Why a doula and a Nurse are needed for your birth team.

Hiring a Doula from a Nurse’s Perspective

I was a nurse for 7 years before I became a childbirth doula and educator. Hiring a Doula, or Labor Support, can be an investment. If your birth place is a hospital, the support from a nurse and your care provider (Midwife or OB) will be covered by insurance, though often a doula’s services aren’t (though some insurances are starting to reimburse couples!) So why should you consider paying extra money? Here are some reasons to hire a doula from a nurse’s perspective:

YOU ARE NOT THEIR ONLY PATIENT

Nurses often have more than one patient, and maybe even more than normal if they are short-staffed. Nurses constantly have to prioritize their time and if their other patient needs more support or medical care, she/he may not also be able to give you the support you need.

A doula on the other hand has you, her only client, and her job is to focus on you and your partner’s needs.

NURSES ARE BUSY 

Helping you cope with your labor, though it may be the most enjoyable part of a nurse’s job, it is not the only part of their job. In addition to multiple patients, they also need to assess, chart, assist co-workers, coordinate care and services with other staff, and keep care providers informed on their patients’ progress. They may also have other responsibilities that do not even involve patient care.
A doula is only busy with YOUR needs. I can’t speak for all nurses, but I know that I appreciated when my clients had someone at their bedside to support them. It gave me more time for my other responsibilities that their support person could not provide, such as giving medication, charting, assessing, calling their doctor . . .

THEY WANT TO CLOCK OUT ON TIME

Nurses work long hours and they want to clock out on time and get home to their families. You could be laboring for hours. They can end their shift with you laboring, but they can’t end it with unfinished charting. I have spent many days, in the past, staying late to finish charting after giving report to my relief nurse.
 Your doula does not have a shift, where many tasks in addition to patient care is required before leaving. She is there throughout your labor, birth, and initiating breastfeeding. This is my favorite part of being a doula. I get to be present with my client without worrying about all the other things I still need to do! My only job is to focus on the needs of my client and her partner – not the needs of the hospital, or the care provider, or finishing charting. I did not always get to do this as a nurse.

NURSES WORK IN SHIFTS

Most nurses work at least 12 hours per shift. So, depending on how long you labor for in the hospital, you can potentially have different nurses caring for you.
This is good because you want and need medical professionals that are well rested, so that they can provide the best care for you. However, it can also be distracting and disrupt your rhythm being introduced to a new nurse. Your new nurse will need to assess you and they may do some things differently than your previous nurse.
Your doula will be there once you tell her you need her, and she will remain throughout shift changes to help you refocus and decrease distractions. She will also be able to give your partner breaks, where a nurse may not have time to do this.

 THIS IS THEIR JOB, THIS IS YOUR BIRTH

Most likely, your nurse is a labor and delivery nurse because she loves women, birth, and babies. However, this is still her job. Though, they hope for you to have a great birth experience, they also have other responsibilities and loyalties. Nurses have a lot of medical and legal responsibility as medical professionals. As such, they need to follow hospital policy to keep their jobs and to protect themselves in the event of a lawsuit.
A doula is not a medical professional with the same liabilities as a nurse (as long as she stay within her scope of practice). Instead, she is a birth professional that understands birth and how to support women.

GREAT ADDITION TO YOUR BIRTH TEAM

A doula does not replace your supportive partner, care provider, nurse, birth photographer, family, or even friends that you want as part of your pregnancy/labor/birth/postpartum team. Instead, she is a great addition. A doula can help facilitate communication among your team, support your choices, aid in comfort, and provide needed information and resources. We each play an important role in your birth and hopefully your amazing birth experience!
I am a certified doula and childbirth and parenting educator. I practiced as a nurse 7 years before that. For more information about me and my services visit www.MYBirthandBaby.com
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Benefits of your partner being at your birth.

