Recognizing Postpartum Depression: How Well Can We Read Our Own Emotions? by Rebecca Servoss

My first pregnancy was unplanned; but a very happy surprise. My fiance (now my husband), was shocked, and nervous--but I remember one of his main concerns was that I “don’t get Postpartum Depression”. I think when a lot of people hear the words “Postpartum Depression”, they think of the awful stories of moms (actually afflicted by Postpartum Psychosis) harming their children. I told him “ I would try not to”. (No pressure). As a young, inexperienced, first time mom, I just took my pregnancy one day at a time. Planning a home birth, I felt pretty confident. At my 20 week ultrasound, the radiologists noticed my daughter had a narrowing of the pulmonary valve in her heart, and *poof* my home birth plans were erased. From that day on, I entered into a very medical pregnancy and birth.

I was induced with Pitocin, had my bag of waters broken, had a vaginal birth in the hospital, and my daughter was whisked away to the transitional nursery before I could even get a look at her. Each of these events was heartbreaking to me...but you know as moms we do what is “best” for our babies. She was in the NICU for 6 days, and during that time I can honestly say I thought nothing of how I felt. I stood at her side as much as I could. I pumped and pumped, trying to do anything I could to be “there” for her when I felt helpless. I ached for her. In fact, I fell fiercely in love with her.

So much so that I gave all my energy to her. I know that statement sounds motherly and sacrificial--which we think of as a good thing in our culture. But as I look back on it, my devotion to my daughter was all-consuming. I became isolated, I felt exhausted and “touched-out”...leaving my fiance in an orbit of his own. I wanted nothing to do with intimacy. I’m breastfeeding constantly--don’t even think about touching my boobs! I didn’t hang out with many friends. I’m the first of my friends to have a baby--they just don’t know how to deal with my new lifestyle. I felt like crap about my body. It’s normal to not fit into your pre-pregnancy clothes. I was all about that baby. At the time, this all seemed normal. I felt happy. We have a healthy baby and that’s all that matters.

I knew full well that I mourned not having my home birth. Not seeing my baby when she was born. Losing my figure, friends, and freedom. Most of all, I felt downright traumatized about having my water broken. I felt like something actually broke inside me when that happened. But every day, my baby was having a new milestone, and we focused our hearts on her. I “dealt” with those feelings as normal. Would I ever have said I had Postpartum Depression? No way. I had a reason for these feelings. It wasn’t some unexplained sadness I was carrying around.

Well, my subconscious kicked me in the butt one day and I signed up for a training workshop to become a Postpartum Doula. I have been a Postpartum Doula for about 3 years and I am also a Lactation Specialist, working on becoming an IBCLC. I knew in my heart that women, and families, needed more support at this time than I felt I had. Four years after my first birth, I had my second daughter. We had a home birth, and she is perfectly healthy. I had an incredible support network. I had my doula and lactation training. I was 100% more informed. But I had a anxiety looming over me that after the birth I was going to go back to that place. Not wanting to be touched. Feeling overwhelmed; exasperated. I talked about this with my midwife, and she offered to prepare my placenta if I was interested in ingesting it. She told me it virtually eradicates Postpartum Depression, helps women get their energy back, minimizes bleeding, and gets your libido back on track faster. Without hesitation, I said “YES! Let’s do it!” After my beautiful home birth and successful latch, I had a pretty severe Postpartum Hemorrhage. After exhausting every method my midwife and doula knew for stopping postpartum bleeding, including placentaphagia, my midwife administered an IV shot of Pitocin. I lost so much blood that three days after the birth, with my milk coming in, my body just couldn’t keep it together. I went to the ER and had a blood transfusion. Throughout this very challenging physical time for me I continued to eat my placenta in smoothies. As I grew stronger and got my blood count back to normal I realized I still hadn’t experienced that listlessness I was worried about! I actually had a very strong sense of hope, a deep gratitude, and an energy to get back at life. I even had to my surprise, a libido. I didn't feel touched out, despite the constant breastfeeding, bed sharing, and baby wearing.

