Sunday, November 3, 2013

WHAT IS A DOULA?

Doula is a Greek word for servant. The definition has been adapted to mean a woman serving a woman in childbirth.

Doulas are trained to provide continuous physical, emotional, and informational support to you and your partner before, during and after childbirth. They assist you during labor with relaxation, breathing, message, verbal encouragement and other comfort measures. They also work with your partner, encouraging his involvement and creating an atmosphere of teamwork and trust.

A doula does not offer medical assessments, advice or treatment. They provide continuous personal support for you and your partner during your birth experience.

I want you to have the best birth experience possible, that's why being a doula is my passion...

My Thoughts on Cesarean Birth

The best policy on Cesarean birth is prevention. I believe that American women would be best served by the Midwifery model for maternity care then the heavily medicalized version we have subscribed to over the past century. Most American women don't realize how different our maternity system is here compared to other modern countries who keep their cesarean rates under 10%.

Our current system has resulted in a cesarean rate of 29.1% (Centers for Disease Control and Prevention, 2005) and an increasing number of women who are traumatized by their birth experience. Hospitals have not made birth safer for mothers or babies. We've been trying to fix a broken system for half a century.

The fix is in. As long as doctors and the powerful money behind our current model reject the midwifery model for maternity care and continue to treat pregnancy as an illness rather than the inherently natural condition it is the system will continue to fail American women. A mother astutely observes that, "There are many rackets in America but the one I find most offensive is "Medicalized Childbirth". The money that is made by the medical community from complicated birth and cesarean sections fuels the miss use of these interventions and women and babies reap the consequences. Before you just accept these medical interventions as necessary research the connection between common medical interventions and cesarean rates in the U.S. Remember when it comes to caesareans prevention is key, and yes in large part they can be prevented.

For those who have already suffered the consequence and who are told that they cannot have a natural birth after a cesarean I would say find another doctor there are doctors who are willing to do this and women are having successful VBAC’s every day. (See my article on VBAC’s to learn more about this issue) For example, a mother I know had a c-section with her first baby because she was told that her pelvis was too small to birth her 9 lb. baby boy. After the birth of her son by cesarean her doctor told her she would not be able to have a baby vaginally, but because this mother had friends in the natural birth community she sought another opinion. The doctor she found was known for his positive position on VBAC’s, he asked her if they had ever done an official measurement of her pelvis which they had not, he measured her and found that her pelvis was perfectly ample and that she would be able to have her next baby naturally. Since then she has naturally birthed five healthy babies with no complications. This is just one story of many like it that should convince women to question what their doctors say and make sure they are receiving the best medical advice.

My Thoughts on Inductions

If a woman is trying to avoid an epidural and allows herself to be induced when there is no pending emergency she will find it nearly impossible. The way doctors induce is aggressive, it is so common to use the epidural with inductions that they don't take any thought for trying to keep the induction as close to a natural simulation as possible. I have known midwives to use pitocin this way with success at giving women a pretty natural experience without drugs, but women should not count on the prudent use of the drug. The standard induction makes the contractions harder and faster than a natural labor progression would be.

An induction stacks the deck against natural birth and one medical intervention inevitable leads to another and another. The induction makes the continuous EFM a necessity to safeguard the baby, which causes unmanageable pain and stress for the mother. The EFM is very physically uncomfortable because of the placement of the EFM around the abdomen a very sensitive area during labor, but it is even more upsetting to the labor process because it limits the mother's mobility so much so that the mother has no physical pain relief at her disposal. She can't really move very easily and usually ends up in bed on her back so the nurses can adjust the straps just right to get a good reading on the EFM, in order to prevent fetal distress. The constant interruptions to adjust the EFM straps disrupt the woman’s concentration and relaxation which is essential to the progress of natural birth.

Women who are induced are also seldom allowed to use the shower or birthing tub to get relief from the pain (except with some midwifes who provide continuous labor support and supervision). It is my opinion that if you are induced you will not likely be able to cope with labor naturally and will just feel like you failed in the end. What you need to know is that failure in natural birth is most often related to medical intervention and not the mother's ability. A women's best chance at having a natural drug free birth is for a women to go into labor naturally, be free from as many medical tools and interventions as absolutely possible, and have natural birth support from a wise woman who knows natural birth well, like a doula or midwife.

