Ah, let’s start at the beginning! Doulas help make birth better. We’re non-medical support people who help families through the birth process. Think Sherpa-guide in the mountains. We support families physically and emotionally, and we help them advocate for what they need and want during the birth. There's great research that shows that doulas improve outcomes for moms and babies.
A midwife's most important role is as the medical guardian for your birth. She (or he) monitors your health and your baby's health, and she usually catches your little one. A doula is a non-medical professional who offers physical support, emotional support, information resources and advocacy skills. As doulas, we are trained in supporting all kinds of births, and our goal is to make it the smoothest, most comfortable and centered process for the new family. Your doula's most important goal is to help you have the best possible birth, however that unfolds for you.
We love the midwifery model of care, and work often with great midwives all around Southwest Michigan. As noted above, your midwife is your medical guardian. Your doula is an expert in supporting the whole family through labor. At various points in every labor, your midwife's attention has to turn toward your safety and your baby's safety; your doula will be focused on your physical and emotional comfort.
Consider too, that some midwives have excellent labor support skills and really enjoy sitting quietly with women for hours on end, and others do not. Often your doula can be with you during your nighttime labor so that the midwife can sleep for a few hours—and it's helpful if your midwife is well-rested and alert at the most critical moments of birth. Even the best hospital-based midwife will not be able to meet you at home and labor with you there, and she may have more than one patient in labor when you arrive at the hospital (we've seen even small practices with three or more women in labor at the same time). In the hospital, we see nurse-midwives acting more like doctors — popping in and out to check on you, but not laboring with you throughout your birth.
Your doula is your expert sounding board and resource both during pregnancy and birth. You can call us at 7 p.m. to ask us about heartburn or swollen feet, or just to talk through any worries. Also, it's important to consider that your doula works only for you, and is not bound by hospital policy or other political considerations, so she may have suggestions that you wouldn't hear from anyone else.
Your midwife and your doula complement each other during labor, and we often find ourselves brainstorming on the best way to support the client or help the labor progress. One midwife told us that it's like each mom needs a basket of support cards during her labor. Sometimes you need the midwife card, sometimes you need the partner card, and sometimes you need the doula card to get you through. The cards are available as you need them!
Absolutely! Most physicians spend very little time with the mother during her labor, so a doula can be especially helpful for labor support. We've worked hard to develop positive working relationships with the doctors in Southwest Michigan. We'll help you communicate and advocate for what you want during your birth.
Doulas can be so helpful at home births! In fact, there is a local home birth midwife who often recommends our services, especially for first-time moms, those planning a VBAC, or women who have been through a previous traumatic birth. Your doula still helps with all the same issues at home as in the hospital—your physical and emotional comfort, your partner's well-being, and informational support about your options and what's happening with your labor. Even advocacy can come into play if transfer to the hospital is recommended, or if you have to make tough decisions during your birth. Many times your doula will labor with you for a significant stretch of time before your midwife comes to the birth. When she arrives, we work together as a cohesive team to help you have the best experience possible.
Sometimes women are told they don't need a doula because their home birth midwife will bring an assistant or apprentice midwife to the birth. The roles of an assistant/apprentice and a doula are actually really different. The assistant or apprentice works for the midwife, and has clinical responsibilities such as listening to heart tones and doing vaginal exams. Her job is to assist the midwife (setting up, cleaning up, charting) and learn the clinical aspects of birth. She may be able to serve as an extra set of hands to support the birthing mother, but that is not her primary role. A doula is specifically trained in the physical and emotional support of childbirth, training that is distinct from the clinical aspects of birth. We often come to your house to support you long before a home birth midwife and her assistant. The doula is also available to you during your pregnancy, and the strong relationship we develop prenatally helps to set the stage for support during the birth. If anything complicated comes up during the birth, the doula's role is to support you in your autonomous decision-making process. All of this is possible because the doula works for the family. We value the role of an assistant or apprentice at a birth, but that role is very different from ours.
