Change in Class Times

The Role of a Doula

by Wanda Sundermann

Most pregnant women today will at some time be asked if they are planning to have a doula at her birth. For many this will be the first time she has ever heard the word “doula”, a Greek word meaning “woman who serves”.  In today’s birth culture, a doula is a birth attendant who gives physical and emotional support to a woman in labor and her partner. The doula is most often a woman, so I will use the pronoun “she” but recognize that there are a few male doulas out there in the world.  There is no licensure or required training for doulas. Most of them learn their craft by attending workshops and many births. Some doulas are just getting started and some have attended hundreds of births.

When considering whether to have a doula at your birth it is important to understand what a doula’s role would be.

A doula will usually meet with a woman and her partner at least once before the birth. The doula is available for consultation by phone or in person to answer questions or concerns that the mother may have about her pregnancy and care. The doula does not give medical advice, but can often explain conditions or procedures that the woman may not understand. 

When the woman thinks she might be in labor, the doula will talk with her on the phone to offer suggestions of what the couple can do in the very early stage of labor to either move labor along or rest and prepare for it.  When the couple is ready for more support the doula will come to their home and help them stay at home as long as possible. This is a key component in a plan for natural childbirth. In the early stage of labor the woman is very susceptible to disruptions that can slow labor. She is the most comfortable in her own home and will make more progress there.

When the doula arrives at the couple’s home she will assess the situation. Doulas do not do clinical assessments such as cervical checks, listen to fetal heart tones or take vital signs. Rather she will observe how frequent and strong the contractions are, how the mother is handling them and ask the mother how the baby is moving. Depending on what is happening, they may stay at the home for minutes or several hours. Having a doula there will usually give the couple the confidence to stay at home longer than they normally would by reassuring them that what is happening is normal and that there is still plenty of time.

While at home the doula will suggest comfortable positions for the mother and help her find ways to progress the labor. She will also remind the mother to eat, drink and empty her bladder, and offer suggestions on how to get some rest if she has been in labor a long time. The doula may use massage, give soft soothing affirmations and encouragement, perhaps suggest a bath or shower, and remind the mother to stay focused on her breathing. If the couple has been laboring a long time already, the doula may need to give the woman’s partner a break to get some food and rest. The doula will also be helpful with the logistics of transition from home to hospital or birth center.

The transition from home to hospital or birth center can be difficult for women and the doula can be a bridge for that. A doula, who has worked in that particular birthing facility can help the couple settle in, knowing what to ask for from the staff to smoothly transition to the new setting. At the hospital or birth center the doula will continue to offer the comfort measures used at home. She is also a guide and advocate for the woman and her partner. Because she works for them and not the institution her only agenda is to serve their needs. She can help them navigate the unknown territory of labor and birth.  She can give them both the reassurance that what is happening is normal and good, or in situations when labor takes a turn from normal she can help them sort through the information they are being giving by their care provider. The doula is there to help the parents get the information they need to make the decision that is right for them and their baby given the labor they have on that day.

The doula is also support for the partner, giving ideas and guidance on how to support the mother. Having a doula at the birth takes the pressure off of the partner to remember and properly implement everything he/she read in books or learned in childbirth class and frees him/her to experience the process without having to be the sole support.  In most situations the partners actually feel more involved in the birth with a doula there giving suggestions on how to support the mother.

In most cases the doula will stay with the family throughout the labor process, for the birth of the baby and usually for an hour or two after the birth. And then the doula will do at least one follow up visit with the family after they get home.

An article summarizing the study Continuous Support For Women During Childbirth review  from Cochrane Library in 2011, issue 2, www.ChildbirthConnections.com reported that overall, women who received continuous support during labor were less likely than women who did not to:

-have any analgesia/anesthesia,

-give birth with vacuum extraction or forceps,

-give birth by cesarean,

-have a baby with a low 5-minute Apgar score,

-or report dissatisfaction or a negative rating of their experience.

And women receiving continuous support were more likely than those who did not to give birth spontaneously (that is, with neither cesarean nor vacuum extraction nor forceps) and have a shorter labor.

The decision to have a doula at your birth is a big one. It involves inviting someone you have just met to be involved in a very intimate and transformative time in your life. It is important that you feel good about that person. To find a doula in your area, ask friends, midwives, childbirth educators and other health care providers for recommendations. Talk with her on the phone, ask lots of questions. A dear friend or family member or a doula in training can also fill the role. Although they will not have the experience, they can be a huge support if you are unable to secure a professional doula.

