Sunday, November 30, 2008

When Should Your Doula Arrive In Your Labor?

A doula is a professional birth guide. Her role is one of non-intervention and non-clinical in nature. She gently guides through her words, suggestions, and knowledge of birth to assist a couple in having a birth that is in line with their birth desires. Many doulas will come to your home in labor to assist before you leave to go to the hospital, for hospital-planned births. The question that arises in labor is when should I have my doula come.


The idea of coaching the woman in labor is one I am uncomfortable with. The birth guide and partner should be there to support the woman but not direct her. If a woman is walking the path of her labor and doing well, I do not think someone should tell her how to do things differently. If she begins to fall off the path and needs assistance- encouragements, affirmations, suggestions, that is when the birth guide should offer to gently guide her back onto the path. Listening to her body and what it tells her to do is paramount.


Marsden Wagner has said, “I feel the most important thing the birthing woman does is to listen to her own body and find out what her body is telling her she needs to do. And that neither the partner, or the doula, or whomever, should be giving orders, ‘Now do this’ or ‘Now do that’ because that interferes with what she is really trying to get from her body. The coach image is the guy who’ standing there telling the player what to do- the coach is up her ea the player down there somewhere.”


Sometimes when I have arrived too early in a labor, I notice that labor seems to stall or slow down. It makes me wonder if the woman is relying too much on my guidance, and me, rather than her own instinctive voice. Pam England in the book Birthing From Within writes, “Well-intentioned, but excessive, support in early labor (as when a birth companion hovers solicitously) can make you feel helpless, weak and dependent.”


Begin a labor project. Some labor projects may surround areas of cleaning or nesting for the baby. Perhaps washing and drying the clothes you have bought for the baby. Sorting items in the nursery. Working on the birth announcements or thank you cards for baby gifts. Putting together photos of the family. Painting the belly cast. Journaling a pre-birth story for the baby. Reading a book on breastfeeding or parenting. Exploring the area of birth art and fantasizing on what the baby will look like. Doing things that will enhance the bond you have with your baby will help you to connect and begin to unfold.


When your doula arrives too early she interferes with the natural process of letting labor unfold. She may be close to you, but she is still an outsider of sorts. This is the time to start allowing your mind to totally trust your body’s ability to give birth. It is essential that a woman start to see how her body can manage through the early stages of labor, building confidence in her ability to handle the ever-increasing intensity of labor. Having access to her doula for conversations regarding anxieties or fears that may arise is helpful. But having a doula there in early labor causes some women to feel pressured to perform and she feels her labor is being watched. This can be an empowering time of self-discovery.


I don’t believe in trying to force labor to begin. If it is early in the day, a normal routine of daily activities should be attempted. Until labor demands your attention, you should go about as normally as possible. If it is late in the day, a restful walk followed by a warm bath will help the mom achieve rest before labor becomes more active. The most important thing is for her to mentally prepare and have a mindset that will help her to let go and unfold for the upcoming birth. Eating, drinking and resting are essential for any impending labor.


As your labor begins, I suggest you call and let your doula know that things may be starting. If it is in the middle of the night, don’t wake your doula. You will benefit more from having a doula that is well rested if this is truly your labor beginning. And if you can go back to sleep, do so- waking to find her number and call her often sets adrenaline into motion and getting more sleep becomes impossible. But call her if you need her no matter the time of day. If it is during the day, stay in touch with your doula, keeping her abreast of any changes or concerns that she may be able to help you with.


As your labor progresses, you may want your doula to come to your home. She can help you with pain coping techniques, positioning and ideas that may help labor progress. At the point in your labor that you want to move to the location for the birth, she will accompany you. This will help the transition from home to the birthplace be smoother.


Your doula will stay with you throughout the labor. She will be the continual support that is needed and welcomed by moms no matter if the labor is a long one or a short one. Most doulas are able to help with the initial bonding time with the new baby. Skilled in breastfeeding, she can help you with the initial time of getting a baby latched on properly, insuring a more successful breastfeeding experience.


Your doula is there to help, not impede your labor. Calling too early might slow things down. As Pam England says, “Relax, breathe, feel the earth; and do nothing extra.” Rely on your doula when you need her, but rely on your instinctive voice beforehand and along the way.

"Relax, Breathe, Feel the Earth; Do nothing Extra"

Pam England

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