Birth Boot Camp® Natural Childbirth Education Classes – Online and Instructor-

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Doula Myth: I Don’t Need A Doula, My Nurse Will Help Me!

 

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Today we are excited to share a guest post from an incredibly experienced doula and one of the driving forces behind our very own Birth Boot Camp DOULA program, Maria Pokluda. Maria’s words of wisdom on the importance of and difference between both a doula and a labor and delivery nurse are so important.  Enjoy reading, and share with your pregnant friends!

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I attended a birth recently at a local hospital. When we arrived at the hospital the nurse greeted us and did all the right things: she asked for the couple’s birth plan, she told them that everything on their birth plan looked acceptable and she smiled as they talked about their plans. She was a great nurse and this couple (who took a Birth Boot Camp class) did go on to have a pretty amazing natural birth many hours later. As the nurse was leaving at shift change, she mentioned that she was excited to have seen a natural delivery because she had only seen ONE other natural birth in the SIX years she had been working as a labor and delivery nurse. I am still stunned by her comment and I think (and hope) that her experience is not reflective of all nurses who work in labor and delivery rooms. However, the fact is that it is neither a nurse’s primary job nor the focus of her training to help couples have a natural birth.

All couples birthing at a hospital will have a labor nurse, and I frequently get asked why a couple would need a doula since they will have this nurse to help them while they are at the hospital. Labor and Delivery nurses are a wonderful resource, however they have the clinical duties of monitoring baby and mom, the charting that is part of today’s medical care and they also have other patients – how many depends on the time of day and how a particular hospital staffs the floor. All of these other roles can limit the amount of time a nurse has to spend taking care of mom’s physical and emotional needs, but perhaps more importantly, most are simply not trained in helping women who are planning a natural birth and many don’t see natural births all that often.  If one sees medicated births day in and day out, that becomes the norm and a couple planning a natural birth will seem unusual.

In a study examining pregnant women’s expectations, first time mothers anticipated that their nurse would spend 53% of her time offering physical comfort, emotional support, information, and advocacy. However studies have shown that the actual amount of time an obstetrical nurse spends doing these things is closer to 6%*. With hospital interventions at an all-time high, nurses may want to do these things for women, but the reality is that they have to spend a lot of time just managing medical concerns and hospital policies. In fact until a women starts to push, nurses do not usually spend time in the labor room but rather monitor remotely at the nurses’ station. In my own experience as a doula, it is not unusual to attend a whole labor and never see the nurse touch mom in a non-clinical manner. She may move fetal monitors, take a woman’s temperature or feel her cervix by placing her fingers in mom’s vagina but never touch the mom outside of these tasks.

On the other hand, a doula’s primary focus is on the laboring couple. Her continuous care allows for her to respond quickly, make recommendations based on how labor is unfolding and provide immediate emotional and physical support. A doula sees natural birth all the time. She is familiar with the sights and sounds of normal labor and can often anticipate what a woman will want as she labors. She is trained to suggest position changes, relaxation methods and comfort measures. If a couple has taken a great birth preparation class they will have confidence and information, but that does not replace having someone there to answer questions and provide ongoing encouragement. A doula does not have to analyze a fetal heartbeat, administer antibiotics or enforce hospital policies.

The relationship between an expectant couple and their doula is also different than with their nurse whom they generally meet the day of delivery. The doula has likely been working with the couple prenatally and often has been laboring with a couple in their home prior to arriving at the hospital. The doula will know the couple’s desires, their concerns and even the dynamics of the couple’s relationship.  She knows if a relative is someone that should be in the labor room. She knows that mom wants to have the cute nursing bra on for pictures even if she says she doesn’t care at the time. A doula is there through as many shift changes as it takes which offers stability when other faces may be changing and a doula will stay with a laboring woman so her partner can get coffee, check on older children or get some food. In the weeks after the baby is born, the doula is available to talk, to answer questions, and to process concerns.

