Birthing Beautiful Ideas

First thing’s first: the lucky winner (chosen at random on random.org) of a copy of Penny Simkin’s remarkable book, The Birth Partner, is…Jillian, who commented on Facebook that, “Doulas are for women who are trained in the medical field, especially those that provide care for others during the time surrounding pregnancy and infancy. Sometimes knowing too much, especially about potential complications, can lead to a lot of anxiety. A doula encourages the quieting of mental noise through reassurance and empowerment, so relaxation and and trusting in instinctual body urges can take over.”  Congratulations, Jillian!

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I have been so moved and inspired by all of the entries to my giveaway contest for International Doula Month.

When I first came up with the idea for this contest, I thought that people would offer up simple statements in their entries: that doulas are for moms of singletons, or moms of multiples, or teen moms, or moms over 40, or women who are birthing in a hospital, or women who are birthing at home, or women birthing with midwives, or women birthing with obstetricians, and so on.

All of these statements are just as important, just as crucial to the public understanding of doula support, as any of the statements that you all sent in to me.

But the ones that you did send were especially thoughtful.

So thank you to all of those who entered the contest.  For those of you who didn’t win, I hope that the statements below are enough of a gift back to you, whether you are a mother, a birth professional, or even simply a friend of birthing women.

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Doulas are for women who want to have an empowering childbirth experience!

Whether through information, support, encouragement, processing, and so forth, a doula helps a woman realize that she has more strength than she ever knew!

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Doulas are for women who miss their mothers.

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For many women and their partners, the cost of doula support (which can range anywhere from a couple hundred to a couple thousand dollars) can seem quite prohibitive.

This is often the case even if they value the commitment and work that a doula offers to each of her clients and even if they already know about the invaluable benefits that doula support confers to laboring women.

But even with limited funds, it can be possible for almost any woman who wants a doula to hire one.  Here’s how.

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Consider hiring a certifying doula.

Doulas who are in the process of certifying will often offer reduced fees or even free services to their clients.  Finding a certifying doula can be a wonderful route to take if you are seeking out more affordable doula support!

Some women have success finding certifying doulas on Craigslist or other local community boards where new (and more experienced doulas) will advertise their services.

As with any other doula search, you can also check Doula Match to find new doulas offering reduced rates in your area.  In addition, you can send an email to doulareferrals@dona.org to request a list of uncertified DONA International member doulas in your area.

For what it’s worth, don’t be worried that you will automatically receive “inferior” support from a new doula.  Finding the right doula is more about finding the person who you feel most comfortable with than finding the person who has attended hundreds of births.  And a new doula might end up being just the perfect doula for you!

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Find a local doula who will barter for part (or all) of her fee.

Do you or your partner make things?  Fix things?  Sell things?

Are you handy with a paintbrush, a wrench, or a sewing machine?

Do you clean houses, cook meals, or offer massage therapy?

Then you might be able to find a doula who is willing to barter with you in exchange for her services!  And especially if your service is pregnancy, parenting, or breastfeeding-relevant, you might even develop a good business relationship in the process.

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Simply ask for a payment plan, a reduced fee, or sliding scale based on your income.

Many doulas will offer a reduced fee to women or families who cannot afford the regular fee.  Many are also willing to set up a contractual payment plan so that you can spread the payments out over time rather than paying the doula fee in one or two large installments.  It never hurts to ask one or more of your local doulas if they are willing to offer these payment options to you!

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Seek out a local or national volunteer doula organization.

Radical Doula created a fabulous list of volunteer doula organizations throughout the United States and Canada.  (Make sure to check out the comments section for further contributions to this list!)

Thus far, the only national program on the list is Operation Special Delivery, an organization that provides volunteer doulas to women whose partners who will be deployed at the time of birth or who have been severely injured or lost their lives during the current wars in the U.S.  I’m not aware of any others, but if you know of one (or more), please let me know!

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So don’t think that a doula isn’t for you just because you don’t think that you can afford one.  With just the right research and just the right questions, you might be able to find low-cost or even free labor support from a doula near you!

