I’ve been asked this numerous numerous times. What does a doula do? Why do I need a doula? What can a doula do that my husband or mom or best friend or sister can’t? I plan on an epidural anyway, doulas are only for unmedicated homebirths.
There’s a lot to unpack here, but I’ll do my best.
Think about childbirth before the medical revolution in this country. Before everyone went to the hospital to give birth, where and how did women birth? First of all, families were immersed in life-giving from young ages. If you had little brothers or sisters, you more than likely watched them come into the world. If you didn’t, you undoubtedly had a cousin or friend who you watched give birth at some point in your life. You already knew the power, the innate intricacies of childbirth, because it was done at home, with healers or doctors, and only in extreme cases ended in a hospital stay (if there was even a hospital close enough). So when it came time for a woman to have a baby, she was already well versed in what it looked like and smelled like and sounded like. We are well-separated from birth nowadays. Until I gave birth I had no clue what birth looked like. I read birth stories ravenously, but had no real idea of how it looked and felt.
So for me, becoming a birth doula and working in this way reignites this option for parents. I am a trained companion, not a healthcare professional, who supports my clients through their labors and births. The role of a doula is to complement healthcare professionals. Medicalized birth in modern society has made birth very one-sided and sterile. A birth doula’s role is to bring the family element back into the room so that a birthing family can have a well-rounded experience. We are there to help our clients cope, to hold hands with them, educate them on their options and make sure they feel like they have a voice in the process. This is a life-altering experience they are going through. An analogy I like is this: while you might go on an overseas trip alone without having any clue how to get through it, you would most likely have a better time if you had a guide. A doula is a well-trained guide.
A birth doula’s role is to bring the family element back into the room so that a birthing family can have a well-rounded experience.”
So let’s start with what a doula does. Let’s start at the beginning. A doula meets with you in your pregnancy and starts giving you information so you can educate yourself on the process of labor and childbirth and postpartum. We have so many resources and have honed our referral lists and contacts in this aspect of life.
I remember being very overwhelmed with questions when I first became pregnant. Who should I see for chiropractic care? Where should I order my breastpump? Are there support groups? How many stretch marks are normal? Oh my gosh, how much nausea could possibly be normal? Which prenatal vitamin is best? These are all questions I’ve been asked and been able to help with. Our job as doulas is to have these resources ready to go for you to help you navigate your pregnancy.
I like to meet with clients at least twice in their pregnancy to help answer some questions and get my families thinking about what they would like their birth to look like and how I can help support them to achieve that goal. Once we have signed a contract and the final payment is made, I go on call for my clients. This is generally 2 weeks before their due date. On call means they have their own (very loud) ringtone on my phone, and my phone never goes on silent. I am available for whenever labor may start. Once labor begins, we determine when the family needs some extra support and I come help with labor. Depending on the person, this can be either at the client’s house or I meet them at their birthing place. From here on out, I stay with the family until baby comes. Once baby comes, I stay for an hour or two after the birth to make sure everyone is feeling okay, and then I leave the family inpeace to digest what they just went through. I text or call over the next few days, and at 2 weeks postpartum I come by for a home visit to check in on the family and our client/doula relationship is over. But I run a support group for parents in the area, and luckily I get to talk to and see my clients and members of the community there. It is lovely to go from working for someone to being their friend and watching their baby grow.
Why do I need a doula? There’s a few reasons. Here is an article I like to refer to when talking about doula care and why it’s beneficial:
They have done many many studies that have shown that having a doula can lead to better outcomes in a labor and birth situation. There are absolutely no negative consequences in any study for continuous labor support with a doula.
I truly can not write anything more comprehensive or helpful than Evidence Based Birth, so I would highly recommend you at least skim through that article. I am quoting directly from that page here but it lays out the very basic reasons hiring a doula is beneficial:
“Of all the ways birth outcomes could be improved, continuous labor support seems like one of the most important and basic needs for birthing people. Providing labor support to birthing people is both risk-free and highly effective. Evidence shows that continuous support can decrease the risk of Cesarean, the use of medications for pain relief, and the risk of a low five minute Apgar score. Labor support also increases satisfaction and the chance of a spontaneous vaginal birth. Continuous support may also shorten labor and decrease the use of Pitocin. Although continuous support can also be offered by birth partners, midwives, nurses, or even some physicians, research has shown that with some outcomes, doulas have a stronger effect than other types of support persons. As such, doulas should be viewed by both parents and providers as a valuable, evidence-based member of the birth care team.”