Wanda Sundermann NCMBT #713, is a professional doula with 23 years of experience helping moms, dads, and babies in the triangle area. She is also a licensed massage therapist specializing in prenatal and postnatal massage and a childbirth educator teaching classes at the Women’s Birth and Wellness Center in Chapel Hill.  She is the mother of two fine young men.

For information go to www.wandaswork.com .

This article was originally written for

www.chapelhillmothersclub.org 

Wanda Sundermann offers a four-week, Saturday morning childbirth education class, 9:00 to 1:00 at the WBWC. The classes cover massage for moms, the normal birth process, common complications, labor support techniques for partners, deep relaxation, breastfeeding, adjusting to life with a newborn and newborn massage, among other things.

If you would like to learn more about these classes please contact Wanda at wandasund@gmail.com or www.wandaswork.com

Upcoming classes are:

March 23, 30, April 6 and 13

June 1, 8, 15 and 22

August 3. 10, 17 and 24

News from the Board

by Kaaren Haldeman   

    

     Happy almost-Spring from the board--here's hoping the warmth is here to stay! The board met on February 20 and was introduced to Dr. Aunchalee Palmquist, an anthropologist from Elon University who will be doing some qualitative research with WBWC. We welcome Dr. Palmquist and team and look forward to hearing about their work at our April meeting. Maureen Darcey updated the board on pending activities at the NC State Legislature, and we thank her for keeping us informed about current proposals and action.

As we head into the months of growth and bloom, the board wishes all at WBWC a healthy and allergy-free season!

Attention New Moms!

Is Your Infant Under 3 Months of Age?

UNC lactation students in the Mary Rose Tully Training Initiative are looking for volunteers! In an effort to try to help more moms understand and be able to recognize infant feeding and satiety cues we would like to collect photos and video footage of your little one.

With your permission, we will take pictures of your infant while he or she is displaying common physical behaviors that let adults know they are ready to eat or finished eating. The photos and video footage will be shared with other new moms so they can become familiar with these feeding-related signals that infants send as early forms of communication.

If you are interested in volunteering please contact Rachel Davis at:

Rachelmdavis715@gmail.com or 803-673-4946

We appreciate your help! Thank you!

What's New at the Boutique

Birth Story

By Mary Rider
      

      As far as I know, I hold the record for number of babies born at Women's Birth and Wellness (although for some it was Piedmont Women's Health Center).  My husband and I have eight children and the last five have been born downstairs at the center.
       The last time started just like all the rest.  On May 2, 2005 I was 39 weeks pregnant and my water broke.  I had been worried I wouldn't have time to get to Chapel Hill from Garner because as each baby has come, my labors have gotten shorter and shorter.  But I noticed when I lay down, the contractions pretty much stopped. So as long as I didn't walk around, I wasn't in labor!  The thing is I had some work to do and wanted to get it done before the baby came so I wouldn't have to be worrying about it with a newborn!
      

     So I laid in bed and paid a few bills and every time I got up to go to the bathroom or get a drink, the contractions would return.
       About lunchtime I told my husband I thought we'd better get ready to go. We're not too quick at getting out of the house, and I didn't want to wait too long or we'd be stuck in traffic on the way to Chapel Hill.
       My dad, who lives at the beach, was in town. So he went and picked up the kids from school, and my friend Debbie Biesack picked up Bernadette from her high school.
      

     Once we got to the center things went pretty quickly. I had given birth under water to the last four (an experience I highly recommend. It's the most relaxing way of laboring I have found!) and so Sher asked me if I wanted to get in the tub. The one drawback to the tub is that it's so big it takes a long time to fill. I really did want to get in the tub, but by then I knew there was no time for that!
       So for the first time in a long time, I gave birth in the bed. My dad never likes to be in the room right at the moment, my mom made it a few minutes late, and Brianna, the oldest, was too far away to make it in time, but the rest of the family was all in attendance along with a few friends thrown in for good measure!
       I remember it being a busy day at the birthing center, with two other births going on at the same time and someone calling in, just starting labor!  (Was there a full moon? I don't remember.) 
      

