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Why a Doula is a Rolls Royce of birth support

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Imagine what it would feel like to give birth feeling supported, informed and involved in all your choices?

What difference do you think it would make if your birth support team helped you believe in yourself?

I’m going to let you in on a little secret. Birth is a normal, everyday physiological event that your body was designed to do naturally. In fact, according to nature’s design, birth is meant to be a joyous and ecstatic life experience.

Sure, birth can be hard work and for a small minority of women pregnancy and birth can present problems. But, the fact is for the vast majority of women pregnancy and birth are healthy transitions in life and yet this healthy state of womanhood is increasingly medically managed as an illness. It has become so normal for our culture to view pregnancy and birth according to the medical model that for most women the first thing they do when they believe themselves pregnant is visit a doctor for confirmation and book in for an ultrasound.

And fair enough, it’s exciting and extra special care is part of enjoying being pregnant. However our culture has come to provide that extra special care comes in the form of ongoing medical tests and measurements that do little to prepare a woman for birthing or motherhood, and does a lot to instil fear that pregnancy and birth are risky business.

Wouldn’t it be special to enjoy a model of antenatal care that treated you like a pregnant and birthing goddess?

Why a doula can be the Rolls Royce of birth support…

It’s common to believe that private health insurance and a private hospital means a ‘superior’ level of maternity care, but this depends on your vision of the birth you want. Choosing a private hospital means an obstetric model of care and therefore a medically managed birth by default. This is because an obstetrician is trained in intervention and surgical delivery methods, and may not ever have experienced normal, uninterrupted physiological labor.

If your vision is for natural childbirth then this not be the best model of care for you.

Unfortunately, many women don’t realise until they’ve had first hand experience that the medical model of care can lead to a medically managed birth often involving routine, unnecessary interventions. Due to patient demands, hospital midwives can be limited in the care they can provide and are often in the difficult position of having to comply with hospital protocols. The medical system may provide for the physical management of your birth experience, but isn’t equipped to support for your mental and emotional wellbeing; the essential ingredient of love and comfort that allows women to feel safe, reassured and in control of their experience.

Although your partner can be a wonderful source of support in labour, your partner is not trained in birth support and it’s unfair that partners are now routinely expected to assume this role. It’s all new to them too!

Evidence shows women birth best when supported by people they know and trust, who are able to stay with them continuously throughout their labour, and who understand techniques to be with women that promote normal, natural physiological childbirth.

And so, I give you the doula.

Doula is the name given to a birth support person who provides one-on-one continuous support of a non-medical nature and is instead trained in alternative, traditional and natural methods of being with women during labour.

A doula will develop a relationship with you and listen to your fears and concerns, providing support for your mental and emotional wellbeing during pregnancy, birth and beyond.

A doula will guide you through your birth choices and help keep you informed.

A doula will support your partner and help your partner support you.

A doula will help you believe in yourself and find the resources within that you need to birth your baby.

A doula will hold the space for you to birth your baby and do so for as long as you need.

A doula is YOUR ‘servant to birth’ and there to support your unique needs. The primary aim of a doula is to provide for your emotional and mental well-being and your comfort. This is why, especially for women birthing within the hospital system, a doula can be the Rolls Royce of birth support.

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Delivering your Placenta: What you must know!

There has been a lot of evidence lately supporting the benefits of delayed cord clamping and this may have you considering a physiological third stage as part of your Birth Preferences.

As a natural birth educator, I’m excited by every step our culture takes to remember birth is a normal, everyday physiological event that your body is designed to do naturally. But recent conversations have me realising that, in educating women the benefits of requesting natural processes, the importance of also ensuring your birth attendants are skilled and comfortable in supporting Natural. 

 

Recently I’ve heard stories about women who’ve had normal spontaneous (not induced) labours and births and then big post partum haemorrhages (PPH) after a physiological third stage in hospital. One woman needed a transfusion of several units of blood and was transferred to Melbourne for intensive care.

These conversations prompted me to ask questions and I want to share with you what I learned in the hope of avoiding similar stories. My hope is to provide you with the information needed to safely support your choice to have a physiological third stage if that is what is important to you.

This is because these conversations have highlighted a huge red flag issue for women choosing a physiological third stage in an environment not familiar with supporting natural processes (i.e. hospital).

SO WHAT IS PHYSIOLOGICAL THIRD STAGE?

Third stage labor is the time immediately after your baby is born until the placenta and membranes have been born.