This post is a part of my “Doulas are for All Types of Women” series honoring International Doula Month.  I’m also giving away a copy of The Birth Partner by Penny Simkin for International Doula Month.  Please see my original post in this series to find out how you can win!

It can sometimes be a mental hurdle for people to get past the idea that doulas aren’t only for women who choose a “natural” or drug-free birth.

It can be even more of a mental hurdle for people to get past the idea that doula support is only for women who are planning vaginal births!

But in reality, doula support can be quite valuable for women and families who are planning a cesarean section for the upcoming birth of their child (or children).  Here’s how.

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A doula can help you to create a cesarean birth plan.

Yes, you can create a birth plan or birth preference list for a planned cesarean section!

And a doula can help you to determine what preferences you would like to include on your list.  What’s more, she might even inform you of some options that you didn’t even know that you had!

For instance, would you like to specify that your urinary catheter to be inserted after the spinal epidural is placed?

Would you like someone to explain the surgery to you as it happens?

Would you like to have music playing during the c-section?

If your baby is healthy, would you like to be able to hold him or her while you are being moved to the recovery room (with assistance, if needed)?

Do you have any postpartum preferences, such as those related to breastfeeding or vaccines?

These items and more can all be included in a cesarean section birth plan or preference list.

(If you’d like to read more about cesarean birth plans, Morgan at Adventures in Diapering and Beyond created this example of a C-section Birth Plan for her readers.  She has had four c-sections herself and has some great experiential wisdom to offer here.)

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A doula can take the time to discuss your feelings about the c-section and offer any tips or advice on recovery well before the big day arrives.

Especially if this is your first cesarean section, you might have some fears or concerns about your upcoming surgery.  Well before your baby is born, a doula can help you practice relaxation techniques (such as breathing exercises or visualization) that you can use during the epidural or spinal placement, throughout the surgery, and during your recovery period.

Where appropriate, a doula can even help you to devise ways to alleviate your fears or concerns in your birth preferences list.  For instance, some women who become nauseous at the very thought of surgery might request that no one describe the cesarean section as it happens–or at least that any conversation between the medical staff be as least graphic as possible.

A doula can also help you to plan ahead to ensure that you to have your best recovery possible. Whether it’s demonstrating the breastfeeding positions (such as the football hold) that seem to be most comfortable to women recovering from a c-section, or recommending that you bring a breastfeeding pillow (such as a Boppy or My Brest Friend) to wrap around your abdomen even when you’re not nursing, or suggesting that you ask friends to offer to perform light housekeeping in lieu of bringing baby gifts, a doula might be able to offer you just the sorts of tips and advice that will make your initial recovery from major abdominal surgery as smooth as possible.

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A doula can support your husband, partner, or other support person while you are being prepped for surgery.

In many cases, a dad and/or a doula is not permitted to accompany a woman into the operating room during the initial preparation for surgery (including the spinal or epidural placement).

And in many cases, dads or partners are extremely nervous during this waiting period!

A doula can help a woman’s support person to remain calm while s/he is waiting for the “okay” to enter the operating room.  She can help to describe what will likely occur during the surgery, she can remind him or her of any “responsibilities” that s/he might have (such as taking pictures after the baby is born), or she can even just offer the general emotional support and encouragement that the dad or partner might need at that very moment.

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If your anesthesiologist and OB/GYN allow it, your doula can remain by your side during the surgery.

In some cases, care providers will allow a second support person (such as a doula) to accompany a couple during a cesarean section.

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This can be particularly helpful after the baby is born.  Oftentimes, the baby must be monitored in an area of the operating room that is relatively far away from the mother.  Sometimes, this monitoring is even performed in a separate nursery.  With a doula by your side, your husband or partner can go to be near the baby without having to worry about leaving you alone.