Maybe it was ingesting my placenta, maybe it was being a little more grown up, maybe it was having so many intuitive support people. But I looked back at my first postpartum experience and saw so clearly that I was very depressed. I feel sad that I could not come out of myself enough to know then that I had Postpartum Depression. I don't wish that I had taken medication or anything, but It did not even occur to me to ask for help. I wish I talked about how I felt more. I guess it felt right to be “selfless”. I imagine that many young mothers do not look their depression in the eyes and call it by its name. It is a vague, shape-shifting emptiness that can often fit into many categories that we would say it is normal to feel that way for this or that reason. I don’t know that we can always read ourselves right at that time. I feel that if I had talked more about how I was feeling, someone who loved me would see that depression in me. I think it is imperative that we give birthing families the tools and resources to recognize PPD in the women they love.

http://www.postpartum.net

http://www.ppdsupportpage.com

Do You Ever Wonder

from Sharon

An amazing poem from a home birthing mama in the US.

Do you ever wonder what it would be like to give birth under your own power?

Your own glorious, womanly, goddess-like power.

Unadulterated, unrefined, unaltered feminine strength.

Do you ever wonder what it would be like to reach deep within?

To the very core of your being, your essence, your very soul

And know that you are strong, wise and made for this task.

Do you ever wonder what it would be like to trust without reservation?

To believe in your body, your baby, your inborn wisdom.

Birthing in harmony with women across the world in passion and faith and wholehearted surrender, knowing that you are the manifestation of Mother Nature's great design.

Do you ever wonder what it would be like to labor surrounded by those who adore you?

Only your family, friends and cherished companions.

Buoyed, lifted, supported by a communion of hands and hearts and minds.

Do you ever wonder what it would be like to be honored in birth?

To be a part of a community that respects your choices, accepts your path and blesses your way.

With shared insight, total confidence and ultimate faith.

Do you ever wonder what it would be like to labor without inhibition?

To moan and sigh and dance and dream.

Responding to your body's intuitive knowing: unreserved, unrestrained and totally free.

Do you ever wonder what it would be like to give yourself over to the forces of birth?

Stretching, expanding. spiraling to the edge of the universe.

Knowing that you will always come back, centered and aware.

Do you ever wonder what it would be like to relinquish yourself to the duality of birth?

Animalistic and serene, primal and still at the very same time.

Allowing yourself to be whatever the moment demands, because the moment is bigger than you and it is you.

Do you ever wonder what it would be like to ******* a baby into an intimate cocoon?

The safest haven of peace, respect and trust.

Secure, protected, encircled with love.

Do you ever wonder what it would be like to bring a child into the world in ecstasy?

In a state of natural, blissful, out-of-this-world elation.

In rapture, divinity, earthly delight beyond all comprehension.

Do you ever wonder what it would be like to bring your baby from your womb to your arms?

Your own hands lifting your baby to your heart.

Touching, caressing and embracing without disturbance or policy or timelines to alter your first magical moments.

Do you ever wonder what it would be like to give birth under your own power?

I did. And I did.

And I will again.

Soon.

My Hands…Mother, Daughter, Doula Part 2

Four years later, I happily called my mom from Venice, Italy and announced my engagement to David. We both laughed and cried. Things were finally beginning to be wonderful again, after the previous years of our family falling apart, divorce, cancer. Four months after this happy day, back in New York, David joked with me that my breasts looked bigger. I brushed off his insinuation that I might be pregnant, and his eyes got really big. “You’re pregnant!” He exclaimed. “No, no I’m not, I can’t be.” I said. Well, of course I probably can be, I thought to myself. We ran out and got a pregnancy test. I couldn’t look at it, after the hellishly long five minutes of waiting. David pulled it out of the box I stuck it back into and we stared blankly at the word before us.“Pregnant.”

After our initial disbelief, and finally getting up the courage to tell our parents, we really started thinking about the details. My mom had given birth to 3 of her 4 kids at home, and I was going to do the same. I found a midwife in New York City who was vibrant, eclectic, and had a commanding presence. On our first visit she said she “could tell we had the soul for a home birth”. We were ecstatic, nervous, and gathering strength for an un-medicated home birth. All my prenatal visits were going smoothly, but our midwife did require that we go to the hospital to see her back up doctor for a 20-week ultrasound. We were excited; we were going to find out the sex and get to see an image of our baby!

