A Dozen Days of Doula Scoop: Day 6

I've ditched the drugs. Now what?

Getting through natural childbirth is tough. (If it was easy, everyone would do it.) Having continuous support from a doula can make the difference between strong, hard, painful contractions and absolutely unbearable contractions. Some dads, particularly ones who have worked hard to prepare through good childbirth classes, extensive reading, and practice, really excel at the nitty gritty of navigating mom through each contraction. Some don't. Hands-on labor support is not something that comes naturally to everyone. However, if dad is the only other person laboring with the mom, he will be the one she turns to for help. If he is not prepared to give her the kind of help she needs, she will often end up turning to the epidural because she wasn't able to cope under those particular circumstances. She may have been able to do it with more support. She may not have. Yet the research is clear. Having continuous labor support from a doula always increases your odds of having an unmedicated labor and birth. Is it a guarantee? No. No one can give guarantees in the birth process, because birth is unpredictable. But doula support may be what it takes to help you have the birth you want, and if it doesn't, you know that you gave yourself every opportunity to birth naturally, and for whatever reason, it wasn't in the cards for you this time. (Maybe next time!)

Because a doula is not (1) laboring herself or (2) emotionally invested in the process as the parents are, she is able to keep her focus on what can be done to facilitate a more manageable labor for mom.

Some of the coping techniques a doula may suggest:

• Counterpressure--The doula or dad places their hands on the joint where the lower end of the spine meets the pelvic bones (exact location depends on where it feels good to mom) and presses. Often mom wants lots of pressure. This helps relieve back pain and pelvic pain and offers some distraction from the massive pressure in the contracting uterus. Because most moms need heavy pressure to experience relief from counterpressure, this is a great time to have doula and dad switch out periodically to give their arms a rest.
• Double Hip Squeeze--Hands are placed on the upper outside portion of both hip bones, and pressure is exerted to squeeze them towards one another. This is easier for two people to do, with one person on one side of the mom and one on the other, pressing in towards each other.
  
• Head Pressure--One hand rest on mom's forehead, while the other is placed either on the back of the head or where the spine meets the head. Hands press in towards one another. This one is relaxing for mom and gives her a place to focus other than her abdomen.
• Relaxation, Rhythm, Ritual--Penny Simkin coined this term; she is my hero for starting the doula movement and coming up with so many wonderful ways to cope with labor. Penny says that as long as a mom has rhythm in what she is doing, she is coping. It could be a rhythmic pounding of her hand, swaying, vocalizing in a rhythmic pattern, rocking--as long as she has a rhythmic ritual, she is coping. If she loses her rhythm, she may need someone to help her find a new pattern.
• Movement and Position Changes--There are many positions that are helpful during the different stages of labor. Staying upright as much as possible (standing, sitting on a birth ball, leaning over the bed) takes advantage of gravity to get the baby's head pressing on the cervix. This usually makes contractions both more productive and less painful. It can be difficult to get into these positions on your own later in labor or if you are tethered to an IV or external fetal monitoring, so having someone there to help you is extremely helpful.
• Heat and Cold--Warm compresses, hot showers, ice packs, and cold washcloths can all be used to help manage pain.
• Breathing, Hydrotherapy, Acupressure, Dimming the Lights, and more!

None of these techniques takes away the pain, but they can often make it possible for moms to manage the pain. Your body was made to give birth! Despite the messages our culture would send us, we are capable of having our babies naturally. Don't think that just because you pop a Tylenol every time you have a headache, you can't handle unmedicated childbirth. The pain of childbirth is a totally different pain. It is a productive pain. Unlike a broken bone or a kidney stone, the pain of birth isn't a sign that something is wrong with your body. It means your body is working, really hard, and at the end, you get a baby for your pains! It is also a pain that comes and goes. Once a contraction is over, the pain is completely gone until the next contraction begins. That means you get a break--time to breathe, rest, and prepare for the next one. Birth pain is pain with a distinct ending. The minute your baby leaves your body, the pain is over. Just like that. While there is usually residual soreness from pushing out seven or eight pounds of baby, the pain is gone!

Next post, you guessed it, more on natural childbirth! I promise I'm going to cover some other stuff too...