In addition, it can be particularly helpful for a woman to have a doula by her side while her uterus is being repaired.  To the surprise of many women, this is the longest part of a c-section, ranging anywhere from twenty minutes to a couple of hours, often depending on how many previous cesareans a woman has undergone.  Having continuous emotional support from a doula at this time can be exceedingly important for some women.

If you would like your doula present during your cesarean section, especially if you plan for your husband or partner to accompany you as well, please make sure to discuss this option with your care provider and with the hospital staff.  Often, the policies on this issue vary from doctor to doctor.

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Your doula can offer physical and emotional support in the recovery room.

The  initial recovery period can be quite stressful for a new mom.  Her spinal or epidural is wearing off, she may feel groggy from that or other pain medication she is now receiving, and she has very limited mobility.  And did I mention that she also has a new baby?!

A doula can help both a mom and her partner to have as peaceful a recovery as possible.  She can guide a mom through various physical comfort measures (such as guided breathing or visualization) if the mom is experiencing a lot of pain.  She can help with positioning, both for breastfeeding and for simply holding the baby.  She can take pictures, she can wipe away tears, and she can even set up an appointment to join you at the hospital later that day or the next to help you as you regain your mobility and begin the sometimes arduous task of walking.

And when desired, she can recommend local or national groups (such as ICAN) that can offer you peer-to-peer support in your physical and emotional recovery.

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So while doula support during a planned cesarean might look much different from doula support during a planned vaginal birth, it is still the same in spirit.  In other words, a doula can still offer physical, emotional, and informational support to you before, during, and after your cesarean birth.

And you might even be surprised find how much this support enhances your experience and eases your recovery!

This post is a part of my “Doulas are for All Types of Women” series honoring International Doula Month.  I’m also giving away a copy of The Birth Partner by Penny Simkin for International Doula Month.  Please see my original post in this series to find out how you can win!

“My husband/partner is going to be right with me during my labor.  S/he even took the whole childbirth class with me!  Why would we ever want or need a doula?!”

I’ve heard and seen many pregnant women ask themselves this very question.  Most of the time (though certainly not all), I think that this question rests on a few misconceptions about childbirth, doula support, the expectations we have of “inexperienced” birth support people, and the realities of birthing in a hospital.

In other words, even if you think that your own personal birth partner negates the need for doula support during your baby’s birth, you might be surprised about just how much you might want a doula when you’re actually in labor!

This isn’t to say that you might find that when it comes to labor, you personally don’t really need or want a doula.

Maybe your partner is a “natural” when it comes to birth support.  Maybe your care provider is one who has the time to stay with you throughout your labor and support you and your partner as you bring your child into the world.  Maybe you are birthing at a place where the staff also has the time to offer you continuous support throughout your labor.  Or maybe you’ve chosen to birth unassisted!

But before you dismiss doula support entirely, please consider the following reasons why you still might want–or even need–a doula when the big day arrives–even if you have a wonderfully supportive partner right by your side.

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Doulas don’t just support the laboring women–they also support their partners.

Without a doubt, the person working the hardest on any “birthing” day is the woman giving birth.  (And before anyone gets the silly idea that the surgeon is the person “working the hardest” during a c-section, let me just remind you that s/he probably doesn’t have to recover from major abdominal surgery and care for a newborn after the surgery is over!)

But this doesn’t mean that the laboring woman is the only person who might need or want support.

A doula can gently remind the woman’s partner to take “nutrition breaks” to keep up his or her energy for the work ahead.  (I even keep a few Luna Bars in my doula bag so that dads and/or other partners–including myself–have something to snack on!)

A doula can model various massage techniques or other comfort measures so that the mother’s partner can know (and have the confidence) to do them him or herself.

My husband and my doula--my perfect partners!

A doula can reassure a woman’s partner about the “normalcy” of the birth process.  A woman’s sounds, her movements, her intensity, her bodily functions, and her vulnerability during labor might be unusual and even scary to her partner in any other situation.  But during birth, these behaviors are quite normal.  And  doula can help a partner not to be overly frightened or bothered by the work and sights and behavior of birth.

