Refocusing on Doulas and Doula Support

A new blog post after a very long pause. To let you know what you can expect to read more and less of on this blog in future.

The Hampshire Doulas blog will be focusing on specifically doula-related blog posts going forward.

In the past, there’s been a wider range of topics covered here including lots of information about pregnancy, birth and postnatal family life. But if you have a scan through now you will see the list of blog posts is down to information on the benefits of doula support and what it’s like to have a doula support you.

If you would like to read more from the same author on other pregnancy, birth and parenting topics please find me also blogging for Informed Pregnancy, Birth and Beyond, which is a South East Hampshire based community support organisation. If you’re pregnant or have a new baby you may also find the IPBB monthly meet-ups really helpful there are two in-person in Portsmouth and Fareham and one online which you can join from anywhere in Hampshire or anywhere you are across the country and the world.

https://www.informedpregnancybirthandbeyond.org/blog

Hampshire Doulas blog will be expanding a little more also to better reflect Hampshire Doulas as a doula-to-doula support organisation. So if you’re already a doula or thinking of becoming one now’s a good time to hit the follow button here.

If you’re a doula who would like to write a guest post on anything that means a lot to you about being a doula then please get in touch for a chat.

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Evidence for doula support

Benefits of doula support. Satisfied with labour and birth experience.

The best kind of evidence for doula support are all the families who feel good about the support they were given by their doula and who value and recommend doulas.

But in a society where a very high value is put on being able to show in scientific research that there are measurable benefits to things. And being people who like to be able to see the research on the measurable benefits of any interventions before deciding whether or not it is one we want to choose for ourselves. We think it’s really great that whenever the Cochrane Library reviews the evidence on continuous support through labour and birth the conclusion is that the kind of support we provide results in many potential benefits for the mother and baby.

The most recent review which came out earlier this month concluded:

“Continuous support during labour may improve outcomes for women and infants, including increased spontaneous vaginal birth, shorter duration of labour, and decreased caesarean birth, instrumental vaginal birth, use of any analgesia, use of regional analgesia, low- five-minute Apgar score and negative feelings about childbirth experiences. We found no evidence of harms of continuous labour support.”

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003766.pub6/full

There are more details if you want to read them in the full report via the link. The Cochrane Library is a great place to go and read up on anything related to pregnancy labour and birth especially because they provide a plain English version of their conclusions of their research reviews which is really helpful for those of us with no medical degree but who want to have all the information before making decisions.

What’s in your bag?

When your doula goes on call for your birth one of the first things she will do is make sure her doula bag is all packed and ready to go and safely kept so it can be grabbed on the way out the door to be with you.

You’re probably wondering what’s in this bag that makes it so special but before we get into that always remember what’s outside the bag is much more important. Sometimes birth happens fast and sometimes it takes even an experienced doula by surprise and we turn up by your side with nothing more than purse and keys. Any of the things we’re going to talk about can be improvised from what we find at your house or the hospital and many women will give birth without any ‘things’ at all just calm loving people marvelling at how wonderful she is.

Sometimes it can be a challenge, especially in our society where we find speed and measurement are so often expected to be a feature in birth experiences and where we often birth in unfamiliar surroundings, to reach that place of being totally in the zone and able to find the power in us to follow what our body is doing. The calm relaxing presence of a doula by your side is her main tool in helping you reach that place of feeling safe and relaxing into what your body is doing and letting it take over and get birth done. Her reassurance and ability to help those around you respect and honour your need for that calm quiet zone is her main tool and you can’t keep that in a bag.

When I asked the Hampshire doulas what from their doula bag they were most likely to use at a birth it came as no surprise that the things we use the most often are things that help women to find their birth zone and follow their body’s cues with the least possible disturbance. Our tools of the trade are the things which work with us in helping to hold the space women birth in and increase their natural levels of the all-important oxytocin.

Here we go with the answer to what is in our doula bags?

Battery Tealight Candles or Battery Fairy Lights.

