doula hospital birth

Most common labor mistakes #2

ACTIVE LABOR:

“Do these 3 things and you won’t feel a thing!” “Don’t do this and you’ll be done in exactly X hours!”

Most of us women would be happy to try almost anything that promised to make birth easier or at least shorten the process. But as nature has it, every one of us is as unique as the children we grow in our bodies and bring to earth with our unconditional love and courage.

Is there a right way and wrong way to birth? If only it was that clear…

For this reason, we decided that instead of the word ‘mistakes’, the words ‘misjudgements’ or ‘miscalculations’ are more compassionate. Let’s face it, labor is no joke.

Early labor may be bearable enough for some to continue with light daily activities. We discussed why this is recommended, along with other suggestions in the article on Common Mistakes: Early Labor. But at some point, the intensity of those sensations changes.

You might be in Active labor when... your contractions feel stronger and harder to bear.

So, unlike before, the distractions may not be working as well anymore. You are finding that you have to stop what you’re doing each time. These are major cues that your body and baby are getting really serious about this birth thing.

How exciting!

Now what, dear Doula?

That’s your cue!

Start timing the contractions again. (Wondering about WHEN, WHY and HOW to time contractions?)

What you are looking for is length and duration.
Longer, Closer, Stronger

 

 

Assuming you had told your OB/ Midwife when you went into labor and depending on whether you chose to have your Doula join you in early labor, let your birthing team know about this new development.

The onset of Active labor is when a woman feels the strong need to do something about the contractions. This in a natural urge designed by our bodies to help baby along. 

So let’s talk about some tempting misjudgements that might go against the natural progression of labor.

 

 

 

 

Doing nothing

This is a go-to whenever we are are in pain or discomfort. Sitting still in a way that feels more comfortable or the good old fashioned bed-rest.  Even though this offers a sense of relief, it could contribute to a longer labor and increase back pain due to pressure on the spine.

If for some reason the mother chooses to or has to stay in bed, it is encouraged to change positions or to lay side to side. Even the smallest change for just a few contractions is helpful.

Moving in rhythm with contractions and changing positions also makes it easier for the baby to navigate the pelvis.

Gravity is a laboring woman’s best friend.
(After a Doula, that is.)

If you would rather hang out in your room for privacy or other reasons, a Doula has got a mind full of positions to ease discomfort and aid the progression. We also bring a ‘bag of tricks’ full of labor equipment you can use.

If you feel up to it, grab your partner or a family member and take a slow walk down the hall. Feel free to pace back and forth in the room. If you are having a home birth, stroll around your house. You are likely to find that you have to stop at each contraction. Having someone by your side is priceless as you can use them for physical support. You are going to appreciate all the encouragement you can get. Enjoy the company of someone willing to walk the walk with you.

 

Doing Everything

Ah, you can’t win can you? Yes you can, I promise!

There is the complete opposite staying in one place: trying every single position and comfort measure you learned because that is what you are ‘supposed to do’.

It’s great to change positions and techniques during labor, but how do you know when to do what?

The amazing thing about our bodies is that, if you are focused enough, you can pick up on the natural cues on what to do.
 

Try positions and techniques in response to cues from your body; not just "try everything." Once you find a good position or technique, continue through several contractions until you feel your body needs a change.

One of the most humbling lessons as a Doula is to learn to ‘lead by following’. This is one way we honor a woman’s innate wisdom. We may make suggestions and help along the way, but above all we trust that women are capable. Forcing changes during labor can be distracting and can pull mental and physical energy away.

*Wait, I thought distractions were good for labor?

Stick around dear mom, there is a time for everything.

 

Distractions

We established that distractions are great in Early labor. Focusing too much on bodily sensations too soon can cause unnecessary stress and get the mother tired way before she needs all her energy. Active labor is a whole different ball game though...

Active labor feels more intense physically and so it takes a lot of mental energy to go through. At this point, too many distractions can cause the mother to lose her focus.

Having someone beside you to talk to during labor can be calming and reassuring. The down side of this is that, the mother might feel obliged to respond and be an active part of conversation in the room.

It is not easy to be there for someone and give them space at the same time.
This is a balancing act that a good Doula practices.

There is a lot of benefit in being mentally present at the labor. It is easy to miss out on your body’s cues or become irritated or anxious based on what is happening in your environment. This can trigger stress hormones, which do not interact well with birth hormones, leading to a stalled or longer labor.

Relaxation at this stage of labor is a priority. Calming or inspiring music is one way to set the mood for the mother.

If the TV is on in the birthing room, let it be by the mother’s choice and that she has the say on what should be on. Preferably, something pleasant that she does not have to pay too much attention to or to follow.

Sometimes visitors or other staff in the room get carried away talking about topics not relevant to the mother. It is ok to give a polite reminder to keep such conversations out of the room.

