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Doula

doulas don't empower women (doula backrub)

Doulas Do Not Empower Women

One common belief about doulas is that hiring a doula will automatically "empower" you. This isn't quite the case. What is true is that doulas can help you empower yourself. We love this guest post from doula and VBAC mom, Alex Rounds. Read it and share it with someone you care about. A doula just might improve their birth.
doulas don't empower women (doula backrub)

Doulas do not empower women, women empower themselves. But having a doula helps.

A few years ago, I had to explain what doulas are to family members, friends and acquaintances.  Now the work is a little less strange and doula work is a little better understood. I see fewer confused faces when I introduce myself as a doula. It’s nice. Word is spreading that women with continuous support from doulas are more likely to have spontaneous vaginal births, shorter labors, less use of interventions such as anesthesia, epidurals and cesareans, and even have babies with higher APGAR scores (Hodnett E., Gates, S., Hofmeyr, G., & Sakala C. 2013).

Still many people don’t know what doulas are and many who would like doula support do not have it. I’m happy to share that rates of doula support are increasing because that tells me more women are having better births with lower rates of interventions. As Kozhimannil et al found, doula support in birth lowers risk of cesarean by as much as 60-80% and increase comfort and satisfaction for one of the biggest events in the lives of parents (2014). But more women want doulas. We are an underutilized resource and the body of evidence for the effectiveness of doula support is growing. If you think you might want a doula, don’t hesitate. We want to help.

Maybe you have heard of the “cascade of intervention” that can lead to more medicalized birth and cesarean. That’s one thing we can help temper. Sometimes it may feel like an intervention is the only option, and one intervention often leads to more. Doulas help women and their families evaluate choices and make sure expecting parents are aware of their options. Medical interventions come with risks, some may seem small, but risks are cumulative and some have known long term consequences.

Doulas work with women to help them use and build their own strength. We help women realize their own strength by supporting them. We are there to offer physical comfort, emotional support, and provide up to date, accurate, evidence-based information to the best of our abilities aiding the process of childbirth. Through this process fewer interventions are needed or elected by the informed and supported family.

Doulas do not prevent women from using medical interventions but offer alternatives so that women may choose what is right for them and do not feel the need for interventions. Doulas do not empower women, but they do help women empower themselves.

We support women and their families. And when women do choose interventions, it’s usually with more time to talk about their choices, receiving more information and after offering or exhausting non-medical strategies.

Echoing the long held assertions of natural birth advocates, the American Congress of Obstetricians and Gynecologists (2014) recently sited doula support as an effective and harmless strategy for preventing unnecessary cesareans. Cesareans carry risks that many women, even those who have undergone them, are unaware of according to the Listening to Mothers Survey II (2006). These include: severe maternal morbidities––defined as hemorrhage that requires hysterectomy or transfusion, uterine rupture, anesthetic complications, shock, cardiac arrest, acute renal failure, assisted ventilation, venous thromboembolism, major infection, or in-hospital wound disruption or hematoma––was increased threefold for cesarean delivery as compared with vaginal delivery,” including complications that effect long term reproductive health.

In the last few years, we have begun to see the cesarean rate dropping very gradually from a high of 32.9% to 32.7% (Hamilton, B.E., Martin, J.A., Osterman M., & Curtin SC, 2014)/ The efforts of many to improve maternity care, from individuals, consumer advocate organizations, labor doulas, medical professionals, medical organizations and collaborative organizations made up of all of the above, are beginning to turn the tide. But we still have a long way to go.

The late, great Marsden Wagner (former Director of the Women and Children’s Health for the World Health Organization) wrote, labor and birth are functions of the autonomic nervous system and are therefore out of conscience control. . . two approaches to assisting at birth: work with the woman to facilitate her own autonomic responses - humanized birth; override biology and superimpose external control using interventions such as drugs and surgical procedures - medicalized birth. Doulas are clearly part of the humanizing model. In a way that an untrained friend, partner and even your own Mother (probably) can’t, a doula can help guide and engage a willing support team, including moms, partners, siblings, kids and occasionally medical providers connecting the team to the laboring woman and improves outcomes as well as satisfaction. Friends and loved ones can help women feel better about their birth, but they don’t reduce the use of interventions (Cochrane, 2012).