One of the most important things for increasing the levels of oxytocin a birthing women is producing is to keep the lights low. Bright lights can make women too aware of their surroundings and the possibility of being observed which can stimulate the production of adrenalin -oxytocin’s natural enemy. Even when we’re at a birth without our bag we will help women to find a nice quiet spot to labour with low lights. The added benefit of the tea lights or fairy lights is they have a soft comforting light that we naturally associate with warm cosy evenings with our loved ones which helps women feel safe and produce more of the lovely oxytocin.

Bendy straws.

Women in labour need to keep hydrated, their bodies are doing really hard work and when we exercise we need to stay hydrated to keep our muscles working well. But when a woman is following her body’s cues to find the best position to stay comfortable she may not be in a great position for sitting back and drinking from a cup or bottle. Also taking small regular sips of water is often easier than trying to take a big drink. One frequent task doulas take on is holding the water and popping the straw in the right place to help the birthing woman stay hydrated without having her natural rhythm disrupted.

Coconut water, honey sticks, honey water, high protein nibbles.

As well as staying hydrated women need the energy to maintain their muscles to keep going through all the hard work, especially if they have a long labour. This needs to be provided, just as with the bendy straws for water, in a way that doesn’t disturb their natural labouring rhythm. So, having small easy to nibble high energy options to tempt mum with that she can finish in between contractions is something we’re practised at. We’re also very prepared for (and used to having) small amounts of things spat into our hands if a contraction hits and a woman feels she would prefer an empty mouth during contractions. One of the other things often in our doula bags is hand cream for ourselves in case we need to wash our hands frequently or have them into the water of the birth pool giving a back rub etc.

Essential Oils

Not in every doula bag but in many because of the benefits of positive and relaxing smells in helping women stay in their labour bubble. A smell that you enjoy can help you relax and can cover up any unwanted smells like the medical smell of the hospital. There are other smells which can help you if you feel sick and others that can help you get your energy back. Some doulas have training or experience in using essential oils and will have a whole selection for you to choose from, the most popular during labour seem to be lavender and peppermint. Your doula will always chat to you about this during your pregnancy to make sure she only brings smells that you like into your birth space.

Flannel or face cloth.

This is a practical tool that gets used for various reasons. Sometimes it can be combined with the essential oils to keep them close enough to smell. (Not to be used for other things after that so sometimes we need two.) Other times it’s covered in cold water and used to help soothe a sweaty brow or on the back of the birthing woman’s neck to help cool her down. Sometimes it’s not needed till right at the end of labour when it can be soaked in warm water and used to support the perineum to help prevent tearing. Last but not least sometimes it’s needed after the birth to help the new mother clean herself up -those times we are ready to say thanks for all the hard work and goodbye to that trusty flannel and time to get a new one.

Homoeopathy, Acupuncture, photography, hypnobirthing, etc.

Some doulas are trained in other therapies or skills too and will bring their tools for that job with them. It might help you decide who’s the right doula for you if you know you would be interested in a certain type of complementary therapy or service check if your doula is willing and able to support you with that.

Snacks and a really good coffee for myself.

Knowing that we may well not get the chance for a break once we arrive at a birth we make sure we have good energising snacks for ourselves and potentially to share with a birth partner or midwife too. We need to keep ourselves full of energy so we can be as useful to you as long as you need us to whether your birth is short or long we’re totally in it with you for the whole time.

Home breech birth

During World Doula Week we have the privilege to share a series of interviews with people who have benefited from doula support. Kirsten had a baby who was in the breech position and decided to have a home birth. For more information on why some women prefer to choose vaginal birth rather than ceasarean for a breech baby this website is good place to start reading.

How did you hear about doulas?

When I had my first son in New Zealand I had a pregnancy massage with an English girl and she had been a doula in the UK and told me all about it. I thought it sounded lovely but as I had an independent midwife, I didn’t feel that I needed a doula.

Why did you want a doula?

When it came time to have my second son I had moved to the UK. Since NHS midwives are not guaranteed to be at your birth (unlike in NZ), I really wanted someone that knew me and my birth preferences to be with me through the birth (apart from my hubby!).

How did your partner (if you have one) and wider family feel about the idea when you first bought it up?

