How a Doula Can Support Your Birth

I sat down with my friend and fellow birth worker, Bethany Bagnell, to talk about how women can benefit from hiring a doula. Bethany is a social worker, certified Bradley Method Instructor/ Doula, DONA International trained, and Certified Car Seat Technician. She is the co-owner of Riverbank Willow Birth Services where they offer birth, postpartum, and bereavement doulas; childbirth education; and placenta encapsulation.

What is a doula?
BB: A doula is a non-medical support person, chosen by the pregnant woman to provide physical and emotional support during pregnancy and labor who is an expert in the childbirth process. There is a misconception in our country that doulas are for homebirth, unmedicated mothers – which is strongly inaccurate. The role of a doula is to help the mother achieve the birth SHE desires, whatever that is. If that means medication, then the doula supports her achieving that birth. I honestly believe that woman who receive medication can benefit more than a woman who is attempting a natural childbirth. Labor is, in my opinion, 50 percent mental and 50 percent physical. If a mother is planning for an epidural labor, she will still have to experience a period of contractions without pain relief due to the fact that hospital staff know the sooner you get an epidural the higher the risk of cesarean, so moms are encouraged to try to hold out  for as long as they can without it. There is also the possibility that the epidural could fail and in my experience in those labors it is VERY tough for the laboring mom to cope. Imagine going into this situation expecting to feel no pain and no other plan to manage such a tough situation and plan A fails – that can be quite traumatic. This can happen even for a mother who has given birth easily with an epidural in previous pregnancies, you just never know. Every birth, baby, and pregnancy are completely different.

With my prenatal hyposis clients, I often say that the opposite of stress is options. I think a doula is a wonderful resource for increasing your options.
BB: A doula is also aware of a mother’s choices. Many times mom’s plan is for an unmedicated birth and for whatever reason, the plan changes – many moms feel defeated in this moment and feel they need to consent to every intervention thereafter because they already gave into the first one they didn’t plan on doing. A doula empowers the mother to still take control of her experience and that the other priorities on her birth plan can still be achieved.

As a multiple time c-section mom, I strongly believe that c-section moms can also benefit from a doula. In fact, maybe they need a doula even more!
BB: A big issue in my opinion in this Northern VA area is the limit on the number of people who can be in the operating room during a c-section. In all area hospitals the limit is one. So many times during a c-section the doula is not present in the room because the father/partner is the one that the mom chooses to be in the OR. However, sometimes there isn’t a partner, or maybe the partner is at a risk of passing out. However, just because there isn’t a physical space in the OR for a doula, that doesn’t mean a mother who has a c-section cannot benefit from hiring a doula. The beginning of a doula’s role is to support and help prepare the mother prenatally. She can help process any fears, develop a birth plan, try to avoid a c-section if it is a malposition issue, etc. A doula would also inform the mother of her choices and things to potentially ask for during her c-section to make it a fulfilling and empowering birth experience. During the day of, whether it is planned or emergency, a doula would stay and wait until the surgery is over, help the mother with getting situated or with breastfeeding for the first time. I have done anything from help move all the bags to the new room to help a mom hand express colostrum into a syringe for her baby going to the NICU while the dad stayed with the baby. The role of a doula is flexible but because of having the experience that we do, we think of things we know that can be helpful for mom and baby to bond, or help mom recover faster in situations that may not be ideal like a cesareans or baby taking the trip to the NICU. There is also the support that comes postpartum.

What do you do to support the family postpartum?
BB: My work never ends at a birth, I always do a postpartum follow up visit, and check in periodically on the days in between to support my clients with community referrals, or helpful tips for the transition to bringing a newborn home. I also am trained in breastfeeding, so I can help identify troubles with latches and make appropriate referrals if needed.

You're kind enough to send me referrals. How do you think prenatal hypnosis can help women?
BB: I always say, the more tools a mom has in labor the better off she will be. You become a completely different person in labor and your instincts take over so just because you thought smooth jazz and positive affirmations would be relaxing, you may find that it is the opposite! Prenatal hypnosis, similar to childbirth education prepares the mother mentally prenatally and can bring comfort during the process of labor. Ignorance is not bliss when it comes to birth, it can be terrifying when you don’t understand what is happening to your body or don’t feel in control. And when we feel out of control, we panic, and our breathing increases which leads to danger to mom and baby and also increased stress hormones being released. Prenatal hypnosis can help mom process fears that she may have before labor even begins to be able to let go and let the labor happen. The mind is half the battle in labor, and we can actually freak ourselves out of labor. Adrenaline cancels out oxytocin which is the hormone that makes labor happen. So if a mom goes into labor fearful, that can inhibit her progress. And then having the skill to utilize hypnosis effectively in labor can bring mom a great source of comfort to relax and not feel so out of control in the process. I always recommend my clients seek out your services, especially the ones who have a history of a traumatic birth or have great fear about particular possibilities in labor.

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