Tuesday, September 14, 2010

HEATHER'S BABY BLOG: What the heck is a doula?

Some women in the Tampa Bay area are bringing a doula into the delivery room to help ease labor and delivery fears, and increase their chances of having a vaginal birth.
Studies show having a doula's support can lower c-section rates, the length of labor and the need for an epidural.
C-sections are the most common surgery in the United States. In fact, one out of every three women has one. A new study suggests women whose labor is induced are twice as likely to have one.
The c-section rate in the United States has shot up from five percent in the 1970's to 32 percent today, which is higher than most industrialized countries. Here in the Tampa Bay area, the c-section rate is even higher, around 38 percent.
There are many reasons that contribute to the high rate, including bigger babies, multiple births, older mothers, medical malpractice concerns and the convenience of scheduling a due date. It can also be a life-saving necessity.
Three and a half years ago, St. Petersburg mother Beth Abernethy had a c-section to deliver her daughter, Ella. The second time around with her son, Colton, she wanted to have a more natural birth. With the support of her doctor and doula, Jane Parker, she had a dramatically different experience.
Beth says, "It made all the difference in the world, to be honest with you. From soothing voices, to rubbing my back, to position changes. My birth with Colton, I was present the entire time. It was a quick birth. I was very fortunate. It was about three and a half hours. It gave me the opportunity that I was really seeking. I wanted to be present at his birth."
Women have been comforting and coaching other women through childbirth for centuries. Doula is a Greek word that dates back some 3,000 years and basically means "mothering the mother."
Beth's husband, David, says having that constant companion eased their anxiety. "The nurses are in and out of the room. It's not like they're standing at your bed the entire time, but the doula is always there. You have that constant attention and you're able to ask questions for yourself and your wife and she's asking a lot of things. So, it's absolutely an invaluable resource."
Doula Jane Parker is a former labor and delivery nurse. She has coached hundreds of parents through the process.
"We can breathe through contractions, use different positioning. If you don't know any better, you would stay in the hospital bed. I use massage, aromatherapy, music, things that can distract. I try to create an environment that is like a cocoon."
Doula Jane Parker answers additional questions:
Why did you become a doula?
Throughout my career as a labor and delivery nurse, I enjoyed and highly valued being able to provide continuous emotional and social support to women as I cared for them in labor. As a doula, I am able to provide this holistic approach to women and their families to help them have a safe and satisfying birth experience.
How can a doula help before, during and even after birth?
A doula meets with the mother and her partner before birth to assist them in formulating and refining a vision for their birth. During birth, the doula is a quiet, continuous, knowledgeable presence who supports them in implementing and further refining their wishes. After birth, the doula may assist in the bonding process, help with breast feeding and review the narrative of this key life experience.
Is a doula recommended along with an OBGYN? What about with a midwife?
Yes! The doula can be a valued member of the birth "team", providing non-medical assistance through comfort measures, emotional support advocacy, continued information about choices and what is happening.
What can a family expect during birth?
A doula is a consistent presence during labor, birth and the immediate postpartum period. She assists with breathing and relaxation techniques, position changes for comfort and to facilitate labor and birth. The doula also supports the family in supporting mom. She will assist in implementing the vision of this family's birth.
What are some of the choices a doula can help parents decide?
One of the most important roles of the doula is to help parents understand their choices within the scope of sound medical and nursing care. Parents, not the doula, are always the decision makers. The "when" and "what" of pain medication, other choices for pain management, positions for laboring/birth, Kangaroo care, breast or bottle feeding are just a few of the choices parents may want to consider.
How do you find a qualified doula? What are the best credentials to look for?
Look for a doula who has received training and certification through a professional organization. Two organizations which train/educate/certify doulas, and with which I am most familiar, are the International Childbirth Education Association (www.icea.org) and Doulas of North America (www.dona.org ). Ask your perspective doula about the number of births she has attended, her availability to you, back-up coverage for emergencies, and if you can speak to families for whom she has provided care. Meet with her in person to determine if you are compatible!
What is the typical cost?
Fees for services range from $200 - $1,000.
Anything else you want to add?
Share some special moments you've experienced with families. The overwhelming delight of a mom exclaiming, "I did it! I birthed my son, my way!" Moments after he was born. A dad, who was unsure he could be at the birth, joyful tears streaming down his face, cutting the umbilical cord of his newborn daughter. Every family deserves a doula to help them have the most satisfying birth experience possible.
Jane Parker, BAN, RN, ICD