"Cynthya was our doula for the birth of our third child in April 2016. As this was my third birth, and I had been attended to by a doula at the first two, I knew that finding the right doula was crucial to a successful and satisfying birth." - Winter Wheeler-Young

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6 Points For Birth Partners to Consider When Hiring a Labor Doula

Sometimes, one partner REALLY wants to hire a doula and the other can't justify the expense or won't face the realities of the upcoming birthday. Here are my suggestions of talking points for reserving doula service and private instruction for an optimal birth experience.

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"HELP! My partner doesn't think we need to hire a doula."


Yikes! I've heard this before from clients and students of my classes. Sometimes, one partner REALLY wants to hire a birth doula and the other can't justify the expense or face the realities of the upcoming birthday. Evidence shows continuous support can significantly decrease the risk of cesareans, NICU admissions, Pitocin, and medications for pain relief, as well as increase satisfaction with the birth experience altogether.

Here are my suggested talking points for reserving the services of a doula and private childbirth classes:

  1. Ask your partner how they plan to support your labor. Do they want to rub your back or squeeze your hips for 18 hours all by themself? Prior to labor, do they want to memorize optimal labor positions to facilitate progress and avoid a stall that can lead to medical interventions?

  2. Have they prepared to be your SOLE source of emotional and physical comfort? Will they be able to provide you with informational support and advocate for alternatives to proposed medical interventions? Here is an article I wrote for preparing labor partners for the big event. It's generic but what everyone should know in the LEAST.

  3. Who do they plan to have present on birthday to help THEM? Most partners want us to be present for them too, especially upon realizing the nurses won't be in the room but for an average of 10 minutes per hour prior to the second stage.

  4. Yes, preparing for childbirth with a comprehensive prenatal class is VERY helpful, but on birthday, recalling pertinent info on little sleep while watching your partner run a marathon is stressful. Doulas remove the burden from the birth partner's shoulders, relieves their stress and helps them enjoy the birthday/night/weekend. Birthday can be a wonderful bonding experience for you two!

  5. Is their hesitation due to financial reasons? Think about the cost of a c-section and an extended hospital stay. Since doula support is a PROVEN way to reduce the risk of c-section, hiring an experienced doula WILL SAVE YOU MONEY. Many of our clients use their HSA/FSA debit cards to pay for childbirth services such as classes and doula support. Our agency includes our NPI number and taxonomy code on our order confirmations so you may attempt reimbursement from your insurance company or HSA/FSA accounts.

  6. The American College of Obstetricians and Gynecologists say doula support is NECESSARY in the prevention of the primary c-section! Here's an excerpt from my blog post with links to the research:

"Today, approximately 60% of all cesarean births are primary cesareans. Although cesarean birth can be life-saving for the baby and/or the mother, the rapid increase in cesarean birth rates raises significant concern that cesarean delivery is overused without clear evidence of improved maternal or newborn outcomes. 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 (111). Given that there are no associated measurable harms, this resource is probably underutilized."


The most important thing a woman needs during labor is continuous support.

Read (and share!) this article by Evidence Based Birth. Here's an excerpt: "Labor support also increases satisfaction and the chance of a spontaneous vaginal birth. Although continuous support can also be offered by birth partners, midwives, nurses, or even some physicians, research has shown that, with some outcomes, doulas have a stronger effect than other types of support persons. As such, doulas should be viewed by both parents and providers as a valuable, evidence-based member of the birth care team."


Prepare for the biggest day of your life!


You will most definitely need to be prepared for your baby's birthday if you plan to go without the professional assistance of a labor doula. Attend a prenatal birthing class. Our intensive prep - the 3 Hour Labor Lesson - helps your partner gain skills to help you on birthday effectively.

 

Related posts:
5 Reasons to Hire a Doula
Epidural, Please!
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5 Reasons to Hire a Birth Doula

It may be your first, it may be your fourth, but when you’re pregnant and considering your baby’s birth and delivery, having the proper support team is critical in ensuring you and your baby get off to the right start. Did you know a doula can help with that?

by Megan Ciampa, Birth Boot Camp Childbirth Instructor
 

It may be your first or your fourth, but when you’re pregnant and considering your baby’s birth and delivery, having the proper support team is critical in ensuring you and your baby get off to the right start. Did you know a birth doula can help with that?
 

