Category Archives: Natural Birth

Exploring Your Options Series

The focus of my doula business is to help birthing families know what their options are.

For this reason I’ve decided to write a series of posts about how to make informed decisions and what different options there are.

There was a study done in the 60s and 70s to evaluate the factors that influenced a woman’s level of satisfaction in her childbirth experience. In the study, women rated their level of satisfaction, filled out a questionnaire, and related their childbirth experience. Then home water birth, opiefoto.com15 to 20 years later the researchers followed up with these same women. What they found was that women remembered the details of their childbirth experiences very vividly and felt the same emotional intensity several years later. The research showed that the thing that made the difference in the level of satisfaction was whether a woman felt like she had a say in the care she received. Women who had a say in the decision making process reported to have the highest level of satisfaction in her childbirth experience. This is one reason why I believe women need to feel empowered and supported in making informed decisions for their care.

The first thing I would like to talk about is making decisions about your care. This formula is not just for pregnancy and birth. It can be applied to any situation where medical decisions need to be made. Think of the acronym “BRAIN”.

“BRAIN”

  • B – Benefits?
  • R – Risks?
  • A – Alternatives?
  • I – Intuition? (How do I feel about this?) Prayer.
  • N – Not now, but wait?

Take time to discuss. Ask your care provider and/or nurse to give you a moment to discuss your options. Very rarely do decisions need to be made so quickly that you do not have time to ask questions and discuss it privately. In the event of a time sensitive

Midwife - careprovideremergency ask for 1 minute alone to discuss it, if a minute is too long, ask for 30 seconds.  In a situation before the birth, you can get a second opinion. If you aren’t comfortable with what your care provider is telling you, you can change care providers. Don’t be afraid to fire your care provider. They work for you and you can find another one who you are more comfortable with and will honor your wishes. During your birth you can ask for another nurse, if you don’t feel supported by the one assigned to you.

More in depth questions you can ask your care provider:

As you ask questions about your care, you will become a responsible consumer and will gain greater satisfaction in your childbirth experience.

 

When a test is suggested:

  1. Why should I have the test? What problem are we looking for?
  2. What will the test tell us? How accurate are the results?
  3. What are the risks/side-effects of the test?
  4. If the test detects a problem, what will happen next?
  5. What is the cost of the test?

When a treatment or intervention is suggested:

  1. What is the problem? Why is it a problem? How serious is it? How urgent is it that we begin treatment?
  2. Describe the treatment: How is it done? How likely is it to detect or solve the problem?
  3. If it does not succeed, what are the next steps?
  4. What are the risks or side-effects to the treatment?
  5. Are there any alternatives (including waiting or doing nothing?)
  6. Ask questions b,c, and d about any alternatives.
  7. What is the cost?

–adapted by Kristi F. Ridd (originated by Penny Simkin)

Coming up we’ll talk about choosing a care provider, the pros and cons of different care providers, choosing a birth place, and a doula.

Photos take by opiefoto at the birth of my 3rd child.

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Birth Declaration by Babies & Bellies

I thought this declaration was wonderful. It describes much of how I feel about how I feel about birth.  CLICK HERE to read the entire declaration

excerpt from declaration:

“Birth, more than any other experience, has the potential to transform the world. It is time that we support women in experiencing birth as a peaceful, positive, and powerful event.

Birth has the potential to be the most powerful driving force on the planet. The healing of birth will surely change the world.

We must reframe the way we conceptualize birth. We must share this wisdom with the world.

Birth is something to be embraced—not controlled.

Birth is something to be welcomed—not dreaded.

Birth is something to be loved—not feared.”

 

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Dads and Doulas

Dad supporting mom opiefoto.comSometimes I hear about a dad not wanting a doula at the birth because he feels as though the doula would take over his role as the birth partner.  Penny Simkin, an author, physical therapist and childbirth educator since 1968, has written a paper dispelling the myths about dads and doulas. Following is the text of this paper.  I have also included some links about how some dads feel about doulas.

Myths About Dads and Doulas
by Penny Simkin, P.T.

Myth 1 – If a woman has her partner, the doula becomes redundant.

