Childbirth Companion

By Stephanie Hayes, CD(DONA), Childbirth Educator

Recently my daughter and I participated in a two-day first aid course.

“Sometimes, as a first aider, it may simply mean holding a hand. That may be the only care you can provide,” our instructor stated at the very beginning of the first day. “But know that it may also be the most important thing you will do for that person.”

Less than a week later, I happened to be at the scene of a tragic accident. As paramedics and fire fighters directed their attention and hopes to saving a life, I noticed an individual pacing the closed highway, anxiety written across his face. No one else was nearby at the moment, so I approached him to see how he was fairing. This was not the first time he had witnessed such an incident, and he commented that it didn’t get any easier to deal with. We chatted for a few minutes until he was needed elsewhere, but I will never forget his last words to me. “Thank you so much! You were a big help!”

When we envision providing first aid, our imaginations conjure up all types of emergent and traumatic scenarios and the various skills we will need to implement. But, despite the tragedy of the situation, none of my technical first aid training was of any use to that man. He had no physical injuries to which I could tend. I never even touched him, and yet somehow I had offered him something significant. All I had done was given him my undivided attention, compassion and reassurance, and an opportunity to express his pent-up anxiety.

As I mulled over this incident the following day, I began to see a correlation between my minute role at that scene and my work as a doula. Many times we feel that we need to use all the tricks in our bag when attending a birth, that if we don’t, we are in some way failing our profession and the women we serve. Studies show that when doulas attend births there is a lower rate of interventions, pain medication use, and caesareans. But, when a client ends up with a challenging birth or a surgical intervention, we often feel that we didn’t provide the type of care that was expected of us, as if we were single-handedly expected to uphold the stats. We fear that our client will be disappointed in us and lack appreciation for our profession, that it will be devalued in the eyes of those anticipating great outcomes. And yet, even in birth, sometimes the most important care we will provide is compassion, empathy, reassurance, and holding a hand.

In over a decade of attending births and teaching childbirth education, I have learned that the most important benefit that a doula provides is her continuous presence. Sometimes there is simply nothing we can do to alter the direction and outcome of a birth, but we can have a huge impact on the mother’s perspective and feelings regarding this experience that will impact the rest of her life. Our encouragement and reassurance can free her from undue feelings of guilt, disappointment, and failure. Our continuous presence can alleviate her sense of isolation, aloneness, and even abandonment. Holding her hand can provide her with an anchor and a sense of security in the midst of confusing circumstances and unknowns.

While there is so much we can offer to provide comfort to a labouring woman, I believe that meeting her emotional needs is paramount to her overall perception of her birth experience. While we often play an integral part in an awe-inspiring and even “perfect” birth, sometimes we might make “a nightmare experience bearable” or a high-intervention birth “magical”. Our goal should be to reduce as much negative impact as possible while promoting the positive, because we might be the only person to offer that mother a silver lining through which to view her birth. Might we go away from every birth knowing that, even in the small things, we were “a big help!”

By Stephanie Hayes, CD(DONA), Childbirth Educator - January 25, 2013

Thirteen years ago I gave birth to our son ten weeks prematurely. The time seems to have passed so quickly as the memories still seem as clear as if they had just occurred yesterday. Last year I began sharing my birth stories on my website as a means of letting others see beyond the professional doula that I am. While I am a strong proponent of the natural birth process, my experiences have enabled me to understand and appreciate the uniqueness of each birth. It may not always go according to plans and ideals, however, each one should be beautiful to the mother to whom it belongs. When a woman is well supported and respected, even a difficult, high-intervention birth can be viewed as “magical”, as one mom described her birth to me.

My ideals for birth were far from carried out the day I was induced at thirty weeks gestation. Who would want to suffer from seizures, be separated from her baby, or spend countless hours attached to a mechanical pump like a cow? And yet, I look back on the birth of my son with many very fond memories. I credit this in a huge way to the respect and good treatment that I received. Yes, there are things that I would like to do differently if I had the chance, but I am also thankful for expert medical care that was available to my son and me at this critical time. I am also thankful that, despite my need for medical intervention, the doctor was willing to honour my wishes, helping me to avoid an unnecessary cesarean. And I am very thankful for my one natural birth which maintained my confidence even when my body seemed to be failing me.

If I was to go through that experience again, I would certainly appreciate the option of having someone there to provide me with continuous one-on-one physical and emotional support. Having a doula there to reassure me and help ease my discomfort and pain would have been a huge comfort to my husband and me. If there is only one thing expectant parents do to prepare for labour and birth, I would encourage them to ensure that they have planned for more-than-adequate support. This is one of the most important times in your life and certainly worth investing in, perhaps even more than a graduation or a wedding. You will remember it, and you’ll want it to be beautiful!

