Q: What is a Doula?
A: Doulas accompany women in labor to help ensure a safe and satisfying birth experience. They provide emotional support, physical comfort, and facilitate communication with the medical staff to make sure laboring women have the information necessary to make educated decisions during childbirth. They provide reassurance and perspective to the laboring woman and her partner, making suggestions for labor progress, and assisting with comfort techniques including relaxation, massage, positioning, and touch. A doula is independent and works for the laboring woman, not the caregiver or hospital.
Q: Why have a Doula when you have taken childbirth classes and have a partner who will be with you throughout the birth?
A: The doula may be the only other person at the labor beside the partner who is there solely for the emotional well-being of the woman. The doula is there from the beginning to end of labor and delivery, sometimes that means going to the woman’s house and following her to the hospital when labor begins. The nurse, doctor, or midwife have other responsibilities and priorities that compete with the emotional needs of the woman, for example, breaks, shift changes, clinical responsibilities, office hours and hospital policies. The doula has few or no other priorities. She stays through shift changes, and until after the baby is born. She is not just another stranger with the couple. The doula knows the couples’ wishes and can assist in implementing them.
Q: Will the doula ‘take over”, displace the partner and interfere with their intimate experience?
A: The doula can actually help to make the couple closer. By making sure that the partner’s needs are met (food, drink, occasional back rubs, and reassurance), the woman and partner can work more closely together. The doula allows for the partner to participate at his or her own comfort level. The partner may or may not want to be the major source of emotional support for the woman.
If the partner wants to be the major source for emotional support, the doula can supplement his or her efforts by running errands, making suggestions for comfort measures, helping to clarify information given by the medical or hospital staff, offering words of reassurance and comfort and give the partner breaks during long labors.
If the partner is uncertain about his or her role or feels unsure about being able to comfort the woman, the doula keeps him/her involved and helps guide him/her through the process, telling him/her what to expect at each stage while it’s happening and together they meet the needs of the woman.
In some cases, the couple wants he doula to take the lead in supporting the woman, in which case the partner would play an important secondary role (holding her hand, supporting her in position changes, timing contractions, massaging her, etc.). In other cases the doula and partner share the responsibilities and trade off being the primary support; this gives the partner breaks to call relatives, eat, sleep, etc. The doula recognizes that the partner knows more about the woman’s personality, likes and dislikes, and needs while the doula probably knows more about the birth process, hospitals, and maternity care. Together the partners and doula along with a competent, considerate and caring staff give the woman the best chance for an optimal outcome.
Q: Does the doula impose her own beliefs about how the birth should go on the couple?
A: The doula’s only agenda is to help ensure that the woman’s or couple’s agenda (birth plan) is acknowledged and followed as much as possible. If the doula is thoroughly familiar with the couple’s wishes, she may actually think more about it than the couples, especially when labor is intense and things are happening rapidly. The doula helps with the decision-making by asking questions that will ensure the right information is given to the woman or couple so that they can make informed decisions. She may also suggest alternatives (like waiting a while or changing positions) for the couple to consider. She does not, however, make decisions for the couple.
Q: When do I contact the Doula?
A: We prefer you call us when you think you are in labor, even if you do not yet need support. Contacting us early in labor allows us the opportunity to answer questions you may have, provide phone support when appropriate, and prepare for your birth experience.
Q: What happens after the baby is born?
A: We will remain with you for approximately one hour after birth, until you are comfortable and your family is ready for quiet time together. We can also help with initial breast feeding, if necessary and desired. Dolphin Doulas will provide a postpartum visit one to two weeks after the birth to assess how you are doing, review the birth, admire your baby, and get feedback on the doulas role.
In summary, the doula helps make the birth experience as rewarding and satisfying as possible. As one father said, “I heaved a big sigh of relief when she (the doula) walked in. I hadn’t realized how much pressure I had been feeling. She not only calmed my wife, she calmed me down.
~ excerpts taken from a handout by Penny Simkin, P.T.
Q: What is a Postpartum Doula and how will she help me when I bring my baby home?
What a postpartum doula does changes from day to day, as the needs of the family change. Postpartum doulas do whatever a mother needs to best enjoy and care for her new baby. A large part of their role is education. They share information about baby care with parents, as well as teach siblings and partners to “mother the mother.” They assist with breastfeeding education. Postpartum doulas also make sure the mother is fed, well hydrated and comfortable. The role of the postpartum doula is fluid. An important part of her role is to come alongside the parents and together decide what type of support they will need. Some families need educational support: breastfeeding, infant support, and how to care for the new mother. Others rely more on the non-judgmental emotional support that the postpartum doula has to offer. Still others have more practical needs – like feeding the family and running errands. Most families find that their doula provides all of these things, according to the needs that develop, as well as the ever-important communication between the doula and her clients.
Q: What will the postpartum doula do when she comes to my home?