Of course, when birth is not “normal”–when something unexpected, such as a cesarean section and/or an emergency, occurs–a doula can continue to offer emotional support, encouragement, and appropriate reassurance to both the laboring woman and her partner.

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A doula can help you and your partner have a more intimate birth experience.

Some couples are afraid that a doula will interfere in an experience that they want to be wholly intimate and personal.

But unless the couple is birthing in a birth center or at home, they might not realize that birth in a hospital is often not intimate and personal.  Between the triage units, the monitoring machines, the rotating cast of hospital staff, nurse shift changes, paperwork requirements, hospital protocol, and the typical noises and hustle and bustle of the hospital, intimacy can be hard to come by on a labor and delivery floor.

Perhaps surprisingly, adding a doula to the mix can help a couple to protect the intimacy of their hospital birth as much as possible.

For instance, if a woman and her partner are sharing a particularly close moment, their doula can wait outside their room and kindly ask any hospital staff or care providers to wait to enter the room for a few more minutes (barring any urgent needs, of course).

A doula can even help to “set the tone” for a birth by maintaining a calm presence throughout a woman’s labor.  Without a calm and peaceful atmosphere–and labor and delivery units are rarely, if ever, inherently calm and peaceful–it can be difficult to achieve any sort of intimacy, especially during a birth!

And finally, the general support that a doula offers to a woman’s partner can help to make a couple’s experience more intimate and personal.  For when a partner is reassured about the “normalcy” of birth, and when s/he gets some idea of what s/he can do to help a woman who is laboring, then it becomes much easier for the couple to feel closer to one another during labor.

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With a doula present during your labor, your partner doesn’t have to worry about remembering everything s/he learned during your childbirth education class.

Here’s one of my favorite analogies: imagine asking someone to watch a couple games of football on television and then go out the next day and coach the Superbowl.

(Or for those not sports-inclined, imagine asking someone to watch a couple episodes of Bob Ross on PBS and then go out the next day and paint like Monet.)

That’s almost exactly what we ask of dads and other partners when we ask them to attend a childbirth education class and then offer labor support like a pro!

This is not to say that childbirth education classes are worthless.  Far from it.  A good childbirth education class is an enormously helpful, if not essential, component of birth preparation.  But it can be difficult for a person to watch his or her partner in labor–to know that the baby is really, truly on the way–and simultaneously remember everything that s/he learned in class!

A doula can take away some of that responsibility.  She can remind birth partners about what they learned in a childbirth education class when necessary, and then step back so that the partner can demonstrate what s/he has learned.

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Doula support has multiple (and unique) benefits for both moms and babies.

I couldn’t say it any better than this (from DONA International):

Numerous clinical studies have found that a doula’s presence at birth

• tends to result in shorter labors with fewer complications
• reduces negative feelings about one’s childbirth experience
• reduces the need for pitocin (a labor-inducing drug), forceps or vacuum extraction and cesareans
• reduces the mother’s request for pain medication and/or epidurals

Research shows parents who receive support can:

• Feel more secure and cared for
• Are more successful in adapting to new family dynamics
• Have greater success with breastfeeding
• Have greater self-confidence
• Have less postpartum depression
• Have lower incidence of abuse

In a word, doula support is truly invaluable for a woman and her partner!

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Doulas support is intended to “fill in the gaps” of your labor support team–not to replace anyone who is present at your birth.

Doulas don’t replace dads, partners, or even nurses, midwives, or doctors–they work alongside them.

Rare is the instance in which a nurse, midwife, or doctor can offer continuous support to a woman throughout her labor.

Rare is the case in which a nurse, midwife, or doctor can offer even temporary support to a laboring woman exactly when she finds that she wants or needs it.

Doulas can help to fill in these gaps.

What’s more, doulas can fill in knowledge gaps (reminding a couple of the risks and benefits of any recommended interventions), emotional support gaps (reassuring a couple of the “normalcy” of the intensity of birth), and physical support gaps (demonstrating comfort measures such as position changes or massage techniques) that may exist among a woman’s other chosen birth partners.

