All About Doulas: A Q+A With My Doula, Christie
Yesterday I wrote a post explaining why I hired a doula to be at the birth of my second baby and today I wanted to follow it up with this amazing Q + A with my doula, Christie.
Christie is the president of the Tampa Bay Birth Network and has been a doula for over six years. On her ‘About Me’ section via her website, Buddha Belly Birth, it says “her greatest natural asset is her ability to connect with her clients on a personal level and her greatest professional strength is her knowledge and experience.” I can personally vouch for this statement and I haven’t even had my baby yet!
Christie’s favorite thing about being a doula is “knowing that I have truly helped a mother find and use her own power, strength and wisdom resulting in her experiencing complete joy, relief and ecstasy when she has the birth of her dreams.”
If you’re looking for more in-depth information on what a doula is, what her roles are in labor and birth, if a doula is necessary in a hospital birth setting, and more information to help you decide whether or not you should hire a doula, then THIS is the post for you!
Thank you so much, Christie, for taking time to provide such an incredibly detailed resource on what a doula is and how she can help expecting moms.
Loriel: What is a doula?
Christie: A birth doula is a trained, experienced professional who provides physical, emotional and informational support to a woman before, during and after birth. The word itself comes from ancient Greek and means “a woman who serves.” Most doulas work independently or with an agency and are hired directly by the expectant mother to provide support.
Loriel: What can you expect from a doula?
Christie: A doula is knowledgeable regarding pregnancy, labor, birth and the immediate postpartum period. She has a compassionate, friendly and helpful demeanor. She should be somebody that you could be good friends with and talk to about nearly anything. A doula should not judge you for decisions you make but would support you. Only you know what is the right choice for you and your family.
Pregnancy and birth are emotional and vulnerable times. Your doula should be somebody that you feel comfortable with who helps you stay calm and focused during a potentially difficult experience. The best doulas make a strong connection with their clients to understand their needs.
Loriel: What are the duties of a doula?
Christie: Your doula will answer questions and guide you to accurate information about topics that concern you such as: inductions, dilation, what to do if your water breaks, comfort measures, prenatal testing, newborn procedures, breastfeeding, etc.
Your doula will meet with you in person to discuss and help you prepare your unique birth plan and discuss any fears or anxiety so that you feel prepared and ready for the birth of your baby.
When you are in labor she will be there with you to support you. Things that doulas may do during labor include:
- Massaging your back, hands, feet, shoulders, neck
- Ensuring you stay hydrated and fed
- Guiding you into helpful positions
- Putting a cool washcloth on your forehead
- Holding your hand
- Putting counter pressure on your lower back
- Doing the double hip-squeeze to alleviate pain
- Helping you get in and out of the birth tub, shower, toilet, etc
- Putting your hair into a ponytail for you
- Staying with you while your partner takes a break or tends to children
- Encouraging and reassuring you, answering questions about interventions or procedures
- Discussing your options if something comes up that needs to be addressed
- Helping you stay calm and relaxed
Your doula provides unconditional support and mothering while you bring your baby into the world and does everything in her power to make it a peaceful and calm environment for you.
She will be by your side throughout your labor and birth and will stay with you until a few hours after your baby is born. She will help you with initial breastfeeding so you get a smooth start and see to it that you are comfortable and ready to rest with your baby.
Leading midwife, Ina May Gaskin says: “If a woman doesn’t look like a goddess during labor, then someone isn’t treating her right.” Your doula is there to make you feel and look like a goddess.
Loriel: In your eyes, what is the number 1 reason a woman should hire a doula?
Christie: This was a hard question to answer because for each family there may be a different reason for wanting a doula.
For many women birth is one of the most important life experiences they will EVER have. It is something that you cannot do over. It happens and it’s done, and your feelings and emotions about it will stay with you forever. You may have a chance to give birth again, but each birth is a unique experience that will stay with you and can never be changed.
It is also a time of vulnerability, softness and inward protection. Everything inside you is working to grow and bring out this new life. During labor you will use all your strength to achieve this.
When you have a person on your birth team (doula!) whose sole job is to look after you - your needs, your comfort, your emotional stability and make you feel safe and calm - this milestone experience of your life is better.
Some women may have already had a traumatic or disappointing birth experience and feel very determined to have a better experience next time. They want to have strong, professional support by their side. A doula can be that person.
Loriel: If I’m having a hospital birth, should I still have a doula? Or are they only for birth center and home births?