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When I was pregnant with my first child in 2009, I heard this new-to-me term thrown around, “doula.” I learned it was Greek for “mothering the mother” and it’s a professional birth worker trained in childbirth and labor who provides emotional, educational, and physical support to the pregnant woman before, during, and after labor. Generally that means she is not one of your friends or family members, or a part of the medical staff. While I thought that sounded nice, I couldn’t imagine anyone else in my birth environment other than my husband and our midwife/medical team. However, I was then exposed to the statistics of labor and birth for when a laboring mom has a doula present, and I was shocked. Doula? Hired.
 

Here’s why you want to hire a birth doula:

  1. With birth doulas, the rate of cesarean section decreases 28%. I didn’t know much when I was pregnant with my first baby, but I knew that if I could avoid a c-section, that would be ideal! A labor doula’s continuous support throughout childbirth help a mom feel more at ease, reduce discomfort, and help her find different positions to move into to help baby down and out the birth canal. A c-section, while it can be a life-saving surgery, is major abdominal surgery and can put mom and baby at risk during and after birth. (Statistics from Cochrane Review)

  2. With a labor doula, the use of Pitocin decreases 31%. Have you ever watched A Baby Story on TLC, or any other reality birth TV? If you have, then you may have seen what happens when a mom who is laboring naturally, on her own, is given Pitocin (which is a synthetic version of Oxytocin, a hormone our body naturally produces during labor, breastfeeding, and lovemaking, which assists in making the uterus contract). When a woman is given pitocin, the intensity and strength of her contractions increase significantly. And because it’s a synthetic hormone, the body cannot respond with its own stress release mechanisms the same way, and it’s extremely uncomfortable for the laboring mom. While labor can be done without an epidural, many a woman opts for an epidural after pitocin is administered to help cope with this incredible intensity. (Statistics from Cochrane Review)

  3. With doulas, the likelihood of spontaneous vaginal birth increases 12%. Spontaneous vaginal birth is the simplest kind of delivery process. It just means vaginal delivery happens on its own, without doctors or midwives using any tools like forceps or a vacuum, to help pull the baby out. This is a good thing because while any of these tools may occasionally be used for emergency purposes, they also come at a risk to the mom and baby. Doulas can help the mom get into a better birthing position that applies the right amount of pressure to her cervix to allow baby to come out safely. (Statistics from Cochrane Review)

  4. With doulas, the risk of being dissatisfied with the birth experience decreases 34%! With a labor doula present, you can know you have probably tried every option and resource possible to ensure you have as good a birth experience as possible. Because they have knowledge, tools and other resources available to them to assist you, it relieves pressure and anxiety on your partner or spouse, who may also be needing some emotional support during labor, and helps equip them to help you. All of this in turn? Drives higher satisfaction for you during your birth experience. (Statistics from Cochrane Review)

  5. With birth doulas, the length of labor can decrease by 25%! I don’t know about you, but when I watched A Baby Story and saw the clock ticking and how long those moms were laboring to bring their babies to the world, my empathetic heart hurt for them. Those can be some long, hard hours. So, with a doula present, who helps you feel more safe, secure, and emotionally present, often labors are shorter. With my first birth, my highly experienced doula had me try several positions: squatting, walking, rocking, sitting on the toilet (it relaxes you in an unexpected way--trust me!) to help me get the baby further down the birth canal. I’m convinced that without her efforts, my approximately 12 hour labor, which is pretty great for a first-time mom, would’ve lasted hours longer! (Statistics from americanpregnancy.org)


Experts agree that Cesarean Sections or c-sections, particularly among low-risk, first-time mothers, may not be necessary and can be actually be risky for mother and baby. Various evidence-based strategies aimed at hospitals and health care providers can help reduce c-sections in low-risk women. Evidence shows that doula support improves birth outcomes, including a vaginal delivery with lowered risk of episiotomy and other interventions.

A doula is a pretty great person to have around when you’re pregnant and giving birth, as well as afterwards in the postpartum period. While doulas weren’t so common about 10 years ago, they are sought after more than ever. Won’t you hire a birth doula today?


References:

https://evidencebasedbirth.com/the-evidence-for-doulas/
http://americanpregnancy.org/labor-and-birth/having-a-doula/ 


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Epidural, Please!

I've had several women tell me, “Oh, I don't need a doula. I'm planning to get an epidural.”

