Doula myths debunked

If you are not familiar with the term "doula," as in birth doula, it is a woman who provides constant emotional and physical support to the mother during labor and birth and in the immediate postpartum time. Or, that's the bare bones of it.

In keeping with my new found birth junkie side, I wanted to address something that I saw on a message board about doulas. In an open discussion about how to talk to a woman looking into doula care for her birth, someone stated that there are three common objections to or myths about doula services:

1. A doula takes the place of a husband/partner
2. A doula only takes clients who wish to have an unmedicated birth
3. A doula has her own agenda for birth

So true I thought... and if I want people I know to give the idea of having a doula at their birth a chance- I best get my story straight. Here's the story....

1. Myth: A doula takes the place of the husband or partner.

Debunked: No way! A birth doula can serve a mother who has a husband/partner, other support people with her or is single. A laboring woman needs all the attention of support people outside of nurses, doctors and midwives (who have their own responsibilities). Many times it does take four (or more) hands to help the mother as she needs it during contractions for pain relief. The doula is more of a conduit between the laboring woman and partner, teaching the partner how to best serve mom as her needs change throughout labor. The mother also needs someone she can rely on for information as needed. She should not have to rely on only herself as her "normal self" may have been taken over by her "labor self" a while ago. Dad is not best for this role either (as anyone with a husband can imagine). The doula, knowledgeable in hospital procedures and protocols, comfort measures, positioning, and breastfeeding in the postpartum time is perfect for information transfer, helping mom and her partner work together to birth their baby.

The best things about the doula/husband or partner combo:
-Dad experiences less pressure because mom's needs are met and he is not the go-to for everything
-Dad has his needs met too
-If dad needs to leave the room to handle childcare for other children or get something to eat, mom is safe and sound and supported best of all
-Dad and mom can share beautiful moments as the doula holds a safe space for them
-Dad can be in the postpartum pictures instead of taking all of them

2.  Myth: A doula only takes clients who wish to have an unmedicated birth

Debunked: Not true! Having a doula is a wonderful addition to any birth "team." Doulas certainly accompany mothers who have unmedicated births but also women who plan to have an epidural or
a baby via c-section. The support given by the doula changes based on each birth but the idea is the same: to help the mother to have the birth experience she desires (as much as possible).

In an unmedicated birth, the two main components to support are emotional and physical support. More effort is needed for comfort measures during contractions and on into birth (as compared with a medicated birth). 

In a medicated birth where a mother receives an epidural, support is more emotional. The pain of labor may be gone but that doesn't necessarily mean every worry or anxiety is gone too. Women may need support for any unexpected side effects as well.

In a c-section, the doula takes on even another role for the mother. The support varies based on if the c-section is a non-emergency, an emergency or scheduled ahead of time. A doula still provides support before and after surgery and in some cases can even join mom in the operating room. Being with mom in the operating room and being able to process the event as it takes place one-on-one can make all the difference to the mother.

Everyone who is having a baby benefits by having a doula as part of their birth team!

3. Myth: A doula has her own agenda for birth

Debunked: If a doula does, she shouldn't. It is true that most doulas believe in the normalcy of birth and that the human body was designed in specific ways to have a baby safely and with little to no interventions. However, a doula is trained to respect that everyone has different life experiences that contribute to their feelings about childbirth. A doula's role is not to impose her opinions on her clients but to help the mother to discover her own desires for birth and put them into action. Doulas do not try to save the world from medications and surgery during childbirth but rather, they try to help the mother have the best birth experience possible, according to the mother.

I hope this helped to crush some myths about doula care.

Stop inducing labor just because... I mean it! Stop!

proud mom with baby sofia

My little darling Sofia will be three years old in 2 weeks. I can't believe it has been so long. She is growing up way too fast! Her birthday and some other experiences that I have recently heard of bring to mind some serious thoughts regarding labor induction.

In a previous post I described my labor induction experience with Sofia. Here are some cliff notes if you are just tuning in. I was 4 days late the first time they wanted to induce. I just didn't feel right about it.... so I called the hospital and literally cancelled my appointment and didn't show up. I was 10 days late the next time my doctor called for induction. Being it my first pregnancy and that when the doctor talked to me he used the term "placental decline," I agreed reluctantly. My whole pregnancy I was waiting for my water to break in the middle of the grocery (clean up- aisle 4!) or to wake in the middle of the night - "I think this is it!". Unfortunately I got up at the crack of dawn on the day of my induction and packed the car and drove there- no pains, no urgency. To top it all off, at the hospital they insisted on wheeling me up to my room- as if I was really in labor or something. Talk about adding insult to injury!