At our ultrasound appointment, the techs happily told us it was a girl, and we both nearly cried. They kept looking at all her tiny organs, and the tech called in another radiologist and then a doctor. They kept saying words like “chambers” and “valves”. No one told us exactly what was going on. Next thing we know, we are sitting in the pediatric cardiologist’s exam room. We sat on the bed looking at each other, worried, waiting for this cardiologist. He finally arrived and did an ultrasound on my belly. Then he sat down next to us, gently but straightforwardly delivering the news that our baby had Pulmonary Stenosis (a narrowing of the pulmonary valve) and may need a balloon catheterization at birth, or in the worst-case scenario, open heart surgery.

“I know you were planning on a home birth, and I know you have a really great midwife, but I have to tell you now, a home birth isn’t going to happen. Ok? Your baby needs to be here as soon as she is born. You might even think about transferring your care to Columbia University, because they are the only hospital here that performs infant cardiac procedures……..” Too much information followed. My head was spinning. I had read in all my pregnancy books not to plan your birth. Already, at 20 weeks, my plan was shattered. I transferred my care to the high-risk clinic at Columbia, where they no longer have a midwife program and I had to discontinue my care with my midwife. She sadly sent us off with all her hope and great faith in the cardiologists, and the number to a great doula she had just worked with. I called the doula right away, the last shred of my homebirth experience resting with her. The rest of my pregnancy went well, weekly ultrasounds, meeting with cardiologists, obstetricians, fellows, nurses, social workers, surgeons. The trip from Brooklyn to Washington Heights something we could do in our sleep.

We received so much information and so many scenarios for the moments after her birth. Catheter? Surgery? Medication? NICU for a week? 6 weeks? I found myself right back in that place where I was after my mom was diagnosed with breast cancer. Blank. Stunned. On the brink of a cave of pain and fear I just couldn’t delve into. The doctors insisted I be induced at 39 weeks. “I know you wanted a homebirth…and a midwife…and a natural delivery…but, “ and there I was, powerless to the hospital, the regulations, and my fear of not giving my daughter the best chance possible, no matter what I had to go through.

I found a skein of soft brown mohair and started crocheting. I made a baby blanket, my fears unraveling into the yarn. But I still felt cold, and stuck in this place where I can’t express myself. Nightly I was on the internet, looking at diagrams of the heart, trying to figure out all the anatomy so I could explain everything to our parents and friends what seemed like a hundred times. The heart is so complex, so beautiful and intricate. Its delicacy bears a great burden for the body. I found myself clenching my teeth thinking of my little girl’s tiny heart, praying for her to be a warrior, to be big and strong and fierce. To know that we love her so much and we will do absolutely anything to give her health and a happy life. David and I often reminded each other through all the confusion and unknown, that all we can control is that we will give it our all—absolutely our everything. Without the possibility of failure, that was something we could commit to.

I made this maroon colored blob, a crocheted anatomical rendition of a heart. This I knew. This I could feel again, and I put all my focus and all my anxiety into my work. I crocheted delicate gold coronary arteries, an aorta, the vena cava, a pulmonary valve, (please baby be strong), pulmonary arteries, (please my little love be a warrior like I know you are). I made three straight arrows on the blanket and stitched the heart on top of them. (Please let us be at our best, our strongest. Our new little family. Let us take on what has been given to us with grace, let us let go of all we wanted and embrace what we’ve got.) I edged the blanket with white, like my mom’s blanket. (Please give us healing, hope, release from this anxiety).

Meissa’s birth came with IV’s, Pitocin, an epidural, and fetal monitors. I kept my baby blanket with me. My incredible doula, Sheila, my soon to be husband, and our proud mamas were with us as I gave birth. Meissa arrived at 6:19 on 6/19 weighing 8 lbs. 9 oz.. My doula swiftly pushed my hand down between my legs to feel her soft wet hair as I pushed her out into the hands of a doctor who immediately turned her over to a man in a surgical mask holding a blanket in his outstretched arms, and she was gone. I saw her 5 ½ hours later, covered in IV’s, a CPAP, bandages, and heart monitors. I cried over her and she grabbed my finger with her mighty grip. I couldn’t even hold her, but I told her how much we love her, we are here, and to be strong.