 

An epidural can be an amazing thing! There's a reason why 60% of women who give birth in the U.S. choose to get one during labor. Many women feel like their birth experience is more positive after receiving an epidural, and I have seen laboring women that I'm working with become so much more relaxed, focused, and finally able to catch their breath and rest after opting for one. For many women, just knowing that an epidural is part of the plan, when labor becomes too painful and intense, relieves some of the anxiety associated with the unknowns of being in labor and having a baby.
 

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I've had several women tell me, “Oh, I don't need a doula. I'm planning to get an epidural.” Or they think that a doula will only support women who want a natural birth. Before I became a doula and when I first started my training, I thought the same thing! I now know that having a doula is a great resource, no matter what kind of birth you are planning to have. 

Your doula sees the bigger picture, and is there for you and your partner before, during, and after labor. As a continuous and trusted presence, your doula is there to help you understand the labor process, what your labor will look like and how it will change when you get an epidural. Your doula wants you to be informed and in control of your birth and can provide information and suggest questions you can ask your health care provider. 

Having a doula is a great resource, no matter what kind of birth you are planning to have.

Even if you are planning to get an epidural, a doula can support you while you labor at home and when you first arrive to the hospital. The transition from laboring at home to getting set up in the hospital and receiving an epidural will take some time. Knowing different methods to cope with the labor pain and any anxiety you feel will help make the transition easier. An epidural is just one form of pain management. A doula will help with other relaxation techniques before you get the epidural and can show you epidural friendly positions as you labor. You won't be able to move around as freely, but you can still change positions while in the bed, which will help you as you labor.
 

Your doula has a peanut ball and knows how to use it!

The peanut ball is most commonly used when a laboring mother needs to stay in bed. Studies show that epidurals lengthen the amount of time women spend in labor. Lengthy labors and ineffective pushing increase your chances of needing a c-section. Your doula will help you use a peanut ball to promote dilation and descent, change positions while you're in bed, and stay relaxed, which can help shorten your labor and make it less likely that you will need a c-section! Getting an epidural won't necessarily take away your anxiety about giving birth. Having someone with you, however, who is familiar with the labor process and can be reassuring and help you feel more confident and relaxed. 

Your doula will also be a great resource to your birth partner! Sometimes our birth partners are so focused on their loved one, they forget to take care of themselves! A doula is there to provide an extra pair of hands and remind both of you to rest and stay nourished. As Cynthya describes in one of her posts about the role of a doula, 


"A doula can preserve the intimacy of the birthing room and be a consistent care provider for you and your partner. Doulas maintain the ambiance of a labor room, keep good energy flowing, and help limit distractions, which allows the couple to relax and know they are cared for. Your doula wants to make sure that you both enjoy the birth of your child and has only your interest in mind. After all, birth is her passion and you've hired her for this special event - use her to your full advantage."
 

Your doula is on your team and trusts that you are a strong and capable woman who can listen to your body and decide what kind of birth you want to have and wants to help you embrace whatever forms of pain management you decide to use. She will be there supporting you along the way.

Review your options for building your support team by reading the profiles of our team.


 

 
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Along For The Ride: Embracing The Roller Coaster of Motherhood

PART 1 OF 3, THE HOLISTIC APPROACH TO CHILDBIRTH AND POSTPARTUM

 

Part 1 of 3, The Holistic Approach to Childbirth and Postpartum

by Stephanie Finn, Certified Pediatric Nurse Practitioner and Registered Nurse

 

In this series of posts I would like to share with you some things to consider when searching for pediatric healthcare setting. First, I will share a little background about myself and few personal insights from my experience with having a doula and snippets from my postpartum journey. 

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I entered the scenario of prenatal care and obstetric services as a pediatric nurse practitioner. In addition to managing my own unique health concerns and wanting the best for our baby, I had several years of education and experience as a nurse working with children under my belt. I have witnessed first-hand the concerns of parents fraught with so many important decisions to make in a short amount of time, albeit a precious emotional time. This spans everything from breastfeeding issues, formula selection, vaccination concerns, treatment side effects, potential surgeries, food allergies, mental health concerns, you name it. I knew that I needed to provide my body with the most healthful foods and supplementation, exercise, meditate, pray, and stay centered and at ease throughout the turbulence that can surround pregnancy and early motherhood. Pregnancy is a joyous time, and although we are designed to carry and birth children well, it can be particularly demanding for mothers juggling work, caring for other children, or managing health concerns. With all of this in mind, I began my search for a doula.  

