Strollerderby : doulas

Chicago Doula Works With Poor Pregnant Teens

Miriam Axel-Lute — Fri, 06 Mar 2009 19:30:00 GMT

For all those tempted to think of a doula as a luxury who merely provides pampering, it's worth taking a little time to watch A Doula Story.

Loretha Weisinger, the subject of the documentary, a former teen mom herself, works with pregnant teens in a poor area of Chicago. She's really a combination of childbirth educator, doula, lactation consultant, and parenting educator, which is a hell of a job, but clearly a crucial one.

I keep remembering the moment where she takes a cell phone away from a new mom who's trying to breastfeed in the hospital in order to tell her boyfriend that, no, breastfeeding isn't "nasty." Or her careful explanation that she wasn't going to leave the delivery room until one of her "girls" was ready to hold her baby and got to do so. Or her repeated insistence that her girls actually talk to their babies, in utero and out.

It's not exactly a feel-good flick, as the lives of these girls, and Loretha herself, are hard. But it also shies away from what I came to realize, as I found myself tensing for it, must be a stock documentary habit of sticking a tragedy in somewhere around 2/3 of the way through. No deaths or horrendous confessions. Just the day-to-day work of trying to improve the lives of babies and parents.

(Hat-tip: Citizens for Midwifery)

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Today Show Says: Doulas Get in the Way

Miriam Axel-Lute — Mon, 24 Nov 2008 18:30:00 GMT

Despite having been exceedingly happy with my own home birth, I know birth location is a very personal choice. When I have friends who are planning to give birth in a hospital, I don't go home-birth evangelical on them. I just have three words: "Get a doula."

A doula, or labor assistant, is a trained birth attendant, but not a medical professional. Their role is to provide support for the laboring woman—reassurance, massage, etc.—and her partner, and also to be a patient advocate when needed, not inserting their own opinions, but understanding what the parents want to happen under certain circumstances and sticking up for it. How many OBs read birth plans these days? Breastfeeding, circumcision, pain relief . . . In these days of understaffed hospitals, it's good have someone keeping track of you, your needs, and your decisions.

The extra, consistent support makes a difference. In fact as far back as the 1970s, all sorts of clinical studies show that the presence of a doula reduces complications and c-section rates and improves mothers' feelings about the birth outcomes. Sounds perfect, doesn't it? A nice middle ground in the birth-location fight, a win-win situation? DONA International, a group that trains doulas, was hopeful that that was the message that a recent Today Show segment on doulas would spread.

They, and many others who have used doulas, were dismayed to find that instead a huge amount of the segment was devoted to a doctor who wanted to emphasize how doulas get in the way, inserting their own (non-doctorly!) opinions, and arguing with doctors. Her hospital has actually banned them. I have to wonder if they had any hard numbers on birth outcomes that contradicted the larger clinical studies, or whether they just don't like being challenged.

If it had just been her inclusion that was the problem with the segment, I would have disappointed but understood that it was coming from the twisted meaning of "balance" that operates in journalism these days (i.e., "We must find one extreme opposing viewpoint, even if it's a lie or represents only 2 people out of the whole world"). But the host and resident expert were also astoundingly snotty and condescending throughout, full of smug phrases like "buyer beware" (You know, unlike choosing an OB) and "this is a luxury for most women" (You know, unlike an increased risk of major abdominal surgery, which is just fine) and "Make sure they know they're not there to get in the way."

Yes, doulas are not medical professionals and shouldn't be trying to act as such. But as this stunning article points out, unfortunately, laboring women often need someone adovcating for them, and it shouldn't always fall on the partner.

Interestingly, the text article on the Today Show's site is very different in tone and content, and much more positive.

DONA hasn't issued an official response yet, but it's planning one. Its supporters are, not surprisingly, already asking people to write in and complain.

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Your Birth Story in 6 Words

Madeline Holler — Fri, 04 Apr 2008 17:56:00 GMT

You know that book Not What I Was Planning, the collection of memoirs that are six words long? Well, a blogger/doula is riffing on that idea and asking people to writer their birth stories in just six words. (I believe "ouch" counts as a word.)

Can you do it?

Here are a few so far:

Front seat, 60mph, early morning, WOW!

Nurse insists it's worth it. Correct.

On all fours, laughing him out.

Unplanned cesarean. Stillbirth avoided. Overwhelmed...overjoyed.

thank god i'm not pregnant anymore.

Don't push, can't not, he's here!

Come on, Babble readers, give us your birth and adoption stories in six words.

Doctors and Doulas Diss Ladies

Kelly Mills — Sat, 08 Dec 2007 16:26:00 GMT

Over at the Huffington Post there's a critique of the way medical professionals and caretakers dismiss the concerns of women. Joyce McFadden contends that while men's problems with docs tend to do more with men avoiding medical help, women are actually ignored or find their valid concerns are minimized. Women complain of pain and are told they aren't really experiencing it. She gives examples of this in childbirth, and here's where I was a little surprised: She calls out doulas as well.