5 Reasons Your Partner Needs to be at Your Birth!

I am a doula and childbirth educator in Lafayette, LA and the surrounding areas. I love birth. I am there to support and educate you. I know tons of tricks to help a laboring woman be more comfortable. However, I will never replace your partner. Here are some reasons why your partner is crucial to your positive birth experience:

KNOWLEDGE OF YOU

Your partner knows you intimately! They know how to motivate, calm, and comfort you. This ability will be very important during the intensity of labor! Additionally, he will be able to remind your birth team of your goals when they offer interventions.

PROTECTIVE

Most couples are very protective of each other. This is important because they can be your advocate while you are deeply in labor. Ideally, there comes a time when a laboring woman stays inside herself to focus on what her and baby need to do. During this time it is helpful if your partner answers questions as needed, and minimizes interruptions.

STRENGTH

Many men, not all, are simply stronger than women. They will be able to apply that extra pressure during a hip squeeze that may make all the difference in your comfort. He will also have an easier time supporting your weight while you are in different positions as well.

OXYTOCIN

This is probably the most important reason! Your partner can stimulate your oxytocin. Oxytocin is the love hormone. Stimulating oxytocin will increase your contractions (helping your labor progress) and trigger more endorphin (this helps you cope with the sensation of pain) to be released. Your partner can help this hormone flow by hugging, being close, kissing, stimulating your nipples, holding your hand, or even sex (if you are trying to induce labor). So, for your partner to increase your love hormone, they need to be close! Your doula probably won’t get the same response . . .

SO WHY A DOULA THEN?

Your partner is going to do an awesome job supporting you! However, they may also need a break. Labors are often long. Your birth team will need to eat and go to the bathroom. However, you should not be left alone. If there is someone else besides your partner, he will be able to get breaks, while you continue to receive support. Or, you may need both people! Your partner can provide pressure while your doula gives you a massage, or vice versa.

Doulas understand birth. We have seen other women in labor and understand what is normal. We have successfully supported other women. Often your partner, unless in the medical field, does not have this knowledge or experience. Birth can be intimidating if you are not prepared (this is why a childbirth education class is also important!). A doula can reassure you of what is normal and how awesome both of you are doing!

A doula also provides answers to questions, resources, and support during pregnancy and postpartum as well, enhancing your overall experience!

 

How do you envision your partner helping you during labor? Comment below!

 

I am a certified Birth Boot Camp doula and childbirth educator, as well as a certified Positive Discipline Parenting Educator. I practiced as a nurse for 7 years before becoming a birth worker. I’m also a wife, breastfeeding mother, and President of Louisiana Constituents for Safe Childbirth. I provide services in Lafayette, Eunice, Broussard, Youngsville, Sunset, Opelousas, Church Point, Ville Platte, and surrounding areas. For more information about me and my services, visit www.MYBirthandBaby.com

4 Tips on Being an Active Participant in Childbirth

4 Tips on Navigating Healthcare While Pregnant

My grandmother recently had a stroke. It was relatively mild, and she is now at a temporary rehab facility. Overall, she was treated respectfully, but most of the time she did not understand what was going on. She did not understand the medications that were given to her, the procedures done to her, the reason for the G-tube (a tube surgically placed into the stomach to feed her, since she was unable to swallow) that was placed, or why they were not giving her any food (My grandmother LOVES food; she can out eat anyone! So no food is a big deal!).

At one point, my grandmother said, “I’m lucky I have you and your mother because this is all so confusing!” She’s right, the medical world can be very confusing. My mother and I are nurses, and were there to speak to the doctors, nurses, therapists, social workers, and anyone else that was involved with her care. We were able to ask what “pill” they were giving her, or which lab the “little bit of blood” was for, or the risks and benefits of the feeding tube. Then explain this to her. But really, she was not an active participant in this process.

I felt so guilty, knowing that she did not fully understand what was being done to her, and why. It reminded me of how women often say they feel during labor and childbirth. How scary and confusing that must be for them. Medical professionals go to school for many years to have the training, experience, and knowledge that they have to practice medicine. However, you do not need a degree to be an active participant in your healthcare. Here are some tips:

WRITE THINGS DOWN

Pen and paper can be great tools for keeping track of appointments, questions, or your to-do-list. There are many things to consider when planning for your birth; write them down. Write down questions for your OB/Midwife appointments, important advice, words that you don’t understand or topics you need to research. When I was pregnant, I used a binder to keep it all organized.