The next day she received a balloon valvuloplasty and lay recovering in her tiny clear NICU bed, covered by her heart blanket. “The procedure was very successful”, the cardiologist said. “ Good thing she was so big, we really don’t like to do these types of catheterizations until babies are a little bigger, at least 8 lbs.” We got to take our little warrior home 5 days later, all pink and smelling of breast milk.

Having a child has given me so much more insight into womanhood, for now I have been the baby, the daughter, and the mother. I have been through the fear of possibly losing both my mother and my daughter. I thank my mom so much for giving me, among so many gifts, the gift to create with my hands. The deep meditative silence of crochet served as my voice. I am sure that in many ways my blankets saved me, carrying the weight of my pain and fear, weaving seemingly impassable emotions into the comforting and warm fabric I used to bridge my love for my mother and my daughter, without speaking a word.

This is the place I try to come from when listening to my clients. As a postpartum doula, I have to keep reaching back into those fresh mother moments, the unraveling of everything you used to know before this day, this arrival. Looking to my strength in the trials I have gone through, and the tools I found to conquer them, is a place I continue to explore. I never know what will happen with a client, but I know I can give it my all. That I can commit to.

My Hands…Mother, Daughter, Doula Part 1

By Rebecca

My mom taught me the basics of crochet when I was about 10. I never would have imagined that what those little hands learned would one day save my heart from breaking, and give my grief a voice and a physical place to reside. I had always thought of myself as a pretty resilient person, but September 2001 would challenge that notion of myself.

I was writing a book of poetry as my final step to graduate college while going through a long, drawn out, passive aggressive breakup with my boyfriend of 3 years, and my parents had just separated. Overwhelmed with all this drama, stress, and poetry, I was certainly not expecting to meet my future husband, David. But I did, working as a waitress in an Italian restaurant in Brooklyn, one week after 9/11. We dated for a month before getting into a relationship, and I was so happy. Then, one day, my mom called me. Somehow I could tell she was bearing a huge weight and my heart started pounding.

“I have breast cancer.” She said reluctantly.

I was shocked. It was as if my heart turned inside out…I could not feel pain for myself at that moment. I wanted to take that diagnosis away from her, take away her fear and this battle and protect her.

My parents were heading towards a divorce, and although I was 22, the idea of them divorcing turned me emotionally into a 5 year old. Now this, I couldn’t really add this to my already ill-prepared emotions. My mom: a strong and muscular modern dancer, constantly caring for her four kids, her husband, and the family pets. She is a woman who has already survived so much. Cancer? That dark and vicious disease you hear about other people suffering from? How could this happen to her? Especially now, with our family crumbling? Trying to console her was a muddy path. I was confused and I’m pretty sure I didn’t say anything too profound or helpful. Integrating this terror I had into my poetry was unsuccessful. I just couldn’t find the words.

I had just started crocheting again and I was in this honeymoon phase with crocheting where I just wanted to make stuff all the time. I could tell people thought I was a little peculiar, crocheting away on the subway, at work, in class. All the while, falling in love and yet walking around with a huge lump in my throat for weeks. I was miserable with the idea that I couldn’t express this pain, or be there for my mom like I wanted to be. I couldn’t even cry. One morning I took the hour-long train ride to my favorite yarn store in Jamaica, Queens. I bought a big basketful of grey, white, light blue, and dark blue skeins of yarn, the colors in my mom’s eyes. The next day at work, I brought some of the blue yarn with me. It was a very slow day at the restaurant and I started to crochet. I made a 6” square, then another, and another. I started to cry. I prayed. I wiped my tears on the squares. I let all my thoughts and fears unravel into the repetitive loops of these grey and blue squares. I continued like this for weeks, saying all the things I couldn’t say and crying all the tears I couldn’t cry into the crocheted squares.

My mom soon had to have a mastectomy and reconstructive surgery using a strip of her abdominal muscles. The day of her operation was a very strange day for my family. My parents had been separated for months but my dad was there, sitting next to my mom on the hospital bed. My mom’s mom, her brother, and all her kids were there to see her roll away to the OR. She tried to keep a sense of humor, putting a sticker on the breast that was not to be removed that read “I’m with stupid à”. We laughed with her, like this wasn’t really happening to our mama.