I guess I didn't expect to see doulas included in the hot seat because part of the whole doula idea is that you want someone advocating for you when you are in labor and may not be able to look after your own interests in the most effective way. And there's an idea that doulas, who operate differently than the medical professionals, will be more responsive to women. But McFadden writes, "A woman says to her female doula, 'There's something wrong with the labor, I need to go to the hospital right now.' The doula repeatedly tells her she should just hang in there, it's not time yet, which proves to be a bad error in judgment." It's a brief mention, but to be honest, I think it's probably reasonable to include it. I believe the majority of doulas are excellent, and often provide real help and comfort for laboring moms. But it's probably safe to say that McFadden is correct, there are a few doulas who are dismissive of women's concerns. I think the point is that we need to work to ensure women are heard and heeded by all those involved in the childbirth process, even in the throes of contractions.

Hospital Rooming-In or Baby Nursery? (They Both Suck)

Karen Murphy — Mon, 22 Oct 2007 11:28:00 GMT

By the time my third and fourth children were born, I was firmly in the camp of having the babies room in with me in the hospital. It seemed, at the time, to be the most natural thing to do, as close as I would ever come to the still somewhat alien energies of a home birth. After all, people have been giving birth for centuries in all sorts of circumstances, and certainly in most of them, babies have remained with mothers in those precious hours and days right after birth. And research seems to agree with that premise, though I have to tell you that having done it both ways, there are problems, as I see it, with both.

I polled the Strollerderby bloggers who kindly reminded me of aspects of each choice, rooming-in and using the convenient hospital nursery, perhaps a parent's last time ever to be alone again for twenty years.

Mike just wanted to watch the game and have some peace while those pesky nurses brought the baby in every hour, claiming she was hungry or something and clanging carts and poking and prodding. He would have escaped down a sheet ladder had he thought of it in time.

Kelly wishes she had taken advantage of the hospital nursery to get at least a few precious hours of sleep, because her child hasn't slept since.

And Rachael missed her twins terribly, having sent them on to the nursery at a nurse's recommendation. She suggests having the baby room in but sleep with daddy, which to me seems to be the best of both worlds but does require the participation of a willing partner.

While supposedly studies show that mothers DON'T actually get more sleep when the baby's in the nursery (I have issues with this premise), they do show that rooming-in is better for babies. Babies who do so generally stay warmer, cry less, have lower amounts of stress hormones, and gain more weight than babies left in the nursery.

And while I get all that, and got it enough to make it my choice, I still think that it depends on circumstance. If there's been a particularly difficult birth for instance, it's not like we typically come equipped these days with a doula or enough family to care for the baby while mom gets her strength back, in which case resting up a bit for a day or two before going home with a newborn may be the best option.

Which did you choose, and how did it work out for you? Would you choose differently next time?

Pregcellent: John Tesh Was My Doula

Kelly Mills — Wed, 22 Aug 2007 12:02:00 GMT

When I was pregnant, I decided I wanted a doula to rub my shoulders and keep my family at bay, so I went to this birth supply store (don't ask) and looked through this book on doulas. Unfortunately, choosing a doula personals-ad-style was pretty random, so I just selected a couple folks, called 'em, and went with the one I liked best. That's why I was initially excited when I saw this article on choosing a doula or midwife--was there a better way than the route I went? Cuz lemme tell you what happened: The first sign there might be trouble was when she gave me this book of natural birth photos that had pictures of babies delivered in the backs of VW vans and crap. The next bad sign was when she said she "strongly discouraged" the use of epidurals (I had a natural labor birth plan, but wanted an open-minded person.) But I had chosen my doula, and so I forged ahead.

Long story short, when I was in labor, I HATED my doula. I was having back labor and was on pitocin and the contractions were wretched and this doula-woman was all in my face telling me to go "ohm." Once one bad contraction had passed I made a slicing motion with my finger across my throat at her and she backed off a little. I was in so much pain, all I really wanted was an epidural and a chance to watch Entertainment Tonight because at least it was utterly mindless. John Tesh calmed me down better than the woman I hired to help me.

Unfortunately, this article is less "Choosing a Doula" and more, "Maybe you should get a doula." Okaaaay, but how do you pick one? And this annoys me: "Pregnant moms interested in a natural, safe and relaxing birthing experience should consider using the services of [doulas and midwives.]" Oh, because I was hoping for an unnatural, dangerous, and stressful birth myself, so I guess I don't need one. Look, I'm pro-doula, but I'd still like a better guide to choosing one. Just in case I get knocked up again and John Tesh isn't free.