Help Your Doula Help You

Written by Dale Bernucca, Childbirth Educator and Doula, with input from other childbirth educators at www.independentchildbirth.com.Childbirth Educators and Doulas have permission to share this article with their students/clients, as long as the author and website are cited.

Support: sup·port (s -pôrt , -p rt )

tr.v. sup·port·ed, sup·port·ing, sup·ports

To bear the weight of, especially from below; To hold in position so as to keep from falling, sinking, or slipping; To be capable of bearing; withstand; To keep from weakening or failing; strengthen; To provide for or maintain, by supplying with money or necessities; To furnish corroborating evidence for; To aid the cause, policy, or interests of, To argue in favor of; advocate; To endure; tolerate; To act in a secondary or subordinate role to (a leading performer). source: The Free Dictionary

Synonyms: uphold, back1, advocate, champion

uphold: maintain or affirm in the face of a challenge or strong opposition; back: material or moral support intended to contribute to or assure success; advocate: verbal support often in the form of pleading or arguing; champion: fight for one that is under attack or is unable to act in their own defense source: The Free Dictionary

It is natural to want to consider having a woman experienced in labor and birth with you when you are in labor. Women have birthed with women for centuries (midwife) and in many parts of the world including the USA women still bring a female relative or friend with them along with their partner when they go to their birth place or make a  conscientious choice to birth at home specifically because they desire the female presence to be primary.

As we have moved further and further away from birth as a normal, organic process women find themselves intuitively feeling a sense of an incomplete birth setting as they near their due date. Some women are unable to define what is missing because they’ve never witnessed a natural birth taking place where it began, in the home. Today the majority of births in America take place in hospitals and hospitals at one time denied women any family support in labor and birth. We are making progress as today many fathers want to be at their children’s births and most hospitals are beginning to outright protect a pregnant woman’s patient rights.1

Still, women find themselves desiring ‘more’. As birth educators, women who have experienced joyful births and as women who have been with women at birth can attest ‘I need something more’ is an oft repeated thought in the laboring woman’s mind. The ‘more’ that the laboring mother cannot define is the intangible that a clinical staff can rarely provide thoroughly if at all: physical, mental and emotional support. This lack can be attributed to many causes ranging from the clinical need to distance oneself emotionally in order to best assess and manage the medical case to never having  witnessed or experienced a spontaneous, unmedicated birth over an intact perineum.

After viewing, sharing and learning about natural childbirth without interventions you may find yourself realizing that you need something ‘more’ at your birth. Hopefully the ‘more’ will be a bit easier for you to define now that you know what your body is capable of doing and you’ve explored where you are on your mental and emotional journey to your baby’s birth day.

Take a look at the definition of ‘support’ above. Right now you are your own best resource for planning your birth. You know yourself better than anyone else you’ve met or will meet as you near the start of your labor. If there is something that you identify as needing bolstering in your labor now is the time to give serious consideration to mending it. For most women who understand the physical process of labor the ‘more’ that is needed is recognized immediately and it is easy for them to choose from the above list why they desire an extra female presence at their birth. If you don’t understand the process of birth then you are probably finding it more difficult to pinpoint exactly why you want a doula and that’s okay IF you let your doula know that. This will help her be at ease in opening herself up to you and exploring all avenues of support she is experienced in giving.

Your doula helps you best when you are proactive in learning about natural birth and all of your birth options. Many books, articles even doula certifying organizations themselves can put out messages about doula definitions. Some say that doulas provide only comfort measures. Some say that doulas are advocates. Some say that doulas cannot make decisions for you. Some say that doulas provide information. The truth is that doulas can be one or all of these things but what they are is dependent on the individual mother they are supporting at that one birth. A doula can play different roles for the same woman for different births. The greater the mutual exchange of insight ~ including setting  boundaries for your doula ~ the more positive your birth experience will be especially if you find yourself presented with a cesarean for true medical indications.

If you are hearing your intuitive voice say that you need something ‘more’ start thinking about what you know about natural birth, all birth options in your area from homebirth to hospital birth, what you know about yourself and what you know about who you currently have in mind to be at your birth.

If you are early in your pregnancy start with a comprehensive natural childbirth class. You will need time to:

• Learn about keeping yourself low-risk and healthy so you can keep all of your options open

• Learn about your local birth care options

• How labor begins

• Variations of normal first stage labor

• Variations of normal second stage labor

• Variations of normal third stage labor

• Recognizing the true medical situation requiring medical intervention

• How your baby’s health is affected by how you labor including,

• Breastfeeding and how you and your baby’s breastfeeding relationship is affected by how you labor

• Understand how your local birth care community affects your birth (you may decide it’s your careprovider that’s leaving you feeling less than fulfilled!)

• Learn about your resources should you experience a traumatic

• Process the information and make some informed decisions and birth planning including changing from your original careprovider and birth location if necessary

This is the knowledge foundation you need before interviewing doulas. You will be prepared to know exactly what you need. Using the same process you applied to identify the careprovider right for you, you’ll be able to recognize the right doula for you. To be clear, your doula will never make decisions for you but she can be pivotal to your decision-making process as at this point you will know what real birth is and you’ll be prepared with real options. Options that she can remind you or your partner about rather than try to educate you when you’re in no mental or emotional condition to think them through with the time and effort you and your baby deserve. She can provide the physical comfort you’ve read about AND she can give you the mental and emotional support that comes from sharing her own birth experiences as well as those of women whom she has witnessed labor and birth. She can share the insight of births with unexpected outcomes, what may have contributed to them and put your decision in a educated perspective rather than being motivated by irrelevant external influences. These priceless experiences shared intuitively let your birth unfold as YOUR birth. The moment you’ve waited a lifetime for.

1 Patient Rights Program http://www.patient-rights.org/about/about.html, Health Law Department of the Boston University School of Public Health

Permission to reprint is hereby granted without further authorization as long as the text remains unedited and the author and source, Dale Bernucca for Enjoy Birth are properly cited and credited. Copyright 2007