So, following from that, I’d like to answer the next question I laid out: What can a doula do that my husband or mom or best friend or sister can’t? And this one is quite simple, really. We can be objective. While we are emotionally engaged and invested in you as a person, we are not related to you or connected as strongly as a friend or family member. It allows us some neutrality when it comes to communication as well as strength even when seeing you uncomfortable or vulnerable. A friend or family member may also not be familiar with the emotional intensity, or the sensory experience that come with the birthing process. This may hinder them from being able to provide their undivided attention. There is also the fact that we are professionally educated on the risks, benefits, and implementation of birthing routines and interventions as well as helpful techniques for birth positioning and comfort measures. In other words, this is our job. We do this all the time. It is a magical job that we do not take on lightly, but it is still work for us. We have seen it before. We don’t care if you poop on the table. We know how to calm you down or squeeze your hips in the right way, or where exactly to put a cold cloth to help with your back pain. We have dedicated our lives to this art, and we are dedicated to helping you.
The last point I set out in the opening paragraph is something I’ve heard a lot and I’d like to comment on it. For a reminder, this is what I wrote: I plan on an epidural anyway, doulas are only for unmedicated homebirths.
Doulas are for everyone.
Let me say that again.
Doulas are for EVERY. ONE.
We are trained to help with any situation. You want an epidural? Bet. Let’s get you on that peanut ball and keep things rolling and get you some ice chips. You want an elective cesarean? Awesome, I have some great suggestions for how to get through that first poop and I know the hospitals in the area that will allow a clear drape and immediate skin to skin. You want a waterbirth? That’s amazing, I know the place for you. We have the resources and the training to get your best birth. Even if everything goes completely sideways, we will be there to emotionally support you and make sure that your voice is heard.
So you’ve made the choice to have a doula, that’s great! How do you find one? There’s a few ways. I would start with a google search. See if you like anybody that shows up in the search and set up a consultation. Ask your friends. Odds are someone has had an experience with doulas. But here’s the biggest tip I have: interview a few doulas. Check in with a couple of us. Make sure that you vibe with the person who will be supporting you through your labor and childbirth. I promise I won’t be offended if you tell me you’re meeting a few doulas. I just want you to have the best experience, because it is such a paradigm shift in your life. Make sure your doula is trained and certified with a reputable agency, and ask them questions.
I hope this information was helpful. I plan to write something up about postpartum doula work and how that works soon. I’m always available for any other questions!
by Lindsay Loring, sleep consultant
Congratulations on your new baby! You’ve navigated your fertility journey, nourished your body for 9-months and had a successful birth. You did it!
I wish I could tell you that the hard part is over!
But, try not to worry. As a certified pediatric sleep consultant and a Mama to twins, I’m here to tell you that it will get better and you will sleep again.
What to Expect
As a first time Mom to twins, I was blind-sided by the sheer exhaustion and anxiety I felt just moments after giving birth. To my dismay, those feelings did not go away; they only got worse. But that is my personal experience and everyone’s story looks different. I think it’s important to keep the discussion of postpartum depression open and honest. In addition, knowing the effects of sleep deprivation on PPD has fueled my passion for helping families get better sleep.
In the days and weeks after birth, your sole duty is to take care of yourself and your new child. Everything else can wait. Order food, ask family for help and let the laundry pile up. Take the time to bond with your child, but also, it’s okay if it doesn’t feel like a natural journey for you. Speaking from experience, it was actually quite hard to establish a bond with my daughters. But nearly 3-years later, we are closer than ever. Give yourself grace and time to heal. If you feel feelings that do not seem right to you, contact your OBGYN immediately.
Newborn sleep is erratic, and they need TONS of it. But that doesn’t mean you will be getting tons of sleep yourself. Their sleep periods are unpredictable and often their days and nights are confused. Which means, parties at 3AM for hours, and it will only take a few days for your sleep deprivation to set in. Knowing this, I want to talk about what you CAN do to optimize sleep for you and your baby.
But first, I want to always talk about safety.
You may remember setting up your baby registry, and within a day or less you were seeing advertisements for every baby contraption on the market claiming to “help your baby sleep through the night”. What we don’t know as first time parents is the misinformation and harm that some of these products can be responsible for. Graco Rock N’ Play is a prime example. They reported 32 infant deaths over a 7-year period related to the incline sleeper and its improper use.
Where can my baby sleep?
When sleeping unsupervised your baby must be in a sleep space designated as a “crib,” “bassinet,” or “playard” (more commonly known as a Pack n Play.) Be sure to look for these words when you’re shopping!
Products that sound similar or Add-ons that are marketed as amazing sleep miracles (like the Dock A Tot or the once popular Rock N Play) will be labeled as a sleeper and even be visually appealing in their ads. You will see a photo of a shabby chic nursery with eye appealing colors and trends, but if you look closer you will see things like, crib bumpers, incline sleepers, blankets, mobiles, pillows, etc. Be sure to check the fine print. If it’s not one of the 3 items mentioned above, it will clearly say on the product DO NOT USE WHILE UNSUPERVISED.
