball, it holds it in more of a supportive way, offering more cushion and less resistance than a chair or other hard surface. Birth balls are easy to move around and can be used to lean on, sit on, or for a partner who doesn't want his/her back to go out and needs to be next to a bed, helping support a laboring mom. Birth balls are also a great way to soothe a baby---an adult can hold the baby and instead of having to stand and pace to soothe, they can sit and gently bounce on the ball. I also bring a birth ball during my prenatal visit. Does aromatherapy really work as a pain coping technique for laboring moms? Absolutely….depending on the mom. We are all different. What works for one, does not necessarily work for another. The option is a great one. Lavender, rosemary, and peppermint, and geranium are common soothing fragrances, which I bring in my birth bag. How do doulas effectively work with partners of laboring moms? As a doula, I often get asked about whether doulas interfere in a partner's role in caring for his/her loved one in labor. My experience has been that partners are all interested in and able to be present for the laboring mom in very different ways. My job, is to help support the partner as much as I can so that he/she can be there as fully as he/she desires, without tiring out, or feeling undully worried. For example, I do things like remind the partner to drink water, eat, go to the bathroom, etc.. The old saying, "you can't take care of someone else, if you don't take care of yourself" is very true. I also am an educated person to have around, in terms of having good indicators for what is normal or not during labor. This is a big plus, because when the partner feels reassured that what is happening is normal, they have more emotional space to be present for the laboring mom. Having a doula present is also a big relief when it is time to migrate to the birthing center or hospital, as one person can pack the car, or get a car service, while the other is supporting the mom. I also tend to show partners ways of effectively support laboring moms that they may not have known, or just needed a reminder about, like: massaging her in particular ways; providing her with cool or warm clothes; and/or learning how to apply pressure in particularly useful areas (the double hip squeeze is a commonly relieving type of pressure applied during contractions and for long term use, is much easier if two people are present to apply the pressure). Labor sometimes lasts a very long time and having someone you trust and know is there to support you and your partner, and not take away from your experience eases pressures, that might otherwise have been there. Finally, sometimes during a long labor, it is really nice to have someone like a doula, who you know you can count on to be there for the laboring mom, while you, the partner, take a needed nap, so you are better rested and able to be there fully for both mom and your baby as well. I love working with partners, because it can be soooo beautiful to see how much they love the laboring mom by the way they take care of her. My job is to only be there as much as the couple desires me to. What is your role, in terms of dealing with medical providers like midwives, doctors, and nurses? I am there to be a liaison for you and your partner. Medical providers diagnose things. I am there for you and your partner's educational, emotional and physical (massage) support. Do you offer breastfeeding support? Yes. We have one prenatal session devoted to breastfeeding and I also am there postpartum to help you establish a healthy latch to begin your wonderful bonding experience with your baby. Yes. You will meet her on one of our prenatal visits and if for any reason you feel uncomfortable, I work with more than one back up. The back up doulas that I work with have a similar approach to doula work and are experienced labor support professionals. Is writing a birth plan really important? I believe having some knowledge of what your vision is for a variety of situations, which can occur during your labor, is important. It is good to not have to make rash decisions and to have given some sort of time prior to labor for you and your partner to figure out what your preferences are. It is also really important to not get stuck on one plan, but to be flexible and understanding that labor takes many shapes and forms and part of the parents job is to be able to accept and manage themselves through the reality of the course of their labor. It is also very important to discuss your preferences with your medical providers and make sure they are in synch with their practice. When you are in labor, if you are birthing at a hospital, your provider may not come in to see you for some time. For this reason it is very important to have something. What is Perineal Massage and should we be practicing it? Perineal massage is recommended (but not necessary) for many reasons prior to labor. The perineum is the area between the vaginal opening and the anus. This is the area that will stretch to accommodate the passage of your baby. Becoming familiar with the burning sensation