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So please don’t assume that a doula isn’t for you even if you have the world’s greatest husband/spouse/boyfriend/girlfriend/birth partner extraordinaire!  You might just find that having the right doula present during your labor might offer you and your birth partner just the sort of support that you want and need as you bring your baby into the world.

This post is a part of my “Doulas are for All Types of Women” series honoring International Doula Month.  I’m also giving away a copy of The Birth Partner by Penny Simkin for International Doula Month.  Please see my original post in this series to find out how you can win!

One common misconception about doulas is that they are only for women who plan on having a drug-free (or “natural” or unmedicated) childbirth.

This is simply not true!

Doulas are for all women, even those who are think that they might want to use epidural medication during labor.

Notably, some doulas only take on clients who are planning for a drug-free birth.  This is often not a form of judgment on the doula’s part but rather a matter of a doula preferring the role she plays in a planned unmedicated birth to the one she plays in a planned medicated one.

In most cases, however, you will be able to find a local doula who will support you even if you strongly desire to use an epidural during labor.  (And it is always best to ask prospective doulas about the sort of support they offer when a woman chooses to use an epidural!)

Here are some of the ways that s/he can offer this support:

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A doula can help you receive accurate and transparent information about epidurals before labor

Although they are generally very effective forms of pain relief during labor, epidurals are not without risks or potential negative side effects.  They can lead to anything from a drop in the mother’s blood pressure to fetal distress to an increased risk of forceps and vacuum delivery.

A doula can help to explain these risks to you during a prenatal meeting so that you can make as informed a decision as possible about your birth choices.  Just think–most of us don’t even want to take an over-the-counter pill without knowing its potential side effects before we take it.  The same goes for an epidural!

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A doula can help you to wait as long as possible before getting an epidural

Waiting as long as possible to receive an epidural can help to minimize some of the epidural risks, such as fetal malpositioning or slowing of labor progress.  The physical and emotional comfort measures that a doula offers can help you to cope with contractions until you do want an epidural.  And you might even find that you are coping well enough to forego the epidural and the potential negative side effects that accompany it!

And even if you are completely set on getting an epidural as soon as possible, it is very unlikely that you will be able to receive an epidural as soon as you walk into the door of the hospital!  Most women have to wait–some even up to a few hours–in between requesting an epidural and actually receiving one.  A doula can help you to cope with your contractions during that “waiting period.”

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A doula will remain non-judgmental about your choice to receive epidural analgesia during labor

Some women who use epidural analgesia hear things like this from their friends and family members:

“Oh, I knew you couldn’t do it without drugs!” or “Yeah, I’m glad you weren’t a martyr for the pain!” or “Aren’t you glad that you just gave in and went for the drugs?!”

A doula worth her weight in birth balls would never make insensitive and demeaning claims like these!  And this is partly because doulas don’t think that women need to be rescued from the pain of childbirth.  All women are strong–strong enough to cope with the pain of labor, but also strong enough to choose for themselves (and not under pressure of the hospital staff or friends and family members) when they would prefer to use pain medication during labor.

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A doula can stay with you for the epidural administration

Generally, anesthesiologists will allow one support person to stay with you while s/he administers an epidural.  Some will allow more than one.  But even if only one person is allowed to stay for the epidural, a doula might come in handy if your partner is known to get queasy or faint at the sight of needles, blood, and medical procedures!

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A doula can help you to change positions during your labor

Even though epidurals greatly limit a woman’s mobility, this doesn’t mean that women must lie completely still on their backs when they are using an epidural.  In fact, it is important for women to stay as mobile as possible, even while using an epidural!

Turning from side to side every twenty to thirty minutes, sitting up (with the help of someone else), or simply rotating between side-lying and sitting can help to prevent a common side effect of epidurals–namely, fetal malpositioning, which can lead to slowed labor progress and, often, cesarean section.  A doula can help you to change positions–or even just to remind you to change positions–so that you can avoid these potential side effects.