Despite all the things I just listed that doulas do, a nurse’s role is just as important. The way most hospitals operate means that the labor nurse is the primary liaison between a couple and their care provider. She will be the one calling the OB and passing along the details of the labor, she will be the one that makes ongoing analysis of baby’s wellbeing.  In the rare event that something needs immediate medical attention, it may seem as though the OB is swooping in to save the day…but it will be the nurse that calls the OB to come. Part of a nurse’s training is being a patient advocate. The American Nurses Association includes in its definition of nursing  “advocacy in the care of individuals, families, communities, and populations.” Nurses can advocate for a couple’s expressed treatment preferences which is a very distinct and different role from that of a doula who can help couples express preferences, consider options and facilitate communication, but not actually advocate for a couple or act as a liaison.

I remember working with an excellent nurse at one birth where the care provider and the couple were in disagreement of the use of a routine intervention that was part of hospital policy.  The nurse pulled a chair up to the bed and told the laboring couple exactly what their options were, what could be expected to happen with each choice and how to say no in a manner that would be most respected by the care provider.  She also took it one step further and told the couple that she would speak to the care provider on their behalf and that she could be the one that told the care provider that they had declined. While this may not be a common scenario, a nurse can choose to do this as part of her job; a doula cannot.

The roles of the labor nurse and the doula will overlap in some areas which actually works out well as very few couples will complain about extra support, but they also have marked differences. Ideally the roles should complement each other, which is why laboring couples need both. With a great nurse and a great doula a couple can expect to have an empowering birth.

 

Maria Pokluda has been a doula serving the Dallas/Ft. Worth area since 2004.   She has a Masters in Political Science and while she finds that slightly funny, she feels her degree helps her work with all types of people and she can now appreciate those statistics classes as she reads the research about evidenced practices in maternity care.  In the last 10 years, Maria has attended hundreds of births, helped form Dallas Birth Network and in 2013 and 2014,  she was voted Best Doula by North Texas Child Magazine. (Maria has recently co-written the Birth Boot Camp Doula program and can’t wait to start training Birth Boot Camp Doulas.)   Maria has been married to Brian for 18 years and they have 4 children, each with a very different birth story ranging from one with all the bells and whistles in a hospital to a homebirth.  

* Tumblin A, Simkin P. Pregnant women’s perceptions of their nurse’s role during labor and delivery. Birth. 2001;28(1):52–56. [PubMed]

 

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Registered Nurse and Natural Birth Instructor- Meet Shazia!

Birth Boot Camp now has over 100 instructors spanning from coast to coast in the United States and a couple in other countries (and more to come!) We simply adore our birth instructors and are so glad they have taken this leap with us to help make birth better through education. Because there are so many of them now we are eager to introduce them to you! Our instructors are diverse in every way imaginable but have one thing in common- they were changed by birth and they want to share that power with you. Our birth teachers know that YOU can have an amazing birth. They know it.

Today I am pleased to introduce you to Shazia Lackey, one of our very first certifying birth teachers. She teaches birth classes in Arlington, TX. Below is an interview with this amazing woman. Check her out!

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First, could you introduce yourself? Tell us a little bit about your own birth experiences and how they influenced your desire to teach birth classes.

Hi! I’m Shazia Lackey. I have one son and am currently pregnant with my second. I had my first baby in 2011 with the help of a Certified Nurse Midwife (CNM). It was a great birth experience that set me up for an easy postpartum recovery. I also successfully nursed my son until he was 23 months. I know that my unmedicated birth set us up for breastfeeding success! Not to mention my son and I being healthy and complication-free, my birth was incredibly empowering! I knew I wanted to help other moms achieve that experience with their own births!

What first got you interested in the realm of birth?

I have been a registered nurse since 2008. I was fortunate that I had amazing instructors at the University of Texas at Arlington School of Nursing. One of my professors was even a CNM! I learned so much about evidence based birth practices during my time in nursing school that I knew it was the best option for me and my baby. My husband and I prepared for a natural birth by taking a comprehensive birth class. I was empowered by my own birth experience and I wanted to help other couples with their journey preparing for birth!