What felt like days later, she came out of surgery and when I saw the huge wound on the belly I was grown in and the absence of the breast I had nursed on. I felt as if all the blood had drained from my body, and my uncle helped me out of the room. The waiting that occurred for the next few hours was a blur. I crocheted.

I went back home that night, exhausted, and started piecing together all my squares with the white yarn. It took me months to complete the blanket. My mom had to go through chemo and radiation. I finally finished just when her hair was starting to grow back. That year for Christmas, I gave my mama a queen size blanket, filled with all the unspeakable and unspoken.

The value of the birth experience

The other morning at work a subscriber canceled her magazine subscription because as she put it “I am tired of reading about birth and how important the experience is, its only one day in the grand scheme of things.” Let me first start of by saying I respect the opinions and beliefs of others-of course-that goes without saying HOWEVER, as a doula, CBE, and a mother who has had a relatively negative birth experience and most recently an extraordinarily empowering experience I say-is she kidding?!

I was inspired to write a response to this event but in truth I have been grappling with this question for quite some time now. I live in Santa Fe, NM. In terms of national averages New Mexico has one of the lowest rates of Cesarean deliveries. I was raised in NJ where many of my lifelong friends are having their babies. Their experiences are profoundly different from what I have witnessed here. New Jersey births are highly medicalized-I would know-my first son was born there. I would go so far as to say (and this relates only to the group of women I am in contact with) 95% of my friends having babies are doing so via Cesarean sections. I am not here to devalue their experiences but it often raises this question for me and I am not sure if I have yet to uncover any answers. I have done quite a bit of research over the last few weeks on this subject and one thing seems clear-we do not fully understand the significant benefits of a well-supported, normal birth.

Speaking from personal experience I am still dealing with issues from my first birth -eight years ago in NJ. I was in labor for many, many hours and at one point (I remember this so vividly) the doctor turned to me and said, “If you don’t get an epidural and let me turn this baby (he was occiput posterior or sunny side up) you are going to have to have a cesarean.” I managed to avoid surgery but to this day every time I attend a birth where the baby is either born occiput posterior or allowed to turn on his own a hint of anger-or more accurately fury resurfaces. On the opposite end of the spectrum nine months ago my son was born at home, in the water, with a midwife and doula present. It was everything you would imagine it to be, empowering, life-changing, confidence boosting, magical, etc…etc…etc…Would my first experience have been more rewarding if I had been part of the decision making process or was the homebirth more significant because I was able to do it naturally and on my own terms? The question then expands to what results in a positive birth experience-a natural, normal birth or just simply being in control, being part of the decision making process. One might argue a healthy baby is enough-but if that were the case would I still hold such a grudge?

In an article for Birth: Issues in Perinatal Care (18:4 Dec 1991) Penny Simkin wrote about a study that analyzed the long-term impact of the birth experience on a group of women. The questionnaire was given shortly after their babies were born, and again 15-20 years later. In short this is what was discovered:

“ Women reported that their memories were vivid and deeply felt. Those with the highest long term satisfaction ratings thought that they accomplished something important, that they were in control, and that the birth experience contributed to their self-confidence and self esteem.”

I wonder then is it possible that on some level women who have had a less than positive experience devalue their birth simply because they don’t want it to have meaning, they don’t want to feel like they missed out. I can certainly relate to that. It could also be said that only once you have experienced an unmedicated, uncomplicated, vaginal delivery would you truly understand the power involved. As you can see in my quest to unveil answers I have only stirred up more questions.

In the end I suppose it depends at least in part to an individual’s world-view in general, their particular set of belief systems. I believe that if one educates themselves and makes informed decisions a positive experience is more likely. At the same time I am a natural birth advocate who has experienced the good and the bad. I do believe that the medical, technocratic view of birth is damaging-to the individual as well as to the collective. I wish only the most gentle and peaceful births for all childbearing women. I know only what I know; I have no words of wisdom-I leave that the experts. I would love to hear from you as well…

In the Doula Spirit,

Simone

“Many women have described their experiences of childbirth as being associated with a spiritual uplifting, the power of which they have never previously been aware ... To such a woman childbirth is a monument of joy within her memory. She turns to it in thought to seek again an ecstasy which passed too soon.”