I got all set up- dressed in my gown, "checked" for progress, hooked into an IV, bands put in place to monitor fetal heart rate and contractions. Enema- check! So much for moving around- it was hard enough using the bathroom. Next- induction drugs. I was given a 1/4 tab of cytotec vaginally every hour for 4 hours. Then the pitocin. Then my water was broken. Then the stadol (a narcotic administered through my IV without my permission that didn't help with my contractions and only made me feel less present during birth). Eventually an epidural. And, at 9:24 pm, my daughter Sofia was born with a little help from a vacuum extractor. Thanks a lot.

While I was overjoyed and super-thankful that we were both healthy, I couldn't help but feel a little disappointed in how things shook out. It wasn't until later that I realized how common my not-so-good experience really was. 

So, recently, I had the opportunity to come along side a friend during her pregnancy. It has been a joy getting to know her and being able to share with her what I have learned from my experience. She recently had a beautiful baby boy... via induction. The night before her induction we met and she told me what the doctor had suggested. She was 39 weeks and 3 centimeters. Oh, and her doctor was leaving for vacation in 2 days. I think I did a great job encouraging her despite the anger that I felt towards her doctor for a morally defunct decision regarding her patient. 

When I went to visit my friend, who did (thankfully) have a successful induction, she told me about 3 of her other friends who just had or are about to have their babies. All had been or had appointments to be induced. Including herself, 2 women had bad experiences with epidurals and one birth culminated in c-section. I just couldn't believe what I was hearing.

It is estimated that upwards of 20% or 1 in 5 births are induced in hospitals today, according to the National Center for Health Statistics. I actually saw 40% on some sites but could not find information to back it. keep in mind that less than 10% are medically necessary. The problem is that it is so common that we think it is normal now. Also, around 40% of all inductions will end with birth by c-section because the body is not ready. This rate could be higher among first-time mommas.  

Some risks of induction :

• Increased risk of abnormal fetal heart rate.
• Increased risk of fetal distress.
• Increased risk of shoulder dystocia.
• Drastically increased risk of your baby being admitted into the NICU.
• Increased risk of vaccum extraction or forcep delivery.
• Increased risk of a cesarean section.
• Increased risk of prematurity.
• Increased risk of jaundice.

If you are not a high risk pregnancy, here is an example of normal labor:

Between 37 and 42 weeks, you go into labor on your own. You labor naturally by breathing, moving, getting into different positions. If you are having a hospital birth you choose whether to proceed with or without medication. You push when your body is ready. Your baby is born.

I am not trying to minimize or idealize birth- it is a process that can take days and it hurts like hell. Straight-up, no joke. What I am trying to show is that our bodies were specifically designed to procreate and birth! Birth is an amazing experience and a gift, not to mention something that sticks with us for the rest of our lives. The medical industry is trying to sabotage the birth experience by shouting lies at us like:

• "Your baby is too big for you to birth on your own"
• "You don't have to suffer during birth"
• "Allowing the baby to stay in the womb past 40 weeks is dangerous"
• "The baby is going to grow too big"
• "You only have so long and then we will have to do a c-section"
• "Inductions are harmless"
•  "C-sections are no big deal"
• Oh, and here's some formula in case you probably don't make milk like most women (what?!?)

I know there are doctors who truly do care and take their profession and patients very seriously. Those doctors unfortunately are far and few between. The thing that pregnant woman MUST KNOW is that they are in control of their bodies and that their doctors provide information to be considered and that is about it. It is undeniable that doctors get paid more for performing c-sections than standard births- check your bill. You don't think they get paid by pharmaceutical companies for using induction drugs like cytotec or a narcotic like stadol? They sure do. Doctors can only have one master- their patients or big dogs who pay the bills. Who wins? Unfortunately it is not you and I.

Modern medicine has a place, don't get me wrong. There are certain situations that require medical intervention for the health and safety of mom and baby. Too much intervention is happening in a realm that should be more personal, exciting and empowering. Patients are being taken advantage of every single day. 