First, I must say, I am so thankful to have a loving and supportive husband, who took great joy in helping me with decisions surrounding our birthing day. This was huge! For those in a relationship, having a doula can bring a lot of relief and support to both you and your significant other. Not every mother will have this support—and as I see it, doula care is even more valuable in these situations. 

Although I have a handful of very close friends and family who have walked beside me in the best of times and the worst of times (incredibly thankful for them), and very kind extended family members, there was one key piece missing for me during my pregnancy, and more so postpartum: Nearby family-the ones I grew up with so close to me. 

We all share the desire to connect with those close to us and to fulfill our needs and matters of the heart.

My mother and the close-knit family I grew up with do not live in the same state as my husband and me. This was disheartening for me as I longed to share more special moments as a new mom with them. Even though they are not extremely far away, I missed the communal aspect of being near them. Growing up with a large family full of women and children, I was blessed with the joys of engaging in frequent chats around my grandmother’s kitchen table, having tea on the back porch, time to vent frustrations with family and share our joys, laugh together, and most importantly, do this with those who knew me well as a person. I realized this interaction was so much a part of my norm and integral to my being. While it did not dampen my joy and gratitude surrounding the blessing of a baby, this need became so apparent during my pregnancy and journey postpartum! I’ve heard many mothers relate to this need in varying ways. Whether one’s family is large or small, the key is that the support network must be one that is relatable and unique to the mother. It’s her village, her sustenance. Though the circumstances are unique to everyone, we all share the desire to connect with those close to us and to fulfill our needs and matters of the heart.  

Social support has been reported to be a buffer to postpartum depression. What social support means is individual. While one mom may need a few weeks to bond with her new baby with one or two significant others around, another may prefer a more extended network of visitors around. Many new moms may need to make arrangements to visit family, and some may need to warm up to visitors or childcare situations. A new life has shifted from the inside of her body, to the outside world; she has evolved, and there is a beautiful yet major shift taking place during this time. This precious time is not without some degree of vulnerability.  

Ensure the new mother is comfortable and has the conditions she needs to heal physically, rest, and bond with her baby.

The common thread which is important to keep in mind postpartum is to ensure the new mother is comfortable and has the conditions she needs to heal physically, rest, and bond with her baby. Baby needs mom to be supported! I vividly remember our doula encouraging us to make choices that would be conducive to mother-baby well-being and our health as a growing family, regardless of outside pressures. 

The experience of missing family postpartum, being extremely exhausted from breastfeeding and the accompanying sleep deprivation (along with expected hormone shifts) certainly granted me moments of feeling anxious. It’s quite the adjustment. To date, my sweet little one has spent more time in my womb than outside of my womb. The motherhood rollercoaster is just beginning! 

My heart is full. I am happy to say that with a supportive husband, an encouraging doula, awesome healthcare provider, a supportive employer and a handful of close friends and family as advocates, I truly ended up with the support I needed. Despite the longing for back home, I was able to stay afloat and keep from spiraling into postpartum depression. Support showed up in unexpected places. 

The good health and smile on my child’s face was more than enough to keep me going on days when sleep was out of reach. I had to be proactive to create time and space for what I needed to take care of our baby and myself. Also, I reminded myself that there are gracious and understanding people who have been there. Moms, do not lose sight of this! Thankfully, from the beginning I had the most joyous bond with our baby girl. My heart has stretched with welcoming our greatest treasure into the world, and also for new moms out there who are in the throes of postpartum hormone swings or depression. 

I had to be proactive to create time and space for what I needed to take care of our baby and myself.

We can all help pregnant women and new mom’s seek out the support they need. Be proactive. Ask, and do not assume what they may need or what they should be doing. As the old saying goes, “Mother knows best.”

As you navigate the world of pregnancy and postpartum, be true to yourself and trust your inner guidance. Reach out for the care that YOU need to be healthy, and fully embrace it. Trusting that you are doing what’s best for you and letting go of the rest will become easier with practice. Pray about it, meditate on it. Find your advocate(s), and extend this custom care to your child and family. 

In my next post, I will share a few things to look for in a healthcare setting for the bundle of joy that is entering your world! Soon to follow I will be sharing more details about my birthing day!
 

Stephanie Finn is a Certified Pediatric Nurse Practitioner and Registered Nurse at CentreSpring MD.

Read Part 2 of 3: Holistic Care For Your Child After Using A Doula

Related articles:
How To Avoid a C-section Without Changing Hospitals
Consider Hiring a Labor Doula 
Childbirth Classes Have A Measurable Impact On Birth
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