The AAP has made it simple when it comes to safe sleep. Just remember, ABC= Alone, back, crib or bassinet.
That means no bumpers, no blankets, pillows, loose clothing or stuffed animals. It’s actually quite hard to find photos of safe sleep environments on social media because it appears “cold” or “not inviting”. There is a reason this environment is recommend as pairing these environments with placing baby on their back has reduced SUIDS occurrences as much as 40%.
But hey, I wasn’t perfect. I made some questionable decisions because I was so tired. My husband had to sit me down one morning and make me promise I wouldn’t lay in bed with our 4-week old who was lost somewhere between my arm and my pillow. We vowed to make changes from that day forward, and at 9-weeks we had moved our twins into their room and at 14-weeks I felt comfortable with gentle sleep training.
How long do newborns sleep?
Your baby will sleep 15-18 hours in a 24-hour period. They will need to return to sleep after about 45-minutes to 1 hour. So realistically, your baby will wake, eat, have their diaper changed and be ready to sleep again.
Back is best
If you are wondering if a newborn can sleep on their side, the answer is No. Studies have found that the number one risk reduction factor in safe sleep is placing babies on their back to fall asleep. This should be done each time a baby is being put down for a nap or bedtime. Many babies do not prefer sleeping on their back, which can make this one of the most difficult safety guidelines for new parents to follow. Your baby is used to sleeping in the fetal position, likely on stomach or side while in utero, so sleeping on their back takes practice. The good news is swaddling helps this transition.
There are plenty of different swaddles on the market. My biggest piece of advice here is to be sure it fits very snug with arms down. A common misconception with the swaddle is parents think their baby hates it. Generally speaking, this happens when baby is over tired and parents are having a hard time triggering the calming reflex. Swaddling, in addition to white noise and jiggling can work to calm your fussy child. Transition your baby out of the swaddle at first signs of rolling.
Can my baby sleep in the carseat?
This is important! Yes, falling asleep in the car will happen. It mimics the womb and will soothe your baby almost instantly. Double check that your seat is properly installed, and the harnesses and straps are being used properly. Don’t add any aftermarket pillows or accessories to increase comfort because they could be hazardous.
However, taking the car seat out of your vehicle and placing it on a flat surface is not considered safe. It changes the angle at which your baby’s neck is positioned and can bring their chin too far forward to their chest, blocking their airway.
Want to bedshare?
I recommend using a co-sleeper bassinet that opens up to your bedside or use a crib with one side removed., that is side-cared to your bed. Place your baby in your bed for a feeding and then move them back to their own space to sleep.
How can I reduce risk?
You’ve told me a ton of things I can’t do…What can I do in the beginning?
My newborn guide is perfect for first and even second time parents. In the guide, I’ve laid out actionable techniques and things you can do to help soothe your baby and prioritize sleep. I tell you what to expect so that you aren’t constantly questioning what is going on, which in turn decreases your anxiety and your baby’s fussiness. Shop my newborn guide here.
In addition, the 5 S’s invented by Dr. Harvey Karp is where you want to start. When done right and with intention, you can calm your fussy baby and achieve sleep easier. Triggering your baby’s calming reflex is your end goal. The 5 S’s will help you do that.
The first 3 months of your child’s life will be full of ‘firsts’ and many sleepless nights, but it’s never too soon to create a routine and environment that is conducive to sleep. Implementing a quick bedtime routine along with the soothing techniques I mentioned above will help you lay a path to better sleep.
AUTHOR BIO: Lindsay Loring is a certified pediatric sleep consultant and owner of Tweet Dreamzz. Lindsay is certified through The Family Sleep Institute and has completed studies in baby and toddler sleep, as well as breastfeeding support and SIDS Awareness. You can find Lindsay providing expert sleep tips on her social media accounts and she hosts a FREE Q & A session every Friday.
Sleep is a passion of Lindsay's, and she truly believes it makes up the groundwork of a family's dynamic. Through her personalized coaching, Lindsay designs plans that will ensure the success of the child according to the family's goals. To learn more about Lindsay, visit her at: www.tweetdreamzz.com.
Considering the current climate around birth in this country, I wanted to write about something that may be deeply painful but needs to be addressed. A lot of birthing people are being asked to give birth alone, without their support system, or with their support system on a video chat or phone call. It is an absolutely heart-wrenching way to give birth, and I know this from experience.