ASK QUESTIONS

Ask your doctor/midwife questions. If your care provider never has time to answer your questions, this may be a “red flag”. Part of their job is to answer your questions. However, sometimes they are simply overbooked, so tell the clerk you need extra time when scheduling your next appointment; and they will give you a longer block of time.  If you don’t like your care provider’s answer, you can always get a second opinion.

KNOW YOUR RIGHTS

Hopefully, before you are in labor, you asked a lot of questions and found the birth place and care provider that is right for you. Ideally, you and your care provider will have a mutually respectful relationship. Regardless of your relationship though, it is important to understand the risks and benefits of any procedure that they suggest during your pregnancy and labor. It is equally important to know that you have the right to DECLINE, as well as CONSENT, to procedures.  It is YOUR body and they need YOUR permission!

BRING SUPPORT

Bring support! Many athletes have support personnel to assist them on game day, you should too! In addition to their partner, women often invite close friends, family, or doulas to their birth. Ideally, it should be with someone you are comfortable with (after all, there is a good chance you will be naked and poop in front of them), who is supportive of your birth plan, and who can help facilitate communication (not speak for you) between you and medical staff. It is also helpful if this person is knowledgeable about birth (either from personal experiences, training, or education).

Navigating the medical world can be confusing, but it is possible! You’ve got this!

Have any other suggestions? I would love to read them! Please comment below.

I am a childbirth and parenting educator, as well as a doula. I am also a registered nurse, breastfeeding mom, and active in my local birth community. For more information on me, my comprehensive childbirth classes, and services please visit MY – Birth & Baby.

What a Childbirth Class can Do for YOU

5 Ways to Prepare for Birth

I recently met a sweet pregnant woman that was glowing with excitement about her unborn baby. Throughout her pregnancy she has been gathering items to comfort and care for her baby once he/she arrives. During our conversation, she revealed that she did not have any plans regarding her birth besides showing up at the hospital in labor. Internally I cringed. I REALLY hope she has a good birth experience! The thing is, there is more to preparing for the baby than decorating the nursery. Between 25-34% women report birth trauma (that is 1 in 3 to 1 in 4 women!)! Birth trauma can affect bonding, breastfeeding, mood, coping with future pregnancies, and so much more. Babies actually do not need many things, but they do need a healthy mama. Here are some additional ways to prepare for baby:

EDUCATION

Education is SO IMPORTANT! I realize that I am a childbirth educator, and this advice probably seems biased. BUT, how will you know what you want if you don’t know YOUR options? I know of some women that had multiple births before they discovered that they had options. It doesn’t have to be that way. Understanding what is going on can decrease a lot of fear, and hopefully trauma as well.

SUPPORTIVE CARE PROVIDER

Find a supportive care provider that has similar birth philosophies as yourself. How do you know if your care provider is supportive? Ask around. Ask friends. Ask local birth workers or advocacy agencies. Ask your care provider questions! In my Birth Boot Camp childbirth classes we discuss possible “red flags” and the questions to ask your care provider.

SUPPORTIVE BIRTH PLACE

You can choose where to give birth! Common birth places are hospitals, birth centers, and home. Tour your birth place. Ask questions. Find out policies/rules. Doctors and hospitals may have different policies. You need to ask for the rules of BOTH! Which location do you feel the safest? The safer you feel in your birthing environment, ideally the easier you will progress through labor.

SUPPORTIVE FRIENDS

Find people that will support you, not try to scare you. People LOVE to share war stories. Pregnancy might not be the best time for that. When I was pregnant, I found my support through my childbirth classes and the local birth community. Many communities have free or inexpensive groups that you can join. If you are in the Lafayette, LA area, check out Louisiana Constituents for Safe Childbirth (LCSC), Louisiana Natural Birth, La Leche League, and Postpartum groups. These groups have online and person-to-person support. They also often have birth workers that can provide resources, as well as other mothers that can love and support you!