As Doulas, we respect the 'birthing space' as a mother’s own NEST.
We allow the mother to set the tone and the pace.

 

So, imagine you've made it this far but there is still a way to go... *They say the next stage of labor, Transition, is the hardest and that it is when women are most likely to ask for an epidural. Next time we discuss how true (or false) this is.

 

 

You'll Do... My what?!

Doulas are hippies that want you to have your baby under a tree by a spring with a family of deer cheering you on... Have you heard something in those lines? I kid, of course I'm exagerating in my description, but hopefully, such old rumors no longer exist. That's what this article is about. Clearing the misconceptions about what a Doula really is. What's the point of a Doula anyway?

A lot of our clients know from the get go that they want a Doula through their pregnancy and at their birth. Some moms and families however only understand the value of a Doula after talking to one and having our exact role broken down.

Thoughts that might go through people's head:

'My Doctor is going to think I'm undermining their expertise by bringing a Doula'
'The nurses at the hospital are gonna think we're total weirdos when we walk in with a Doula'
'Why does my wife think I'm not good enough to support her during labor?'
'I have a midwife so she'll meet every little need I have'
'My mom and sister will be there with me, they'll be my Doulas'
'No thanks, I don't want a total stranger in my family business, I prefer privacy'
'I'm totally not having a natural birth! A Doula will try to make me feel bad'

Truth is, there might be a tiny possibility that these scenarios have happened in somebody's story. Good news is, Birth Prep Doulas, do not bring a 'report card' into your life. What I mean by this is that is that, our bottom line policy is to offer unconditional support, honor your choices, respect your space and work in harmony with your team of supporters including you Doctor/ Midwife/ Nurses/ spouse and family. 

No judgement from us. Zero. You call the shots and we get on board and keep everyone involved focused on your wishes, comfort and well-being.

 

Let's talk Doctors and Doulas. Many modern Doctors appreciate a good Doula on the team. Birth Prep Doulas understand that to keep these relationships efficient for the mom to be, being professional at all times and working within our scope of practice is important.

Midwives are medical professionals and focus on the woman and baby's medical progress and safety. This makes it a bit difficult to be available for some of the small detailed needs that do come up during labor. A Doula is there for this sole purpose. We get you a fresh cool rag, we rub your back, we help you change positions, we hold your hand, keep the mood in the room right... You name it, we're at your service.  It is never an interruption or a bother for us because this is exactly what we are there for.

Nurses as well know the value of having a knowledgable assistant with the laboring mother at all times. Having worked as a Nurse myself, I can not underestimate the peace of mind it gives one  to know that they can focus on the woman's and baby's medical needs while the Doula handles other aspects of labor. When it comes time to document or be with other patients, the Doula keeps the pace going while the Nurse is out of the room. And at the end of the day, Nurses have to clock out. Doulas do not change shifts!

Family members too sometimes need to leave the room for a break or for other life obligations. Husbands, moms and sisters have personal knowledge of the mom-to-be, which is very reassuring to her. Doulas on top of that, have skill sets and an educated understanding of the progression of Labor and can help in explaining some of the medical terms if need be. Doulas do not replace dads, or moms or sisters... We are happy to work on your team, alongside them.

Privacy is a big deal to most of us! No wonder medical  professionals are held accountable to protect your personal information by HIPAA (HIPAA stands for the Health Insurance Portability and Accountability Act. It's a law that protects your private information) Birth Prep Doulas understand the sensitivity and intimate nature of pregnancy and birth. We include a HIPAA form for all our services that both parties sign. All the information you give your Doula is between you and your Doula, period. We do not reveal clients identity and we do not post any client details on social media (unless requested or authorized). 

Private to some may also mean that they feel like a complete stranger is coming into their personal lives. I can totally relate, especially with everything that could go down during birth. It's a natural instinct. Even animals in the wild are known to seclude themselves when in labor. Which is why Doulas hold several prenatal meetings with the mom-to-be. Partners and family members are welcome to these as well. Birth Prep Doulas will come to a Doctor/Midwife visit if requested. We are happy to meet with the mom-to-be, wherever she chooses, and work on building a comfortable relationship. We are available to her throughout the pregnancy for any questions or even just to chat about the day. The Doula/ client relationship is unique in how personal and how fast it develops. Our goal for the day you deliver, is for you to feel like your Doula is a professional, yet your friend at the same time!

Women have so many options on how to birth. Birth Prep Doulas celebrate that!

We pride ourselves in offering non-judgmental support to all. We leave our personal preferences out of your story. As our mission statement states, "We believe that given the right information and with the right support, women are capable of making the right choices for themselves and their babies." 

We truly believe and live this mantra. Our hope is that you get to live it too.

What are your thoughts on the true role of Doulas?

 


 

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