Posts Tagged ‘Midwives’
Do I Need A Doula?
Thanks Birthtalk.org for sharing this thoughtful article on the power of the doula! This is a great read if you are thinking about hiring a doula.

Says Melinda, after her first son’s birth, where she was supported by her husband and a doula, “I think that this birth experience has given me a sense of calmness in the way I mother.”
Do I need a doula?
Although most of us expect to have our partners at the birth of our child, there is much research that suggests the presence of another support person can greatly enhance the experience for everyone. Some partners are reluctant to “share” the birth with an outsider, and worry they will be made redundant in the birthing room if there is someone else there in a support role. But talk to couples after the baby is born. The actual experience of having extra support is usually expressed as a blessing, and a part of their positive view of their birth.
Benefits of continuous care
Research indicates that continuous caregiver support during childbirth has a number of benefits, including a reduction of the need for medical intervention such as forceps, vacuum or caesarean, a tendency for shorter labors, and a reduction of negative feelings about one’s childbirth experience. Catherine, a mother of two young children, wishes she knew about this before her first child was born. “I didn’t think I would need any support, as I knew exactly how things were planned to go. I so wish I had someone to advocate for me, and explain my options in more details, and offer me the continuous care I know I needed. I could see the birth just getting away from me, and I didn’t know where to turn.”.
Who will be there for me?
So who is going to provide this continuous presence throughout the labour if it is so beneficial? Usually not the obstetrician…they are generally only called in towards the end of the labor. Traditionally this support has been provided by midwives, but currently our health care system places many limitations on our health carers. And this is especially true of midwives. In our hospitals, it is generally difficult for midwives to really get to know women prior to their birth, as often they don’t meet the woman until she arrives in labor. So it is hard for midwives to know your particular needs, and the “flow” of birth you are looking for. Plus, midwives are often unable, due to hospital policies, to remain with a woman for her entire labor.
Doula definition
Many women are now seeking the services of a professional support person (known as a doula) who see their job as supporting both partners as they enter this new phase of life. A doula can stay with the woman at all times, as well as act as an advocate on your behalf, to work with the midwife to ensure that, as much as possible, your birth is a positive event. She might come to your house when you are in early labor, or meet you at the place of birth.
Midwives and doulas together
If you choose to employ a doula, it is important also that the midwife attending you is a key member of your birthing team. Not only for the safety of you and your baby, as the midwife is the health professional responsible for your care, but also so that you FEEL safe, and have your labor supported from all sides. Your doula can then support you and your midwife by sharing information and providing continuity of support.
First time mum
Melinda, a first-time mum, had doula support for her birth. Her doula attended sessions of Birthtalk’s Antenatal Course with Melinda and her husband. Melinda says, “[During the birth] I was acutely aware of voices around me and the nurturing, supportive energy of my doula, my husband, and a new gentle midwife. When I had a couple of moments of saying out loud ‘I don’t know if I can do this’ they each reassured me that I was already doing it and things were progressing beautifully. Strong, reassuring words that encouraged me to keep going. All the while my husband and my doula kept scooping the warm bath water onto my lower back until their arms would ache and they’d switch over.
Melinda experienced a gentle drug-free birth, from which she emerged confident and strong. She says, “The birth of Tion is probably the most empowering experience I’ve had in my life. I feel content about the way events unfolded and so grateful for the two amazing support people I had present. I think that this birth experience has given me a sense of calmness in the way I mother.”
VBAC (Vaginal Birth After Caesarean) support
Kay, 37, is a mum who experienced a vaginal birth after caesarean (vbac), and hired a doula to support herself and husband Jake. We asked her some questions about the experience…
Birthtalk: Why did you choose a Doula?
Kay: Having experienced hospital policy with the birth of my first child that culminated in a possible unnecessary emergency cesarean, I could not imagine giving birth in the hospital environment without the support of a doula. To know that I was going to take a doula second time round probably gave me the confidence to proceed with falling pregnant.
Birthtalk: Did having a Doula enhance the experience for you in any way?
Kay: Birth is an extremely personal event, physically opening parts of yourself that very few people see over the course of your lifetime. I needed the support of a woman who had already done that, who had absolute confidence in a woman’s ability to birth and who had spent many years present with birth. I needed her confidence, knowledge and belief.
Birthtalk: How did you feel knowing your Doula was there for you?
