Doula on Call

On Thursday, our doula officially went on on call for us. For those of you who aren't familiar with what a doula is/does, the "What Is a Doula?" and "Why Use a Doula?" portions of the following site provide a good, brief overview:
http://www.dona.org/mothers/index.php

Basically, a doula is a labor support person that assists women/couples in preparing for the baby's birth through the creation of a birth plan. She also provides emotional and physical support during labor, helping the mother's labor partner guide the mother through pain management techniques, as well as facilitating communication with hospital staff. Studies show that having a doula assist with labor can shorten labor and reduce the likelihood that pitocin, epidurals, vacuum or forceps extraction, or c-section will be introduced into the birth process.

I'm particularly interested in avoiding pitocin (http://www.childbirth.org/articles/pit.html), if at all possible. I was put on pitocin within an hour of arriving at the hospital when I had Sam, and didn't care for the experience. Pitocin use does not result in the same type of contractions that you would get naturally. As a result, the contractions are often more intense and painful, both for you and for the baby. Labor involving the use of pitocin is more likely to lead to the introduction of an epidural, which can create a vicious cycle. The epidural decreases the intensity of the pitocin-induced contractions, requiring a bump up in pitocin, which brings more pain requiring a boost to the epidural, and so on. What can and does happen on a fairly regular basis is that the baby then goes into fetal distress and/or the labor stalls out, leading to vacuum or forceps extraction (rough on both mother and baby) or, even worse, c-section. I personally fall in the camp that feels that c-section is major surgery that should be avoided, if possible. I also think that your body knows how to have a baby, and that the more artificial means of getting through labor you use, the greater potential there is for everything to go awry. Labor and delivery are the result of a complex symphony of triggers, hormones, etc., and when you add chemicals and surgical procedures to the mix, problems can quickly escalate.

All of that said, I DO think there is a time and place for all of the interventions mentioned above. I just think that the medical establishment gets overly fixated on getting through labor in a set timeframe, with the idea that all labors can and should play out the same way. For this reason, if milestones aren't hit in what they consider a timely manner, the mother faces pressure to allow various interventions. Having a doula on hand to remind the mother that she has control over the decisions that are made, and to make an informed decision about what to do and when, can be key to a positive birth experience for the family.

I will admit, I'm still scared about going through the birth process again, and am worried I won't have what it takes to go through the process naturally. My doula will support me if I choose to get pain medication, but in hiring her, I'm obviously hoping to bypass the trauma of having a needle stuck in my spine.*

Anyhow, we're really excited about working with our doula, and I've been emailing back and forth with her over the weekend. We're going to meet with her this week to talk about aromatherapy and accupressure massage techniques to help stimulate labor. Sam arrived 2 weeks late, and I'm worried that if I start go this way again, I'll be under pressure from my doctors to get an induction. By starting with natural labor induction techniques now, I might have a shot at avoiding the dreaded pit. I'm also thrilled that our doula also works as a massage therapist, so many of her pain management techniques involve not just positioning, but also massagge and counterpressure. As someone who feels that the world would be a better place if everyone had access to frequent massages, I think that it can only be a good thing when it comes to labor.

Once we've gotten through the birth and I'm halfway coherent again, I'll be sure to report out on the doula experience for those of you who are curious. I've heard only good things from those friends and family members who have used them, and I'm sure it'll be the same for me.

*I honestly think the most traumatic part of Sam's birth, aside from the pain, was trying to force myself to sit still so that someone could stick a needle in my spine. I've got an aversion bordering on phobia when it comes to people messing with my spine and still cringe when I think about it. It didn't help that the hospital staff acted like I was a big baby for being nervous, but I did thankfully have an awesome husband who held my hands and talked calmly to me through the entire process.