Yes, of course! For people who want a low-intervention birth, it's really helpful to labor at home until strong, active labor. This is one of the big benefits of having a Birth Kalamazoo doula. We're usually in touch with clients by phone in very early labor, and then if you'd like, we can meet you at your home as things pick up. We're not medical providers so of course we are not monitoring the baby or doing vaginal exams. But for families who want to stay at home until hard, active labor, we can help you move your labor forward until that point, help you recognize the signals that things are getting strong, and then help with the transition to the hospital.
It's hard to say ahead of time because every birth is different, but basically we're ready to do all the things. We bring an entire toolbox of ideas, tricks and techniques. Sometimes we might rub your back for 16 hours, or trade off with your partner in that role when their hands are aching and they need to eat and rest. We might be the quiet, calm, reassuring voice whispering in your ear, or the firm, anchored voice that will help you get back on track when labor starts to feel intense and overwhelming. Your doula could be focusing on natural ways to help your labor progress, or how to straighten out a baby in a wonky position. Perhaps we'll give you ideas on how to negotiate with the staff to achieve some important elements of your birth plan. Sometimes we are offering a lot of support to your birth partner, showing your loved ones how they can best help you, and reassuring them about what's normal. Maybe we'll offer a hand massage to help you rest and relax, or we'll explain your options and help you brainstorm questions when you're facing medical interventions for you or your baby. If you have an epidural, we'll be working to keep your pelvis open and mobile to help your baby move down, even though you're less upright. On occasion, our help and reassurance after the birth might be key to establishing your nursing relationship.
Every labor unfolds in its own unique way. Our job is to bring our expertise in birth to the table and stay fully present and supportive, whatever your needs.
Partners are sometimes nervous that a doula might take over their role, and they'll be "shut out" of the labor process. That is not the case at all! Partners and doulas actually complement each other in labor. A doula is kind of like a tour guide in a foreign country. Your tour guide doesn't take away from your trip, she enhances it for both of you. The same is true of your doula. She can help you both navigate the health care system and understand the process of labor and birth. We often find ourselves reassuring partners about the normal sights and sounds of labor, which can be disconcerting to even the best prepared support person. Your partner knows you, and we know birth.
Doulas can show partners particular techniques to help the laboring woman, based on exactly what is happening in her body at that moment. Experiencing back labor? "We might try this counterpressure technique, let me show you exactly where to put your hands." Relaxing in the bath? "How about gently pouring water over her belly with each contraction, like this. Yes, that's it, just like that!" Mom is laboring in the bathroom? "Here, let me get the birth ball so you can sit on the ball and she can lean on your to rest between contractions."
During labor, the person giving birth usually retreats into their own private "laborland." As doulas, we often find ourselves bonding closely with the partners during the birth, as we work together to figure out the best way to support the laboring mom. In our experience, partners really love having a doula as their "wing-man" through the birth.
Friends and family members can make wonderful labor support people, but their role is really different than a doula. Your doula brings specialized training in birth and labor support. In most cases, she has seen many births in a variety of settings, and she can help you know what to expect at each stage. We don't have the same emotional attachments as your family, so it's easier for us to separate ourselves from your choices—we're there to support you in whatever kind of birth you want, whatever that looks like for you. You don't have to worry about what we might say or do in any given situation, your doula is there for your unconditional support. And we can support your friends and family, too, just like we support dads and partners in the birth space.
In the past, labor support was a big part of a labor and delivery nurse's job. Today, however, nurses have many other responsibilities, including medical monitoring, detailed charting and caring for other patients. Even if they had time, some nurses enjoy and are very skilled at labor support, while for others that is not their strength. When you hire a doula, you'll know that you have someone at your birth who will meet you at home and help with the transition to the hospital, is devoted only to you, whose personality is a good fit with yours, and who has specific training in attending to mothers' (and fathers') physical and emotional needs. We enjoy working as a team with your nurse, but our roles are completely different.
Ah, the doula magic. It's not really magic, though, it's science.
We understand the hormones of labor and we help create the ideal environment that allows them to work right, so labor can progress—better outcomes.
The physical assistance and information we offer can help couples avoid unnecessary interventions—better outcomes.