Kay: I knew that my birth experience was going to be supported and validated. That if there were need for medical intervention, it would have been an intervention decision that I had participated in instead of being subjected to.
Birthtalk: Did having a Doula change the way your husband participated in the birth?
Kay: My husband did not have to be so defensive of my space and needs, and so could attend me in other ways. Having the additional person there was an assistance
Birthtalk: Would you recommend having a Doula to other women?
Kay: If I were contemplating a third baby I would take a doula again. I would sincerely recommend that any women contemplating pregnancy or pregnant to research this option. The step into motherhood following a supported birth is streets ahead of the step into motherhood following my [previously unsupported] birth where I felt a failure.
Choosing a Doula
The woman you have as your birth support needs to be someone with whom you connect, and feel safe, and who feels like ‘the right fit’ for your whole family. It can be helpful to see a few doulas, & ask them some similar questions, which may give you more of an idea about whether a certain doula is going to be right for you.
The process of meeting them and talking with them can give you greater clarity about what your needs are, so it can be a worthwhile process!
Most doulas will travel to support women, so even if they might not be from your immediate area, it is still worthwhile interviewing/chatting with them, just to see who seems like the right “fit” for you and your family.
For a list of Doulas currently available in the Anchorage area, www.AnchorageDoulas.info
For a great rundown on what to ask a prospective Doula, both in the initial phone call, and during an interview, check out this article at Belly Belly dot com dot au
And to read Melinda’s birth story click here
This article ©Birthtalk2010
Melinda with Karen, her doula, who is holding brand new baby Tion.
A Surprising Downside to Epidurals
Epidural anesthesia remains the most popular form of pain relief in labor. Nurses, physicians, and many midwives like epidurals because the mother is comfortable and quiet, resulting in less work for hospital staff.
Laboring women like epidurals because they can remain awake and alert, while feeling little or no pain during labor.
Many negative aspects of epidurals have been debated among researchers. Downsides to epidurals reportedly include delay in labor, increase in vacuum/forceps deliveries, and increase in c-sections. But aren’t these possible side effects outweighed by the positive effect of a pain-free labor?
In one research study, investigators found that women who had pain eliminated during labor still reported that they suffered! Concluding that no pain did not necessarily mean no suffering, Wuitchik¹ emphasized the need for women with epidural anesthesia to have continual labor support available. In this study, women described distress over itching, numbness, and nausea–all side effects of epidural anesthetic. The women also reported concern over the baby’s well-being. A common effect of epidurals is a prolonged drop in the baby’s heart rate. While hospital staff may take this in stride, it can be very frightening to the laboring woman. Another interesting finding was that women reported feelings of incompetence and fear over being left alone once they were “comfortable”. Wuitchik concluded, “With epidurals, pain levels were reduced or eliminated. Despite having virtually no pain, these women also engaged in increased distress-related thought during active labor. The balance of coping and distress-related thought for women with epidurals was virtually identical to that of women with no analgesia”.
Women who had epidurals expressed just as much need for continued support as women who had unmedicated births, concludes another research study.² In fact, satisfaction with the support received during labor had more influence on the woman’s satisfaction with her birth experience than her level of pain relief did, according to Mother-Friendly Childbirth — Highlights of the Evidence.
If you are planning an epidural, or even if you are not planning an epidural but plan a hospital birth — do yourself a favor and hire a doula for continuous labor support. It can make a huge difference in your satisfaction with your experience. I think the fact that continuous support influenced birth satisfaction more than pain relief explains why many studies conclude that women who had unmedicated births (most often these are women who have doulas and/or midwives during labor) were happier with their experiences than those with medicated births. It’s not the medication or the absence of medication that made the difference, but the presence of someone there to give continual support. A partner may give excellent support, but partners need support, too! Partners get tired, need to eat, go to the bathroom, get discouraged, just like laboring moms do. A doula is there for both of you, and a good doula will give you your space when you need it, time for just the two of you when you need it, yet be there with just the support you need at the right moment when it is needed.
1. Wuitchik M, et al. (1990) Relationships between pain, cognitive activity, and epidural analgesia in labor. Pain 41:136-142.
2. Lally JE, et al. (2008) More in hope than expectation: A systematic review of women’s expectations and experience of pain relief in labour. http://www.biomedcentral.com/1741-7015/6/7/abstract

