Birth Doula Blog
So, you've decided on getting a doula. Now what? To give yourself a few options, interview at least three candidates and choose based on the connection, not just on the fee, experience, or reputation. A pricey doula doesn't necessarily mean she's giving you quality support. An experienced doula doesn't always mean she's right for YOUR experience. And a popular one is simply one who's talked about, but there might be another one who could be a best-kept secret. Ask the following questions to get to know the person she is, her values, work ethic, and client-doula relationship. Make sure you and your partner both get the same positive vibe and that she meets your individual priorities.
Ask the questions that are important to you. Oftentimes, potential clients just go down a list of questions they found on Google and the meet-and-greet quickly becomes a high-pressure job interview. Maybe experience doesn't matter to you or maybe meeting often isn't a deal breaker for you, so skip those questions. Stick to the topics that are suited to your needs and goals.
P.S. If you decide to pass on her, be courteous and let her know. It's just the nice thing to do!
I'm a straight shooter, so I'll start by saying that there is a time and place for an epidural. Personally, I believe it's overused, rarely necessary, and not fully understood by laboring people. If the immediate and future benefits and risks are truly considered then I see no problem with the use of an epidural. My biggest issue with it is that the promise of quick pain relief overshadows the uncomfortable prep work that is needed prior to administration, the potential risks during its use, and the effects after it's been removed. That being said, there are actual circumstances in which the benefits outweigh the risks.
So, maybe you are new to this doula thing or all of your friends have gotten one for their labors and swear they couldn't have done it without the help of a doula. Now you're wondering if you should get one too. I mean, all the cool kids are doing it, right?
Even though I'd love your business, I'm not going to lie to you. Doulas aren't the only ones who can improve your birth experience. I say it all the time, surround yourself with the RIGHT people! Studies have shown that having doula support during pregnancy and labor can decrease your chances of a C-section, need for pain medication, and assisted delivery. We can also increase your overall satisfaction with your birth experience and improve breastfeeding and bonding outcomes. But how does a doula have that effect and can anyone else give you those amazing outcomes?
\Let's talk perineal prep and care! Many women wonder if they will tear during a vaginal birth and if they can do anything to prevent it.
WHY DO TEARS HAPPEN?
Contrary to popular belief, a baby with a larger head isn't always the cause of tears. They typically happen when the perineum doesn't have enough time to gradually stretch due to a baby who's emerging very quickly or if the skin doesn't easily stretch even with a slowly emerging head. During the pushing stage, you might have a provider tell you to slow down your urge to push if they believe the skin hasn't fully stretched. This is easier said than done, but some controlled breathing, small grunts, or laying on your side can help slow down the process.
Tears may also occur if baby is malpositioned. Getting in certain positions can encourage baby to turn into an ideal position to prevent a tear. Laboring upright for too long can also apply too much pressure on your perineum. I suggest you switch positions every 30 minutes. Pushing with an Epidural means you may end up with directed pushing, where the nurse tells you when and how long to push. Directed pushing could sometimes be ineffective and exhausting because you can't properly feel the urge to push or recognize the muscles required to push. I recommend you turn down/off the Epidural at 8-9 cm. so that you can feel your pushing urges and listen to your body. It'll know how and when to push.
Lastly, you're more likely to tear for your first vaginal delivery than subsequent ones.
CAN TEARS BE PREVENTED?
While no one can predict if you'll tear, you can definitely help yourself during labor by forgoing numbing meds such as an epidural or getting a low dose of them. If you are unable to feel your urge to push, the staff will likely direct you to push before your body is ready, before your perineum is ready. This unnecessary pressure against your perineum can increase your chances of tearing.
During labor, a warm compress to the area can help relax the muscles, provide counterpressure, and help you focus on where your pushing muscles are.
Studies have also shown that laboring with a midwife or at a birth center/home setting reduces your chances of tearing. Midwives are known to do fewer interventions, which can lead to tearing. Laboring in a comfortable environment such as your home leads to better outcomes due to your relaxed nature.
When choosing a provider, remember that YOU are the customer and you have choices. If you're not vibing with your provider, move on and find someone who will support you.
Be honest with your doctor and tell them there are a few important questions you'd like to ask. If they don't even take the time to hear you out then that's your sign to find someone else. It's best to know early on if they're a good match for your labor experience. Keep in mind that there is no labor police and you have total autonomy over your body and baby's. Provider preference/recommendation is not law and you have the right to choose what feels right to you, even if it's outside of the norm.
If you truly have no say about which provider you get and you're not quite comfortable with them, consider switching to a midwife, a home birth, laboring as long as possible at home, or having a rockstar support partner with you at the hospital.
QUESTIONS TO CONSIDER WHEN CHOOSING A PROVIDER:
-Do you support unmedicated births and what are your views on them?
-How do you support medicated births and what are your views on them?
-Do you support breech births, how?
-Who are your backups and will I meet them?