Christie: In all settings nurses, doctors and midwives are first and foremost responsible for your health and all medical and clinical matters. Your doula is not involved in any clinical matters.
There are some big differences between the midwifery model of care in a homebirth or birth center setting and the medical model of care in a hospital setting.
In a homebirth or birth center setting, the midwives spend a good amount of time with each client prenatally and during labor and birth. During a prenatal meeting they will spend up to an hour with a client answering questions, building a relationship and doing their routine exams. The midwife herself is also present for and supervising much of her client’s labor and the birth personally. Midwives do have back-up midwives for emergencies, but they typically do not take on a large number of clients. This allows them to better guarantee they will be present at their client’s births.
In a hospital setting with many women giving birth at the same time, there is less one-on-one time with your care provider. If you are with a large group practice, whoever is the on-call doctor or midwife that day will manage your care. He or she will not sit with you throughout your labor, but will come when you the baby is being born. Nurses will take care of the majority of your needs. You will be monitored with electronic fetal monitors. Your nurses will also look after other women at the same time, will change shifts and new nurses will arrive to work with you.
So based on these differences in birth settings, it is my opinion that a doula is even more valuable in a hospital birth. You will have personally chosen your doula. She knows you and understands your preferences and birth wishes. She will be the one constant person there with you the entire time.
Loriel: What are 5 uncommon things women don’t know about doulas?
- Doulas are not all hippy, crunchy, natural, organic types. There are many doulas who are. But there are also many doulas that are not. Interviewing a few doulas to find the one that is right for you is a great idea.
- Doulas really do like doctors and nurses. Doulas know the value of trained and professional medical personnel and are thankful and grateful for their service. Many lives have been saved due to the skilled hands of our health care providers and we appreciate everything they do.
- In many hospitals doulas are allowed to attend and support women in the operating room during a cesarean. A cesarean, especially if unplanned or unexpected, can sometimes be an overwhelming or scary event for a mother. Having a person there with you to comfort you and let you know that everything is okay while the doctors and nurses are rapidly taking care of your surgery is helpful to alleviate fears and anxiety and makes the experience a little easier.
- Sometimes doulas do nothing. That sounds weird – but it’s true. After all the prenatal meetings, education, preparation and talks are done there is also a time to simply let things be and let the mother follow her instincts. There are times during a birth where a woman is coping with her labor in her own way and is doing fine. She is connected to her inner strength, peace and calm. She is listening to her body and following its cues. She is riding the waves up and down on her own. These are the times when nothing needs to be done. A doula will simply sit and be a witness to the beauty and strength of this mother and will do her best to help others to do the same and maybe even discourage disruptions. Doing nothing can be an empowering act on its own.
- Doulas do not replace partners or take their jobs away. Doulas augment the support given by the partner to the mother and are also there for the partner too. Doulas help partners by showing them how they can provide support if needed, answering their questions, letting them know what to expect, giving them a break to get a cup of coffee, lunch, or to care for other children.
Loriel: Are there any misconceptions revolving around doulas? What are they?
Christie: Some believe that a doula will save them from their birth outcome or will prevent certain interventions from happening. This is not true.
Most doulas abide by a code of conduct and scope of practice that does not allow them to interfere with any of the medical events that take place. A doula will be there to discuss and help you to explore your options or remind you that you have the right to informed consent and refusal. She will not take action beyond that or interfere with the care being provided to you by your doctor or midwife. Only the mother and her partner have the power to give consent or refusal to a procedure that takes place.
Loriel: I have a midwife, do I still need a doula?
Christie: A midwife and a doula are two very different things. There are some qualities that we share but our duties are different.
Midwives take care of your clinical needs and supervise the health of you and your baby to ensure a happy delivery. Things a midwife would do include:
- Taking your blood pressure
- Measuring your baby’s growth
- Administering your prenatal exams
- Monitoring your baby’s heart-rate and much more
Doulas don’t do any of those things.
Doulas help prepare you for birth with information, education and then support you physically and emotionally throughout your labor and birth.
Your doula might even be the person you go to for midwife recommendations. She could also help you find your way through info about pregnancy and birth to determine what your preferences are: “Will I be able to move around and get into comfortable positions? What can I do about hip pain, sciatica pain? What are the pros and cons of delayed cord clamping?”
Doulas help you find the answers to these and many other questions so that you can work out what your birth plan and wishes are.