What are your particular passions concerning birth?

I am passionate about giving moms and dads all of the information that they need so they can make their own decisions to ensure the best birth possible. I also love that couples who prepare and plan for a natural birth are more likely to be successful meeting their breastfeeding goals. I am a huge breastfeeding advocate. I nursed my son for 23 months and have served on the lactation committee at a local pediatric hospital for the last 2 years. I have the privilege in my nursing career of helping other moms nurse their babies as a breastfeeding resource nurse for my department at work. I also am beginning to help lead a local mom to mom breastfeeding support group! I utilize this passion to help each and every one of my Birth Boot Camp students succeed with breastfeeding.

There are lots of different birth educator training programs out there. Why did you choose Birth Boot Camp?

Birth Boot Camp covers EVERYTHING! While my husband and I were well prepared for birth, I do feel that we missed out on some crucial information during our comprehensive birth class. I love that Birth Boot Camp also covers pregnancy, breastfeeding, postpartum, and newborn care. I also love the up-to-date and modern material we use to teach Birth Boot Camp curriculum.

Tell us a little about your Birth Boot Camp training experience. Where did you train? What did you like about it?

I trained to become a Birth Boot Camp instructor in April 2013 in Texas. I loved getting extensive information to help me teach my classes and be successful as an instructor. I also loved getting to network with other birth professionals from all over!

How is teaching your own classes going for you? What do you enjoy most about it?

I have been teaching for a little over a year now and am currently teaching my 5th class series. I love it! I love getting to know each couple during the 10 week series and especially love hearing about their great birth experiences! Many of my students have stayed in touch and I enjoy seeing their babies grow and helping moms with breastfeeding and newborn care!

In what ways did the Birth Boot Camp teacher training help prepare you for teaching actual classes?

I loved that I met moms at instructor training who have had all types of birth experiences! It was so helpful to hear their stories. I take much of what I learned from them and incorporate that into my teaching. For example, I haven’t had a home birth myself, but through the experiences of other instructors, I can confidently prepare my students who are planning a home birth.

Tell us a little about your students. How do you believe childbirth education is having a positive impact on them?

I have taught 17 couples since I became certified last year. I have seen first time moms achieve amazing, empowering birth experiences. I have seen second or third time moms finally get the birth experience they deserve! I have even seen moms who have had complications during birth and were well-prepared to handle them and still went on to have a great birth!

One of my second time moms was adamant about having a better birth this time around and her husband was totally not on board. He came to class each week but rolled his eyes and even fell asleep a few times! She ended up having an amazing birth experience! At our class reunion, her husband was a completely changed man! I have seen women be moved and changed from their birth experience, but never a dad! It was amazing. He spoke about her birth experience with such passion. He admitted that he was totally skeptical going in to birth and afterwards said he tells all of his friends and coworkers with pregnant wives to take Birth Boot Camp! He was especially impressed with his wife’s postpartum recovery. He said it was amazing how much faster she bounced back after her birth than the first time. He also said he felt he bonded instantly with this baby that he attributes to being involved in the birth instead of sitting on the sidelines the first time around.

To close, tell us how you see natural childbirth education having a positive impact? Why does this work matter to you?

Our maternity care in the United States is suffering! Many women believe that all of the interventions are “necessary” and birth is painful and awful. I have encountered many women who have thought I was completely nuts for telling them my birth was amazing and their birth can be too. Natural childbirth education is not only preparing moms and dads to achieve a natural birth, but also to empower and encourage other women around them to do the same!

Shazia-Lackey-web

Where can we find you?

I teach classes in Arlington, TX. You can find my class schedule and contact information at www.AboveBeyondBirth.com

And you can hear from Shazia on our You Tube channel!


https://www.youtube.com/watch?v=7jsktW5weiU&list=UU9VTK51bWOJ5o0S5A0h8VWw

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