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A doula will ensure that you–and not the tubes and machines surrounding you–are the center of attention

Some women find that after they receive an epidural, the hospital staff and others around them almost “forget” as if they exist anymore.  The focus seems to turn solely toward the fetal monitor, the blood pressure cuff, and the IV fluids and/or medication–but not toward the woman who is still laboring.

While a doula does not play as active of a role after a mother receives an epidural, her attention is still always turned toward the laboring woman.  Whether she is reminding and/or assisting you in changing positions, “tucking you in” so that you can sleep, reminding you to ask questions about recommended interventions, or simply continuing supporting you emotionally, you are always her primary focus!

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So don’t think that a doula “isn’t for you” if you have your heart set on an epidural.  Doula support can offer benefits to all types of women–even those who strongly desire epidurals during labor!

This post is a part of my “Doulas are for All Types of Women” series honoring International Doula Month.  I’m also giving away a copy of The Birth Partner by Penny Simkin for International Doula Month.  Please see my original post in this series to find out how you can win!

May is International Doula Month!

And in honor of this celebration, I’d like to self-sponsor my first giveaway.  (What does that mean?  Well, the prize is coming from me, and not an outside sponsor, company, or PR firm!)

The prize isn’t huge, but it’s hugely important for pregnant women, their partners, and doulas alike.

What is it?

IT’S A COPY OF PENNY SIMKIN’S ENORMOUSLY HELPFUL AND INSPIRING BOOK, THE BIRTH PARTNER!

Why is this such an important book?  Just read The Birth Partner’s tagline:

A Complete Guide to Childbirth for Dads, Doulas, and All Other Labor Companions

And that’s exactly what it is.

Simkin covers everything from the process and stages of labor to labor comfort measures to birth interventions to the postpartum period–all while maintaining a non-judgmental, encouraging, and inspiring tone!

The Birth Partner has been one of my favorite “birth books,” and I know many, many other women (and men) who have found it to be an invaluable resource.  (In my opinion, the images depicting the different positions and movements for labors and birth–AND the accompanying descriptions of what these positions help to accomplish during labor–are worth the cost of the book alone!)

So what can YOU do to win this book?

Well, you need to help me celebrate International Doula Month!

And you can do this by completing this sentence:

Doulas are for women who…

Easy enough, right?

You see, lots of people are under the impression that doulas are only for women who want a drug-free birth, or women who are birthing with midwives, or women who are birthing at home.  And this is simply not true!

Doulas are for all types of birthing women!

And all types of women need to know this.

You can enter the contest–and let the world know that doulas are for all types of women–by:

1. Leaving a comment on this post, letting my readers know that “doulas are for women who…”

2. Sending a tweet to your Twitter followers, letting them know that “doulas are for women who…” and using the hashtag #doulasforeveryone

3. Leaving a comment on my Facebook Fan Page, letting the “fans” know that “doulas are for women who…”

So each person has three (but only three) chances to enter the contest.  Not too shabby!

(Side note: although I’ll only count one entry per Twitter account, please feel free to tweet as much as you like with the #doulasforeveryone hashtag!)

The contest ends on May 31st (the last day of International Doula Month), and the winner will be chosen at random.

What’s more, I’ll be writing all month long using the “Doulas are for women who…” theme.  (I’ll be kicking it off tomorrow with a post on “Doulas are for Women Who Want Epidurals.”)  I hope that your contest entries will help to inspire some of these posts!

So comment, tweet, and Facebook away!  I look forward to hearing from you–and to giving away this fabulous book!

(Oh yeah.  Void where prohibited, etc.)

Edited to add: Even if you already own a copy of this book, consider winning it for a pregnant friend or doula-in-training!  It would make a wonderful gift!

In (belated) recognition of International Doula Month, I’d like to extend my appreciation and respect to all doulas all across the globe.  Birth doulas  provide an invaluable service to pregnant and laboring mothers, and postpartum doulas provide an equally invaluable service to new moms–even if (and sometimes especially if) they have already had other children.

