Doulas Do It Anywhere - Pt 2

Doulas help women give birth anywhere. We offer support in a home birth setting, hospital birth setting, birth center birth setting, medicated birth setting, and even cesareans.

Again, the definition of a doula:

A doula is not a midwife (unless, of course, she’s certified as both), in that she has no authority to make medical decisions, nor is she credentialed to deliver a baby. She’s not considered on the level of a nurse, either; doulas cannot administer or regulate medicine, operate monitoring devices, et cetera. In fact, a reputable doula will tell you that she doesn’t even have the authority to speak on behalf of the mother should a complication or other medical surprise surface.

But sometimes it’s the unnameable, intangible aspects of the conclusion of a pregnancy that require the most help and planning. And that’s where a doula is indispensable. In addition to the priceless knowledge and experience she brings to the laboring phase and to newborn-care assistance, she’s a wellspring of intimate emotional and physical support. A doula educates the family ahead of time; keeps the laboring mama focused and lucid; instinctively retrieves things she needs, like water or compresses; supports her body while walking through contractions; suggests different laboring positions; initiates massage and breathing patterns; reassures other labor partners; works alongside hospital staff; advocates for the mother; and, afterward, ensures that the new mommy is getting enough rest, is recovering well, and is bonding with the baby.  - Divine Caroline

That said, a doula is definitely a soothing presence in all birth settings, including UNMEDICATED HOSPITAL BIRTH.

It's a really cool thing when a woman who might need or simply want a hospital birth can still benefit from the intimacy, emotional encouragement, and fortitude that home prenatals provide. During these prenatal appointments, we are establishing rapport with you, getting to know your idiosyncrasies, as well as your needs and wants for your birthing time. We might give your additional support people tips and tricks for early labor, and we definitely want a home walkthrough for if you are planning on laboring at home for any amount of time.

During labor, we normally will show up at your home, again if you are planning on laboring at home for any given time, unless we have reason to believe it might be a good idea to move to the hospital sooner rather than later. Some of the things that a doula does during an unmedicated hospital birth:
  • Doula-y stuff. Yup, we still do the normal things like massage, counterpressure, acupressure, recommendations for position changes, relaxation exercises, body work, aromatherapy, encouraging you in word and actions, and overall caring for you emotionally and physically. 
  • We make house-calls. Doulas normally like to labor with you a little at home, help you decide when you are reaching your 'I want to be at the hospital at this time' time, and help you get as much of the intimacy that home labor allows as possible. 
  • We travel. When it is time to head to the hospital, we will go with you and offer continuity of care from the home to the hospital. This continuity of care is so helpful during admission and gives so much peace of mind knowing someone is going to be with you/your partner throughout both home and hospital care. 
  • We nurse flirt. Flirting with your nurse is a great talent many doulas have. First off, we work hard to make sure that your nurse is on your side. If we can't win her to your side through compliments and hard work, we simply try to get you a cooler nurse. Some things we do to make her love you and us: change out your pads for you, get you another blanket, get you another drink, help you to and from the bathroom, help get through check-in faster by knowing you, help you fill out your admission paperwork faster so she can do other things, reaffixing the monitor or BP cuff if it falls off or isn't tracing correctly, and silencing those pesky alarms before finding her (quietly and non-demandingly (I know, it's not a word)) so she can fix whatever the alarm was for.
  • We Med-translate. If we can explain it more thoroughly or more easily to digest, we will. If we can't, or you need further explanation, we will ask your care provider for clarity. We jump start informed consent/refusal by asking the tough questions and urging them to give you more information in a non-confrontational manner.
  • We memorize and reiterate. Your birth plan? yep, we try to remind you and your birth team about that. We try to get you as close to that as possible. In the heat of the moment, we are keeping an extra eye out for deviations from that birth plan too (i.e. scissors in the hand of the doc when you clearly stated you don't want an episiotomy). 
  • We watch your intake. We make sure that you are eating and drinking as much as you need to keep your energy and hydration up. We also make sure your partner/husband/other support person is eating and drinking. This is important - you wouldn't believe how easy (and common) it is for a birth team and laboring woman to forget to eat or drink during labor, resulting in low energy or a slowed labor. 
  • We watch your output. We not only keep tabs on how much water you are taking in, but also how much you are urinating. This helps keep you off of an IV if you don't want one. We can 'report' your output to your provider. We also watch for other body fluids. Whenever we change a pad, we are sure to watch for bloody show or amniotic fluid, both of which give you more information with which to provide your doctor or hospital-midwife. The more information you have for them, the more confident they are in you!
  • We take pictures. If there is a camera or video camera lying around, you bet we will take some birth pictures for you (if you want). 
  • We burn the candle. Again, especially in longer labors, partner/spouses need to sleep so that they are fresh for the birth. You don't want a sleep-deprived partner to miss out on the birth either! Your doula will burn the candle with you. And sometimes they just need time to walk the halls, get some fresh air, and regroup.
  • We Lady-Wait. After birth, while everyone is fussing over initial baby vitals and daddy is loving on the newborn or calling family, we can help mom get in and out of the shower, to the toilet, get into fresh clothes and pads, make her bed up nice and comfy, and get her hair brushed. She feels clean and shiny when she slips under the covers, ready to love on her baby and enjoy the fruits of her labors. If mama wants an herbal bath, we can make one up for her, even in a hospital setting.
  • We assist. In the off chance you are a speedy birther, many of us are skilled in emergency childbirth. In the off chance you are a speedy birther but we made it to the hospital, and your nurse needs an extra set of hands in a sticky situation, we can definitely do that.
  • We glue the bits together. I love this part of my job. We help the man of the group (usually the father of the child or the partner of the woman), the 'extraneous' member, to glue his place into the birth event. We help make sure he isn't stuck with all the grunt work, the contraction timing, the childbirth class remembering, or the gopher work. We ask for his expectations as much as the birthing woman's. And, on that note...
Anything the doula might do on this list is definitely interchangeable with your other support person (spouse/partner, etc..), so that we can  make a seamless team of support for you where none of your needs, or the needs of your other support person, go unmet.

Doulas do it at unmedicated hospital births!

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