Read Part 1 here.
Part 2: A doula’s toolbox
Doulas have many tools in their repertoire that can help a woman in labour.
“When I first go to a birth, I observe what my client is doing and ask her some questions,” says Anderson. “For instance, if the mother says the pain is all in the back, I would start straight away with counter-pressure and ask her, ‘does that feel better?’”
Communication with your doula is key. Anderson will check in with her clients repeatedly about what is working, what’s not, and will change up her techniques accordingly. She can offer the use of a TENS machine, which can help some woman cope with the pain better. Anderson will also remind the labouring woman to stay hydrated, to rest, to breathe.
It’s not uncommon in birth for emotions to come up.
“If somebody gets really emotional, if they need to cry, I tell them, ‘Just cry’,” says Anderson. “I can ask them questions as to what’s coming up, what are you worried about and sometimes they’re very valid worries.”
And if something comes up on the medical side, Anderson can help remind the woman or the couple that it’s okay to ask questions. Rarely is there ever anything in birth that requires such an immediate response that there isn’t time to ask questions and find out what’s happening before making a decision.
“Sometimes in a hospital setting people can find it overwhelming where [information] is often presented as ‘this is how it is’ and some people have a hard time going against it,” says Anderson. “Sometimes it’s really hard to collect your thoughts when people are looking at you waiting for an answer, so I might say to them, ‘Ask for five minutes’.”
The discussions a couple has with their doula at their pre-meetings, as well as work they did on the birth plan, will make all of this easier to navigate, as there will be a bond and the couple will already be privy to a foundational understanding of the choices they may face during labour.
“Many times, at the hospital,” says Anderson, “the nurses would say to me, ‘You’re really lucky because you got to know these people. I just met them and they’re in labour’.”
The support a doula can provide for the non-birthing partner is amazing as well.
“[Partners] have a hard time because they feel like ‘oh, my love is in this much discomfort and I can’t do anything’. They feel helpless and that’s a difficult place to be.”
Doulas can help partners learn massage and counter-pressure techniques to help reduce pain, which gives the partner something to do and can help them feel more connected to their labouring partner and the birthing experience as a whole. Doulas can remind partners to breathe and to take time to rest, eat, or drink, especially if it’s a long labour as was the case for Chris Brown’s wife Debbie. Her labour went on for several days and they were sent home from the hospital a number of times, plus there were other complications such as meconium, a complication where the baby poops inside the amniotic sac and runs the risk of aspirating it into their lungs before they are born.
“I actually hyperventilated and left,” said Brown. “I think it was because I was afraid for Debbie and the obvious pain she was undergoing.”
But he credits their doula with providing them with a lot of information ahead of time, that allowed he and his wife to navigate the overwhelming elements of their daughter’s birth.
“She was genuinely there for us when we needed her and she did provide a lot of comfort and knowledge,” says Brown.
There have been some studies conducted on birth outcomes for woman with labour support and while some of the results are harder to quantify, in general most woman did better with continuous labour support. According to the Journal of Perinatal Education, “Doula-assisted mothers were four times less likely to have a low birth weight (LBW) baby, two times less likely to experience a birth complication involving themselves or their baby, and significantly more likely to initiate breastfeeding.”
(At the end of the article there will be an additional of list of resources and recommended reading that you might want to explore if you are contemplating a doula for your next birth.)
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