WHATZADOULA!

What is a Doula?
Birth Doula
Women have complex needs during childbirth. In addition to the safety of modern obstetrical care, and the love and companionship provided by their partners, women need consistent, continuous reassurance, comfort, encouragement and respect. They need individualized care based on their circumstances and preferences. The role of the birth doula encompasses the non-clinical aspects of care during childbirth.
The doula’s role is to provide physical and emotional support and assistance in gathering information for women and their partners during labor and birth. The doula offers help and advice on comfort measures such as breathing, relaxation, movement and positioning. She also assists the woman and her partner to become informed about the course of their labor and their options. Perhaps the most crucial role of the doula is providing continuous emotional reassurance and comfort.
Postpartum Doula
Postpartum Doulas are trained in postpartum adjustment, new born characteristics, care feeding and development and promotion of parent-infant bonding. They are experienced in supporting families through their postpartum experience. Coming into the home during the fourth trimester (12 weeks following birth). The doula’s role is to provide education, non-judgmental support and companionship; and to assist with newborn care and family adjustment and household organization (including meal preparation, laundry and other light household tasks). Postpartum doulas offer evidence-based information on infant feeding, emotional and physical recovery from birth, infant soothing and coping skills new parents and can make appropriate referrals and suggestions when necessary.
The Doula’s goal is to facilitate the transition to parenthood by supplying reliable and factual information, reassurance and hands-on support with children and household organization. The non-medical support of a doula meets the practical and psycho-social needs of the family and allows doula’s to make referrals to quality care providers such as lactation consultants, pediatricians, counselors and support groups when appropriate.

Excerpted and adapted from DONA International Position Papers. www.dona.org

FAQ's

What does the word doula mean? The word “doula” comes from the ancient Greek, meaning “Woman’s servant.”
What effect does a doula have on birth outcomes? Tends to… result in shorter labors and fewer complications, reduce negative feelings about childbirth experience, and reduce need for labor inducing drugs, forceps or vacuum extraction. Reduces requests for pain medication, epidurals and the incidence of cesarean sections.
What effect does a doula have on mother? Women reported greater satisfaction with their birth experience, more positive assessments of their babies, fewer cesareans and medical interventions, and less postpartum depression.
What effect does a doula have on baby? Studies have shown that babies born with doulas present have shorter hospital stays with fewer admissions to special care nurseries, breastfeed more easily and have more affectionate mothers in postpartum period.
Does a doula replace medical staff? NO. A doula does not replace the nurses or other medical staff. Doulas do not perform clinical tasks such as blood pressure or temperature, monitoring fetal heart rate, doing vaginal exams or provide postpartum care. They are there to comfort and support the mother and to enhance communication between the mother, her support team and the medical professionals.
Will a doula make decisions on my behalf? No, a doula will not make decisions for clients or intervene with clinical care. She provides informational and emotional support, while respecting the families’ decisions.
Will a doula make my partner feel unnecessary? No, a doula is there to support both the mother and her partner and plays a crucial role in helping the partner become involved in the birth and newborn care to the extent he/she feels comfortable.
What is the difference between a birth and postpartum doula? A birth doula is a woman trained in childbirth who provides physical and emotional support during labor birth and the immediate postpartum period. A postpartum doula is a woman trained to care for the new family in the first weeks after birth providing household help, advice with newborn care, infant feeding and emotional support.
What are the benefits of having a postpartum doula? Some of the benefits include: increased success with breastfeeding, less chance of postpartum depression, less maternal exhaustion and frustration, greater understanding of newborn emotional, physical needs and behaviors.
Is it possible to have a non-medicated birth in a hospital? Absolutely, your body is designed to give birth. While there are many medical advances in the area of pain control there are also many options for non-medicated pain control. Most hospitals and physicians are quite respectful of your wishes as long as there are no complications that could endanger you or your baby. If you have any questions as to what your hospital or physician will allow; call them and ask.
What if I am considering pain medications? A doula is there to support the laboring woman with any decisions she makes and to help ensure a safe and satisfying birth as she defines it. She still needs continuous support even with pain medications. The doula can give dad/partner a break to go get something to eat or to take a nap if it's been a particularly long labor. She can take pictures, get ice-chips, do hand massage or just sit quietly while the woman rests.
Are most doulas licensed? At this time no license is available. There are a couple of nationally recognized organizations that offer certifications. Doulas of North America www.dona.org and Childbirth and Postpartum Professional Association www.cappa.net. Some doulas choose not to certify, I am currently working towards certification with DONA.
What does a doula cost? Cost varies from area to area and doula to doula. It is usually based on experience and the market. I am willing to barter, set up a sliding scale, and a payment plan. Do not allow money to keep you from looking into doula service.
When will I see a doula I have hired? You will see me at least twice for prenatal visits. As soon as labor begins I will meet you at your home and we will determine if it is time to transition to the hospital. I will stay with you through labor, delivery and up to two hours after the birth. You will see me again once in the hospital and for a minimum of 6 hours postpartum once you have gone home.
Are there any books that I should read? One of the most important parts of a successful birth and postpartum experience is being educated on what is happening to your body, your life and your baby. I suggest the following books:
Birthing From Within by Pam England
The Birth Partner by Penny Simkin
Ina May’s Guide to Child Birth by Ina May Gaskins
Mind Over Labor by Carl Jones, Marian Thomson, & emit Miller
Pregnancy, Childbirth and the Newborn by Simkin, Whalley and Keppler
The Baby Book by Drs. William and Martha Sears
The Breastfeeding Book by Drs. William and Martha Sears
Your Amazing Newborn by Klaus and Klaus
The Ultimate Breastfeeding Book of Answers by Dr. Jack Newman