Doulas help women so women can make choices about their care. We can’t guarantee outcomes, but we can help women improve theirs. I hear people say that doulas empower women. I don’t agree. Doulas do not empower women, women empower themselves. But having a doula helps.

If you think you might want a doula- then you probably should. If you don’t already want a doula, maybe you should consider the conclusions Hednet, et all came to… “All women should have support throughout labor and birth.” A doula is one of the best kinds of support you can have for your labor and birth.


Alex Rounds, Doula

In a nutshell, Alex Rounds is a moderately well-adjusted human being.  She is a member of La Leche League, a Breastfeeding Counselor, and Mom. She has three fun, quirky and ever-challenging sweet kids. Presently, Alex's time is consumed with homeschooling, studying midwifery, volunteering, providing breastfeeding support, and attending birth as a doula. You can find Alex at www.AlexTheDoula.com or on Facebook at Facebook.com/alexthedoula.

 

 

References

American College of Obstetricians and Gynecologists and Society for Maternal Fetal Medicine. (2014) Obstetric Care Consensus Series- Safe Prevention of the Primary Cesarean. Delivery. Number 1. 2014, March

Declercq E., Sakala C., Corry, M., & Applebaum S. (2006) Listening to Mothers II: Pregnancy and Birth. New York: Childbirth Connection, October 2006.

Hamilton BE, Martin JA, Osterman MJK, Curtin SC. (2014) Births: Preliminary data for 2013. National vital statistics reports; vol 63 no 2. Hyattsville, MD: National Center for Health Statistics. 2014.

Hodnett E., Gates, S., Hofmeyr, G., & Sakala C. (2013) Continuous support for women during childbirth. Cochrane Database Systemic Review. 2013 Jul 15;7:CD003766.

Kozhimannil, K., Attanasio, L., Jou, J. , Joarnt, K., Johnson, P., & Gjerdingen, D. (2014) Potential Benefits of Increased Access to Doula Support During. American Journal of Managed Care. 2014. Vol 20. N 8. Retrieved from http://www.ajmc.com/publications/issue/2014/2014-vol20-n8/potential- benefits-of-increased-access-to-doula-support-during-childbirth/3#sthash.fwMhGi3R.dpuf

Wagner, M. (2000). Fish Can’t See the Water. Retrieved from https://www.birthinternational.com/articles/birth/18-fish-cant-see-water)

doula at water birth

50 Things Doulas Do Best

50 Things Doulas Do Best

What do doulas do best? Well, that is actually a much longer list than the one below. Doulas have an amazing array of skills, many of which can't really be put into words. It is no secret that at Birth Boot Camp we love doulas. Here are just 50 of the many amazing things that doulas do best. Not sure what all of them are or how they will benefit your birth? Call your doula and ask her if she knows. You will be amazed! Good luck and happy birthing!

  1. Pack snacks
  2. Hip Squeeze
    doula double hip squeeze
  3. Rebozo
  4. Listen
    DSC_0554
  5. Comfort
  6. Horse-lip demo
  7. Moaning with you
  8. Getting up early
  9. Going without sleep
  10. Or food
  11. Pumping in strange places
    Doula Pumping
  12. Questions
  13. Phone calls
  14. Support
  15. Recommendations
  16. Hand holding
  17. Back rubbing
    doula back rub- one thing doulas do best
  18. Massage
  19. Interesting things with tennis balls and frozen rolling pins
  20. Remembering the hot pack
  21. Cup holding
  22. Bendy straw bringing
  23. Staying calm
  24. Believing in you
  25. Staying quiet
    doula at water birth
  26. Smiling when you need it
  27. Wiping your brow
  28. Bringing cool washcloths
  29. Bringing warm washcloths
    water birth- something doulas do best
  30. Getting ice chips
  31. Getting a steak (when ice chips just aren’t cutting it.)
  32. Pressure points
  33. Filling birth tubs
  34. Boiling water
  35. Slow dancing
  36. Supporting dad
  37. Feeding dad
  38. Helping siblings
  39. Breastfeeding tips
    doula at a birth
  40. Postpartum support
  41. A friend to call
  42. Birth story listener
  43. Natural birth supporter
  44. Keeping unwanted (but excited and well-meaning) visitors at bay
  45. Manipulating a hospital bed better than inspector gadget
  46. Having unwaivering faith in your abilities
  47. Providing non-judgemental support
  48. Recommending care providers
  49. Partner calming
  50. Fix your pony tail

