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

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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)

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4 Reasons You Should Travel For Doula Training

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Have you checked out Birth Boot Camp DOULA? You probably noticed some big, exciting differences between our training and other trainings out there These differences are well thought out, purposeful and based on the experience and expertise of the birth professionals who created this professional doula certification program.

One of the things that sets Birth Boot Camp DOULA apart is that we host training in one location and you come to us! Yes, you heard that right, (currently) we train only in the Dallas/Fort Worth area and unless you live there, you will need to travel to attend our training.

Why on earth should you travel when there are doula trainings all over the country put on by organizations who will come to your doorstep? Like the rest of our program, this is intentional and we want to share with you some of the reasoning behind our decision to train in this very specific manner.

1. Birth Boot Camp DOULA training is uniform

What this means is that ALL of our doulas have the same training experience. They are trained by the same two women (Amanda Devereaux and Maria Pokluda). They all learn the same techniques, business skills, professional practices and standards, ethical considerations and much more. This is nothing short of groundbreaking.

How many organizations have dozens of trainers? While the trainees get the same certification, they are not all equally trained. Variation can be great depending on who leads the training. This just simply isn’t acceptable for us. So, in order to have a consistent training and consistently trained doulas, we have set up our training in this manner.

2. Birth Boot Camp DOULA training prepares you for a sustainable doula career, not just a doula hobby

The word ‘doula’ is one that is still foreign to many people in our culture. Often the first people ever hear of a doula is when they are pregnant and start looking around for birth support. Because even the idea of a doula is fairly new in our country, it is no wonder that the work of doula as a professional career is just gaining traction.

For most birth workers, the passion for birth must be equally yoked with a need for sustainability. Working as a free or low cost doula isn’t sustainable due the very real cost and time necessitated in this amazing, but often difficult, work.

We want doulas to be financially successful because we know this is needed to maintain joy in their profession and enables them to benefit from their work rather than just sacrifice. We believe that doulas who know how to run a business are better doulas and will have a long, satisfying doula career that is both emotionally and monetarily rewarding.

3. We can charge you less if you come to us

Birth Boot Camp DOULA (and childbirth education) organize training differently than any other doula training company out there. We believe there is a lot of value in working as a team. Your training involves many people, not just one. This has benefits including different teaching techniques, personalities, areas of expertise (including lactation, marketing and business support) and experience that are brought to the table from a variety of people who comprise the Birth Boot Camp team. We know from practice that this makes our training both comprehensive and unique.

We also know from experience that it is very expensive to travel with our large education team. We are not willing to sacrifice the quality of your training simply so we can pump out more doulas. We want our doulas to be the best, and after much thought and work we have decided that this is the best way to help build and support them.  We value quality over quantity. After all, when you are empowered, knowledgeable and supported to have a sustainable practice you will have a greater impact in your community. More doulas don't make as much of a positive difference as better doulas.

4. Community, community, community

Birth Boot Camp DOULA is part of a larger community that includes (currently) over 100 Birth Boot Camp childbirth educators and our growing family of doulas. As a company we strive to keep our people connected to one another.

This begins at training. As mentioned, you will attend a live training with the same trainers as every other Birth Boot Camp DOULA. Even the doulas you didn’t train with will share your experience and connection.

After training you will be added to the private Birth Boot Camp DOULA facebook group where all of our doulas can communicate and learn with one another as well as have a safe and supportive place to process the sometimes difficult job of a doula. The community of doulas continues on in our unique mentor program. You should never feel alone as a Birth Boot Camp DOULA.

Doula work is precious but not always easy. The value of community with your common trainers (who you will have continual access to) and fellow doulas is immeasurable. This will help you be successful and happy in this amazing career.

~

Your training comprises so much. This includes: marketing instruction, Q&A, hands on techniques, business information, a breastfeeding course and breastfeeding training specific for doulas from an IBCLC, and access to the full 10 week Birth Boot Camp online childbirth classes. This means you don’t have to pay for another childbirth class, another lactation training, or struggle wondering how to market your small business. These are things we think every doula should have knowledge of when she leaves training, and we make sure it happens.

Feel free to contact us if you have any more questions about Birth Boot Camp DOULA!

Meet our amazing doula trainers, Maria and Amanda. They are incredible.

doctorbirth

What Your Doctor Wants To Tell You About Birth, But Can’t

doctorbirth

Too often, medical doctors are portrayed as the bad guys in the birthing world. In truth, there is a lot we don't see and which they really can't talk about. We are excited to share this guest post today from Jessicca Moore, a family nurse practitioner and filmmaker in Petaluma, CA. Jessica is currently raising money to help finish a film all about medical personnel who birth at home. (There are more of them than you would think!) You can read more about her film, "Why Not Home?", on their website. Her words are wise and incredibly helpful. Happy birthing!

If you’re planning a hospital birth in the US, you’re likely seeing an OB/GYN. Some of you are seeing a family doctor or a certified-nurse-midwife (CNM) who will attend you at the hospital.