In labor your doula is there throughout the experience helping to make you comfortable and calm. If you arrive at a point where you are ready to give up your doula will be there to tell you: “You are doing great and your baby is almost here…let’s do this one contraction at a time.” She will be by your side, no matter how long your labor. These things have made all the difference to women in birth.
Each woman has her own unique needs and wants. Some might feel they are fine without the support of a doula. Maybe their mother, sister, friend, husband or even their midwife is filling this role for them and they don’t want a doula. That is okay too. But many women want a highly trained, experienced doula to serve them and to be their supporter, assistant, friend, coach and personal guide to lean on throughout their pregnancy, labor and birth.
Loriel: Are there any statistics you can share about the benefits of having a doula present while a mother is in labor and birthing her baby?
Christie: Let me share these quotes:
“In the past twenty-five years, together with colleagues, we have studied the effects of restoring to the childbirth experience this important element of having women as helpers during labor. Continuous support from an experienced labor companion has proven dramatically beneficial. In studies of over 5,000 women involving comparisons of outcomes with and without such support, we have seen a major reduction in the length of labor, a greater than 50 percent drop in cesarean sections, a remarkable drop in the mother’s need for pain medication, and several other important and measurable benefits.” The Doula Book, by Marshall H. Klaus, M.D, John H. Kennell, M.D., and Phyllis H. Klaus, C.S.W, M.F.T
From the DONA (Doulas of North America) website:
Numerous clinical studies have found that a doula’s presence at birth:
- tends to result in shorter labors with fewer complications
- reduces negative feelings about one’s childbirth experience
- reduces the need for pitocin (a labor-inducing drug), forceps or vacuum extraction and cesareans
- reduces the mother’s request for pain medication and/or epidurals
Research shows parents who receive support can:
- Feel more secure and cared for
- Are more successful in adapting to new family dynamics
- Have greater success with breastfeeding
- Have greater self-confidence
- Have less postpartum depression
- Have lower incidence of abuse
For more in depth research and studies:
- https://childbirthconnection.org/pdfs/CochraneDatabaseSystRev.pdf
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647727/
- https://www.sciencedaily.com/releases/2014/03/140305124943.htm
Loriel: What are your favorite resources for an empowered birth?
Christie: The best resource for an empowered birth is the mother herself. Nobody can influence the experience more than you can yourself.
Your state of mind is important. Feeling calm, centered and relaxed during birth is important. Stress, anxiety and fear affect your hormones and slow down your labor. Oxytocin, the love hormone, is associated with reproduction, birth and breastfeeding. This is the hormone that you need and want to have flowing during labor and birth.
By preparing yourself through whatever means including: education, mentoring, therapy, yoga, mindfulness, hypnobirthing, etc - you will empower yourself to have a smooth and peaceful birth.
And even then sometimes things happen and they are out of our control. Being flexible, being able to stay calm and make good decisions when plans change and you have to transition to a new plan is important too.
In addition to the above I would say the following are some of my favorite resources to help you prepare for birth:
- Factual information: Evidenced Based Birth provides factual research and information about many topics related to pregnancy, labor and birth.
- A safe and supportive birthing environment: For those wanting to give birth in a hospital, chose one that has a low cesarean rate. Here is a blog post that provides more information on how to choose your hospital. For those wanting to find a local midwife for an out-of-hospital birth The Tampa Bay Birth Network provides a directory of local midwives.
- Childbirth Education Classes: For a list of local childbirth educators (and many other local resources) again go to www.tampabaybirthnetwork.org and check out the directory of resources provided by the Tampa Bay Birth Network.
- The Peaceful Birth Project: Evelyn Ojeda-Fox is a transformational mentor that provides numerous services to women to help them including: birth story healing sessions, fear release sessions, mothering circles, massage and more.
- Birth Without Fear: a blog and community of support for women and their families through their trying to conceive, pregnancy, birth and postpartum journeys.
- International Cesarean Awareness Network: This organization and all of its local chapters provide information, education and support for women regarding cesareans and vaginal birth after cesarean.
Loriel: If you could tell moms who are on the fence about hiring a doula one thing, what would it be?
Christie: You will always remember the day you gave birth. It’s your special day. Be prepared and responsible for your own health. Learn what you can about the process. A doula will make that easier for you.
Research and call up some doulas and schedule an interview. You will know when you meet the right one and she will probably help you over the fence while massaging you at the same time.
