Supporting women and their partners to birth: Gently, Confidently, Safely
Welcome to My Blog!!
"So what do you do?" "I'm a Doula." "(pause) What's that?"
This is the usual response I get from people when I'm asked about my work. Every hundred or so people I get the "Oh really? That's great", and I nearly fall over in surprise that they know what it is!
Doula's are still a fairly new breed within Australia, and even newer in SA, so it's a bit of an uphill battle to educate people about who we are and what we do, particularly as the period of time that someone needs us is relatively short, but we're getting there.
I absolutely love my job. Supporting women and their husbands or partners during the most significant time of their lives is an incredible privilege, one I do not take lightly. I have toyed with the idea of midwifery, but for me, I am far more interested in supporting a woman to have the most magnificent birth experience she can have, than in worrying about the clinical side of things. I want to be there to support women and their families on an emotional, mental and spiritual level, to "hold the space", as I watch a woman transform into a mother. What can be more beautiful than that!
I hope you enjoy my blog. There will be plenty of joy, some helpful tips for those on the journey toward parenthood, and lots of things that inspire me as a woman, wife, mother, Doula and friend! Welcome!!
Finally I've worked out how to upload pictures!! Woohoo!! These gorgeous shots are of the beautiful Kath and her partner Tom waiting for their little girl to arrive. Kath and Tom had changed care provider towards the end of their pregnancy, when they realised that the OB they had chosen was not supportive of their birth choices. They changed hospital and OB so they could have the natural labour and waterbirth they wanted. Kath was so focussed throughout her labour, this pic is of her blowing onto the water to help her focus on breathing through the contractions. Tom was absolutely fantastic. He was really involved and supportive of Kath, and very protective, NO-ONE was going to do anything to Kath that she didn't want! His presence and strength was such a huge comfort to her. Kath was determined to have a waterbirth, but as she got closer to birthing, we discovered that there were no midwives available who had experience with waterbirth, and it was starting to look like it may not "be allowed". The lovely dutch midwife caring for Kath informed her that although she would be happy to support a waterbirth, she had no experience with it and protocol demanded that she get out of the bath to birth. Kath and Tom faffed around in the bath until it was too late to get out, so the midwife rolled up her sleeves and with Tom in the bath with Kath, their beatiful baby was birthed exactly as they had planned, with her father lifting her out of the water into her mothers arms! What a beautiful mother and baby!! It's such an honour to be able to support women and their families during birth, and to be able to support 2 such amazing people as they welcome their baby into the world is an absolute privilege! In Kath's words, "Both my partner and I walked away in disbelief, amazement and excitement at both the miracle of birth and that we had been so lucky to have such a wonderfully positive birth experience."
If you are thinking of choosing an Obstetrician as your care provider for pregnancy and birth, it is essential that you choose someone who is the right fit for you. Just because your sister or friend had a particular OB and was happy with them, doesn't mean that you will be. After all, you wouldn't choose their husband/partner for yourself, so why would you automatically go with their OB?
The movie Knocked Up was less than impressive on the birthing side, but they did get a couple of things right. Interviewing at least 3 OB's is vital in discovering whether that person will respect your wishes for the birth you want. I wouldn't accept the "intimacy" of the interview process in Knocked Up (totally un-necessary!), but at least they didn't settle for the first OB they met. You might form a really good opinion of OB #1, but when you interview #2 you may discover that the first was really not on the ball with current evidence-based care.
Be informed of what is acceptable and safe obstetric practice before you begin interviewing, otherwise you won't know if what you're hearing is myth or reality. Unfortunately there are many OB's who would rather do a caesarean for their own convenience than wait and give you time to birth your baby naturally. However there are also some fantastic OB's who will not rush in to perform un-necessary surgery, and will give the birthing mother the respect, time and support to birth the way she wants to. But how do you work out who is good and who should be avoided?