which occurs when pressure is placed on the perineum can help you relax your pelvic floor and assist in avoiding the tearing of this tissue during labor. During our prenatal visits, I will give you a handout on how to practice this type of massage. It is recommended to begin preineal massage during your last 5 or 6 weeks of pregnancy. Absolutely. I think it is important to talk to other people who I have attended during labor to help you make your own decision on what is right for you. If I am planning on using pain medication should I hire a doula? You should consider hiring a doula if you feel likehaving educational, emotional, and physical support will be helpful to you. Pain medication is offered at specific times during labor. It will not make you feel totally numb throughout your entire labor and it will most probably not be present during pushing stage. Having a doula present can help you make educated and conscious decisions. She can help you relax, and encourage you to continue being an active participant in your labor. Sometimes, when a lot of interventions are involved, it can make someone feel powerless. Feeling empowered by your labor, no matter whether you have a natural childbirth experience, use medications, other interventions, or a c-section, is very important in your experience of becoming a parent. My job, is to help you really own the experience, no matter what your choices are. The more confident you are in gong with your gutt, the better you will feel as a parent and the more room there is for you to develop a strong bonding experience with your baby and partner. DONA is an acronym for "Doulas of North America". They are the organization I trained with and am certified through as a birth doula and a postpartum doula (two separate certifications). During 2004 DONA became the premier international doula organization, officially changing their name to: DONA International. If you would like to know more about them, please visit their website: http://www.dona.org I think having healthy families are the basis for a healthy society. I am fascinated by childbirth, and have been since I was at the birth of my brother (when I was 9 years old) and believe that when parents have positive birthing experiences, it really helps them get off to a wonderfully loving and powerful start. I have had many other jobs and doula work makes me feel so extraordinarily alive and connected with our world in the most positive of ways. Meconium is a newborn's poop (a collection of enzymes and residue from swallowed amniotic fluid). It is sometimes expelled during labor, and most often sometime after birth. It is dark, sticky and tar-like. The easiest way to clean off if you rub some vegetable oil on your baby's bottom, right after delivery (it won't stick to the skin this way). What about sex during pregnancy? The following are quotes from "Pregnancy, Childbirth, and the Newborn", by Simkin, Whalley, and Keppler: "For most women and their partners, pregnancy brings changes in the sexual relationship, but these changes are not the same for everyone [and vary per pregnancy]. While one woman may feel ripe, beautiful, and sexual, another may feel clumsy and fat….Intercourse or orgasm may cause problems if you are at risk for a miscarriage or preterm labor, if you have had vaginal bleeding during pregnancy, if you have continuing or painful cramps after intercourse, or if you have a new sexual partner who has a sexually transmitted disease…If you are not at risk for a miscarriage or preterm labor, most medical caregivers recommend sexual activity as desired by both partners. Uterine contractions are a normal part of orgasm and so not pose a problem for a healthy fetus…." Do you have any recommendations about questions we should ask our medical caregivers, or caregivers we may want to hire? The following questions were taken from, "Pregnancy, Childbirth, and the Newborn", by Simkin, Whalley, and Keppler Since an initial interview will probably only last 10-30 minutes, choose a few key questions that are important to you. Make sure to listen and look for how the answer is being answered, as much as what is being said. Possible Questions to ask to a medical provider:
Do you have any recommendations about questions we should ask while on tour at a birthing center or hospital? The following questions were taken from, "Pregnancy, Childbirth, and the Newborn", by Simkin, Whalley, and Keppler Choose a few key questions that are important to you. Make sure to listen and look for how the answer is being answered, as much as what is being said. Questions you may want to ask while on a hospital or birthing center tour:
What questions do you recommend to ask a potential doula I/we are interviewing? The following list of questions was borrowed from, "The Doula Book", by Klaus, Kennell, and Klaus I recommend editing this list to what is important to you and really listen to what the doula says, and very importantly how you feel as you talk together. (note: these questions are geared towards birth doula services)
My back-up Doula: Childbirth Education Support: |
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