Doctors and nurses are trained not to impose their own values and beliefs onto their patients. To the woman who says she doesn’t want to feel any pain during labor and wants an epidural as soon as possible, our training tells us to accept this as her choice and support her in it. To the woman who says she wants an unmedicated natural labor, our training tells us to accept and support this choice as equally valid.

Your provider is supposed to maintain some professional distance and remain unbiased toward her patients. Because of this, she likely won’t tell you about how difficult her recovery from her c-section was and how she couldn’t pick up her toddler for weeks.

She won’t tell you about the intense rush of emotion and joy that came over her when she gave birth to her daughter after a long 30 hour unmedicated vaginal birth. If she did, you might feel like you should do it the way she did, or do it differently, depending on her story.

In your 10-15 minute visits, it can be hard to delve deeply into all the possible risks and benefits of each decision, the research, and your personal values and preferences. Even if you did, the chances that that provider is going to be the one attending your birth are pretty slim.

So much of birth is out of your control. Once you’re in labor, things can go any number of ways.

If you want to have a natural birth, here are some things you can do to stack the deck in your favor.

  • Get prepared. There are lots of great childbirth preparation programs out there. Try a few and see what fits. Knowledge is power when it comes to birth.

  • Read birth stories. Positive ones. Listen to your friends who had great births. Focus on those. Your birth can be great too.

  • Get support. Hire a doula. Don’t think you can afford one? Call and talk to a few. You may be surprised. If you can’t get a doula, ask friend who has experienced birth and knows your plan to be there to support and advocate for you. Your partner will be having their own experience. Don’t rely on them to be everything for you.

  • Get informed. What is your hospital’s c-section rate? Trying for a VBAC? What’s the VBAC success rate at your hospital? Birth by the Numbers has a great site for getting this information. www.birthbythenumbers.org

  • Ask questions. Especially if something doesn’t feel quite right. Is the induction necessary? What if we wait 2 more days? It’s your body and your baby. You’re allowed to ask questions.

  • Take care. Rest. Eat well. Stay active. Try prenatal yoga. You’ll be that much better off entering labor if your body is strong and healthy.

Do all that, and then let go. Birth is big. Birth is beautiful. There’s no one right way to do it.

You are powerful. You are capable. You can do it.

If and when you need help, it will be there for you.

No one can tell you how it will go for you.

You and your baby are starting your journey together. You’ll have your own unique experience.

Your doctor may have seen hundreds or thousands of births, but they’ve never seen yours.

Nurture Nature Photography and Erin Wrightsman -c- 2013 erin@erinwrightsman.com  2013040920130409-RRL_0819 (1)

Jessicca Moore is a family nurse practitioner and filmmaker in Petaluma, CA where she lives with her husband, two children, and two sheep. She is currently in production on her first feature-length documentary, “Why Not Home?” The film follows hospital birth providers who chose to give birth at home. You can watch a trailer and get more information here: www.whynothome.com and support the project on kickstarter at bit.ly/whynothome through October 10th.

Follow the project on twitter and instagram @whynothome and facebook at facebook.com/whynothome

You can find Jessicca on twitter @jessicca_moore

(Photos by Erin Wrightsman, used with permission.)

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From Epidurals To Home Birth- Meet Instructor Hailie in Abilene, TX

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Birth class couples after playing a game to learn how epidurals work in Hailie's birth class!

We are excited to share with you a series of articles highlighting our diverse group of birth instructors. These are the amazing women who are doing real work trying to make birth better for women and their families all over the world. Today we introduce Hailie Wolfe, a birth teacher in Abilene, TX, mother of five (and kinda famous You-Tuber) who has birthed in so many different ways. In fact, one of her birth videos is featured in our classes! We love Hailie and we are sure you will too. Thanks and enjoy!

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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.

My name is Hailie Wolfe and I own Country Bumpkin Birth Services in Abilene, TX. I have five children - four of them were born in the hospital; three of which were medicated and one was unmedicated.

My medicated births were very standard hospital births. There were several things that I didn't like about those experiences, but it was years before I realized that how I was made to feel for those births really DID matter. I had some wonderful nurses, but oddly enough, the one I remember most was the one who treated me terribly and that makes me sad. I was given routine episiotomies. I was given the highest pitocin drip on more than one occasion. I thought all of this was "normal".

When I became pregnant with my 4th child, I decided I wanted to do things differently. At the time, we planned for #4 to be our last baby and I didn't want to miss out on the opportunity to experience birthing naturally. I came to view it almost as a rite of passage I had missed out on because of my ignorance during my previous pregnancies. When I gave birth naturally, I finally understood WHY it was so important. I had an easy postpartum recovery for the very first time. I was on a birth high for days and felt very empowered.