GRANTLY DICK-READ, Childbirth Without Fear

“Natural childbirth allows the hormones that have been working for women for thousands of years to fulfill their functions. This is more important than just helping a woman through labor and delivery. Birth-related hormones also affect well-being much later in life.”

JANET SCHWEGEL, Adventures in Natural Childbirth

“In achieving the depersonalization of childbirth and at the same time solving the problem of pain, our society may have lost more than it has gained. We are left with the physical husk; the transcending significance has been drained away. In doing so, we have reached the goal which is perhaps implicit in all highly developed technological cultures, mechanized control of the human body and the complete obliteration of all disturbing sensations.”

SHEILA KITZINGER, Women as Mothers

The Value of Postpartum Support

The Value of Postpartum Support

by Rebecca Servoss

In most social situations with adults, one of the first questions people ask each other is “What do you do?” When I answer, “I am a Postpartum Doula”, I usually get one of three responses. A) A blank stare. B) A quizzical look hinting for further expansion, or C) A recognition of the word “doula” followed by a story of how their sister/friend had a doula who they “couldn’t have done it without”. This lack of recognition of just what exactly IS a Postpartum Doula is just one reflection of the need for Postpartum Support. In mainstream American culture, there is a great excitement and build-up to the day of the birth. The lives of the parents-to-be are filled with gifts, parties, and advice from friends and family, and educational resources and outreach from both public and private sources on matters of birthing their child, pain management, infant feeding, and parenting methods. But what happens in the days after the baby is born or the family returns home from the hospital?

After a baby’s birth, the new family’s world is often a maelstrom of joy, doubt, fatigue, elation, and reflection. Relatives and friends often surround families. While the love of extended family is irreplaceable, the new parents may feel overwhelmed at times by the presence of the many opinions, advice, and expectations of their extended family. Unfortunately, the presence of extended family may not facilitate the protection of a quiet, relaxing space for mother and baby or new family as a whole to rest and establish breastfeeding. I do believe a support person for the mother and baby needs to be trained in what to do at this time, whether it is passed down through generations of women-knowledge, or taught in classes as our doula training is. This alleviates the new mother of having to tell everyone what she needs all the time, which is not relaxing. Also, following the birth of the baby, families are bombarded with corporate/cultural imagery of “the new family”. Formula campaigns, diaper commercials, and baby clothing companies show happy, quiet, thriving families. When times get really tough in our own households during the postpartum period, we are subliminally linked to these commercials as an answer to breastfeeding problems, diaper rash, and colic. This is overlapped with the advice of family, friends, and medical professionals. Where does a new family turn? There is a strange unbalance of too much and not enough information.

Postpartum support from an individual who is willingly giving their time to the new family’s adjustment is invaluable. I feel proud to be a Postpartum Doula because I feel my role as a maven is a comforting and static presence in a time of such great change and uncertainty. I see my job as taking the many strands of a family’s life and giving them the tools to weave it all together into a succinct picture that they are comfortable with. I am there to listen to a mother’s birth story and reflections on her experience and to support her role. I have the skills to recognize Postpartum Depression and offer resources if necessary. I aid other family members in supporting the new mother’s journey with feeding her baby and adjusting to her new body. I am a resource on normal infant characteristics to a partner who is worried about newborn care. I am educated in both breastfeeding and alternative infant feeding and can recognize the signs of a breastfeeding dyad that needs help or is feeding successfully. I am a resource for the local health care options for mother and baby as well as a resource for the “gear”, from car seats, clothes and diapering options, to breast pump rental, maternity clothes, and breast pads. I am there to help the family organize their lives a bit, from what they will eat for dinner tonight to how to support their three year old through this transition. As a Postpartum Doula, I can assess the needs of the home and find ways to support all members of the family in a time when all the attention is primarily focused on the baby. I am an advocate for the new family when they are confused or have too many visitors, and I am someone who can gently guide parents back to their own intuition during times of doubt. My role, in its highest success, creates a stability that is calming and non judgmental, allowing the family to find their own confidence.