My hubby thought it was a great idea.

How did your doula help you prepare for your birth?

My doula gave me lots of positive affirmations which I stuck around my house to help me keep feeling positive and prepared for my baby’s birth. She was happy to answer any questions I had and if she couldn’t, would find out the answers for me. She came to meetings with me. I was planning a home breech birth which was outside of normal hospital protocol so I had some meetings at the hospital about this. My doula supported my decisions and choices throughout the preparation.

What did your doula do on the day when you went into labour?

My doula was available on the phone to discuss options/plans. When I asked her to she came over to my house (I had a home birth) and helped calm the atmosphere. She coached me through the contractions reminding me to slow my breathing and relax my shoulders. She encouraged me. She answered the door when the midwife arrived. After baby arrived he was a little slow to breathe deeply (which is normal for breach babies and he remained well with a strong heartbeat throughout) and the midwife asked my doula to call an ambulance so that she would have any equipment and fast transport if needed. As it happened the ambulance crew weren’t even needed in the room as baby began to breathe deeply of his own accord and the midwife was able to give him a little oxygen and was happy with how well he was doing after a couple of minutes.

What did she do after the baby was born?

Cuddled him! While I was feeling faint and my husband was engaged in necessary practical tasks and my midwife looking after me it was good to have my baby still held in loving arms. My doula then looked after my placenta ready for encapsulation and tincture. She gave me a small piece of placenta for under my tongue to help prevent excess bleeding. She was able to remind my midwife that I did not want the injection to expel the placenta. She made me Vegemite toast and a glass of chocolate Nesquik! Later she brought me an amazing chocolate cake!

What was the best thing about having a doula?

The total unbiased support. Knowing she’d be in my corner.

Would you recommend having a doula to other families?

Without hesitation. Every woman should have a doula in my opinion!

Caesarean birth

During world doula week we’re privileged to be able to share a series of stories from people who have benefited from doula support.  A common misconception is that doulas only support ‘natural’ births but that couldn’t be further from the truth. Vickie’s baby was born by planned caesarean and she found the support of her doula invaluable.

How did you hear about doulas?

I heard about Doulas from Mumsnet and from a friend who I ended up choosing as my Doula.

Why did you want a doula?

I have complicated pregnancies, and having had a really terrible experience with my second child, I wanted an informed third party to advocate for me, and act in my interests as I didn’t feel my partner was confident enough to fully assert my wishes.

How did your partner (if you have one) and wider family feel about the idea when you first bought it up?

My family had no clue what a doula was, but when I explained it they all said having someone with both medical and holistic information was a great idea. My partner was equally confused initially, but valued the support particularly when our daughter was taken straight to NICU.

How did your doula help you prepare for your birth?

My Doula gave me information on my birth options, even down to types of caesarian, and empowered me to actually request these things. She came to consultant appointments and translated the medicalised language used, and was another pair of ears.

What did your doula do on the day when you went into labour?

My birth was a planned section at 33 weeks, my doula arrived on the morning of the section with my partner, and massaged my legs, and helped me decompress from the previous horrid evening. She advocated for me as there was some confusion regarding whether the birth was happening that day. My Doula went with my partner to NICU to meet our daughter, which was a comfort to him in such an alien environment.

What did she do after the baby was born?

My Doula acted as a buffer between me and the rest of the world, which was needed as I was exhausted, had lost a lot of blood and had a baby in NICU. She provided me with information and encouraged me.

What was the best thing about having a doula?

Having another female to support, inform, and advocate for me. Someone who fully understood and unconditionally supported my decisions. This was especially valuable in a situation where a partner may not fully understand what you are experiencing.

Would you recommend having a doula to other families?

I have, and will continue to! Such a positive experience that every woman should be able to have!

Home birth after c-section

During World Doula Week we are sharing a series of interviews with people who have benefited from doula support. Emily and Stuart’s first baby was born by c-section and their second baby was born at home in the birth pool with the support of both a doula and an independent midwife.

How did you hear about doulas?

I met a doula in a breastfeeding support group who explained what doulas were.

