Take a journey with me as your view the birth of a mother and father supported by their doula. As you read, think about how her presence not only relieves the anxiety of these parents but also how they would feel or what may happen if she was not. In these comparisons, you will see the value of a doula in your birth space.
The months of waiting preparation and expectation are at an end. Finally this pregnant woman experiences some early contractions and a show of bloodstained mucus. She is excited when she realises that her labour is properly underway and she will now be able to tell her doula, who she has been in regular contact with, that this definitely isn’t just a false alarm.
She busies yourself with some last-minute cleaning and tidying. She recognizes that these chores and others that have occupied over the last weeks are simply the famous nesting instinct.
She feels a little bit nervous, but her preparation with her doula, childbirth education & an understanding of how birth is healthy for her & her baby allows her to look to the future with pleasure.
This woman has chosen her partner & doula to be present for her labour because she feels comfortable and secure in their presence. She absolutely feels positive about their ability to offer her their love and complete support. She has trust in them all and feels certain that whatever comes, she will have the right answer with the right medical & labour support. Instinctively she prepares the room for the birth putting some essential oils in a burner and scattering cushions on the floor. As the contractions begin to take all this woman’s concentration she retreats to her familiar space and takes a position on all fours, which is how, for the moment she is most comfortable. Her partner calls their doula & by listening to the woman & partner she decides it’s time to make her way over. The doula gives some suggestions to dad like using the shower for pain relief and reminding him to use the counter hip pressure that they enacted in their prenatal visits.
During this mother’s pregnancy she has practised a number of positions and stretches suggested and now she finds it’s easy to move from one to another as her labour progresses. She seems to know instinctively which position will help her to ease the pain which will help guide the baby into an anterior lie and which will facilitate his journey down the birth canal. Her doula arrives, and the couple feel relief that she tells them all is progressing normally. The doula allows the woman to do what she feels works for her body & only intervenes with gentle encouragement or suggestions when she can see the woman is loosing her focus. This includes massage, deep breathing techniques and counting down the contractions. All of which have been discussed in detail with the couple and are unique to their liking.
It has been some time & the couple have been in regular contact with the hospital to take direction regarding whether there is any concern. They confirm all is progressing normally & to join them when the contractions are 4 minutes apart, spanning a minute and lasting the same. The doula has helped the woman in and out of the shower, kept the lighting low & encouraging the woman when she needs. She shows the partner massage techniques & encourages him to speak lovingly to her. She leaves the room & gives them privacy. The doula recognizes that the partner is the main support & wants to allow them this special times as much as possible. There is a point when this mother is moving into active labour, but the couple are not ready to move to hospital as they understand it is still early in the process. At the same time this mother is struggling to see the finish line & feels that she needs some form of relief.
The doula knows that the woman preferred non medical pain relief and so she makes the suggestion to try the TENS machine. The parents quickly oblige and it is set up in between contractions and adds noticeable relief. The labouring woman is able to regain control & returns to where she needs to be.
When the time comes to move to the hospital, she is examined and found to be 5-6cm. The midwives smile and lead the three to the birth suite. However, once she’s out of her familiar environment, the contractions, which at home were strong and effective, become weaker. Her trip to the hospital, the admission procedures, internal examination on arrival, and her apprehension have caused her body to produce adrenaline which is Inhibiting the effect of oxytocin, the hormone which causes her uterus to contract once alone. The woman feels disappointed but her doula reminds her that this is to be expected & she is doing so well & can do it again.
The doula turns the lights down & uses a number of other techniques that she has shown the woman’s partner & soon she is labouring well again. The couple stay in the dark bathroom, while the partner utilizes his encouragement and hands to bring support to the mother of his child. He feels confident that everything is going well. The doula reminds him to make sure his partner is drinking regularly and relieving her bladder to help with the descent of the baby. She also gets him refreshments to keep him sustained.
In between contractions the mother rests & prepares herself for the next great wave of sensation that she meets with a loud groan. The sound comes from deep inside her belly and its intensity quite surprise her. But her groaning, together with the production of endorphins, which other bodies natural painkillers, help her through the tide of pain as it ebbs and flows.
The doula gives the couple privacy and takes photos as the couple have requested. She aims to document the day silently so the couple have something to go back on. Looking at the clock, the doula knows that the midwives will return soon to feel the cervix for dilation. She chooses a time in between a contraction & asks the woman if she would like to practise some of their maternal positioning movements to help push effacement and dilation for the next few contractions. As these movements have been practised antenatally, the mother finds it easy to assume the positions and her doula & partner count her through the breaths, reminding her that all of this hard work is not for nothing.
The midwives eventually return to examine the woman & the couple are not surprised as they were expecting it. The woman is encouraged to lie on the bed and it is found that little dilation has been achieved in the short time since arrival.
The doula asks the mother if she would like to know how “thin” or “effaced” she is, and the midwife says that she is paper thin. She reminds the couple that a thin cervix can change rapidly & now the lack of progress in dilation does not dim their spirits.
The midwife recommends breaking the waters & the couple are unsure. The doula kindly asks if the couple would like a few minutes to talk about it, and they ask the midwife to return shortly.