When I had my daughter 2 years ago, my husband was waiting in the Middle East for a plane to fly home to us. He had left when I was 14 weeks pregnant, barely showing and only just getting over the nausea. He finally did arrive back home one week after my daughter was born. I do not write this for pity’s sake, but hopefully to encourage those people getting ready to give birth that do not know if their partner will be allowed to be with them. So I’m going to write about a few things that I went through in my pregnancy and birth experience that those people might be going through, and how I got through it all alone.
A lot of birthing people are being asked to give birth alone, without their support system, or with their support system on a video chat or phone call."
Like I said, my husband was gone by the time I was 14 weeks pregnant. Our situation was obviously different, but the lack of a partner is the lack of a partner. He was across the world, in a dangerous place, and I didn’t know if he would come home at all, let alone in time for me to give birth. I’ve heard from families that they’re facing the same kinds of issues during the pandemic. “The doctor’s office won’t let my husband into the room for ultrasounds.” “I don’t know if they’ll let him be at the birth.” My husband was not at any of my ultrasounds, of which there were many, except for the first “dating” ultrasound at 11 weeks. It is hard sitting in a room with people you don’t know, excited and giddy at the sight of your baby’s toes and nose and belly and having no one to share it with. The technicians were always willing to print extra photos, however, since they knew I was alone. So ask the technicians if they’ll print you some extra keepsake ultrasounds.
During your pregnancy, it is absolutely paramount that you educate yourself. You have to be the person in the room willing to ask questions of your doctors and midwives, because there is no one else there to advocate for you. Find your voice, educate yourself, and do not be afraid to ask the questions you need answered. I was much more assertive with my doctors and midwives during my third pregnancy than my second, because I had to be. If we’ve learned nothing else during these last few months, we’ve learned that we can do hard things. Take a childbirth education class, research every aspect of birth, hire a doula experienced with virtual work just in case, and be ready and open to talking with your providers.
Now, to the hardest part. Giving birth alone. It is not guaranteed at this moment that you will have to give birth alone without support. Most hospitals will allow you to have at least one support person there. But I encourage you to pre-mourn the experience you wanted. Acknowledge that times are different now, and while you can still have an absolutely beautiful empowered birth, there are things that may not be possible. Educating yourself helps here too. Know the questions to ask your providers if they come in and recommend things to ‘speed things along’. Research the policies of your birthing place to see what changes they’ve made during the pandemic. And recognize that you are doing an incredibly brave thing. Acknowledge the greatness and the beauty and the wonder in yourself that you are capable of giving birth alone if you must. And take a million photos. Video call your partner during labor if they can’t be with you. Enlist the help of your nurses and doctors and midwives. They feel the weight of this burden and want to help you lift it. When I gave birth to my daughter, the anesthesiologist held my phone with my husband on a video call throughout the entire surgery. He did not have to do that. The OB who delivered my daughter sat with me and patiently answered my questions about the surgery I was about to have, making sure I was an active part of the decision. The OR nurse found the perfect song to play on her personal phone so my daughter could be born to the sound of David Bowie. And they did this because I asked.
The same goes for after your wonderful baby is born. Take a million pictures, and enlist the help of your nurses. I gave birth at a baby friendly hospital with no nursery, and the nurses took turns holding my darling girl so I could sleep for a few hours in between nursing. I will be forever grateful for that.
It is not guaranteed at this moment that you will have to give birth alone without support."
I also want to touch on a topic that is not fully mine, but needs to be addressed. The guilt of the partner that misses it. It doesn’t have to be a partner that misses either. It could be a mother, a best friend, a sister. My husband has struggled with the guilt of missing his daughter’s birth for the last two years. It’s a hard thing to grapple with. So it’s important that we address the guilt and the grief a partner may be going through in this situation and remind them that it is not their fault in any way. There is nothing they could do or have done to make it this way. And maybe help them find a way to be there in other ways for the new baby, and for you. Help them brainstorm these ways now, so they do not feel they are left out. Something quite sweet that a friend of mine did for his wife was decorate the house when she brought their son home for the first time. He bought a special garland, put a sign in the yard, had fresh flowers waiting for her. Find a way to make that moment when they meet their child for the first time special. I had a onesie printed for my daughter to wear at the airport that said, “I’ve Waited My Whole Life To Meet You, Daddy,” and it made my husband cry (quite a big feat). Find these little special things to do, and make it better for them in the ways that you can.
Giving birth alone is one of the hardest things I’ve ever been through. And while it was lonely, I worked hard to make sure that I had a good experience, and I feel like I did. I also recognize that it pales in comparison to the situation at hand. Giving birth alone during the pandemic is a different beast, and I applaud anyone going into that situation. And my God, what a story you’ll have to tell your child.