If you have questions about doula options in the Gravenhurst, Muskoka, Parry Sound areas or how professional labour support would benefit you, please contact Stephanie for more information or to arrange a complimentary consultation.

By: Stephanie Hayes, CD(DONA), Childbirth Educator

I have been musing for some time on how to present the value of a doula to a society that enjoys many benefits of a free health care system. While much of the dilemma relates to misconceptions of a doula’s role and the lack of awareness of the proven benefits of continuous labour support, paying out of one’s own pocket for care not covered by government programs is a huge drawback to many parents. Over the years, we have seen cutbacks to many areas of health care. Still, a number of these additional costs are often covered through third party insurance which helps to relieve some pocketbooks.

Many professionals are feeling underpaid and undervalued and endeavouring to gain public support for their needs. Some are age-old professions feeling the stress of the economy. Others are a mix of old and new alternative health care options struggling to obtain equality and acceptance among society and their peers. Doula care, while a relatively new profession, provides an age-old service to the maternity world. Still, we are not government-funded and rarely covered by third party insurance. DONA International (www.dona.org) has been successful in implementing third party coverage of doulas in the United States. While this is still rare within Canada, doula clients are encouraged to approach their own insurance companies regarding coverage of doula care and childbirth education.

Studies have shown that the continuous care provided by a doula to a labouring woman reduces the need for many costly procedures and interventions which, in turn, could aid in reducing health care costs significantly. Yet we remain a highly overlooked profession on the obstetrical scene. The option and benefits of a doula are not readily passed between medical care providers and pregnant women. As a result, many remain unaware of this availability to them. Those who do learn of doulas often find the cost factor a drawback. It is not that doulas are actually expensive. Rather that there is a lack of understanding of what they actually do and how much time and energy they invest into each client. That understanding tends to come with the experience. When parents go through hours of labour with their doula (not to mention the hours of prenatal preparation, postpartum care, and breastfeeding support, plus phone and email conversations and traveling), they come away with different perspective on the dollar-value of a doula.

Most doulas have chosen this profession because they have a passion for assisting women in having the best birth experience possible. I, personally, chose this line of work because of the lack I felt in my own births for continuous emotional support, physical comfort, and information. Two of my five babies did not survive pregnancy, and two were born prematurely due to complications. My middle pregnancy and birth remained uncomplicated and relatively intervention-free. Out of these experiences was born the desire to assist other women as they embark on their own journey to motherhood, to help them achieve a positive experience regardless of the type of birth they may have. I see this as an opportunity God has given me to minister other women and their families.

So, what does a doula actually offer that sets her role apart from other birth professionals? Perhaps I should clarify that a doula is not a clinical care provider. While she possesses knowledge and education regarding the process of birth, medical pain management, and many other procedures and interventions common to modern birth, medical practice is not a part of the care that she provides. Instead her focus is on assisting women to discover and obtain information that can aid them in making informed choices during pregnancy and birth. She meets with them, often in the comfort of their own home, to help them prepare for childbirth. She is a constant presence for them throughout labour, a familiar face that doesn’t change with shifts and call schedules, and an advocate for their wishes. During this time she continues to provide reassurance, encouragement, and physical comfort through numerous natural techniques. She offers breastfeeding education and assistance, and follows up with visits after the baby’s birth. In the hours that a doula spends with parents over the weeks and months of pregnancy, a connection is made that provides comfort and reassurance to them when labour begins.

Doulas realize that there are many different factors that come into play when connecting with women in need of labour support. There are those who, while realizing how valuable doula care is to them, truly cannot find it financially feasible. Others may have special needs or circumstances which are not easily served by just any doula. It is important for a woman to be matched to a doula with whom she feels comfortable and well-suited. Regardless of the situation, a doula endeavours to ensure that every woman who wants a doula can have one. This is often challenging, but it is why many doulas volunteer or offer another financial solution.

Doula fees are as varied as the doulas themselves and the areas that they serve. Rural Canadian doulas are near the bottom of the scale compared to their urban or American counterparts. While a new city doula may start out by charging $500, even experienced doulas in the Muskoka region, where I currently live, rarely exceed that for a complete birth package. At this rate, if I devote 30 hours to a client for her birth, prenatal & postpartum visits, phone/email communication, and office work (research, writing the birth story, etc), then after traveling, and other expenses, I may be lucky to clear the minimum wage. This is being generous. Doulas usually begin care early in labour and can often spend more than 15 hours at her client’s birth. Some may offer more prenatal or postpartum care. Others must pay for childcare for their own young families while they are attending a birth. Regardless of the diversity, doulas are committed to caring for their clients and often go to great lengths to ensure that they receive the support that every woman deserves during birth.