There is so much more that your doula can bring to your birth: doulas are truly priceless! Not looking to hire a doula, but would rather become one? Check out our doula certification. We have tried to develop the absolute best doula training program out there covering not just comfort measures but how to run your business and intensive postpartum and breastfeeding training. Check it out!

 

removingfearbirthpreperation

Taking The Fear out of Birth Prep- The Cycle of Cs

fearbirthprep

How do we take the fear out of birth prep? Every childbirth educator is aware of the Fear-Tension-Pain Cycle. It is frequently talked about as we help prep students for birth. Helping students understand that their emotional state can impact their physical experience of an event such as birth is eye opening and important. However, our words are powerful and lasting, especially if we focus on fear and pain. Today Amanda Devereux, co-creator of Birth Boot Camp DOULA, talks about re-thinking our reliance on Fear-Tension-Pain with a shift to something new and vastly more positive. Check it out. She has good words to share.

It is imperative that prep for birth help remove fear. There’s always more than one way to look at things and it’s time for a different perspective on the Fear-Tension-Pain Cycle. We all know the value of understanding this cycle, but when a woman is in labor this mental image and these words are not where her energy, nor ours as doulas, should go. Pointing out a person’s tension, fear or pain is never helpful.  Instead, a good doula sees the tension, notices the fear, and then takes steps to help relieve tension or help remove the fear. We can then offer ways to help cope with pain in labor.

When we turn the cycle inside out and look at how great labor really works, we can see the Cycle of Cs. This is where birth happens and this is where a good doula finds her work. The three Cs of labor are:

Confident - When a woman has confidence in her ability to birth her baby and confidence in her baby’s knowledge of birth, her fears are gone. She knows this journey is the perfect one for this baby and she makes way for this little one’s birth. Although doubt may sometimes creep in, her confident roots gained from childbirth education and innate wisdom will give her footing. Her birth team will remind her of the magnitude of her strength and continue to further build her confidence.

Calm - Birth is primal, raw and sometimes loud; but even in this there is calm. A mother’s confidence leads to this calm. Laboring mothers are reassured by the smiles and supportive eye contact of their team, by routine, and the calm energy offered by all those confident in her ability to birth this baby. A laboring mother finds calm in her atmosphere, smells, sounds and rhythms.This becomes the grounds for her coping.

Coping - Each birth is unique and will require that a mother discover just how to best cope with the sensations of the birth of this baby. Her calmness and trust in her abilities will allow her to open her mind, heart and body to this birth. Though this she will find ways to cope. As she moves further through her labor and her baby nears, she will find increasing confidence through her ability to cope.

When we see in a mother the fantastic strength and power she shows us when she is birthing, we are seeing what has always been there. Her strength, her power - these are not new, she’s just reaching depths that she likely never knew she had. As doulas, it is our job to help her move through the Cycle of Cs, to shed light on her confidence, to help provide the calm and to make way for her to find her best way to cope.

Amanda-Devereux-web

Amanda Devereux is a doula based in New Orleans, owner of Nola Nesting, a mother of three and co-creator of Birth Boot Camp DOULA. Join Amanda at Birth Boot Camp DOULA training and help couples have amazing births in your own community. 

newborn breastfeeding

Newborn Breastfeeding and the 10th Day Growth Spurt

newborn breastfeeding

Breastfeeding success has always been an important goal for Birth Boot Camp and breastfeeding education is included in our online and in-person classes through a long and detailed video presentation by Mellanie Sheppard, IBCLC. One thing that often throws people off in their breastfeeding journey is the very early days and the confusion and lack of personal confidence that unexpected growth spurts can cause for the nursing mother. We love this guest today from Alex Rounds, an experienced breastfeeding mother and lactation counselor. Our hope is that you will read this and share it with expecting mothers so that they can thrive during the first months of breastfeeding. And, if you are really passionate about breastfeeding, taking her advice and giving mom a gift during this "10th day growth spurt" just might change a life and help preserve a nursing relationship. 