A physiological third stage is to allow the third stage to happen naturally, without the use of oxytocic drugs. The cord is left unclamped and uncut until it stops pulsating or until the placenta is born. The placenta is birthed by your own efforts and may take a significantly longer time then when active management is used.

Active management of third stage is the term given to the medical management of third stage. This usually involves being given an intramuscular injection of an oxytocic drug (syntocinon) immediately as your baby is being born; clamping and cutting the umbilical cord immediately after birth; and applying gentle traction to the end of the cord to birth the placenta reasonably quickly.

The risk associated with third stage is post partum haemorrhage (PPH). Active management has evolved as the reported best practice to reduce this risk, and in light of the stories of women who’ve opted for a physiological third stage and then had a PPH, this would seem to support this practice.

However, upon further questioning of these stories it is not the physiological third stage that increased the risk of PPH (nature did not intend for women to bleed to death after birth!) but the management of physiological third stage by staff not trained in supporting normal, natural processes.

In such a situation advising women the benefits of choosing physiological third stage may become dangerous if their care providers do not have the appropriate training and understanding of normal physiological childbirth: a situation that represents the vast majority of hospital based midwives, obstetricians and doctors.

 

To best illustrate this point, let me share with you a story…

My client had opted to have a physiological third stage. The labor and birth had gone beautifully.

As the baby is being born the doctor complies with the mothers wishes of a ‘physiological third stage’ and not given the standard injection of syntocinon.

BUT THEN almost as soon as the baby is born the doctor reverts to standard practice and within minutes of birth – without syntocinon – starts to apply cord traction. This means the doctor is pulling on the umbilical cord to try and hasten the delivery of the placenta. This is a permitable practice with active management as syntocinon is a powerful oxytocic drug that strongly causes the uterus to contract and the placenta to sheer away from the walls of the uterus within minutes.

Without administering this drug, applying traction to the cord is downright DANGEROUS.

Physiological third stage requires TIME for the mother’s natural oxytocin hormones to produce the uterine contractions that  help the placenta come away.

How long this takes is dependent on many factors including: a calm and quiet atmosphere; privacy; the undisturbed and unhurried ability to enjoy skin-to-skin contact with baby and eye gazing; taking time to initiate breastfeeding; time-out to recover from the activity of birthing; and the ability to adopt the position most comfortable.

It is estimated normal physiological third stage may take anywhere between 20mins to 2 hours.

The mother started hemorrhaging. The doctor administered syntocinon. The mother continued to weaken and the bleeding did not stop. Eventually she was admitted for surgery where it turned out she had retained placenta. She suffered massive hemorrhaging and required several litres of blood transfusion.

Sadly, her story will be recorded as a PPH because the mother refused syntocinon, and seen as further justification for the active management of third stage rather then the truth of another birth story where no one is held accountable for birth malpractice. This kind of malpractice due to ignorance of Natures processes is not an isolated incident and is a big concern for women requesting physiological third stage in hospital.

I wholeheartedly believe physiological third stage is the best practice for both mother and baby in an environment that supports normal physiological labor. I’d love to be able to say that for all women but that may not be so.

That’s not to say you can’t safely experience physiological third stage in a hospital setting, but if this is your preference please ensure your care providers understand how to support this practice.  

Please don’t assume that this is the case!

Remember, normal physiological childbirth is almost never witnessed in hospital.

Understand that it may be up to YOU to educate your care givers and provide them with information on how to work with Nature. This means ensuring a mandatory hands-off, do not interfere approach and respect for the body’s timing.

“Choosing to forego preventative oxytocics, to clamp late (if at all), and to deliver the placenta by our own effort all require forethought, commitment, and that we choose birth attendants that are comfortable and experienced with these choices.

A natural third stage is more than this, however – we must ensure respect for the emotional and hormonal processes of both mother and baby, remembering how unique this time is. Michel Odent stresses the importance of not interrupting, even with words, and believes that ideally the new mother feels unobserved and uninhibited in the first encounter with her baby. This level of non-interference is uncommon, even in home and birth centre settings.”

– Dr Sarah J Buckley, Gentle Birth, Gentle Mothering

Please click here for excellent research and scientifically backed information about the benefits of a natural third stage.


Did you know that placenta is rich in the hormone heparin as well as Vitamin K that helps stop bleeding? Thousands of years of evolution didn’t get it wrong! Traditional midwives know to encourage women to bite on a small piece of placenta cord or membrane after birth to aid and prevent post partum haemorrhage. Find out more about the benefits of placenta (without the squeamishness) with Placenta Encapsulation.