Why did you want a doula?

In my first pregnancy, I felt clueless and unsupported. I felt I had to go along with everything I was told to do without having it explained to me. I felt that with a doula to support me I would be more confident finding all the information I needed to make decisions. I felt I would be more confident asking questions. I also felt I would be more confident making and expressing my decisions. I felt I would have someone to be my back up if I disagreed with what I was told to do.

I also wanted more support for my partner because he felt pushed out during my first pregnancy and birth. I knew that a doula would support us both and help him to feel involved and confident with asking questions and talking to health professionals. I knew it would also help him feel more confident during the birth. 

How did your partner (if you have one) and wider family feel about the idea when you first bought it up?

My partner thought it was a good idea, he was keen to have that support just like me. My family were confused about what a doula would do and how one was different to a midwife. Once explained, they were supportive of the idea. My mum had another job looking after my eldest which helped her not feel too disappointed at not being a birth partner.

How did your doula help you prepare for your birth?

My doula supported me in a meeting with the hospital to review the notes from my first pregnancy. This was good as it helped me to get closure on what had happened. We also did birth partner training with our doula which helped my partner know what to expect and how to support me through the stages of birth.

My doula reassured us that no matter what happened on the day she would support us to make birth a positive experience regardless of anything that came up which might cause us to change our plans for the birth.

She suggested alternative therapies and comfort measures for dealing with the aches and pains of pregnancy, labour and after childbirth and to help my body get ready and go into labour naturally.

If I or my partner had any questions I could always ask my doula and she would support me finding answers or reassure me what was normal, keeping me away from the worry that can come with googling!

My doula supported me at hospital appointments when I had an ICP diagnosis (this is a rare liver condition associated with pregnancy there’s more information here http://www.icpsupport.org/ ).  She supported me thinking through and making decisions around plans for if I needed to be induced or potentially to choose a c-section as a result of this condition.

She supported me when pre-labour started and stopped. Including one occasion when things seemed to be happening one evening, she came round to our house and then helped me stay positive when everything stopped.

What did your doula do on the day when you went into labour?

I first called in my doula at 4 am when I was having contractions and my son was awake and needed attention. She provided an extra person to occupy my son, or set up the birth pool or support me.

In the morning, she helped my son get ready for a party he’d been invited to and co-ordinated a friend to pick him up and look after him for the day so I could rest and focus.

She tried to encourage me to eat and drink to keep up my energy through the day. She kept this up gently even when I wasn’t keen to eat as I was struggling with nausea and vomiting. She helped to keep track of how frequent contractions were and also encouraged my husband to eat and drink to keep up his strength too.

My doula helped me deal with sickness with acupressure, massage and essential oils and by avoiding strong food smells and helped me choose small amounts of food that I could manage. She also caught my sick for me (in a bowl) when that became necessary.

She helped my husband fill the pool the first time and empty and refill the pool when it got cold and needed reheating.

She reminded me to get out and go to the toilet and encouraged me to change positions to help keep things moving.

She allowed my husband to be able to focus on supporting me in the way I needed him to and not be distracted by all the practical things that also needed doing.
She took turns with my husband providing physical support when he needed to rest, eat or go to the toilet. She used hand massage during contractions. This helped because I was more able to concentrate on my hand being held which distracted me from the intensity of my contractions.

She also took photos and video during the labour and when our baby was born. Although I didn’t notice this happening at the time I enjoyed looking at them after my baby was born.

What did she do after the baby was born?

My doula helped to empty the pool and take it down after the birth. She put fresh sheets on our bed making it all comfortable to get into with our new baby to sleep. Which was a real relief and allowed us to relax and enjoy our baby rather than worry about those practical things.

She made a placenta smoothie right after the birth and prepared the placenta into ice cube trays for freezing for future smoothies.

What was the best thing about having a doula?

Knowing that I had someone with me who would be sure to stay calm and have a level head. Knowing even if something happened that might have made me and my partner feel confused or upset someone would keep us calm. That we had someone who would be on our side whatever situation occurred.