The couple discusses whether they would like to move from their birth plan, try some more of the positional movements which can be successful and perhaps break the waters at the next interval. The doula assures them that whatever decision they want to make she will be there to help them through it.
This is where your story changes into your own. If the couple chooses to have the waters broken, the doula will attend to them and help the woman as she did before. Perhaps as time goes on the woman asks for another form of pain management. According to how the partner and doula balance the line of encouragement and relief, she may suggest morphine, gas or sterile water injections for back pain. An epidural may also be discussed earlier or later depending on the woman’s preferences. Every choice along the way the doula keeps the couple informed to know what to expect & how to manage with positions, advice even practical tools she brings with her. Perhaps the baby needs to turn or the mother is having muscle pain. There are many ways to naturally relieve this things and she teaches the birth partner how to do it and they take turns as everyone is getting fatigued. Regardless of this couple’s birth choices, the doula works with the mother & will help her find suitable positions to aid gravity & help her push her baby out. Whether she is lying down with an epidural or standing and moving.
If the couple allow the labour process to unfold on it’s own & there are no worries from the medical staff, then the doula and partner will try to recreate a safe environment to allow contractions to resume well. At last, the bag of waters breaks as the contractions increase in intensity until the woman feel she can no longer continue.
Her midwife and doula, know that this is a significant part of all labours and symbolizes her transition into soon pushing with her baby. She now may try alternative strategies and movements for the next few surges to help push her to this stage. Often it is a reminder of how close her baby is and it is loving comfort from her birth support team and usually dad that they are so proud, she is almost there.
As she reaches this stage, the pace of her labour changes, and shortly she is overwhelmed by the intensity of her desire to push. She no longer feels pain, but a strong, powerful movements in her body. As she does so the pressure on her rectum causes her bowels to open, but she is not inhibited or embarrassed, just amazed at the strength and power of her body and all encompassing pushing sensation. Now she is reminded by her doula to take short shallow breaths and her midwife supports her perineum as they work together to minimise any tearing.
Things begin to heighten and the mother’s partner is uneasy at the sounds that have escalated. Their doula, who notices, encourages him to get close because all is well & his baby is coming. All that is needed is his presence. She begins to take more pictures now that dad is the main centre for the mother’s support again.
The doula encourages the mother to ask the midwife if she can reach down and
feel the exquisite softness of her baby’s head as it crowns. She has one final push and in a great orgasmic rush, the head is born. The shoulders and body slither out, covered in thick creamy vernix. “Oh, I did it!” She sees the tears in her partners eyes, and there are tears in her eyes too. They are euphoric.
There is an amazing energy in the room. It transmits itself to all those present and the new parents are struck with the force and intensity of the emotion they feel. The baby cries briefly before his mother drawers him across the empty belly to her breast & quiet pictures are taken of their first moments. In the warm room there is no sound, there are no harsh lights, but the atmosphere is charged, and the mother is elated. Her sense of achievement and power know no bounds. She has never experienced anything equal to the rush of fulfilment and energy that she feels now, almost high.
The umbilical cord stops pulsing in the new father cuts it ceremoniously. At last, many minutes later, the mother experiences another contraction & the placenta is expelled. There is laughter and amazement that this act assumes so little important. They gaze in awe, marveling at the perfection of their baby – the miracle of their creating.
Regardless of which way this story turns, along the way, the doula & partner work together to hold the woman both physically and emotionally. This birth may end in a vaginal birth or it may end in a caesarean depending on the many variables when it comes to labour & her choices.
Whatever the case, these choices become the woman’s, not the doctors or the hospitals. So, when a woman holds her baby, feeds her baby & reflects on the birth, she feels a sense of empowerment & joy.
These were her choices that made her birth unique and what was the best for her & her child. Perhaps it does not go according to her ideal birth plan, but she feels safe & supported throughout & her memories of labour are not full of fear, pain & uncertainty. Regardless of whether she is under the influence of medication at birth, the couple have planned for the possibility & so the partner knows that he would like to keep their baby close & that all non-urgent checks on the baby be completed when the mother is ready. She may not be ready to feed straight after birth, but the doula assures her that there is plenty of time & to keep her baby close to help baby calm & enjoy bonding. Feeding takes place gradually & the baby and mum learn to latch & feed together with the help of the doula, midwives & lactation consultant at the hospital.
As the couple return home, the doula joins them but is in regular contact prior. Feeding may or may not be a struggle, but their doula watches over and shows little techniques to help with each movement & feed. She tidies the home, warms a meal for the mother & partner and puts a load of washing on. The couple and doula talk about the birth & begin to fill in blanks for the woman who was unaware of time moving as she so gracefully laboured in her own world.
The doula keeps in contact with the couple and visits again to make sure all is well. She again tends to the home where she is needed and helps in any way she can, encouraging the couple to trust their intuitive instincts. As she leaves, the mother knows that her doula is available to ask questions over the next few weeks & that a number of resources are at her fingertips to help her parent with support & community. She looks forward to sharing her positive birth story & is glad that she realized she deserved extra help & support for the birth of her child.