Tuesday, April 15, 2008

3 Reasons Babywearing Reduces SIDS

3 REASONS BABYWEARING REDUCES SIDS
If SIDS is basically a disorder of respiratory control and neurological immaturity (and I believe it is), anything that can help a baby's neurological system mature overall will lower the risk of SIDS. That's exactly what babywearing does.
While wearing our own babies, I noticed how my breathing affected theirs, especially when I was sitting still with a sleeping baby nestled in a sling against my chest. Whenever I took a deep breath, so did baby. Sometimes the stimulus was the rise and fall of my chest, at other times the air exhaled from my mouth and nose against baby's scalp or cheek-stimulated baby to take a deep breath.
Have you ever wondered why mothers in other cultures have for centuries worn their babies in homemade slings? I used to believe this old custom's purpose was simply to protect babies from jungle dangers or to enable mothers to do manual labor. Wrong! When I was researching parenting styles in other cultures, I interviewed African mothers who wore their babies in slings that were extensions of their clothing. They agreed that babywearing protected their infants from dangers, but that wasn't the main reason for doing it. Instead, they said, "It makes life easier for the mother," or "It does good things for babies." "What good things?" I inquired. These mothers replied, "The babies seem happier," or "They cry less," or "They seem more content," or "The babies grow better."
Note: these observations were not from mothers who attended parenting classes, read books on baby bonding, or relied on scientific studies. These were mothers whose "sources" were their own powers of keen observation and centuries of tradition, both of which told them babies thrive better when carried in slings. Now, modern researchers have scientifically proven what these intuitive mothers have long known: Something good happens to babies who spend a lot of time nestled close to nurturing caregivers. Here's why.
1. Babywearing gives a vestibular connection. Babywearing exerts a regulatory effect on the baby, primarily through the vestibular system. This tiny system, located behind each ear, controls baby's sense of internal balance. It is as if there are three tiny carpenter levels back there—one tracking side- to-side motion, another for up-and-down motion, and a third for back-and-forth motion—all functioning together to keep the body in balance. Every time the baby moves, the fluid in these "levels" moves against tiny hair-like filaments that vibrate, which sends messages to the brain to help baby balance her body.
In the womb, the baby's very sensitive vestibular system is constantly stimulated because a fetus experiences almost continuous motion. Babywearing provides the same kind of three-dimensional stimulation and "reminds" the baby of the motion and balance he enjoyed in the womb. The rhythm of the mother's walk, which baby got so used to in the womb, is experienced again in the "outside womb" during babywearing.
Activities such as rocking and carrying stimulate the baby's vestibular system. Vestibular stimulation is a recently appreciated tool for helping babies breath and grow better, especially premature infants—those at highest risk of SIDS. Some studies showed premature babies placed on professionally-monitored, oscillating waterbeds grew better and had fewer apnea episodes than other preemies did (although one study disputed this.) Babies themselves recognize that they need vestibular stimulation; infants deprived of adequate vestibular stimulation often attempt to put themselves into motion on their own, with less efficient movements, such as self-rocking. Researchers believe that vestibular stimulation has a regulating effect on an infant's overall physiology and motor development.
Kangaroo care. Newborn nurseries have recently begun using a method of vestibular stimulation called "kangaroo care," in which a premature baby is wrapped, skin-to-skin, up against the mother's or father's chest. The parent rocks, holds, and gently moves with the baby. The rocking motion, the skin contact, and the rhythmic motion of the parent's chest during breathing produces the following beneficial effects:Babies show:
More stable heart rates
More even breathing
Fewer episodes of periodic breathing
Fewer and shorter episodes of apnea
A healthier level of oxygen in their blood
Faster growth
Less crying and increased time in the state of quiet alertness
