Coming home from Teaching a great birth doula workshop at the University of Pennsylvania where I have been teaching nursing, midwifery, medical, anthropology, women’s studies students, and community members for over 13 years, I always feel blessings and gratitude to see so many young students sharing a passion to transform maternity care. This weekend was so exciting as we shared our passion for doulas and the many ways that including respectful, loving care will transform, not only our broken maternity care system, but the lives of MotherBaby, Father, partner, family’s and community’s.
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Are you wondering what is a doula and why should I have one?
Doulas are women who support women and their families during pregnancy, birth and postpartum. Her-storically women supported women in childbirth and passed along time tested comfort measures, nurturing and massage that helped make birth easier, shorter and as we are learning from science; safer and more satisfying. Childbirth was a social event that took place in family’s homes. When birth moved to hospital it became a medical event which while we have had benefits from our technology, the loss of support from other women often makes birth longer and harder. Many of our mother’s and grandmothers labored all alone, by breaking the circle of support of women, we lost traditional wisdom and with it the knowledge of natural comfort measures. Lying on our backs, having to endure physical activity without food and drink has made birth more challenging, frightening, and painful. It’s hard to imagine when all you know is the system of fear and pain that saves women with medication and surgery what birth can look like if we truly offer women and their partners a full range of comfort measures and the nurturing support that we know can help you to reduce interventions and have an easier more satisfying birth taking you from pain to power.
What a doula does?
A doula supports mothers, fathers, families and partners to experience birth as whole, honoring that birth involves Body Mind and Spirit. We often forget how- what our mind sees our body feels. I believe by cutting birth off from the rest of our lives we have lost touch with how much our emotions and our spiritually effects our bodies. Think about when you feel stressed, do you feel it in your body? Your hormones change. Enter the Doula! Just as women who live together – have their menstrual cycles come together, we are beginning to understand that women help other women to lower stress and secrete the essential hormone of calm, connection and childbirth called oxytocin. So having another woman at your birth is not just nice, it actually affects your hormones and even a wonderful male with all their nurturing will not have the same affect as a female offering continuous support. So that’s not to say then that he shouldn’t be present, we actually know that when a doula is there to support both of you, you both will be more satisfied and often enjoy even more love and nurturing.
What else do Doulas do?
A Doula offers: touch, acupressure, counter pressure, and a toolkit of position that actually help the baby to rotate and can often help make labor shorter and easier. One of my favorite tools is a Rebozo, a Mexican shawl. Doulas learn how to wrap and rock a MotherBaby. Think of how we swaddle and rocked the baby and how soothing that feels, imagine how it feels when you are wrapped with a warm embrace and gently move to help your baby find its way through your body.
Doulas help create what I call birth ambiance, to help you feel safe, private and relaxed with music, lighting, smells, art, images… doulas help you to create sacred space so that you can relax and open.
Doulas help you to advocate and understand all the choices you have so that you receive informed collaborative decision-making with your caregiver, understanding and choosing what is best for you and your baby
Doulas honor that birth is an emotion and spiritual journey. Doulas help you welcome you baby with respect, love and sacredness.
Why is the time now?
February 19, 2014, The American College of Obstetricians and Gynecologists released a very important consensus statement for the safe prevention of cesarean delivery, there were many key findings that when implemented will not only reduce the overuse of major surgery in childbirth, but it will reduce the sadness and trauma that many women experience, and help birth to return to the joyful blissful state that it should and could be.
I won’t go into details of all the recommendations but the one that has me the most excited, yes you guessed it – here is what they say about doulas:
Published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula. A Cochrane meta-analysis of 12 trials and more than 15,000 women demonstrated that the presence of continuous one-on-one support during labor and delivery was associated with improved patient satisfaction and a statistically significant reduction in the rate of cesarean delivery. Given that there are no associated measurable harms, this resource is probably underutilized.
Yes, Underutilized for sure, but now for long. With the many benefits of a doula, as the late Dr. Kennel said, “If a doula were a drug, it would be unethical to with hold her!”
To learn more about doulas, read DONA International’s standard of practice, and to find a doula visit www.dona.org
Watch ABC News report on “New Medical Warning From the Nation’s Top Doctors on C-Sections.”
Enjoy Lamaze’s Blog from Judith Lothian Safe Prevention of the Primary Cesarean Delivery: ACOG and SMFM Change the Game http://www.scienceandsensibility.org/?p=7958
Or to Access the full ACOG Consensus statement http://www.acog.org/Resources_And_Publications/Obstetric_Care_Consensus_Series/Safe_Prevention_of_the_Primary_Cesarean_Delivery