Enjoy!

~

Experienced parents recognize some baby shower gifts don’t end up getting much use. We can’t predict what we’re really going to need until we meet our babies. But there are some things about infants that are predictable, like dirty diapers, sleep debt and growth spurts. We know babies grow quickly by the sheer volume of newborn to 0-3 month clothes on the registry, but the actual implications in terms of feeding aren’t often talked about. So I want to share a proposal that would make a fantastic tradition of giving a 10 day growth spurt gift/IOU to every mom out there. Women Infant and Children (WIC) Director Peter Schlichting brought up the idea with intent to give new moms extra attention and love at a time when hormone levels are dropping and infant needs are increasing as a way to promote continued breastfeeding, but a 10 Day Growth Spurt Gift should be for all moms.

All moms can probably use a little extra attention during the postpartum period, but breastfeeding moms and their newborns may especially benefit from a reminder around the time of the first major growth spurt. The gift of time and companionship when a new mom is home alone with what may seem to be an insatiable newborn can be incredible. In the United States, breastfeeding initiation rates are almost 80% but rates drop to 40% by 3 months (CDC, 2014), a drop largely attributed to concerns regarding milk supply (Li, R., Fein, S., Chen, J., & Grummer-Strawn, L 2008). Often this is misguided: it is not necessarily a supply issue but a growth spurt. If we can help moms get through the first growth spurt, maybe we can help increase breastfeeding rates at 3 months and beyond.

The gift can be anything from a pedicure, massage, lunch date or anything special for the mom. It should be something for the woman, not for her baby, and adaptable to whatever the moms needs are at the time. After giving birth, focus shifts from the woman to her baby, a new mother’s hormones are in flux and if she is like most women, she has lost a little sleep since her darling little one arrived. The combination of a baby with a growth spurt and a hormonal shifts can be rough on Moms to put it mildly, so a little extra attention and focus on the Mom can help her adapt and give Mom the boost she probably needs.

Getting out of the house might be a treat at this stage, but not all women are ready to venture out, so keep in mind your friend’s perspective. If you plan a trip out- you might want to include an hour of your time to help Mom get out the door with her little one, and to offer to drive. For Moms who aren’t ready to leave home, bringing take out lunch from a favorite restaurant or having a home visit by a massage therapist with postpartum experience can be phenomenal. Take the time together to ask how she is doing, if she’s getting enough help and how breastfeeding is going for her.

The first growth spurt usually occurs between 10 and 14 days and comes at an often difficult time for breastfeeding moms. Whether breastfeeding has started off without a hitch or with challenges, the breastfeeding mom may feel that things should be getting easier. But then a few weeks after birth the baby will increase the frequency and often amount of time spent at feedings. Uplifting mother centered support can be the light that helps her get through the frequent feedings that come with growth spurts. When you give her the 10 Day Growth Spurt Gift, talk with her, she how she’s doing, and ask her if she has noticed a growth spurt, and if she hasn’t yet, you can remind her to expect one soon.

Some points that are important to know about breastfeeding that can help Mom, family and friends understand breastfeeding are:

Milk production is triggered by demand. The more a baby nurses, the more milk will be produced.

Frequent feedings are normal for a few days during growth spurts but typically space out within 2-3 days.

Breastfeeding takes more time in the beginning but long term is less time consuming than formula feeding.

Breast milk is easy for babies to digest. It moves through their digestive system with ease. That’s why babies need to nurse frequently. Formula is more difficult to digest.

Newborns should breastfeed 12 or more times in 24 hours. At the same time, it’s important to watch babies hunger cues, and not necessarily go by the clock.

Babies may cluster feed, or feed several times over several hours, then take a break. This is normal.

