Monday, 22 June 2009

What Would I Do Without my Doula?

by: Suzanne Doyle-Ingram
By the time my husband and I finally got pregnant the first time, I had done a lot of reading about birth options and we had already decided to have a midwife instead of a doctor. We believe that pregnancy is a healthy state of being, and unless something came up, a midwife was the best way to go for us. Besides, where we live, a midwife can deliver babies at hospitals, so I felt that was the safest way to go. (Although, now, I feel I could have had my babies at home... but that is a whole other article!).

When I was a few weeks pregnant I came across an article on doulas, but I had never heard of a doula so I wasn't quite sure what to make of it. A doula is a woman who supports women through childbirth. "Doula" is an ancient Greek word meaning "servant to women". A doula provides a woman with continuous emotional support, aides in her physical comfort, and encourages the laboring woman. She also provides praise, reassurance, and explains what is going on during the labor. While some husbands and partners may feel that it’s their job to offer support to the laboring woman, and therefore initially feel that they would not want a doula, after the birth they are very pleased and relieved that they had one. A doula can help husbands and partners by suggesting ways they can help the laboring woman, and doulas actually assist the husband to feel like he is contributing.

Studies have shown that women supported by a doula during labor have:

50% reduction of cesarean rate
25% shorter labor
60% reduction in epidural requests
30% reduction in analgesia use
40% reduction in forceps delivery
From Mothering the Mother: How a Doula Can Help You Have a Shorter, Easier and Healthier Birth by Marshall H. Klaus (Perseus Press, 1993)

When I was about halfway through my pregnancy, we decided to interview some doulas and see if it would be right for us. We met with three doulas. The first one was Jan, who we ultimately picked. We liked her right away and I wanted to hire her on the spot, but my husband insisted that we meet the other doulas too because we might find someone we like even more. (How could that be possible?, I wondered.) Well, it turned out that the other two doulas were wonderful too, but our instincts told us to go with Jan. So we hired her.

We had to give her a deposit of $100 to confirm our commitment, and sign an agreement as well. How do I describe this fabulous woman? She is very tall and has a great presence. She is quiet, knowledgeable and thoughtful; she doesn’t speak a lot, but when she does it is carefully thought out. In other words, she is not “chatty” but not shy either. She has an engaging smile, she is discrete, and she is strong. I felt like she could sweep me up in her arms and take care of me!

Jan came over several weeks before my due date to do some one-on-one prenatal training with both James and I. She is a lactation consultant as well so she helped by answering my questions about breastfeeding in addition to my questions about what to expect during labor.

I went into labor three days before my due date, on August 13, 2001. It was about midnight and I was just getting into bed when I felt (or heard?) a loud POP! And then another one. And warm liquid dribbling down my legs. My water had broken. Yay! This was finally happening.

The contractions started immediately and James rubbed my thigh while I rested on the bed. The contractions got closer and closer together and James called Jan at about 5:00am when they were about 5 minutes apart. They got really intense after that and by the time Jan arrived, I was vomiting in a bucket on my bed.

Jan threw down the birth ball she was carrying, flew across the bed, grabbed my hand, looked me straight in the eye with her face close to mine and said, “I want you to breathe like this.” In an instant, she had me calmed down and breathing effectively. She was amazing. I went from being in a total panic to feeling like everything was going to be ok.

When my midwife arrived at 7:00am, she told me I was about 3 centimetres dilated. I was so disappointed! But Jan was my cheerleader, telling me that I was working so hard, and managing so well, and that my body was only going to give me what I could handle. She helped James help me by suggesting things he could do for me, and he felt taken care of by Jan as well.

It was only about an hour later that Jan noticed my breathing had changed and she called out to our midwife who was in another room doing paperwork. Our midwife didn’t think that I could have progressed that quickly but Jan stood her ground and said, “It really sounds like she is trying to push.” So the midwife checked me again (doulas do not perform medical tasks) and I was about 7 cm dilated! This was going fast. Suddenly everybody sprung into action and started gathering up all the bags and things we needed for the hospital. If it wasn’t for Jan, I really don’t think we would have made it on time. [Note: In British Columbia, Canada, midwives are allowed to deliver in hospitals, and that was our choice.]

While James drove, Jan sat with me in the backseat holding my hand, talking to me, encouraging me and calming me. She was so amazing! After we got to the hospital, she never left my side. James had to go fill out the paperwork and park the car, but Jan was there beside me constantly.

I felt such complete trust in Jan that I had to hold her right hand a particular way through each contraction. It was quite funny! A contraction would start and I’d yell, “Hand! Hand!” and Jan would come running and grab my hand. I don’t know why, but it was only Jan’s hand that comforted me. It had to be Jan’s hand.

She also helped by taking me to the bathroom and getting me water to drink, a cold cloth for my forehead (without being asked), and waving tissues with aromatherapy oil on them around the room. I found that I couldn’t communicate what I wanted or needed, but Jan always seemed to know, thank goodness. She suggested different laboring positions and she helped during the delivery by suggesting positions for pushing, too. I only pushed one hour and then our beautiful Hana was born. (Hana means "flower" in Japanese). Jan stayed with me while I delivered the placenta (James was on the other side of the room with Hana) and helped me attempt to breastfeed right away. She stayed for about 4 hours after Hana was born and helped me
take a shower and gave me lots of help with breastfeeding.

What more can I say about having a doula? She made my birth experience fantastic. I am one of those people who can honestly say that I enjoyed labor (twice!) and I want to do it again! When we found out we were pregnant for the second time, I could not imagine doing it without Jan. It was a much easier labor and birth, but I am still so grateful that Jan was there – she made it a great experience again. It is true that continuous support during labor has many, many benefits, and I am one of the "lucky" (or is it "well prepared" because I hired a doula?) women who was able to fully experience birth without drugs, or intervention. I had a healthy birth and a healthy baby. And a doula to help us through it all.

For more information, or to find a doula in your city, visit http://www.dona.org, the Doulas of North America website.

I wish you all the best during your labor and birth!

About the author:
Suzanne Doyle-Ingram is the mother of two daughters, Hana and Alexa, and married to her best friend James, who is a stay-at-home dad and educational game developer (and he makes a mean grilled chicken!).
Suzanne is also the creator of http://www.pregnancy-leads-to-new-babies.com an informative site for pregnant women and new moms, which provides information on pregnancy, labor, and how to take care of your new baby.

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