March 2015

Vol u m e 1 , I s s u e 1

M OTHER S L OVE
A Mothers Dream, Serving Wayne & Ontario County
www.carlywigmoredoula.weebly.com carlywigmoredoula@gmail.com 215.450.3100

What is a Doula?

Inside This Issue

By Carly Wigmore

What is a Doula?
Navigating Natural Birth in a Hospital Setting
Primitive Labor
Upcoming Events

Doula; a term that comes from the ancient

Greek meaning "a woman who serves or woman
caregiver" and is modernly known as a physical
and emotional support person professionally
trained to assist before, during and after
childbirth. A doula provides physical and
emotional support primarily to the mother, but
also to the spouse and family involved in the
birth. Two types of doulas are birth doulas and
postpartum doulas. However, there are many
other doulas, branching out to more specific
areas in childbirth such as stillbirth and many
more evolving.
A birth doula assists throughout prelabor, active labor and delivery. A doulas support
merges from emotional and other nonmedical
physical aspects. Before labor a doula will help
answer any questions, develop a birth plan, help
her client to alleviate fears and essentially
prepare the mother and family for their new
arrival. During labor a doula will assist with
laboring positions, finding ways to keep the
mother comfortable and calm, guiding the
spouse and other companions in how to support
the laboring mother. A doula will always help to
follow the birth plan as long as it doesnt
interfere with doctors protocols. Birth is very
unpredictable. Everything may not always go as
planned. A doula can reassure a worried mother

Every mother is entitled to

have a doula present for her
labor, delivery and
postpartum experience
There is always the right
doula for the right mother.

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2
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with guidance through physical measures

(massages, laboring positions, etc.) and
knowledge. Many physicians arent trained to
explain each step to the patient and some may
not understand all the terminology used. This is
where a doula can be very insightful.
The first few days and weeks home from
the hospital can be very difficult physically and
emotionally. A postpartum doula is trained to help
the mother and family at this time with the
recovery from birth and basic newborn care. The
mother may have a hard time physically,
especially if she had a cesarean section delivery;
a doula can assist with chores around the house
as well as helping the recovering mother feel
comfortable with her new baby. A doula is a
listener, a resource, a companion and so much
more. Doulas are led by the clients needs. In one
situation, a postpartum doula may show up and
sit to listen to the mother, guide her with
breastfeeding positions and maybe cook her a
few meals. Another client may need to seek
additional therapy because of postpartum
depression or psychosis. A doula can refer her to
the correct resources. Doulas are not nannies,
babysitters, house cleaners but can be all of that
in some ways, and so much more. Doulas have a
passion for the mothers well-being and will go
above and beyond to meet her needs as well as
those of the new baby.
The benefits of hiring a doula are endless.
Statistics show the decreased rate of cesarean
deliveries when doulas are present. Evidence
based studies also show the rising rates of
successful, satisfied births and breastfeeding
experiences. Every mother is entitled to have a
doula present for her labor, delivery and
postpartum experience. This doesnt matter if she

Page 2
Navigating Natural
Birth in a Hospital
Setting
By Jennifer Orcutt, MS CNM

Many women choose to give birth in hospitals for

a variety of reasons. In some areas of the
country access to freestanding birth center is
limited. Some states restrict home birth. For
other women they may have medical or
obstetrical issues that put them at higher risk
and they are unable to birth at home. Lastly
some women are hoping for a natural process
but are not comfortable with an out of hospital
birth.
Historically hospitals have a reputation of
being interventional. Much of the use of
intervention is based on a culture of fear (of
litigation, poor outcomes etc). Women deciding
to have a hospital birth need to understand they
always have choices and the right to say no.
Examples of customary interventions include;
Saline lock or IV
A saline lock is often placed at time of admission
as a standard order. A reason given is that it
easier to insert while in early labor then when
needed later in an event of an emergency. A
saline lock is used for administration of pain
medications, blood products, antibiotics and IV
fluids. Intravenous fluids are commonly ordered
along with a saline lock. There are some
reasons why a saline lock is needed. For
example if antibiotics are necessary for coverage
of Group B Strep or for induction of labor for
conditions such as preeclampsia. However for
healthy women in spontaneous labor, IV access
is not mandatory. Women have the ability to say
no to this usual procedure.
Continuous external fetal monitoring
Although many years of research has not shown
any benefit to continuous fetal monitoring it is
still widely utilized. In fact studies have revealed
that this practice has increased the number of
cesarean sections without improving outcomes.
Continuous fetal monitoring limits a laboring
womans ability to move and change position
freely and use such therapies as birthing balls
and water immersion. Intermittent fetal
monitoring is safe and supported by all
obstetrical professional organizations. After a
period of initial evaluation, it is ok to ask to be
taken off the monitor and have your nurse
intermittently monitor your baby. . Exceptions to