If you would like another perspective on the value of a doula, I’d encourage you to read this blog from one of our American counterparts. (http://www.bigbellyservices.com/doula%20fees%20detail.htm) I found her perspective quite insightful. Hiring a doula could be one of the best investments you make. The more clients who are able and willing to pay a realistic fee are also giving back to their community by enabling her to provide care to those who are less privileged. As Dr. John Kennell said, “If a doula were a drug, it would unethical not to use it.” Let’s change the face of maternity care. Value the doula!

As I sit here tallying homeschool grades that need to be submitted by the end of the week, I am acutely aware of how quickly time passes. It wasn’t that long ago that my teenagers were just babies, and these days of high school and summer jobs weren’t even a blip in my thoughts of the future. Now, as I live them, I often wonder where the day went as I compare my aspirations with what actually was successfully eliminated from my daytimer.

When I consider what fills my life these days, it is not diapers and naps and breastfeeding, or frantically searching for my young daughter when she spontaneously decided to visit our friendly neighbour for cookies. Nor is it teaching my 5 year-old to ride a bike without training wheels, or begging God for patience as I go over the process of long division with a child for the one hundredth time in the same lesson. (What better way to gain appreciation for one’s own mother!) I still require patience on a daily basis, and there are still many teachable moments – life is full of those, but the daily events surrounding these lessons look quite different than when my children were little people.

As I ponder my daily activities, there is a reason why my kids know that the first place to look for me is in the office. Aside from the many responsibilities related to administrating our home life and our children’s education, much of my work as a doula also occurs in this room. It is here that I do research and paperwork, document birth stories, reply to emails, and connect with the birthing community not only locally, but even worldwide thanks to the internet and social media. My work goes far beyond simply attending births and cuddling new babies. It occurs in the home and encompasses community events and organizations. It involves sharing information to raise awareness about birth options and the role of a doula. It encourages women to take ownership of their births, and to empower themselves to make choices that reflect good information and their personal desires. It’s about re-educating our society in its view of modern birth and restoring a trust in the natural process. It goes into the realm of labour to provide reassurance, physical comfort, and support. And the believing in a woman is paramount while being there for her as she navigates through her individual journey of motherhood.

Doula work covers such a broad spectrum that it is no wonder my day is easily absorbed by an enlightening article or in searching for a new video clip to add to my Facebook page. Or that I become engrossed in responding to a birth or breastfeeding question, visiting a client, or attending an organizational meeting within the Muskoka communities. And then, of course, there are always the births. Momentous occasions that invariably play havoc with a well-planned schedule because babies come in their own time. And there again we move full circle to that one life-riveting word – TIME.

By Stephanie Hayes, CD(DONA)

(Originally published in WHAT'S UP Muskoka - May 2, 2012)

When my journey to motherhood began a number of years ago, I embraced it, with confidence in the natural process of birth. Yet as I navigated through three very different labours, I discovered how much I would have benefited from the constant presence of a birth-wise woman. Though I had my caring husband by my side, many times, as a nurse entered the room, I wished she could remain. Her presence and experience strengthened and comforted me in a reassuring way.

At one time in our not so distant history, birth was quite different from how it appears today. Most babies were born at home, with their mothers surrounded and supported by family and community women. Their wisdom came from years of childbearing experience and attending others’ births. Even in our modern society, this one thing remains constant: birthing women benefit from the continuous care of other women.

Commonly, the role of “mothering the mother” is filled by midwives and nurses. However, as workplace pressures and medical responsibilities require more of their time and attention, they often appreciate assistance in providing this support. Now we are seeing the age-old art of women caring for women being revived in the modern form of a doula.

The term doula (doo-lah) is a Greek word which has come to describe women, trained and experienced in childbirth, who provide non-medical care to labouring women throughout their birthing experiences. The presence and support of a doula has been repeatedly proven in numerous studies to reduce the incidence of interventions, caesareans, and the use of pain medication. Labours were reported to be somewhat shorter, and women expressed greater satisfaction with their births, with less likelihood of postpartum depression. Bonding between mothers and babies appeared enhanced, with breastfeeding more successful. (Visit www.dona.org and www.childbirthconnection.org for more information on these studies.)

Typically a doula will meet with the mother or couple prenatally, enabling them to get to know her and to explore their birth options and resources. She works in conjunction with midwives and doctors, within the chosen birth location of home, hospital or birth centre. She respects the intimate connection between a couple and encourages them in making informed choices for their birth. Throughout labour the doula provides a continuous presence and support, remaining constant through shift changes, often arriving in early labour before the attendance of the medical care provider may be required. She offers reassurance and assistance with techniques that can aid in labour progress and comfort to the mother. After the baby’s arrival, a doula also provides guidance with breastfeeding as well as postpartum support. This continuous woman-to-woman care can empower the birthing woman and enhance her transition into the mothering role.

Stephanie Hayes is a Certified Doula through DONA International and trained in childbirth education and breastfeeding support.  She resides with her family in the Gravenhurst area and provides care to Muskoka families.