I enjoyed birth so much that it influenced our decision to add another baby to the family. My fifth child, a surprise breech birth, was born at home in my bath tub. You can watch her birth video here: https://www.youtube.com/watch?v=oFabMR4sg5g

I was able to have a natural birth with self education, but the whole time I was pregnant with my 4th child I wished there was an accessible class where I could get the information in one place. That inspired me to become a Birth Boot Camp instructor. I wanted women in my community to have easy access to this important information. 

What first got you interested in the realm of birth?

Looking back, I always have had an interest in birth itself. I remember as a teenager being really into watching shows about birth on the Discovery Channel and being disappointed when they didn't actually show the baby come out. When we had to watch The Miracle of Life in high school health class, I was secretly excited to see what it would look like for a baby to come out.

I'd like to say that I was so inspired by birth that I went into the medical field after high school, but that would be a lie. I didn't want to go to nursing school because I didn't want to wipe butts or clean up puke - no gross stuff for me. I don't know why I didn't realize that was in the job description for motherhood, because I signed up for that without concern! I became an elementary teacher where I wiped noses and pulled teeth. What can I say? I have a mothers' stomach.

The point that REALLY got me interested in pursuing birth work was when I went through a very painful induction with my third child and had a terrible recovery. When I decided to go natural with my fourth and I had such a wonderful experience - that was when I really discovered my passion sharing birth with others.

What are your particular passions concerning birth?

Over the last few months, I'm becoming increasingly interested in reaching disengaged dads. I hear birth workers constantly blast dads for thinking birth classes, doulas, etc. are a waste of money. It hits home for me because my husband was one of those dads. He pretty much agreed to hire a doula just to make me happy - but then seeing was believing for him. He was amazed at how much better the experience was when we birthed with a doula. I want to figure out how to reach the skeptical dads like my husband, and I want to reach them before their wives are insisting on having a doula because they've been through a bad experience. I'm preparing to host a Doula Dad night soon so that my husband can speak to other dads about the benefits of having a doula. I'm hopeful that hearing another dad's perspective will encourage others to be more open about birth preparation.

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

I actually have a dear friend, Megan Martin, who teaches classes in Burleson, TX. When I voiced my interest in Birth Boot Camp she really encouraged me to go for it. I didn't even do very much research on other programs. The organization is very transparent about their beliefs, which perfectly align with my own birth philosophy. It is clear, concise, and complete, and those are attributes that will truly prepare couples for birth. I knew early on that it was the right program for me to teach

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

I attended Birth Boot Camp instructor training in July 2013 in Grapevine, Texas. I really enjoyed getting to meet and gain knowledge from other woman across the country who share the same passion as me. I love my children with my whole heart, but it was refreshing to stimulate my brain for a few days alongside a great group of ladies.

During my hotel stay for the training, I was roomates with Lauren McClain, creator of MyBreechBaby.org. She taught me so much about breech birth during break times and when we'd stay up late chatting. I remember thinking how great it was that I was learning all this new breech information in preparation for teaching other moms. I never would have dreamed that I would personally be putting all that information to use when I delivered my own surprise breechling just three weeks later. I will never forget Lauren.

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

Each series I've taught has gone great! The part I enjoy most is getting to connect with couples and share information that I wish I had known earlier in my birthing years. It makes me feel like I am making a difference. It is also incredibly enjoyable to see dads gradually become more and more engaged in birth preparations. Over the 10 weeks it gets very "real" for them. It's a neat process to watch.

HAILIEprofile
Hailie with her youngest baby, born at home.

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

I was really nervous at instructor training when we had to individually teach a specific topic. It was reminiscent of my elementary teaching days when the principal would come in for observations; judgement from colleagues can be intimidating. BUT, it was completely judgement free with lots of constructive feedback and I even learned new information from some of the other trainees during their presentations.

I also really liked that we practiced relaxation exercises and labor positions in groups. You'd be surprised how difficult it can be to read aloud using a "yoga voice" for the first time ever. It was great practice, though! I was 36 weeks pregnant at the time, so it was super relaxing to be the guinea pig for some of those - I felt like I was getting pampered at the spa!

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

I feel like my students are benefiting so much just from hearing about all the choices they will be making for in preparation for their births. My students almost always leave with a list of questions for their care provider that they would have otherwise never known to ask . I truly feel that it's also helping the dads be able to connect with the pregnancy on a more meaningful level. As the series progresses, I notice dads becoming more confident in their ability to make joint birth decisions,  and also more confident in their ability to be a good support to their wife on the day of baby's arrival. Seeing the friendships develop between the couples is great too.

To close, tell us how you see natural childbirth education having a positive impact? Why does this work matter to you?
Specifically in my community, where we have a 37% cesarean rate, I am hopeful that my empowered students will go out into the community and share the impact that education had on their births. I really feel this will lead to more and more couples investing in their births and having more positive experiences. Also, when we as women are educated, we can hold our doctors accountable and at a higher standard. This is the first step in lowering the astronomical cesarean rate in the Big Country.

Where can we find you?
A few different places, actually! Come visit me. I LOVE communicating with moms and dads who are interested in birth!
doulamyth_o

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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