My Thoughts on Epidurals

To be honest Epidurals are my favorite pain relief choice of the medical sort. Are you shocked? Well, let me explain. The Epidural is not a narcotic, it does not end up in the baby’s blood, and if managed well it can be adjusted to wear off for the pushing stage of labor to allow the women more mobility to aid her baby at that stage. What’s the catch? The catch is babies whose mothers have had epidurals are less responsive after birth, more fatigued, less likely to breastfeed within the first twelve hours. Women who have epidurals have harder recoveries, more difficulty breastfeeding, and more often experience long term negatives effects from the epidural. In contrast natural birth babies are wide awake after birth and usually stay that way for some time, they are alert with their mothers, and ready to feed immediately. In fact, they have a totally different countenance then epidural babies. It's obvious that the difference is the epidural but why? What does the epidural do to babies if it doesn't "drug them"?

I believe that labor and birth is very difficult on an infant’s body, I believe they are affected by the intensity of it, and I believe that the longer the labor the more fatigued the infant and mother. Studies have shown that in non-medicated births labor time is reduced by at least 25%, this is mainly due to the many advantages of having the entirety of the mothers body engaged the work of labor. The epidural on the other hand renders the powers of a mother’s body useless to her infant and places the unnecessary hardship and stress on the infant during labor; after all they can still feel the pain unlike their mothers.

In an epidural birth the mother who feels no pain attempts none of the natural measure to relieve such pain, therefore as the uterus labors down often assisted by Pitocin to increase the strength of the contractions to speed the labor, the baby alone feels the pain of the labor which pain is significantly greater because no natural measures are taken to relieve it. To further complicate the birth process epidurals with render the mother immobile often lead to a slowing of the labor, which is then treated by the artificial augmentation labor contractions through the administration of Pitocin. Since the mother cannot feel the pain of the contractions it is generally viewed as “no problem” if the contractions are close and hard, in fact it is seen as a benefit of the epidural that the labor can be augmented to speed it up artificially.

Though it may be no problem for the mother it seems from the apparent difference between natural birth babies and epidural babies that it is a problem for the baby. Whether or not the mother feels the contractions they go on crashing down on the baby (who in many cases is without the cushion of the amniotic fluid because of the routine practice of rupturing the membranes early to speed the labor). I believe this is the reason why epidural babies are so exhausted when they are born and less interested in their mothers.

Mothers who are active in their labors are using every measure and tool available to them to speed their labors naturally and help their babies descend the birth canal safely. There are less presentation problems in natural labors due to the labor movement that helps babies get into the right position for birth. There are far less vac and forceps used at delivery because unmediated moms are more effective during the pushing stage, and there is far less fetal distress including respiratory distress postpartum. Only 10 to 14% of mothers who labor without drugs have c-sections, compared to 25 to 30% of epidural moms who end up on the c-sections table.

To add to the benefits of a natural labor there are significant postpartum advantages. Natural birth babies breastfeed earlier and natural birth moms report less breastfeeding problems in the months following labor then epidural moms. Many respected lactation experts believe that there is connection between the reported 60% of American moms reporting breastfeeding difficulties and the American epidural rate of 80% on average.

Early baby bonding is a sad casualty of the unusually high epidural rates in American hospitals. The connections between early bonding and natural birth are most the reason women who choose natural birth do so with such passion. In the long term there may be no measurable difference between the bonding of mothers and their children, but there is a stark difference between the two categories in those precious bonding hours just after birth when natural birth babies are awake and alert, ready to breastfeed, and natural birth mothers enjoy the added benefits of natural hormones that fuel their energy and interest as well.

Many modern women have been convinced that the sweaty exertions and primal sounds of naturally laboring mothers are evidence that natural birth is violent and hopeless. What they observe as painful and undesirable is in reality one of the most empowering, precious, and fulfilling experiences that life has to offer. As a doula I have come to love the sweaty smelly work of labor that transforms women into mothers and brings babies into the world in a truly gentle loving way. These mothers throw all their might, mind, and strength into labor and shield their infants from a greater portion of pain, by doing the essential work necessary to bring their babies into the world naturally. This is why natural birth in reality is the gentlest of births.