Your Doula: Personalized Comfort for your Birthing Time

by Hope Lien, CD(DONA), PD

You’ve practiced the hip squeeze and your breathing techniques in your childbirth education classes. You’ve even been to the Comfort Measures parent topic session. You (and your labor support) feel ready for your birthing time. And, you really should be proud of yourselves for preparing so well. But journeying through the birth process is a big deal, and there are lots of emotions going on. It can be a lot of pressure (especially on a partner) to have to recall which comfort technique is going to help at the right time, and if that is going to help move things along in your labor. What if the birthing mom doesn’t really like the way that the partner massages her or presses on her back? Then what?

If you have hired a doula, you have covered your bases. Your doula knows the various comfort measures backwards and forwards. She is, for the most part, freed up emotionally to just be there without having to go through the process of becoming a mother or a father. She is like a chameleon, quietly changing into the type of support person you need her to be when you need it. Perhaps things are going smoothly– your doula can be available to get you or your partner food, or just step in if your partner needs a nap. She can offer gentle reminders in early labor which comfort techniques you might enjoy, and suggest alternative options in active labor. She can be as much or as little as you need her to be.

She can subtly help your partner get the feel of things so that he or she can support you just right way, and the only thing you remember afterwards is that your partner was “just the best“ at supporting you in your labor. She can help your partner stay hands on, or not, if he or she prefers. Doulas are wonderful at filling in the gaps so that you get what you need, while allowing the partner to participate to their comfort–in a very loving and supportive way.

Your doula may also have specialized training in hypnosis techniques, acupressure, healing touch or spinning babies techniques. This is a great question to ask when you are interviewing doulas, as many doulas have done specialized training in other areas.

The doula can support you in your labor differently than anyone else on your team, because you have met with her before the birth. You know her, and she knows you. When your birthing time comes, she already knows the types of touch you like or don’t like. She knows your greatest fears, your strengths and your weaknesses. She uses that kind of relationship to be a very unique support person for you and your partner.

She knows the kind of environment you would like in your birthing space, and will create that for you seamlessly, so you can have peace of mind knowing things are like you want them to be, without having to say anything. She knows the hospital room well, and has never ending ideas to try to keep things moving along. She even knows creative ways to put that bed sheet to work! She can magically make the birthing ball, warm or cold compresses and warm blankets appear without having a big discussion about it.

Your doula is an abounding resource of different things to try– who wouldn’t like that kind of additional support for their birth? She will work with you and your partner until you find that technique that is just right for you. She will be there with you through the toughest moments you come up against, until you are over that hurdle. And she will be there waiting, cheering you on, as you (and your partner) cross that finish line.

Hope Lien has been working as a DONA-certified birth doula for 3 years,

and also serves families as a postpartum doula. She is passionate about helping each family find their unique path to parenthood. You can learn more about her by checking out hopethedoula.com

Writing Your Birth Plan

by Karen Bruce, AAHCC, CD(DONA)

A birth plan, or care preferences document, is a statement of your preferences for your birth and it demonstrates to your birth team that you intend to take an active role in the decision-making process of your labor and birth.  Your doula can help you prepare this document, and you should share it with every member of your team in advance in order to address any questions or concerns in advance of your birth or to catch any preferences which cannot be accommodated at your birth place or in your particular medical situation.

Keep in mind that your audience is your care team (OB or midwife, nurses and other medical staff, and your labor support people), and be specific to your birth place — it shows you did your research when you are familiar with specific hospital or birth center protocols.  If you are planning a homebirth, you might have a plan for home with a back-up birth plan in case of hospital transfer.  These two documents should look radically different because of audience and options available in each setting.

Consider the specific options available to you in your birth place and do your research as to the risks and benefits of each option.  What does your intuition tell you is right for your family?

Once you have explored your options, you have an opportunity to communicate your hopes and dreams for the labor, birth, and immediate postpartum period.  What should you include in your birth plan and how should you organize your thoughts?  I recommend you find a few sample birth plans to get you started — ask your doula or childbirth educator for an example or two, or find some online, keeping in mind that online birth plans may not reflect the practices in your birth place, and should be edited carefully.

Here are some basic guidelines for preparing your birth preferences document:

• Make it personal — use your own voice and language whenever possible, and include information or photos that reveal something of your family’s personality.
• Keep it to one page.  If you really can’t keep it to one page print it back to back.
• It’s OK to plagiarise.  If you find a well-put statement on a sample birth plan and like how something is stated, don’t reinvent the wheel.
• Be succinct.
• Say it clearly and get specific — don’t be vague.
• Bullet, bold and highlight your priorities.  It should be obvious what is most important to you.

Whenever possible, make positive statements of what you do want to happen rather than gathering of list of “don’ts”.  Birth plans that demonstrate a cooperative attitude and flexibility will be well-received by your birth team and show your willingness to work together.  Your birth plan does not replace your conversations for informed consent/informed refusal, but can remind you and your partner of your preferences when decisions must be made.  If the circumstances of your birth take you down an unexpected path, writing a birth preferences document will have been a valuable exercise in educating yourself as to the risks and benefits of various birth options, even if you change your mind along the way.