The Doula - Continuous Labor Support

pregnancy shopping birth postpartum feeding baby/family business profiles keyword search	"The Doula" Continuous Labor Support Why use a doula? Birth is one of the most important days of your and your partner's life. A doula helps you labor with less stress, with more comfort, and speedier progress. The Cochrane Library, issue 3, 2003, published a review on the effects of continuous labor support. Women who received continuous labor support were less likely to: Have any analgesia/anesthesia Have regional anesthesia Give birth with vacuum extraction or forceps Give birth by cesarean Report negative rating of or dissatisfaction with their birth experience How Your Partner Benefits Remember, this is a special time for you and your partner. Your partner most likely does not have specialized training in assisting a woman through labor. You need your partner to be there emotionally for you, holding your hand and reassuring you, not trying to give physical comfort. Why should your partner be stressed and worried about being able to adequately assist you in labor? Your partner will already be anxious and worried about whether you and the baby will make it through labor safely. If you have a 16, 24, or 36 hour labor, how is your partner going to assist you after birth, and help take care of your new baby, when exhausted? You are going to need rest. You are going to need your partner even more after birth. I would say this alone is a good reason to hire a doula. Prenatal Doula Visits The number of prenatal visits will depend on how each doula practices. They will typically see you from one to three times before labor. At your prenatal visits, the doula will discuss birth options, help with preparing a birth plan, and begin establishing a supportive relationship. You will be taught breathing and coping techniques for labor. Some doulas offer childbirth preparation classes taught in group or private sessions. Most importantly, they will answer any questions you may have in a personal private atmosphere. There are also massage doulas. A massage doula is a licensed massage therapist and certified doula. There is a separate certification, Certified Massage Doula, (CMD), through The Massage Doula Network. Prenatal visits with a massage doula will include pregnancy massage and labor preparation massage with an emphasis on relaxation. These visits will also include discussion of birth options, preparation of your birth plan, and instruction on breathing and coping techniques for labor. Also, you can hire a doula for labor only. Continuous Labor Support Once in labor you call your doula, even if it is 2:00 a.m. Your doula is on call twenty-four hours a day, two weeks before and two weeks after your due date. Doulas that attend several births a month are usually on call at all times. If your doula is ill, has a family emergency, or goes out of town, she will provide a back-up doula. You should make sure the back-up doula has the same philosophy and practices as your doula of choice. Your doula will either come to your home or hospital. Most women like to labor at home with their partner during early labor. Early labor is when your contractions have not developed a pattern. A pattern is when your contractions are consistent, e.g., five minutes apart and a minute long; this is typically when your doctor wants you to go to the hospital. You may have read or been told to labor at home as long as possible before going to the hospital. How long is as long as possible? You should go to the hospital when you are in active labor, which is when you have a consistent labor pattern and when you are having trouble coping. You should not be planning to show up at the hospital at 9 cm or barely making it there before birth. If you are hiring a doula so you can labor at home longer, you should think again. A doula does not perform any medical procedures. A doula does not listen to fetal heart tones, take blood pressure, check temperature, etc. A doula should only be hired for her expertise in labor support. Your ultimate goal should be having a healthy baby. You are delivering in a hospital because you want medical resources available immediately if an emergency arises. If you really want to deliver at home, you need to hire a midwife. Your doula will let you know how she practices and when to call her. A doula is still invaluable whether you are planning a hospital or home birth, because she provides emotional and physical support that is not offered by the rest of the birth team. Once your doula is with you in labor, she will stay with you continuously. She will support you emotionally and physically. A good doula is in-tune with you at all times. She knows at what point you are in labor, and what position or techniques you need at that moment. The doula helps with hot and cold packs, massage, showers or Jacuzzi, music, and information. Most importantly, she offers reassurance and informed advice to you and your partner. However, she does not make medical decisions for you. Planning to Have an Epidural A doula's support is still invaluable. She can help you labor longer before getting your epidural, which lowers the risk of stalled labor. Once you've received the epidural, she will help you stay relaxed, offer information, and remain with you while your partner eats a meal or sleeps. She will be able to help you with pushing positions, (since it's harder to push when you have an epidural), and assist with initial breastfeeding. Postpartum Doula Visit At your postpartum visit, your doula will discuss your birth with you. This gives you the opportunity to ask about parts of labor you may not remember or are confused about. She will see if you need recommendations or referrals for further support. Along with the above, the massage doula will give you a postpartum massage and teach you and your family infant massage. Editorial provided by Patti Heimlich, RMT, CLA, CD, ICCE, of Houston Pregnancy Massage & Doula Care in Houston, Texas.