-How do you feel about doulas?
-How do you feel about birth plans?
-What are your induction and C-section rates?
-Do you support a VBAC and how do you ensure it'll be as successful as possible?
-How do you view pain during labor?
-What is your plan if I go past my due date?
-How many hours will you allow me to labor after my water breaks?
-How long will you allow the umbilical cord to remain attached?
-Will you administer Pitocin to deliver the placenta?
Remember that if you choose an OB you will likely only labor with them for a short while, as they tend to cover multiple births at a time. Still, knowing ahead of time how they can support you during the expected and unexpected can help you decide who better aligns with your wishes.
For an even better experience, choose your hospital wisely and get support from a doula, or make sure you and your birth partner are well-educated and able to make decisions during complex situations.
Choosing your hospital is just as important as choosing a provider. You will likely labor with the staff much longer than you will with your provider so be sure they can meet your needs.
Call the Labor and Delivery Department, take a tour, or visit their website to find the answers.
QUESTIONS TO CONSIDER WHEN CHOOSING A HOSPITAL
-What kind of pain medication do you offer?
-What laboring tools do you provide (birth ball, stool, tub, etc.)?
-When are vaginal exams performed and are they required?
-How is baby's progress monitored?
-Am I allowed to eat, drink, and move freely?
-What are your C-section and induction rates?
-How do you support complicated births?
-Do you support breech births, multiples, and VBACs?
-What procedures do you follow immediately after birth for mom and baby? When do they begin? Are any of these optional?
-What security measures do you have in place?
-What do you provide during my stay?
-How are you prepared for emergency situations?
-Do you have a NICU?
These are all excellent questions to get a conversation started, but remember that your birth education and support system have an even greater impact on your experience than where you deliver.
Not one book could ever truly prepare me for breastfeeding. Yes, I had understood the physiology behind it and knew of the benefits, but the actual feeling and experience could never be accurately described in the books. And it wasn't just the feel of a small mouth on my nipple that was never explained, it was the emotional toll it would take.
Thirteen years ago, I was the first in my family to breastfeed, so I wasn't able to get any insight and words of wisdom from my sisters or mother. It was somehow easier for me to envision being a first-time mom than it was to have a baby latched at my breast. That first feeding in the hospital was so awkward. How could something so natural feel so unnatural? I thought that first latch would be the end of the uncomfortableness of nursing, but so many more challenges faced me.
You're almost there, but don't quit just yet! You did great on that birth plan but have you planned for the "after" time? Also known as the fourth trimester, the twelve weeks after baby's birth is a period of growth, change, and adjustment for parents and baby. It's no secret babies require lots of time and attention from both parents while they're running on little sleep. This can make some new parents pretty overwhelmed and make it harder to make decisions, find time for themselves, or feel like they're nailing it.
To prevent feeling underprepared, many experts recommend crafting a postpartum plan that can help you transition into parenthood and identify helpful resources before you need them. You don't need to literally write one up, but you should discuss important questions with your partner, such as household responsibilities, newborn care, intimacy, and visitor policy.
Just as with a birth plan, your postpartum period may not go according to plan, but it will help you feel prepared to make decisions and make clear how you envision the first few months after giving birth.
Click here for a printable postpartum worksheet and scroll down.
The Five Mistakes I Made Giving Birth
Almost fourteen years ago, my husband and I carefully crafted the birth plan for our first child. We attended the 12-week Bradley Method course, read What to Expect When You're Expecting, and Ina May Gaskin's Guide to Childbirth. In my last trimester, I began attending La Leche League meetings and my baby's nursery was stocked and ready for her. On paper, we were prepared, informed, and diligent. We deserved a good birth experience. We were sorely mistaken and looking back at the plan I had saved on my Google Drive only reminds me of how poorly prepared we were. Sure, my plan detailed what I wanted to avoid, how I would labor, and the newborn procedures we preferred. It all checked out...it was easy to read and even buttered up the hospital staff. The goal: healthy mom and baby. Who doesn't want that?
Me. I wanted more.
If I could redo my births, I'd do them at home! But alas, I was young and uninformed. It goes like this: You're pregnant, you see an OB, and you deliver at a hospital, right? Well, I sure wish someone had told me I was an excellent candidate for home birth and that I didn't need to be a hippie to give it a try. In fact, home births and the use of midwives are on the rise but only 1% of births are at home.
The benefits of home birth appeal to many first-time and repeat moms, including those seeking to avoid a repeat C-section. But a home birth is not for everyone and it requires more preparation and responsibility from the parents.
No nurse interrupting your laser focus with her monitoring and cervical exams?
No time restraints or restrictions on movement or nourishment?
No nurse waking you every few hours after you've had baby? Trust me, sleep is hella precious after birth!
Less risk of infection and use of forceps and C-section?
SIGN ME UP, LIKE YESTERDAY!
Still unsure? Read on to calm those doubts.