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Doulas: the Rolls Royce of antenatal care

Imagine what it would feel like to give birth feeling supported, informed and involved in all your choices?

What difference do you think it would make if your birth support team helped you believe in yourself?

I’m going to let you in on a little secret.  Birth is a normal, everyday physiological event that your body is designed to do naturally.  In fact, according to nature’s design, birth is meant to be a joyous and ecstatic life experience.

Sure, birth can be hard work and for a small minority of women pregnancy and birth can present problems. But, the fact is for the vast majority of women pregnancy and birth are healthy transitions in life and yet this healthy state of womanhood is increasingly medically managed as an illness. Think about it: it is so normal to view pregnancy as a medical event that for most women the first thing they do when pregnant is book a doctor’s appointment and an ultrasound.

And fair enough, pregnancy is exciting and extra special care should be part of that. However, our culture tends to provide that special care in the form of ongoing medical tests and procedures that do little to prepare a woman for birthing or motherhood, and does a lot to instil fear that pregnancy and birth are risky business.

Wouldn’t it be better to choose a model of antenatal care that helped you trust your body and feel confident in yourself? 

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Let me introduce you to the role of a doula…

Doula is the name given to a birth support person who provides one-on-one continuous support of a non-medical nature and is instead trained in natural and traditional methods of being with women during labour.

Evidence shows women birth best when supported by people they know and trust, who are able to stay with them continuously throughout their labour and who understand techniques to be with women that promote normal, natural physiological childbirth.

The support a doula offers is recognized as having the following benefits:

  • Reduced incidence of Caesarean sections.
  • Reduction in requests for epidural and analgesics.
  • Increase in initiating and continuing breastfeeding.
  • Increased report of mother satisfaction with her birth experience.
  • Reduce the incidence of postnatal mood disorders.
  • Increased new parent confidence in their care for their newborn.

A doula will develop a relationship with you and provide the emotional support to listen to your fears and concerns. A doula will guide you through your birth preferences and assist you to make informed choices. A doula will support your partner and help your partner support you. A doula will encourage you to believe in yourself and find the resources within that you need to birth your baby. A doula will provide practical birth support skills to help you cope with the demands of labor. A doula will provide ongoing practical, emotional and social support long after your baby is born.

Why you shouldn’t give birth without a doula…

Given that pregnancy and birth are a healthy state of womanhood, doesn’t it make sense to choose birth support that promotes normal, natural physiological labor?

One of the side effects of modern obstetric methods has been to concentrate power in the hands of the hospital system. Sometimes women don’t often realise until they have had first hand experience that the medical model of care can lead to a birth often involving routine, unnecessary interventions.

The one thing in common with women who have had a negative birth experience is a sense of losing control of the situation, not knowing what is happening to them and why.

Unfortunately hospital midwives can be limited in the care they can provide and are often in the difficult position of having to comply with hospital protocols. They may not be able to stay with you continuously for the duration of your labor. You may not be able to see the same midwife throughout your pregnancy, some may not be trained in natural methods of birth support and their time may be spent managing technology rather than providing comfort and support. Additionally choosing an obstetric model of care can mean a medically managed birth by default because your obstetrician is trained in intervention and surgical delivery methods and may not have experienced normal, uninterrupted physiological labor. And although your partner may be with you throughout the duration of your labor it’s a huge ask to expect them to step into the role of birth support without any prior understanding of what is involved.

Having someone by your side providing emotional and physical support at this time who you trust and who will stay with you throughout makes a profound difference.

There is nothing new about a doula. It’s the way women have been supporting women to birth since time began. It is also the way women will continue to support women, despite having deviated to a medical model in very recent times, because for women a safe birth must provide for their emotional and psychological wellbeing as well as their physical needs.

Imagine having an antenatal (and postnatal) carer that helped you feel special by treating you like a pregnant and birthing goddess… 

Want to know more?

Contact me for more info about doulas and trainee doulas servicing the local region.


Peta-ElmerAbout the author…
Peta Elmer is a Traditional Chinese Medicine practitioner and Doula with a passion for promoting trust and respect for the wisdom of women’s bodies. She helps women learn to work with their body’s natural rhythms for maximum health, vitality, fertility, creativity and feminine power. She has a deep calling to birth work and her special mission is the message birth is meant to be a pleasurable and ecstatic experience. She believes a holistic Mind Body Spirit approach is key to preparing for the unfamiliar opening sensations of birth.