HIRE A DOULA

A doula can also help you prepare for your birth. Doulas provide informational, emotional, and physical support for you and your partner. A doula does not replace a childbirth class, but can help remind you of what you learned. She can also help you navigate through the birth world and recommend other local professionals as needed.

There you have it – 5 ways to prepare for an AMAZING birth! 

I am a childbirth and parenting educator, as well as a doula. I am also a registered nurse, breastfeeding mother, and active in my birth community. For more information on me or my classes please visit MY – Birth & Baby.

Labor Support

Doula? Oh . . . Like a Midwife?

“Doula? Oh . . . like a midwife?” is probably the number one comment, along with a confused look, that I now get when I tell people my job. I totally get it; I too had no idea what a doula was until I watched The Business of Being Born. After the movie, I googled the term. I even thought, “Well I would have a midwife, so I would not need a Doula!” Boy, was I wrong. No, a doula is not a midwife, though they do often work together. So, what is a Doula then?
Another name for a doula is a labor support person. There is debate in our community of what we should be called because some find the term Doula demeaning, since it means to “serve”. I, however, think it is an instant conversation starter; sounds cool, and therefore like the name. Plus, we do serve; we serve our families.
A Doula supports the client and partner however they may need. This can be physically, emotionally, psychologically, informational, or even spiritually. Labor is a lot of work! It can be sweaty and exhausting physically and emotionally. A Doula can help a mother pace her efforts, facilitate position changes, provide comfort measures, maintain a calm and positive birth space, and even simply provide a reassuring presence.
Doulas are also often a great resource. They can provide you with information, as needed, before, during, and after the birth. As a Birth Boot Camp Doula, I was required to read many books as part of the certification process, and to remain certified I need to read and stay up-to-date on the latest research. Most Doulas also have a local resource list, and can make suggestions depending on your needs. Doulas also come from different backgrounds and experiences that add to their knowledge.
Between visits, a Doula further assists clients by answering questions via phone, email, or text. This labor support person is often on-call for a month around your estimated due date as well; ready for the big day!
A doula does not replace a partner. Instead, the doula supports the partner by encouraging closeness, assisting with comfort measures, providing suggestions, giving breaks, and answering questions.
So, back to the original question, doesn’t a midwife do all this? They may, but this is not their primary responsibility. A midwife is a medically trained professional, with the number one responsibility of the safety of both mom and baby. They are often busy with assessments, charting, vital signs, postpartum care, newborn assessments, and whatever else they may need to do.
The doula’s role, on the other hand, is not as the medically trained professional, regardless of previous experience. They will not perform any medical skills, but instead, will explain what is going on, hold your hand, and be there for you and your partner. The doula is there to focus on you and your overall birth experience. They can also assist you with breastfeeding, postpartum care; listen to your birth story, and check-in postpartum to see how you and your family are adjusting.
So, there you have it! No, a midwife and a doula are not the same thing, but they can both be a valuable part of your birth team. So, go find one that will “serve” you today!
I support families through pregnancy, birth, and parenthood. For more information on services and classes visit MY – Birth & Baby Website!
Counter-pressure