When interventions are medically necessary, we can help mitigate the side effects—better outcomes.
We have breastfeeding expertise and can offer encouragement and insights based on helping lots of women nurse their babies—better outcomes.
It would be impossible to list all of the ways a good doula can help improve a couple's odds of a normal birth, but this gives you an idea of how our support impacts outcomes for moms and babies. Your doula brings skills and knowledge to the birth team that no one else can offer. If you're interested in the nitty gritty of this question, you might enjoy this blog post that our owner Jessica English wrote for DONA International: The Doula Difference: Lowering Cesarean Rates.
Your doula comes into your birth space with an open mind and an open heart. We're not there to carry out some agenda, we're there to help you have the best birth possible, whatever that looks like for you. We'll talk in-depth during our prenatal meetings to learn more about what kind of birth you envision, and we'll put all our energy toward helping you get there.
When people use pain medication, the birth gets more complex. Sometimes our help is even more important in these situations! For nitrous oxide or narcotics, we can help you know when these medications might be helpful, and help you manage the side effects. With an epidural, we're focused on minimizing side effects and also using tools like the peanut ball to help keep your pelvis open and gravity working in your favor. Sometimes pain medication doesn't work as expected, but mom's movements and coping tools are suddenly limited—your doula will get you through.
And of course the information, nurture and support we offer stays exactly the same, whether it's an all-natural birth, a medicated birth, or a cesarean. A birth is a birth, and support is support. We're with you, no matter what.
There are so many things a doula can do to help make a cesarean birth the most loving, family-centered experience possible. For example, your doula will be with you before the surgery, to help with relaxation and assist you in brainstorming questions for your health care team. We can support you in advocating for some of the things you might want during the surgery. We've had great success working with surgeons and anesthesiologists to allow skin-to-skin contact on the operating table, while the surgeon is finishing the operation. This is so much more family-centered than taking the baby to the nursery or to the recovery room to wait for you, and we have found that it significantly decreases birth trauma for the mother.
In Southwest Michigan, we are often allowed to stay with you and your partner in the operating room during the surgery, although this is always a case-by-case decision by your surgeon and anesthesiologist. If we are in the OR, we can help explain what is happening during the surgery and show your partner some physical comfort measures to help you deal with the sensations of surgery. Sometimes a baby needs to go to the nursery or the NICU after a cesarean birth, in which case the dad or partner generally goes with the baby, and your doula will stay by your side. This helps mothers to not feel so alone as the surgery is finished and recovery begins, and helps partners to not feel so torn between mom and baby. In most cases, though, the baby will go with the mom to a recovery area, where we can help you establish nursing and skin-to-skin bonding.
And finally, if the cesarean was unexpected, your doula will offer a compassionate, listening ear to help you process the birth. We can also connect you with resources like our Birth Kalamazoo VBAC and Cesarean Support Group.
Because we work in a group of doulas, we have automatic, built-in back-up. The goal is always that your doula is the one who attends your birth, but on rare occasions a doula might be sick, at another birth or unexpectedly tied up.
We're really careful about the doulas we bring in to our group. Usually if you connect with one doula, you'll love any of them. And people bond really quickly in labor.
Also, if your birth runs long, we'll send in another doula to support you after 24 hours, so you have a fresh perspective. There are no extra fees, we have a special fund that pays for the backup doula.
Absolutely not. Never, never, never. Some doulas start charging you hourly if your birth goes over a certain number of hours. We will never, ever do that. Those kinds of fees prevent families from calling their doula when they might need them in early labor, and they penalize clients who are having a long labor (through no fault of their own).
Tired doulas can be a problem, but we have a solution. If your doula has been with you for 24 hours, she can call in a backup from our team to take over. We pay for that out of a special backup fund that our groups runs. Your original doula makes their normal fee, and the backup is paid too. This means that your doula will never hesitate to call a backup in when she's tired because she might make less — everyone is paid fairly, with no extra cost to you. You'll benefit a fresh doula with new ideas and energy to help you through a really hard birth.
The longest birth we've supported? 73 hours. Not a penny in extra fees.