     As always, once our little one had made her way out into the world, everyone got to hold her and get a good look at her and admire her beautiful red hair. Then she went outside with her dad for a few breaths of fresh air, and I sent someone to get me some food because birthing is a lot of work, and I had built up quite an appetite.
       But this time something was different. After a few hours, our little one started having some troubles. By then Maureen had come in too, and so she cleared everyone out and we talked about what was going on.
      

     As I had suspected for many months (but hadn't confirmed with prenatal tests), our baby, Mary Evelyn, has Down syndrome. The most devastating part of this discovery was that her heart wasn't working correctly, and she had to go to UNC Hospitals.  We told the older children what was going on and sent everyone off with my mother to stay with friends in Carrboro.
       There is no way to express the fear and pain of the next few days. The ambulance came and took my newborn baby away to the hospital, and we really didn't know if we would ever see her again.  I followed in another ambulance a little later, and my husband drove.
      

     At UNC Hospitals, it was no time before we had a better idea of what was going on.  Although Mary Evelyn's condition was serious, and she had to spend several days in the neonatal ICU, her heart condition was treatable and eventually (in November 2005) corrected with surgery.  Today she is a healthy, happy little girl who greets everyone with a smile and a wave and is currently crawling around the house, taking books off the shelves, a seemingly favorite past time of most of my children at that age!
      

     Would I have done anything differently if I had known that Mary Evelyn would be born with health problems? Most certainly not.  The loving and professional care we received from Sher and Maureen was extraordinary and while the hospital folks were nice, concerned and professional, the birthing center is home for us.

By Patrick O'Neill

     As a father of eight children, I probably have more stories to tell about the birth experience (from the less-intense father-side) than most men. Five of our children (Veronica, Timothy, Ann, Michael and Mary Evelyn) were born at the birth center in Chapel Hill, and another daughter (Bernadette) was born in 1988 at the "original" birth center in Siler City. My oldest daughter, Brianna, is also the business director, so we have an intimate connection with the center -- both the offices upstairs (where our children have watched countless birthing videos, and the "Arthur" animated video for years) and of course the downstairs birthing rooms (I think we've been in all three!) Although our last child was born May 2, 2005, it seems like we're there all the time. (And I love reading the interesting bumper stickers in the parking lot.)

     My wife, Mary, has had four of our babies in the water (in those big bathtubs in the birthing rooms), and that's just one of the many amenities we have appreciated in choosing to experience our family's most intimate moments in the center as opposed to a hospital. For example, when our daughter, Moira, was born in 1994 in a hospital (prior to WBWC), a nurse came into the room with designs on leaving with our newborn daughter to take her somewhere else (I have no idea where). We said, "No, thanks, we'd like to keep her with us," something you would never have to worry about at the birth center, where contact between parents and newborn is sacred, and anything that has to be done is handled bedside.

     I especially appreciate the emphasis birth center founder Maureen Darcey places on honoring the birth process as a natural, essentially non-medical experience. Maureen's role, and that of the rest of the midwives, is to assist a mother in a miraculous, natural event. When my children have been born, I've had total confidence that Maureen and staff have matters under control (and since I have been a major player in helping my wife throughout the delivery process, I appreciate the way the midwives have integrated me into the process in a meaningful way).

     With such a large family, you can imagine the crowd accompanying us to Chapel Hill on the days when Mary's water breaks and a new baby is on the way. When we're there, we basically take over the entire downstairs as the time passes, waiting for the birth of a new baby sister or brother. That's also a special part of having a child at the birth center, where the birth experience is open to all, and the entire family is welcome. At all five of our birth center births, siblings have cut the umbilical cords of the newest member of the family (some volunteered to do the cutting, but then backed out as the process unfolded, but another kid has always stepped up to the plate).

     The birth center has been a blessing to us. It is a place where the miracle of childbirth is allowed to unfold in all of its natural wonder.

Talking to Legislators: Midwives and Birth Centers Improve Healthcare

Maureen Darcey, CNM, and Brianna Honea will be attending a Congressional briefing in Washington, DC on February 7. This briefing will bring attention to a study to be published in the Journal of Midwifery & Women's Health, demonstrating the positive outcomes, health-wise and financially, associated with midwifery care. For more information about the briefing and how you can be involved in bringing awareness to your congressional representatives, follow this link:

http://www.birthcenters.org/content/aabc-acnm-congressional-briefing-february-7-2013

To read a summary of the article published in the Journal of Midwifery and Women's Health, click here.

For the full article, click here.