If your friend who has planned to breastfeed is having trouble or has questions, many communities have La Leche League Chapters (find them here http://www.llli.org/webus.html) which typically hold monthly woman to woman support meetings. LLL leaders, Breastfeeding or Lactation Counselors, International Board Certified Lactation Consultants (IBCLC) and other professionals who specialize in breastfeeding are great resources too!

A little extra support, a treat, and a reminder about normal developments can help a new Mom when things may seem hard. Let’s do our best to help new moms transition into motherhood. Let’s make sure new Moms know they have a community that cares, who they can lean on, and that there are resources. And most of all, let’s take care of them.

Alex Rounds, Doula

In a nutshell, Alex Rounds is a moderately well-adjusted human being.  She is a member of La Leche League, a Breastfeeding Counselor, and Mom with a total of 8 years personal experience breastfeeding, not all of which were easy.  She has three fun, quirky and ever-challenging sweet kids. Presently, Alex's time is consumed with homeschooling, studying midwifery, volunteering, providing breastfeeding support, and attending birth as a doula.

 

Pregnancy and Chiropractic Care

Pregnancy and Chiropractic Care

Pregnancy and Chiropractic Care

Chiropractic care during pregnancy is something that we have always encouraged for our students. The reasons for this are many and can  include:

-Increased comfort during pregnancy. Back pain during pregnancy is a common problem that can be helped with chiropractic. The benefits can extend beyond this issue and help other sources of discomfort like SPD.

-Improved positioning of the infant for birth. Webster certified chiropractors are famous for their ability to adjust the pelvis and release the round ligament on the pregnant mom and thus allow the baby to move into a position that is more advantageous for the birth. This can help with breech presentations as well as posterior or other variations.

-Faster labor. Many midwives notice that their clients who have regular chiropractic care from a skilled practitioner have faster births than those who don't. This may be due to the improved positioning of the baby which can allow it to more easily navigate through the pelvis.

The benefits of chiropractic care can even extend beyond the birth of the baby and into the breastfeeding relationship. Some lactation consultants refer to chiropractors for latch issues or trouble breastfeeding.

Dr Hosaka adjusting an infant
Dr Kristin Hosaka, Birth Boot Camp Advisory Board Member, adjusts a baby.

The video below briefly describes how and why we include chiropractic in our online childbirth classes and encourage our live instructors to invite a local chiropractor to their own classes.

We believe that chiropractic care can be an important part of achieving a natural birth.

Looking for a chiropractor for your pregnancy? Check out this article on how to find one for you.

References-

This small study found that chiropractic adjustment could relieve back pain during pregnancy:  http://www.ncbi.nlm.nih.gov/pubmed/1829312?dopt=Abstract

This small study also found chiropractic care to give significant relief to a high percentage of women: http://www.ncbi.nlm.nih.gov/pubmed/16399602?dopt=Abstract

This case study chronicles the labor pattern of one women and quick progress after adjustment: http://chiropracticpediatrics.sharepoint.com/Pages/2009_1002_dystocia.aspx

Three patients discussed whose labor quickly proceeded after chiropractic adjustment: http://icpa4kids.org/Chiropractic-Research/chiropractic-care-of-women-during-pregnancy-and-the-possible-success-at-resolving-dystocia-a-case-series.html

30 pregnant patients undergo Webster technique adjustments and most see improved fetal positioning: http://icpa4kids.org/Chiropractic-Research/patients-with-malposition-and-malpresentation-pregnancies-cared-for-with-the-webster-technique-a-retrospective-analysis.html

5 patients with breech babies undergo chiropractic care and all have improved positioning: http://icpa4kids.org/Chiropractic-Research/the-webster-in-utero-constraint-technique-a-case-series.html

A survey of chiropractors practicing the Webster technique finds a high percentage of patients have resolved breech presentation following adjustment: http://icpa4kids.org/Chiropractic-Research/the-webster-technique-a-chiropractic-technique.html

Review of chiropractic during pregnancy evidence: http://www.ncbi.nlm.nih.gov/pubmed/18722200

9 examples or studies of chiropractic benefiting the breastfeeding relationship or improving latch: http://icpa4kids.org/Chiropractic-Research/Breastfeeding-Difficulties/

 

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