Firstly, work out what you want your birth to be and why you want that. Do you want a completely natural, drug free birth? Do you want a natural birth, but are open to the idea of drugs if you decide to use them? Do you want every drug under the sun? Do you want a caesarean? Are you basing these decisions on what is best for you and your baby, or are you making decisions based on fear? Have you considered and researched all the options for maternity care? Don’t forget that although some women may need obstetric care, for the vast majority of women the very best maternity care you can receive is from a midwife.
Secondly, take responsibility for your birth. It is not the OB's responsibility to make the decisions and tell you what to do. It is your responsibility to accept this birth as yours, and make wise well thought through decisions about what you want, and then tell your OB what will be done. If they try and push you to do things a certain way that is against what you want, then they are not the right one for you, and you should take your business elsewhere. Do not forget that you are the client, you have the business they want, and they need to be respectful.
Thirdly, inform and prepare yourself well. Read the good books, not the ones written just for a laugh, (see recommended reading list below) remember that knowledge is power, and if you are well informed you will make wise decisions. Speak to people who can help you find answers to your questions, not just your mum or girlfriends, as helpful as they may be. Talk to midwives and Doula's. Even if you would never consider homebirth, talk to the independent midwives, they are highly trained, experienced and a wealth of knowledge, they will offer a different perspective which can only ever be helpful in giving you a more well rounded understanding of birth.
Fourthly, hire a Doula to support you and your partner throughout your entire labour and birth. Doula’s, unlike hospital based midwives and obstetricians, will stay with you throughout your entire labour and birth. Having that continuity of care makes an enormous difference to your ability to cope with labour and both mother and baby’s well-being.
Write down all your questions, so that you won’t forget them at your appointments. It’s all too easy to get distracted by listening to baby’s heartbeat and the myriad of other checks, and forget the questions you’ve been waiting all week to ask.
Here are some Interview questions for Obstetricians.
Under what circumstances do you consider Induction necessary?
If my waters break but I do not go into labour immediately, how long would I have before you would want to intervene?
What is your policy on breaking the waters, epidurals, episiotomies?
What is your episiotomy rate?
What is your policy regarding monitoring of the baby?
What is your policy on eating and drinking during labour?
What is your policy on Vaginal Breech Birth and Water Birth?
What is your caesarean rate for first time mothers?
What is your VBAC (Vaginal Birth after Caesarean) rate?
Under what circumstances would you consider doing a caesarean?
How do you try to avoid the need for a caesarean?
If an Obstetrician is very vague and dismissive of your questions, or if they patronise, ridicule or try to use scare tactics to convince you of their reasons, go somewhere else. It is better to choose a new care provider than to try to fight for what you want while giving birth. It is never too late to change care-providers. I know of women who felt unsupported by their Obstetricians, so at 8 and 14 days past their respective due dates, they changed care-provider and had the wonderful births they wanted.
Remember this is your birth and your baby, and you deserve to be supported and cared for in the way YOU require.
A Doula is a woman trained and experienced in supporting women and their partners/families during the pregnancy, birth and post-natal period.
Doula's offer physical, emotional and informational support during this time. The role of a Doula is to enhance the experience of birth for you, your partner and your family. Doula's are not medically trained, and therefore will not perform any clinical tasks, this is the midwife's responsibility. Doula's do not make decisions for you, or tell you what to do, but will support, encourage and provide information for you and your partner to make wise decisions for yourselves. Your Doula will support you wherever YOU choose to birth, be that home, birth centre, public or private hospital. Doula's are employed directly by you, and not by the midwife, doctor or hospital.
The benefits of having a trained Doula are many, studies have shown Doula's to be the single most effective "pain relief" available! Having a Doula at your birth will: shorten your labour; significantly reduce caesarian rates, forceps or vontouse; significantly lessens the mothers wish/need for pain medication; improves mothers perception of her experience, her ability to cope and her self-esteem; lowers anxiety and reduces post-natal depression; has a positive effect on breastfeeding and mother-baby bonding; improves the well-being of your baby.(Klaus, Kennell & Klaus, The Doula Book)