MY Biggest Birth Regret

Like for many couples, it gets expensive planning for a baby, especially a first. I knew I wanted a home birth. Unfortunately, in Louisiana, if you want a home birth, you are most likely going to pay out-of-pocket. There are necessities, such as birth supplies, midwife, childbirth education, and baby supplies that add up fast. So, when considering a Doula, I cringed when I thought about paying for something else out-of-pocket! We debated this option for many months. However, to reserve a bit of our money for life after the baby came, we decided not to have a Doula.
Well, one of the first things my husband said after my long 21 hour labor was, “We are not doing this again without a Doula!”  I couldn’t disagree! Not hiring a Doula is our number one regret. Here are some reasons why:
You don’t know what your labor will be like. Every pregnancy, labor, birth, and child is different. I took Birth Boot Camp childbirth education classes, and I do feel like I was well prepared, as much as I could be as or a first-time mom. The information I learned stayed with me, so much so that many times during labor, my childbirth educator’s voice was in my head. However, it can be overwhelming to remember everything you should be doing while in the labor zone. I just needed someone at the birth reminding me to do what I already knew.
I needed to move more. I wanted the romantic water birth that I had pictured in my head. Since, my contractions intensified quickly, I thought I was progressing faster than I was through labor. I got into the birth pool way too early, and really did not want to go anywhere else. I needed someone pushing me to move more. She may have said, “Hey, this position isn’t working for you, let’s change it up.”
My husband needed a break. I had intense back labor most of my labor, and my husband provided counter-pressure for almost 21 hours. That left him with little time for rest, food, or bathroom breaks. Our midwife and her assistant did offer to relieve him at times, but he was the only one that knew how to give the pressure that I needed, so I wouldn’t let him go far. Doulas have experience with how and when to offer comfort measures, and she might have been able to provide me comfort and my husband a break.
I needed a cheerleader. My husband was behind me most of my labor providing counter-pressure. My midwife and her assistant were assessing, taking vital signs, listening to heart tones, charting, and conserving their energy for the main event. I did not have someone just “holding space”, providing calm encouragement.
I had trouble breastfeeding. My nipples decided to flatten after birth, and I had no clue what a proper latch looked like, despite watching videos and reading books about breastfeeding. So, my midwife gave me a nipple shield, which helped with milk transfer, but not with pain and nipple damage. Around postpartum day 10, I finally saw a lactation consultant, and things immediately started turning around. By 2 months, my son completely weaned himself off the nipple shield. As a Birth Boot Camp DOULA, I now have extra training in breastfeeding. I am also active in La Leche League and have a resource list with lactation consultants. I wish I had a Doula that could have provided this support.
I didn’t have anyone to listen to my birth story. It took me almost 14 months to finally write my birth story. I thought about doing it many times before, but I still hadn’t processed it, so I continued to put it off. If I had a Doula, during my postpartum visit I would have been able to talk about my birth story from beginning to end. My husband, too! He carried around guilt for months thinking he was the cause of my tear. For his perspective, check out my husband’s birth story.
I feel like a hypocrite. I totally understand hesitating to hire a Doula; I’ve been there, done that. I did not hire a Doula for my birth. However, I wish I had. My wish for every woman and couple is to have an amazing birth, and I truly believe a Doula can help you prepare for one. Through my own studying to become a Doula and Childbirth Educator, I realized the importance of this extra support person. A doula does not have the emotional investment, like your partner, or the medical responsibility, like your care provider. They can truly be there to support you, without any other agenda or responsibility to distract them.
I did, finally, write my birth story, and I often wonder how different it might have been with a Doula. However, I am not one to dwell on the past. Lesson learned. Next time, we will have a Doula.
I support families through pregnancy, birth, and parenthood. To check out my classes and services visit MY – Birth & Baby Website!
Fight for Birth Options

Ask Lakeview to Support Women

If you have been on any of the birth forums in Louisiana lately, you probably have seen this petition. A hospital in Louisiana, Lakeview Regional Medical Center, is requiring that doulas go through a credentialing process to practice in their hospital. Some of the requirements include Proof of Doula certification, Flu shot, background check, drug screen, client confidentiality class, tuberculosis testing, and some other yearly testing. Originally the cost quoted was over $700. Now, with doulas and other entities voicing their concern the cost was reduced to around $100. Even at $100, if this requirement spreads to other hospitals this could become very pricey. Lakeview is a HCA hospital. Louisiana has five other HCA hospitals in the state. Click here for the complete list.

BENEFITS

For the Doula – You will likely get business from this hospital. Your name will be given to prospective clients. You will be “approved” by the hospital, so hopefully reluctant staff will embrace your presence.

For the Client – You will be given a list of approved doulas. This will make researching a doula easier for you.

For the Hospital – They can control which doulas work with their clients. They make money from the qualifying fees.