- Provide hands-on education on infant and mother care
- Come alongside the parents and help them to get to know the abilities and talents of their new baby
- Create a nurturing, restful atmosphere in which parents may eat, shower and nap
- Shop for groceries and prepare meals
- Play with older children and offer suggestions for how to integrate the new baby into the family
- Spend time with the baby, allowing parents to cuddle and have quality time with older children or just be alone together
- Introduce parenting tips, helping parents to learn skills that will enable them to cope with their new responsibilities
- Screen for hurdles such as breastfeeding challenges or postpartum mood disorders
- Make referrals to any local or informational resources that the parents might need
- Work herself out of a job by helping parents to gather the skills and resources that they will need in the upcoming weeks and months
- Help to organize the nursery and home
- Take care of the baby’s laundry
- Offer a listening, non-judgmental ear
A postpartum doula supporting a family during the “overnight” hours might…
- Work herself out of a job by teaching parenting tips and strategies that will eventually make her services unnecessary
- Assess and help with breastfeeding
- Diaper and burp baby, so that mom does not need to move around – she can just stay cozy in her bed to feed and snuggle baby
- Bring snacks and beverages to the mother while feeding her baby at night
- Prepare pump supplies or bottles for the next feeding or the next day
- Take the contentedly fed baby to another room and help the baby to go back to sleep, so parents can sleep soundly between feedings
The relationship between the doula and her clients requires the same maintenance as other important relationships in life, such as marriage or close friendships. It is important that communication remain open, as clients’ needs or priorities may change with time or experience. The doula anticipates these changes and will be prepared to remain flexible in her role.
Q: How long does a postpartum doula spend with a family? What hours can I expect my Doula to work?
Doula support can last anywhere from one or two visits to more than three months. Some doulas work fulltime, with 9 to 5 shifts. Others work three to five hour shifts during the day, or after school shifts until Dad gets home. Some doulas work evenings from around 6 pm until bedtime, 9 or 10 pm., and some work overnight. Some doulas work every day, some work one or more shifts per week.
Q: What is the difference between a postpartum doula and a baby nurse?
A: The role of a postpartum doula is to help a woman through her postpartum period and to nurture the family. Unlike a baby nurse, a doula’s focus is not solely on the baby, but on fostering independence for the entire family. The doula is as available to the father and older children as to the mother and the baby. Treating the family as a unit that is connected and always changing enables doulas to do their job: nurture the family.
Q: How do postpartum doulas work with a mother’s partner?
A: A doula respects the partner’s role and input, and teaches concrete skills that will help the partner nurture the baby and mother. The doula will share evidence-based information with the partner that shows how his or her role in the early weeks will have a dramatic positive effect on the family.
By mothering the mother, doulas maks sure that the mother feels nurtured and cared for, as well as making sure she is eating well and getting enough sleep. In addition, postpartum doulas are trained to help clients prepare themselves for parenthood, maximizing support and rest. These doulas will help their clients to screen themselves for PPMDs and will make referrals to appropriate clinicians or support groups as needed.
Q: Can I do inversions while pregnant?
Many women who have regularly included inversions in their practice before becoming pregnant wish to continue doing inversions while pregnant. Women should listen to their bodies. If it doesn’t feel good they shouldn’t do it. It is not recommended that women who do not regularly practice inversions before pregnancy do inversions while pregnant.
Q: Can I do backbends while pregnant?
As with inversions, if they haven’t been doing backbends before pregnancy, women should listen to their bodies and shouldn’t start doing intense backbends while pregnant. Moreover, because there is more weight being put on the spine during pregnancy, especially in the late second and third trimesters, intense back bending is not recommended. (demonstrate with the ball)
Q: Why can’t I lay flat on my back while pregnant?
After about four or five months of pregnancy, women should not lay on their backs for more than a minute at a time. The reason for this is that one of the major blood vessels called the vena cava runs along the back. The vena cava is responsible for bringing blood to the heart from the rest of the body. When a woman lays on her back the heaviness of the uterus can compress the vena cava, thereby diminishing the blood supply to the heart and to the baby. The results of lying on the back for a prolonged period of time are dizziness and lightheadedness as well as decreased blood flow to baby.
Q: Can I use yoga to help turn a breech baby?
One of the most effective ways to turn breech babies after 36 weeks of pregnancy is to use yoga positions. The most effective position is the supported bridge. A woman should place a large stack of pillows under her hips making the angle of her hips to head at least 45 degrees. The higher she can get her hips, the better. She should stay in this position for a minimum of 10-15 minutes two or three times a day. This position will not be very comfortable and the baby will probably move quite a bit. To make this position even more effective, the woman should place an ice pack on top of the uterus, near the sternum where the baby’s head is. This encourages the baby to move away from the cold into the head down position. Note: Once the baby moves into a head down position, the woman should frequently sit in Bound Angle pose, with her feet together and knees out. This position encourages the baby’s head to engage in the pelvis. Women should avoid this pose while the baby is breech.
Q: How long after the birth of my baby until I resume my yoga practice?
Every woman is different and when she can return to her yoga practice is based on individual factors. Before returning to any exercise or yoga practice she must first get the “ok” from her doctor or midwife. Most healthcare practitioners will want the woman to have stopped any bleeding before returning to any yoga practice, this is typically two to three weeks. If she starts bleeding again or bleeding increases after doing any activity it usually means she did too much. Again listening to your body is pivotal in resuming yoga practice postpartum. Women who have had cesarians should consult with their doctor and usually they will want her to wait at least 6 to 8 weeks postpartum before resuming regular yoga.