In a time where women are striving for autonomy, are wholly self-sufficient, and serve as the sometimes-invisible backbone of their families, they need postpartum support dearly. Many women expect themselves to be running around again, taking care of it all a week after the baby is born. It is an honor for me to be able to create some space for the mother, to settle in to her new life, to offer a non-judgmental ear, a quiet compassion, and a remembrance of her right to rest, heal, and enjoy these first few weeks and months with her new baby. I am also honored to take some weight off the family by being available not only to the mother, but to the whole family. The postpartum time is one of, if not the greatest, transition of a family’s life together. Having support during this time can help create a home life that can set many healthy standards; caring for one another, carrying equal weight, paying attention to proper nutrition and sleep habits, and not being afraid to ask for, or accept help.

The Purpose and Value of Labor Support-Part 1

I was going through some of my old papers and I came across the essay I wrote for my doula certification...I don't remember exactly but I think I wrote this after attending only a few births. Recently I attended my 20th birth and I thought I would rewrite "The Purpose and Value of Labor Support" and see what if anything has changed or become more significant for me. I have not had the time to get around to that yet (in-laws visiting) but I thought I would post this for now.

This is the beginning of The Birthing Tree blog and I thought I would christen it with my first take on what it is we do as doulas...I hope to include different essays, writings, musings from the amazing women that comprise the cooperative-I am confident that their words of wisdom will be a source of inspiration to us all.

Yours in the Doula Spirit,

Simone Snyder

The Purpose and Value of Labor Support

There are many reasons why a woman should obtain labor support throughout her pregnancy and labor. Some of those reasons include continuous emotional and physical support, advocacy, and the benefit of having an experienced resource available to you at all times. For many women this is known on an intuitive level but for some more research is needed.

There have been numerous studies published in places such as the Journal of the American Medical Association, and the New England Journal of Medicine that can attest to the benefits of having labor support. There have been books written on the subject as well; one such example is The Doula Book written by Klaus, Kennell, and Klaus. According to their research having a Doula present has been shown to lower the caesarean rate (86-88), shorten the length of labor (80-83), lessen the occurrence of augmentation (83), and reduce the need for pain medication and the request for an epidural (83-86). In addition to these findings it has also been shown that the likelihood of breastfeeding increases as well (101-111). Referenced in the DONA position paper is the work of Hodnett-a meta-analysis of 15 trials of continuous labor support from North America, Europe and Africa.

These findings were similar to what I have found elsewhere. For example, according to the research women cared for by a birth Doula are 28% less likely to use any analgesia or anesthesia, and they are 33% less likely to be dissatisfied or negatively view their birth experience. Having labor support present helps a woman and her family to feel more comfortable and confident. Knowing that someone is there for constant support helps reduce fear and anxiety.

One of the greatest benefits of labor support is to provide the mother and her family the comfort of a familiar, knowledgeable companion who knows them and what they want and need. Doctors, nurses, and midwives though well intentioned are just not capable of providing constant care and support like Doulas can. Doulas are able to establish a relationship with the mother and her partner on a personal level yet they are able to remain an objective component of the birth team. Where as a father or partner may have difficulty dealing with watching their loved one experience discomfort, the Doula- knowledgeable of the mother’s wishes is able to step outside the situation and keep the mother focused. The Doula is a calming presence, invaluable to both the family as well as the care provider.

The Doula’s role is to provide physical and emotional support. She is there to help the family gather information, provide resources, and act as an advocate for the family. The Doula will offer suggestions for comfort measures and positions for labor. She will also be more than happy to show partners and family members what they can do to help during pregnancy and labor. She is there to help women have a rewarding birthing experience whatever that may be to them and to ensure a positive memory of their birth day. Their support does not end with the birth of the baby; most Doulas are committed to making at least one post-partum visit. This gives the mother the opportunity to seek help for things such as as breastfeeding and newborn care. It also gives the mother and her partner the opportunity to process the birth and go over anything that might need clarification.

Speaking from personal experience as a woman in labor and as a Doula, having constant emotional support, undivided attention and a calming presence is an invaluable asset. I do not need to read about all the studies that prove the value of having a Doula, I know in my heart the significance of having another woman present to assist in bringing a child into this world. It is a practice that has gone on for centuries in cultures all over the world-that is enough for me.