 

Would you recommend having a doula to other families?

Yes, I regularly do. 😊

 

 

 

Three babies two doulas, induced labours

For World Doula Week we’re running a series of interviews with families who have had the support of a doula or in this case two doulas. Emma laboured in hospital calmly and peacefully with her doulas’ support.

How did you hear about doulas?

I heard about Doulas during my second pregnancy. They were recommended to me when I sought advice on anxiety during birth as I had ptsd from giving birth to my first child. (Editor’s note: traumatic birth can often have a huge effect on mothers -and also on fathers -if you are struggling with processing your birth memories of a birth or if they are causing you to struggle with your mental health you are not alone. You can call a doula at any time and many will be able to help you talk through and debrief your experiences. You may also need to talk to your GP who will be able to help you access to mental health support if needed. You may also find it’s helpful to contact the birth trauma association who can provide both trained and peer support options.)

Why did you want a doula?

I wanted a doula to play the role I always imagined a supportive mother would play with more experience, confidence and wisdom. I also wanted a doula to help me overcome fear. My first doula taught me how to view birth as a natural experience instead of a life and death hospital procedure.

How did your partner feel about the idea when you first bought it up?

My partner was very keen to have a doula again in my third pregnancy as he totally understood the benefit of feeling supported in labour and for him – it was his first birth. He too believed that birth was an empowering natural phenomenon. He also understood my anxiety and the need for someone experienced to make sure our wishes were respected.

How did your doula help you prepare for your birth?

My doula was on the end of the phone for a month before the birth as my baby was late. I was very anxious as I did not want to give birth in hospital due to my ptsd. My doula was calming, supportive and informative. I had many false labours too which she supported me well though.

What did your doula do on the day when you went into labour?

She attended the hospital with us before the induction having counselled me the night before. She stayed with us the whole time. In the labour, she supported my partner as I actually just went into myself and laboured with my eyes closed and headphones on. I am sure she was very valuable at this time but I was elsewhere! I felt very safe with just her and my partner and laboured up until my first push in blissful peace. She held one hand, my partner held the other and with just a few pushes my baby was here.

What did she do after the baby was born?

My doula nurtured me and my partner from this point. She followed my every wish and when I was ready she took me to clean up. She took care of my every need whilst daddy snuggled up with baby.

What was the best thing about having a doula?

Feeling safe and confident. Empowered.  Without her I couldn’t have retreated into myself.

Would you recommend having a doula to other families?

Definitely. With Doulas my births have been amazing experiences. The second birth was pleasurable despite being induced. The third was harder due to baby refusing to be induced but still a pleasure. I had no fear.

 

Third baby, first time with a doula

For World Doula Week we will be sharing a series of interviews with people who experienced doula support. We’re starting with Sarah one of the Hampshire doulas who was also lucky enough to have a doula for her third birth.

How did you hear about doulas?

I can’t remember when I heard of doulas. I read a lot during my first pregnancy and I think doulas were probably mentioned in at least one of the books or if not for sure on one of the websites. It wasn’t until after my second birth that my interest and understanding grew and I discovered it was what I had always wanted to do but never realised.

Why did you want a doula?

Being a doula myself, when I fell pregnant, one of the things I was excited about was that I would be able to have a doula. I knew all of the statistics and that I would be more likely to have the birth I wanted with a doula to support my husband and me and I knew from the experience of my clients that whatever this baby and this birth had in store for me I would feel more positive through it all with a doula by our sides.

How did your partner and wider family feel about the idea of a doula when you first brought it up?

My husband knew more than most about what doulas are like and how they work and expected me to want one when we found out about our daughter being on the way. He was known to joke that we were getting a doula so he could spend more time playing on the play station with his day off for the birth. But really, he knew it was a good idea because he knew how much practical work there is at a homebirth and was glad to have someone to share the responsibility with.

My extended family were the same well aware of the benefits of doulas and mostly just thought it was our business what we did around our baby’s birth. I find that the most common reaction I get when asked to explain what doulas do is wow I would have loved that for my birth.

How did your doula help you prepare for your birth?