Unless you have witnessed or even experienced a doula at work before, however, you may be wondering just what it is that a doula does for a mother and the rest of her support team during labor.  The general answer to this question is that doulas provide continuous physical, emotional, and informational support to laboring mothers.  To expand upon this response, I’ve listed below a few particular examples of what this support may entail.  For what it’s worth, all of these examples are types of support that I have either tried myself or that my own doula used to comfort me during the birth of my second child.

Emotional support

• Believe it or not, sometimes a woman can get so caught up in the intensity and power of her labor that she actually forgets that she is having a baby.  Gently reminding the mother that “each contraction brings you closer to your baby” or “you are getting closer to holding your baby in your arms” can do wonders for a mother who has temporarily lost sight of the purpose of all of the hard work that she is doing.
• When a mother claims, “I CAN’T do this!” there is sometimes nothing  more reassuring than to tell her that she IS doing it.  (In general, there can sometimes be nothing more emotionally reassuring than to remind the mother of her incredible strength!)
• If a mother desires, a doula can remain by her side for the entirety of labor and delivery.  While a doula’s role is never to replace the role of the partner or other loved ones, her calming presence can help to reassure the mother and her other support persons about the normalcy of the various physiological and emotional aspects of labor.
• In that same vein, a doula can help to guard the privacy and sacredness of the labor experience for the mother and her partner.  For instance, if she notes that the parents are sharing an empowering or tender moment together, she can wait outside the room and kindly ask a nurse or other care provider to wait for a few minutes before entering the room.

Physical support

• While only some doulas are also licensed as massage therapists, most doulas have some experience or training in helpful massage techniques during labor.  Massaging the mothers legs in active labor, gently stroking her arms in between contractions to increase her endorphin levels, or even performing counterpressure on her lower back during back labor can all provide welcome physical comfort to a laboring mom.
• Many doulas will have hot water bottles, heat-able rice packs, or cool backs in their “doula bags.”  These hot and cold remedies can provide soothing relief to aching backs or thighs.
• Doulas often have knowledge of many positions that the laboring mother can take to help rotate a posterior baby, help the baby to descend, facilitate the progress of labor, soothe back labor, or even  help the mother to get in a variety of effective pushing positions.
• A doula can model various physical support measures for the mother’s partner or other loved ones so that they can play a more active role in the labor.  One position that many couples enjoy (and one that helps to facilitate labor and relieve some discomfort) is slow-dancing.  This not only brings the couple more emotionally close to one another but also allows the doula or other support person access to the mother’s back for counter-pressure or massage.
• A doula will remind the mother to change positions often in order to relieve discomfort and to encourage labor progression.  She will also remind the mother to drink (and possibly eat) after each contraction so that she stays well-hydrated and keeps up her energy for the hard work ahead of her.

Informational support

• I ended up needing to switch OBs at 36 weeks during my second pregnancy, and the first person I turned to was my doula!  She not only referred me to another care provider but also (because she had a good working relationship with him) called him up ahead of time to inform him that I would be contacting him.  Doulas–especially experienced ones–often have a sizeable list of community resources for their clients, resources involving everything from local OBs and midwives to prenatal yoga instructors to perinatal loss groups to nutritionists.
• When an intervention is suggested during labor, a doula can help to remind the mother and her partner that they can (and should) always ask questions about the potential risks and benefits of any procedure that is recommended, especially if they are not comfortable with the use of the intervention.
• In addition to providing labor support, most doulas also help their clients to create a birth plan.  During the birth plan meeting, the doula can provide information and offer resources regarding pain medications, cesareans, episiotomies, forceps and vacuum-assisted deliveries, and other interventions during labor.

For what it’s worth, studies have shown that all of the wonderful things that doulas do help to lead to “shorter labors with fewer complications and healthier babies who breastfeed more easily.”  Doula support can also help to reduce the need for cesareans and other interventions such as forcep and vacuum deliveries.  These benefits are all worth celebrating and appreciating during International Doula Month–and every month!