Reality – The doula may be the only person at the labor besides the partner who is there solely for the emotional well-being of the woman. The nurse, the doctor, the midwife have other priorities that compete with the emotional care of the woman: for example, breaks, shift changes, clinical responsibilities, office hours and hospital policies. The doula has few or no other priorities. She stays through shift changes, and until after the baby is born. She is not just another stranger with the couple. She has the woman’s needs as her sole priority. In some cases, the couple will bring several other friends or family members into labor with them. Sometimes these people can be uncertain of how to help which leads to confusion and actually adds to the woman’s stress. The doula can direct and coordinate the efforts of a group of people, giving them all some-thing useful to do, so they work as a team on the woman’s behalf.Dad supporting mom by opiefoto.com

Myth 2 – The doula “takes over”, displacing the partner and interferes with their intimate experience.

Reality – The doula can actually bring the couple closer. By making sure that the partner’s needs are met (food, drink, occasional back rubs, and reassurance), the woman and partner can work more closely together. The doula allows for the partner to participate at his own comfort level. Some partners prefer to be there only to witness the birth of their child and to share this experience with the woman they love. They may not want to play an active role and do not want to be responsible for the woman’s comfort and emotional security. The doula can fill in and allow the partner to participate as he wishes, without leaving the woman’s needs unmet. When the partner chooses to be the major source of emotional support, the doula can supplement his or her efforts by running errands, making suggestions for comfort measures, and offering words of reassurance and comfort. During a long tiring labor, she can give the partner a break for a brief rest or change of scene. While the doula probably knows more than the partner about birth, hospitals, and maternity care, the partner knows more about the woman’s personality, likes and dislikes, and needs. Moreover, he loves the woman more than anyone else there. The combined contributions of partner and doula, along with a competent, considerate and caring staff gives the woman the best chance of an optimal outcome.

Myth 3 – The doula has her own beliefs about how the birth should go, and imposes it on the woman or couple.

Dad holding baby by opiefoto.com

Reality – The doula’s true agenda is to help ensure that the woman’s or couple’s agenda is acknowledged and followed as much as possible. If the doula is thoroughly familiar with the couple’s wishes and their birth plan, she may actually think more about it than the couple, especially when labor is intense and things are happening rapidly. The doula can remind the staff or the couple of some items on the birth plan that are forgotten, but which later might be important. Sometimes if a birth plan is not followed, the couple later look back with regret or disappointment. The doula helps with decision-making by asking questions that will ensure that the right information is given to the woman or couple so that they can make an informed decision. She may also suggest alternatives for the couple to consider. She does not, however, make decisions for the couple.

In summary, the doula helps make the birth experience to be as rewarding and satisfying as possible. As one father said, “I heaved a big sigh of relief when she (the doula) walked in. I hadn’t realized how much pressure I had been feeling. She not only calmed my wife, she calmed me down.”

Penny Simkin, PT, is a physical therapist who has specialized in childbirth education since 1968. Among her books are Pregnancy, Childbirth and the Newborn: The Complete Guide, now in its third edition, The Birth Partner: Everything You Need to Know to Help a Woman Through Childbirth, Episiotomy and the Second Stage of Labor, and most recently,The Labor Progress Handbook: Primary Interventions to Prevent and Treat Dystocia, with Ruth Ancheta. She has written chapters for three major medical textbooks, and a series of materials on pain medications and comfort measures for childbirth has recently been published by Childbirth Graphics.

Currently, Ms. Simkin serves on several boards of consultants and editorial boards, including the journal, Birth: Issues in Perinatal Care; the International Childbirth Education Association; and the Seattle Midwifery School, where she also teaches. She is a founder of the Pacific Association for Labor Support (PALS), Doulas of North America (DONA), and trains doulas and doula trainers. Her practice consists of childbirth education, birth counseling, and labor support, combined with a busy schedule of conferences and workshops.
Copyright 1999 Penny Simkin.

What Some Dads are Saying About Doulas

http://www.bloomspokane.com/2009/07/05/hiring-a-doula-a-husbands-perspective/
http://pregnancy.about.com/od/doula1/a/dads-and-doulas.htm
http://daddyconfidential.com/2012/parenting/i-challenge-you-to-a-doula/
http://www.evolutionofdad.com/a-dads-experience-with-a-doula

Photos

Taken by: opiefoto.com at the home birth of my 3rd child.

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