Labor induction is an epidemic. Women- be encouraged! Your bodies were made to grow and birth babies- on their own. Read, read, read! You are in charge. You can birth your baby. You can have a great birth experience. You are awesome! 

Please read more about inductions and the drug cytotec from the blog Pregnancy, Parenthood & Playtime

http://blog.ctnews.com/elwood/2009/09/15/labor-induction-what-you-may-not-know/

The risks of induction list from above was borrowed from this site.

The birth experience

Oh, birth, where do I start?

Birth is not a blip in your history. It is not one exact moment but a combination of moments that have lasting affects. Back in the day (way back), everyone's birth was probably pretty similar in terms of choices. There was just one way to do it- vaginally and with little to no medicine. Surgery was a rarity. If you know anyone who has been pregnant or is pregnant, you know the options are quite different. This is good and bad. For a lot of women and their doctors, birth is just business- if you are pregnant, the baby is going to come out one way or another! Little consideration seems to be given to the experience of birth. Having a good birth can make all the difference in the post partum time and as you continue to bond with your baby as s/he grows.

me and sofia

I had two very different births. My daughter Sofia was 10 days late and I ended up being induced. My induction led to camelbacked contractions and an epidural. Sofia, thankfully, was very healthy despite the wack-o contractions, the vacuum extraction and being forced to "move out" before she was ready. She was 7 lbs and 8 oz. My second daughter Leila was born 5 days early (thank you to my wonderful midwife Julie for getting things moving!). I opted to be present for this birth and have her completely naturally. I switched from a obstetrician to a CNM/midwife and hired a doula (a birth assistant for mother and family). It was awesome. It hurt like hell, but it was awesome and amazing and super-empowering. She, thankfully, was also healthy and weighed in at 8 lbs 4 oz.

me and leila

When I was planning for my birth with Leila, I had to make some big changes. I did not want the same experience I had with my first birth. First, I had to break-up with my doctor. It was a bummer because I really liked him and he had delivered my other daughter. It also sucked because I thought he might be mad at me or something. Once I made the switch to my midwife I didn't look back. It was the best decision I could have made. It is so important to have a doctor that cares about what you care about.  YOU PAY THEM. YOU ARE THE CLIENT! Be encouraged if you feel like you need to make a change. Secondly, I hired a doula. A doula is someone who does not replace your partner or mother but is in addition to and takes care of everyone. She makes sure that mom and dad rest if possible, that everyone is eating and breathing and drinking water. She is there from start to finish. She is constant. Thank you, Jordan, for being that for me! Third, I wrote out an easy to read, bulleted birth plan stating what I did and did not want while at the hospital. It was very clear. I am flexible but I did not want to be pushed over in a very vulnerable state (ahem, labor).  Lastly, I got my labor mix set on my ipod and jammed-out until things got serious.

The things that kept popping into my head when I was thinking about what I wanted for my birth experience:

• The nationwide rate of c-section according to the Centers for Disease Control is around 30% and higher in some places around the U.S.
• Inductions can lead to fetal distress or breaking of water which can lead to c-sections
• Having a c-section, although common, is major surgery
• Recovery time for vaginal birth is shorter than for c-section 

As you look to your birth experience, here are some things you should do:

• Ask yourself it your doctor cares about what you care about. If not, dump him/her and interview new ones
• Visit hospitals and birthing centers to see where you will be most comfortable and even look into homebirthing options
• Consider hiring a doula (Doulas of North America www.dona.org/mothers/index.php) who will be your advocate during
• Read- the more familiar you are about birth and what is normal, the less freaked out you will be when it comes on
• If your doctor even mentions c-section, start asking questions and a lot of them!  

A final note about c-sections-

It is literally all the time that I hear someone say "I had to have a c-section." I actually hear of more people having c-sections than I hear of people having vaginal birth (hello, the way we were designed to birth children). I am thankful that we have the technology to perform c-sections. I think there are certainly times when c-sections are necessary. I however strongly believe that the power to perform c-sections is being greatly misused in our current health system. I do not believe that a doctor going on vacation or just because the mother wants one or being scared of having a baby are valid reasons to have a c-section. I do not buy it that 30% of American women can't birth babies vaginally. I just don't buy it. Like I was saying before, if your doc says c-section and your red flags go up, start asking questions or even get a second opinion. 

Woman, you are powerful! You can take back your birth experience! 


leila and sofia, loves of my labors