There is a good chance your Great-Grandmother gave birth surrounded by women
knowledgeable in the birthing experience. Over time it became more common for
women to labour alone in a hospital tended to by staff. Fortunately these days it is
likely you will have your partner with you throughout labour and birth, and now the
element of a knowledgeable woman being present has reemerged.

A Birth Doula is a woman who provides continuous emotional and physical support
for you
during your labour. She visits with you and your partner during pregnancy to build a
rapport, answer questions, and help prepare you for the birth. Once you are in
labour, you can count on your Doula coming to you when you need her and staying
until after the birth of your baby. She will stay at home with you in early labour,
keeping you comfortable and offering reassurance. Once labour is well established,
she accompanies you to the hospital and continues her support. This continuity has
been proven through research to shorten labours and reduce the likelihood of
interventions including medication and cesarean sections. Because each labour is
unique, your Doula will adapt to your birth and your needs. She can offer a
combination of massage techniques, position changes, and verbal reassurance that
can help you throughout your experience. After the birth your Doula can help you
establish breastfeeding and encourage bonding with your infant.

A Doula also
permits your partner to participate in the experience without feeling entirely
responsible for your emotional and physical needs. Birth can be a transformational
experience for a couple, and a Doula helps to eliminate the fear of the unknown and
unforeseeable. Her commitment is to you and your partner and helping you obtain
the birth experience you want. She supports all decisions you make and offers
suggestions and information based on your needs.

In the days or weeks
following birth, many women are now using the services of a Postpartum Doula.
These women are trained in the care of new moms and babies and offer services
including infant care, light housekeeping, and breastfeeding support. Mothers with
additional children, twins, or partners who have returned to work, benefit
particularly. Some Birth Doulas offer both services.

When choosing a Birth
Doula it is important to select someone with whom you are very comfortable. She
should be familiar with the birthing process, but not necessarily need to have given
birth herself. The number of births she has attended may be less important to you
then the confidence you feel in her presence. You should ask about her education
and most importantly her philosophy on birth. Postpartum Doulas are trained in
infant-mother care and may have other skills and certifications that you would
value. Fees for Doulas vary according to experience, skills, and services offered. In
any case, interviewing 2-3 women will help you determine the type of Doula you are
looking for.

Stacelynn Caughlan is a Clinical Nutritionist and Certified Herbalist who
specializes in pregnancy, birth and childhood. She is currently the editor of
http://www.motherandchildhealth.com an online source of advice on nutrition,
herbs, and natural healing for pregnancy, birth, and childhood. It includes
parenting advice, articles, experts, and a variety of resources that help
support natural lifestyle choices.

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Have you considered hiring a doula for added support during labor? Wouldn’t it be easier for a mother to have someone nurturing, guiding, suggesting and comforting throughout the entire childbirth process? Doulas have your best interest at heart because they work for you not the hospital.

WHAT ARE DOULAS?

Specially trained women helping women through childbirth.

Offer a continual presence vs. the hospital staff coming and going.

Provide pre-natal visits to go over birth plans and birth desires.

Give suggestions to help facilitate labor progress.

Massage, encourage and guide a woman throughout labor.

They have a bag full of labor aids that help eliminate the discomforts during childbirth.

WHAT DOULAS DON’T DO:

Vaginal exams, or medical interventions.

Deliveries

Speak up for the woman; rather encourage her to voice her wishes

Take over Dad’s role

WHAT’S IN IT FOR BIRTH PARTNER?

The birth partner can participate at his own comfort level.

When he wants to be the main partner, he has an assistant. He
can go to the bathroom, eat or even sleep if he needs to without compromising the woman’s comfort.

Women love when their partners are nurturing during labor. This is taught by the doula’s example. Bonus points for Dad.

Doula’s can provide education and knowledge through out the labor, explaining procedures, etc. This can reduce Dad and Mom’s anxiety.

THE BONUSES FOR HAVING A DOULA

50% reduction in cesareans

25 % reduction in the length of labor

40% reduction in pitocin

60% reduction in the need for epidurals

30% more likely to be breastfeeding 6 weeks post-partum

Less incidences of post-partum depression

More bonding with the baby

Women experience a more satisfying birth experience

You may find a doula in your area by the internet, or by talking to your childbirth educator.

Julie L. Johnson is a wife and mother of three who has experienced every pregnancy, childbirth, postpartum and breastfeeding situation there is and has lived to tell about. She is a Certified Lamaze Childbirth Educator, Certified Doula and an International Board Certified Lactation Consultant practicing in Southern California. Her website http://www.mybirthangel.com provides services and products to help ease the transition into motherhood.

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I coached as my wife was delivering our third child. She was at the final phase of delivery where the last few pushes would result in the birth of our second daughter. As the crown of our daughter’s head protruded slightly from the very end of the birth canal, my wife’s obstetrician yelled, “Stop! Don’t push…”

He quickly positioned a hypodermic needle and injected anesthetic into a section of my wife’s perineal tissue - the skin between the vagina and the anus. Next he grabbed a scalpel and carefully addressed the freshly anesthetized area. The attending nurse and I instinctively wheeled our heads to the side so that our eyes could not see what happened next. “I never watch this part,” she told me, as the doctor quickly performed a simple procedure known as an episiotomy. Our daughter was born minutes later. As mother and daughter were meeting face-to-face for the very first time, the doctor was busy stitching the incision created during the episiotomy.

The idea behind performing an episiotomy is twofold. The first reason is concern for the baby. Passing through the vaginal canal is the most stressful time for a baby experiencing a traditional vaginal birth. Cutting the perineal tissue creates a wider opening so that the baby can slip through more easily. The second reason is, in theory, to prevent out-of-control tearing of the mother’s perineal tissue. The idea is that, by making an incision, the area affected by cutting or tearing is controlled to a certain extent by the attending physician. The problem is that not all mothers experience tearing, so the laceration can be unnecessary.

According to an article by Salynn Boyles published on WebMD (http://my.webmd.com/content/article/110/109783.htm), The Journal of the American Medical Association (Vol. 293 No. 17, May 4, 2005) reports that researchers screened nearly 1,000 medical resources published in the past 60 years looking for data measuring the effectiveness of the procedure. Data from twenty-six articles contained relevant content and were aggregated to form conclusions.

The article reported that there was “fair to good” evidence that the results of routine episiotomy were not advantageous over the results of those with restrictive use of episiotomy. In cases where episiotomy was performed routinely, the severity of the laceration, the degree of pain suffered, and the amount of medication needed to treat was no better than for cases where episiotomy was not routinely performed.

Though most of the individuals were not followed late into life, relevant studies have shown no benefit from episiotomy for the prevention of urinary incontinence or pelvic floor muscle relaxation. Studies have also shown that “impaired sexual function - pain with intercourse - was more common among women” who had the procedure. A report published in the British Medical Journal in January of 2000 reported that women who received episiotomies during delivery had a significantly higher incidence of anal incontinence - the inability to control bowel movements and gas - than their counterparts who did not receive the procedure.

At best episiotomy is something no one wants to observe; at worst it can cause pain, lengthen the time it would normally take for a couple to resume sexual relations, and cause anal incontinence. The ideal situation would be to not only avoid episiotomy, but also to avoid tearing.

Informed mothers are learning more about this subject and taking the time to speak with their obstetricians about it, well in advance of their scheduled birthing date. They are adopting a strategy that includes special exercises using a device called EPI

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