Better sleeping
Researchers believe that using kangaroo care helps the parent act as a regulator of baby's physiology, including reminding the baby to breathe. In other experiments, infants with breathing difficulties were placed next to a teddy bear stuffed with a mechanism that seemed to "breathe"; these babies also had fewer apnea episodes. When this "breakthrough" in teddy technology hit the newspapers, a reader wrote in, "Why not use the real mother?"
Back to top
SIDS Stories
As an example of how closeness regulates a baby's breathing, a mother shared the following story with me: "My baby was born four weeks premature at five pounds, fifteen ounces. I held her all day long and never put her in a bassinet. She breastfed well. She seemed perfectly healthy, pink, and breathed normally. The evening the pediatrician came to check her, she took her into the nursery and put her in a bassinet. As soon as our baby was lying in the bassinet alone she had a stop-breathing episode, which alarmed the neonatologists, and she was put into intensive care for nine days. They never found out why she had apneic episodes, although they thought it was due to a 'slight seizure disorder.' All they had to do was touch her and she would start breathing again. She never had any stop-breathing episodes when she was in my arms, only when she was lying alone. The doctors told me she was a prime candidate for SIDS. They convinced me that she needed to be on an infant monitor at home. I agreed, but it turned out to be a nightmare for our whole family. They told me not to put her in my bed, so she slept alone with the monitor. The monitor went off all night long, probably from false alarms, and no one got any sleep. I left her on the monitor but put her next to me in bed. We both slept wonderfully, and the monitor alarm never sounded. I strongly feel that my presence stimulated her to breathe until she outgrew her stop-breathing tendencies. My touch and closeness to her was all she needed. In fact, while she was in my arms, all day long, in the hospital no one ever knew she had a 'breathing problem.'"
2. Motion regulates babies. Motion calms babies. Carried infants show a heightened level of quiet alertness, the behavioral state in which infants best interact with and learn from their environment. Researchers believe that during the state of quiet alertness, the child's whole physiological system works better.
3. Carried babies cry less. Parents in my practice commonly report, "As long as I wear her, she's content!" Parents of fussy babies who try babywearing relate that their baby seems to forget to fuss. This is more than just my own impression. In 1986, a team of pediatricians in Montreal reported on a study of ninety-nine mother-infant pairs, half of whom were assigned to a group which was asked to carry their babies for at least three extra hours a day and were provided with baby carriers. The parents in this group were encouraged to carry their infants throughout the day regardless of the state of the infant, not just in response to crying or fussing, although the usual practice in Western society is to pick up and carry the baby only after the crying has started. In the control, or non-carried group, parents were not given any specific instructions about carrying. After six weeks, the infants who received supplemental carrying cried and fussed 43 percent less than the non-carried group. Anthropologists who travel throughout the world studying infant-care practices in other cultures agree that infants in babywearing cultures cry much less. In Western culture we measure a baby's crying in hours per day, but in other cultures, crying is measured in minutes. We have been led to believe that it is "normal" for babies to cry a lot, but in other cultures this is not accepted as the norm. In these cultures, babies are normally "up" in arms and are put down only to sleep—next to the mother. When the parent must attend to her own needs, the baby is in someone else's arms.
In addition to the physiological effects of vestibular stimulation, there appear to be psychological benefits. Sling babies seem to show a feeling of rightness, enabling them to adapt to all that is unfamiliar about the world to which they are now exposed, lessening their anxiety and need to fuss. As baby senses mother's rhythmic breathing while worn tummy-to-tummy and chest-to-chest, the babywearing mother acts as a regulator of her infant's biology

No comments: