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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. 

5 things you need from your doula certification

5 Things You Need From Your Doula Certification

5 things you need from your doula certification

We are pleased to share thoughts from Amanda Devereux today. We first met Amanda when she certified to become a Birth Boot Camp childbirth instructor. Struck by her passion and intelligence, we soon recruited her to help form the Birth Boot Camp DOULA program along with Maria Polduka. By systematically looking at what existed, what was lacking, and what professionals needed, they developed something truly unique. Here are few reasons why your doula certification should give you more than just letters after your name.

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I am familiar with the increasing numbers of doulas disheartened by the certification options available to them. Doulas work hard to complete their certification and often feel they don’t gain much more than letters at the end of their name. Many are choosing not to recertify with their original certifying body because they gain little from maintaining their certification. I fully believe that when a person completes their doula certification they should be proud of the letters at the end of their name, not just because of their meaning, but because of what they get. You deserve more than just letters. Much more. Here are just five of the top things you get with Birth Boot Camp DOULA certification. We’ve set our standards high - expect a lot from us!

1. Confidence

You will not only know some doula techniques, you will be confident as a doula and business person.  You will know how to gain clients, interview and get contracts signed in addition to being confident working as a doula. Confidence is an important key to success in any business, but especially one that involves the interpersonal skills needed in doula work. From interviewing potential clients, to handling the variations of labor, you will be confident and poised.

2. Business Support

Birth Boot Camp DOULAS receive business training, contracts, all of their paper work and filing; and each of their clients receive a copy of Supporting Arms, a book just for Birth Boot Camp DOULA clients to help them prepare for their birth.  This means no crazy handouts and no copying and printing- it’s all ready for you.

3. Marketing Support

Birth Boot Camp DOULAS receive marketing training at their workshop and have continued marketing support available to them including websites, business cards, promotional materials and stock photography - this is all INCLUDED. You will have access to marketing videos you can watch at any time from a marketing professional which will guide you in the days ahead. We do this because we want you to be successful and fulfilled through your passion for birth.

4. Lactation Training

Doulas often help mom initiate their first latch and check on breastfeeding during a postpartum visit.  This means that doulas really need more breastfeeding training than just attending a breastfeeding class.  Birth Boot Camp DOULAS not only take a full breastfeeding class covering newborn through weaning, but attend a lactation workshop focused specifically on doulas and lactation support. This ability will set you apart and make you more than a doula who can provide counter pressure in labor, but one who can help mom and baby have the best start.

5. Mentorship and Community

All Birth Boot Camp DOULAS have available to them mentorship by experienced doulas and peers as well as continued community, which is invaluable in this line of work.  The culture of Birth Boot Camp is one of support - both personal and professional.  From sharing marketing ideas, celebrating births and professional highs and lows - this community is unbeatable.


Amanda Devereux-web

Amanda Devereux is an accomplished doula in New Orelans, a registered nurse, a childbirth educator, and co-creator of Birth Boot Camp DOULA. 

 

 

8things

8 Things to Consider When Choosing Doula Certification

8things

There are a variety of doula certifications available for women venturing into the thrilling and rewarding work of supporting families at the time of birth. There are so many available that it can be hard to choose when you are new to the birth scene. We love this list of things to consider when choosing a doula certification. Written by our very own Birth Boot Camp DOULA trainer, Amanda Devereux, she simply knows what she is talking about. Not only is Amanda an experienced and successful doula, she, along with Maria Pokluda, helped form the stellar Birth Boot Camp DOULA program. Enjoy her words and if you have any questions, feel free to contact us. We would love to help!

8 things you should consider when choosing doula certification-

1. Will I learn how to support a woman during labor and birth?

Of course, a doula training should actually train you to do the work of a doula. One of the doula’s main jobs at the birth is hands-on, physical support and knowledge during the labor and birth of the baby. Online or distance courses simply can’t provide this in the same way an in-person training can.

2. Will I learn how to support a woman’s partner during labor and birth?

Birth support is more than just supporting the laboring woman. The doula should not be the center piece, the partner is her hero and champion; the doula is the partner’s life line!

3. What type of business support and training will I receive?

Having the skills of a doula is just part of this. Learning to be an entrepreneur is equally important. Will you learn interview skills? Will you be provided contracts? Will you gain networking tips? Will you be prepared to leave training and launch a successful business? The skills to support at birth will find little foothold if you lack the ability to implement them and let people know about the incredible service you offer.

Nancy Rebarchick (left) and Maria Pokluda, part of the Birth Boot Camp DOULA team, show off some of the beautiful materials we have created for our doulas.
Nancy Rebarchick (left) and Maria Pokluda, part of the Birth Boot Camp DOULA team, show off some of the beautiful materials we have created for our doulas.

4. How will this certifying body market me?

You pay a good chunk of money for training and certification. What do you get from this? Is your certifying body promoting you? Providing marketing materials? Anything else?

5.What type of lactation training is provided?

A doula typically helps with baby’s first latch and then with some breastfeeding support at a postpartum and often times in between. You should know what training is provided for this. You should be comfortable not only with providing support during this time but with knowing when to refer. Truly being able to help in the precious first days of breastfeeding will often require more than just personal breastfeeding experience or attendance at a La Leche League meeting.

6. Is the philosophy of the program congruent with my own ideas of birth work?

A certification agency should offer you something - a community- and this is most beneficial to you when the philosophy of the program is one that promotes your work and passion. Ideas relating to birth abound! Find an organization that you can truly get behind.

7. Am I comfortable with the Scope of Practice and Code of Ethics?

Do you find it limiting? Does it help you build your professional practice? Does it result in greater professionalism? Doulas are present for one of life’s great events. A doula who doesn’t understand how to practice in an ethical way or within her scope can cause heartache for the entire community.

8. What do I gain from re-certification?

Re-certification, in professional fields, is important to show that an individual is current in their area of expertise, is safe to practice and is maintaining their knowledge and standards as a professional. You should gain more than the maintenance of letters at the end of your name. Doula re-certification should offer you personal growth as well as continued business, education and/or marketing support.

Amanda-Devereux-web
Amanda Devereux, Birth Boot Camp DOULA trainer


I am proud to say Birth Boot Camp DOULA offers all of this and more.  Learn to doula beyond “The Birth Partner.”  Whether you are an aspiring doula or an experienced doula, we offer you MORE.  Join us in 2015. 

Click here for a Birth Boot Camp DOULA application.

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