One benefit I discovered that I hadn’t realised a doula provides in the run up to my birth was having someone who was as interested as I was in my pregnancy and upcoming birth. If a thought occurred to me about my birth plan or I was worried about something there was always someone I knew I could talk to and not think they’d probably had enough of me going on about birth or babies!

I had a trial run of labour when I thought my waters had gone and started having regular mild to medium contractions. This was the only time it was difficult being the client rather than the doula because although I knew nothing was happening for quite a while I also knew that I had told my doula (as I should have done -us doulas like to know) what was going on and after that I kept thinking about how she was feeling wondering what was going on. When you’re a doula and a client goes into labour but doesn’t need you yet and then you don’t hear from them for a while you try to relax and know that they will call when they need you but the little niggle is always there at the back of your head, what if everything went fast and sudden and they haven’t had the chance to call me and then you worry about them just a little. So, although I knew nothing interesting was happening I tried to keep my doula up to date! This was also helpful to me because it meant I knew I was not in active labour because I was able to think rationally about whether to call my doula over or not!

I did call my doula over in the end and she made herself very useful working with my husband to find and patch the hole in the birth pool! We pottered around through the night and everyone had a nap. It was after that I realised I wasn’t having contractions. We tried a few things to get my contractions going again. My doula made herself useful keeping the clary sage oil in the burner going. But no success so I sent her home and had a quiet day.

What did your doula do on the day when you went into labour?

The next evening when I started having contractions again I kept it to myself as I didn’t want to get everyone’s hopes up again with nothing to show for it. I went to bed and slept between the contractions which were coming about every 15 minutes. I got up at about 4 am as I couldn’t sleep any longer. By 5 am I was fairly confident this was the real thing as the contractions were much stronger and were regular. I woke my husband up at 6 am and asked him to put my TENS machine on. By 7 am he had the pool inflated and my doula on her way and my kids and mum were up. I bounced on my ball chatted to the boys and breathed through my contractions. My mum took the kids to school and my doula arrived. She was immediately able to give my husband confidence that he should, as he thought, call the midwives even though I hadn’t asked him too!

My doula helped me get myself sorted out with my top and into the pool. She remained calm as I started to make pushy noises and asked how long the midwives would be and helped my husband to keep calm too. When I needed to have my husband right there to hang on to through the last bit of my labour my doula was able to keep up the practical tasks around us, passing me a drink, sorting out the music and the oil burner. When I felt my baby’s head crowning I asked her to get the camera and she took a brilliant set of photos of the arrival of my daughter which I really treasure.

What did she do after the baby was born?

After my baby arrived my doula helped my mum and my husband to clean up and helped me to snuggle on the sofa skin to skin with baby. She took more lovely photos and helped me upstairs to have a shower when I was ready. I was able to relax and enjoy my baby. My doula provided us with amazing chocolate brownies to eat after our baby was born which my older children would list as the number one benefit of doula support!

What was the best thing about having a doula?

For me, the best thing was the relaxation of knowing there was someone who knew me really well who would be there with me and my husband whatever happened and who would understand and support my point of view unconditionally.

Would you recommend having a doula to other families?

Yes, I do constantly even though it can’t be me at the moment. I believe every family can benefit from doula support. This is the reason I put my time and energy into Hampshire Doulas so we can increase awareness and provide information so that more families can discover this wonderful addition to their birth team.

 

Are you a Hampshire Doula?

Calling All Hampshire Doulas

Wondering what Hampshire Doulas is all about? We’re here to support you, to provide opportunities for you to share mutual support and to encourage and help you to support families.

How do we do that?

We have a local meet up once per month, alternating between weekday and weekend mornings. We have a facebook support group. I send regular email newsletters with information about what’s going on locally and support and ideas on topics that have been raised in the meetings and Facebook discussions. We work together on helping to raise awareness of what doulas are and help local families to find the right doula for them.

That sounds great I’d really like that kind of support. 

Come and join our facebook group here https://www.facebook.com/groups/hampshiredoulas/

Or pop over to the contact page and leave your email and the message sign me up for emails, please.