• Dawn Herring

Doulas Are For Hospital Births Too



In honor of #worlddoulaweek, I thought I’d write about what I feel is a common misconception about birth doulas, and that is that doulas are only home births or for women whose goals are for a natural childbirth. Doulas are for hospital births too, and for women with varying goals for birth.


Though birth doulas play a very important role in home births, birth center births and natural childbirth, as a Doula and childbirth educator, I’ve seen firsthand how doulas can support Mamas in all environments and with varying goals for birth. I personally believe that they play an even more critical role in a hospital setting to helping laboring Moms achieve their goals and to having an empowered experience.


Why?


Well, let’s first start by reviewing what a birth doula does.


The 4 Pillars of Support


Birth doulas provide emotional, physical and informational support to both Mom and her partner, as well as play a role in advocating for Mom’s goals for birth.


Emotional support is just what it sounds like - reminding Mama of what a flippin’ rockstar she is leading up to labor and during. There are many things to think about in those last months/weeks of pregnancy, and it can be overwhelming. We can be the voice of reason, the sounding board, the comforting presence to help you move through those times with compassion and confidence. We are the ones cheering you on when things get tough during labor, providing you with a smile, a hug, a shoulder, sometimes wiping your tears away and affirming just how amazing you’re doing.


Physical support is all the hip-squeezing, counter pressure back support, comfort measure bringing, rotating on the peanut ball goodness (and more) that you can take! We are there to ensure that you use your tools during labor, to help encourage you to move into positions that keep labor going, to help your husband grab on to your hips and squeeze (if he and you want him to) and to ensure that you’re comfortable and moving every 30ish minutes after an epidural. And a whole lot more magic, too.


Informational or educational support, which as a childbirth educator and doula is totally my jam, is helping Mama and Dad along the way to make as informed and educated decisions as possible. To me this is one of THE most important ways to support your growing family - to know and understand your options as choices arise, and to feel as confident in those choices as possible. You will never forget the day you meet your baby, and I am so passionate about helping my clients have as positive an experience possible by being informed and empowered to make the choices that are right for you and your family.


This leads to the last pillar, which is the advocacy aspect. So, with the informational support we offer, we support you in making choices that are aligned with your goals. During your labor, we can help to remind you if there is something presented in your care plan or during labor that strays from that. As long as there is time to discuss and think about your options (and not an emergency situation), we’ll do our best to encourage that and make that possible.

This is the aspect for me that really had me see just how important a role Doulas play in a hospital setting. And this is not where I’m going to go off on a tangent about how bad hospitals are and that every woman should birth at home or in a birth center. Though there are some major issues right now in our country with maternal and fetal care and outcomes in the hospital, but that’s for another post.


Here is what I will say....


Hospitals are “medical” environments. They are designed to be ready if and when emergent scenarios occur. OB’s are trained surgeons, also trained to look for what’s not working, and provide a solution in the event that it’s needed, such as cesarean birth or other interventions.


However, birth for most women, is not a “medical” scenario, when all things are going as they are designed to. In most cases, when a laboring woman is left to her own accord, to do her own thing, supported, nurtured and feeling safe, birth goes along just as it’s designed to. Now in the case that something goes awry, it’s a beautiful thing that we have hospitals and medical staff to help and keep Mama and Baby safe.


Is Your Goal to Have a Natural Birth in a Hospital?


Mamas who have the goal of a natural birth within a hospital setting need all the support they can get to stay in the zone, feel safe and “stay the course.” They need to be able to feel comfortable, to settle in, and to let the labor process unfold.


A doula:

  • ensures that they are supported in entirety regardless of what’s going on around them

  • never leaves their side (well, we do have to pee from time to time)

  • helps to provide a buffer to some of the interruptions

  • holds space for her and her goals

  • and provides all of the different kinds of support I mention above

In most cases, when a laboring woman is left to her own accord, to do her own thing, supported, nurtured and feeling safe, birth goes along just as it’s designed to.

What if Mama Wants an Epidural or Isn't Sure?


Now let’s say that we have a Mama who knows that she wants to get an epidural, or is unsure. How does a Doula support and serve her? Just exactly as I shared above. We provide that same emotional, physical, informational and advocacy support to ensure that she has the kind of birth that works for her and that she feels empowered by.


Doulas can:

  • answer questions about what to expect with an epidural

  • help you navigate when the “right” time to get one is

  • help to support you prior to getting an epidural

  • move you into different positions and stay comfortable to help labor continue to progress

  • help you to understand risks and benefits of any proposed procedures and how to help weigh those against your goals

We are the steady constant for you as the nursing staff changes shifts, there to keep you comfortable and feeling safe.

The Difference in the “Model of Care”


There’s an overarching reason that I’ve touched on above, but want to be sure that I speak to because it really helps to demonstrate my point about how important a role a doula can play in a hospital setting in order to help Mamas feel empowered and have a positive experience in that environment. And that is the difference in the “model of care.”


Mamas who are laboring at home or in a birth center are in a "midwifery model of care" that is typically speaking very empowering, supportive, and steeped in the gorgeous vibe and energy of “girl you’ve got this and you’re a flippin' rock star, and you birth that beautiful baby." In the care of midwives, they are looking for what’s going right about your birth and what is working, and their goals are to support the natural and physiological unfolding of the labor process.


When you have your baby in a hospital, you are in the "medical model of care." A Mama who is laboring here has to work hard to navigate the common medical conversations, protocols, standards, etc. of that “medical” environment. It's just the way it is. Therefore, having a solid team you feel comfortable with is critical to your ability to navigating that with power, starting with choosing the right care providers. Choosing an OB team you feel comfortable with or being in a “hybrid model of care” which is an OB/Midwife team (meaning you have both OB's and Midwives in the practice) will make all the difference for you in terms of your experience of pregnancy and your comfort levels going into your labor.


I can’t begin to tell you the amount of women who have shared that their care providers let them down, made them feel small, disempowered, and where they didn’t feel they had a say in their care and or how their labor unfolded. Not good.


Note: I have worked alongside some incredible Midwife teams in the hospital, so feel free to message me for recommendations.


In Summary:


If you are laboring in a hospital, adding a Doula to your team can help you to feel more comfortable in that environment and you will be supported to do your thang and let labor do it’s thang by providing all the different kinds of support we offer.


Every woman deserves to have an empowered and positive birth experience, regardless of what her goals and birth locations are. It is by far one of the best and most humbling honors to support a laboring Mama; and to witness both a baby being born, and a new Mother being born at the same time.


If you’d like to inquire about my Doula services, send me an email here and let’s chat!

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