CONS

For the Doula – The doula will have more out-of-pocket expenses. The hospital will have more control over them, even though they are not employed by them. The concern with this is that doulas will be working for the hospital (without being paid by them) instead of the client (who’s paying for this service). This article discusses some of the dilemmas labor support may face. I practiced as a nurse for 7 years. There were many times when I felt that my patients did not receive the best care because of hospital rules. There are a lot of politics involved when working for a hospital, and unfortunately sometimes patient care is sacrificed. When deciding to switch from nurse to doula, the idea of simply focusing on my clients needs, instead of the hospital’s needs, was very appealing to me. Will this hospital certification change this? Only time will tell.

For the Client – The client loses autonomy. Women are smart human beings, capable of researching and making their own decisions. What matters is that women feel supported, not if the HOSPITAL thinks the doula is qualified. To read one woman’s thoughts on this topic, read this Improving Birth post. Instead, the hospital will offer a small list of doulas, that may, or may not be, the best fit for that mother. Additionally, prices will go up to pay for extra certifying costs, especially if other hospitals jump on this bandwagon. Many doulas travel at least an hour to a client’s birth place. That will include a lot of hospitals.

For the Hospital – “Boycott” is being whispered throughout the state. They may lose business from clients that do have other hospital options. They will not be the hospital that is known for supporting women’s choices. Women talk, we give advice, and we give a lot of referrals.

 SO, WHAT IS A DOULA OR A CLIENT TO DO?

The answer is easy right? –

For the Doula – Sign the petition if you don’t want this to happen. Spread the word. The more people who know about it the better. This is easy with so many social media forums. Don’t get credentialed through this hospital. Don’t take on clients that plan on using this hospital.

For the Client – Sign the petition. Choose a different hospital and doctor. (I only mention doctor because some doctors are only affiliated with one hospital, so it may be an all or nothing deal.) You are the consumer! You or your insurance company is the one paying this bill. Make your thoughts known! Let them know that you are capable of making your own decisions about hospitals, doctors, AND doulas! Birth workers are small in numbers, consumer’s numbers are much larger. The hospital is more likely to listen to you (the paying customer) than a doula. You are more likely to make change happen! Get involved! Louisiana Constituents for Safe Childbirth and Citizen for Better Birth are some groups that are working toward change statewide. If you are in the Northshore area, join Northshore Birth Options.

BUT WHAT IF BOYCOTTING IS NOT AN OPTION?

For some women, switching hospitals and doctors is not an option. It’s easy for women, with birth options, to tell a woman not to go to this hospital, but if their insurance only covers this hospital, that may be THEIR only option. Many people cannot afford to pay out-of-pocket for a hospital birth, or want to. They also may not want to switch doctors. Additionally, they may have limited transportation. Some families do not have cars. I’ve had many co-workers that depended on bikes or public transportation to get around. Or they may not want to labor in a car going to a farther hospital. Whatever the reason, this is THIS consumer’s decision.

What about these women? Doulas chose birth work to support women. If women choose to birth at this hospital, do they not deserve this support? Should all doulas boycott this hospital to take a stand? This is the dilemma that many doulas in the Northshore area are facing. These are tough questions, and I do not know the answer. I do, however, hope that our birth communities stay a safe and supportive place for consumers and doulas alike, as they make these tough decisions.

GET INVOLVED!

As we remain respectful to doulas and mothers alike, I hope that more consumers will make some noise. Sign the petition. Contact the hospital. Write letters. Go elsewhere is you can! The petition should actually say Ask Lakeview to Support WOMEN. This is really about women having birth options, not doulas having employment.

I would love to hear from consumers! What do you think about Lakeview’s new policy? What should these doulas do? Take a stand and boycott the hospital? Refuse clients that choose this hospital? Go through the credentialing process, even though they don’t agree with it, so that they can still support women? Or better yet, do you have another suggestion/solution? Comment below!

I am the President of Louisiana Constituents for Safe Childbirth. We are a statewide non-profit with a mission of providing research, education, resources, support of birth options in Louisiana for healthy moms and babies. Check us out: Facebook page, Facebook group, Twitter, Website.