Mothers Love

intermittent monitoring are if Pitocin is being

administered for induction of labor or with
epidural analgesia.
For women choosing hospital birth it is
important to find a provider that they are not
only comfortable with but also share their
same values regarding pregnancy and birth.
While many men and women will research
statistics on new cars or appliances they do
not put in the same effort in looking for
practitioners that mirror their beliefs. Ask
your providers their opinion on issues such as
IV access, artificial rupture of membranes,
delayed cord clamping and fetal monitoring.
When you find that ideal provider, develop a
birth plan that incorporates all your wishes
and desires for your birth process. Make sure
you review it with your provider well before
your due date so that he or she is aware of
your desires. Also have a copy placed in your
record and bring an extra with you to the
hospital for the nurses to review.
Most hospitals allow tours of their labor and
delivery unit. This is beneficial because it
allows new parents the ability to speak with
nurses about labor support and hospital
policies. Ask about rooming in, C-section rates
and breastfeeding support.
It is recommended that new parents take
childbirth preparation classes. Many hospitals
offer these educational classes but the
curriculum may have little emphasis on
physiological birth or non-medical measures
for working through labor. If there are classes
available for those that focus on breathing
techniques such as; Hypno-birthing or the
Bradley Method.
Lastly hire a doula. This is especially
important if the closest hospital is a large
teaching facility where interventions are
frequently used. The use of doula has been
shown to reduce the number of interventions
and the risk of operative birth. Family
members can be very supportive but
frequently will become upset seeing laboring
women in pain, even if they innately
understand it is a normal process. Doulas
have training in labor support and comfort
measures. They can also act as advocate for
you when you are feeling vulnerable in
advanced labor. If you do not think you can
afford a doula there may be a doula co-op in

Mothers Love

Page 3

Primitive Labor
By Kimberly Henderson, LPN, Birth Doula
I was recently reminded by a birth I attended, as a
friend and doula, about the importance of privacy
and helping a woman disconnect from her
neocortex and tap into her primitive brain during
labor and birth. Labor is a complex dance of
hormones, a woman's hopes, fears, past abuse,
present love, excitement, anxiety and the sexual
nature of letting her sexual organs open and
expand to their full capacity.
When I am invited to attend a birth, I consider how
my presence will affect the birthing mother. If I
don't feel like we have a level of intimacy and trust,
I might not attend the birth. Like the conception,
birth requires a level of safety, intimacy and
privacy for things to go smoothly that we don't
often see in this culture. Unfortunately the modern
hospital is not evolved enough to create the kind of
intimacy and privacy required to let hormones flow
in such a way that facilitates the most easy birth
that mother can have.

stress at best, being designed to deal efficiently

with catastrophe such as strokes, heart attacks,
car accidents and overdoes. A hospital does a
brilliant job of dealing with such human drama.
But we all know that hospitals are not quiet, cavelike environments, where the mood can be relaxed
and loving.
The famous midwife Ida May Gaskin says that the
best way to get a baby out is to create the same
type of mood that got the baby in there in the first
place. If we look at other mammals for examples
of what type of birth environment might be most
productive to our own labors and births, we can
see that peace, quiet; darkness and privacy are of
the upmost importance for a laboring mammal.
Oxytocin is the hormone that not only facilitates
contractions, but facilitates bonding between the
mother and baby, helps the mother's uterus clamp
down after the birth as well, to keep the bleeding

Because mammals have evolved in a dangerous

world which sometimes required birthing women to
stop the process of childbirth in order to find a
relatively safe place to give birth in, we have the
hormonal capacity to do that. We cannot override
our biological nature, which has evolved over the
millennia.
Catecholamines, which are essential to helping
along the birthing process, especially a fast and
easy pushing stage, can also be a hindrance, if
their levels get too high, especially at first. These
stress hormones can slow or stop the release of
oxytocin, which is the hormone that facilitates
contractions.
Is it any wonder that we rely heavily, in our birthing
society, on the use of fake oxytocin, namely
pictocin, to "augment" labor? You take me to the
hospital under the best of circumstances, when I
am not in labor, and my stress hormones go
through the roof. And I am a nurse who routinely
works in a hospital, so I am used to that
environment. The environment is one of high

Dont forget to bring your

sense of humor to your
labor Ina May Gaskin

Mothers Love

Page 4

Neocortex continued from page 3

Other common practices in modern hospitals
which I've observed which hamper the release of
hormones needed to make birth what it should
be, are as follows: 1) denying a woman in labor
access to food and water, 2) denying a woman in
labor access to the friends and family she wants
with her to support her, 3) denying a woman in
labor the ability to move freely, by tethering her
to her bed by having her hooked up to IVs,
epidural, and monitors of all sorts, 4) helping the
woman release fear hormones by constantly
reminding her that if "things don't start
happening quickly, we might end up with a Csection," and other phrases which seem to be
strategically placed, as though baiting the woman
and preparing her for those eventualities, and
causing it to happen, by constantly reinforcing
her fear while dehydrating her, letting her blood
sugar drop by denying her food, keeping her
under florescent lights, and denying her access to
the people she loves, well, that can be, and often
is, a recipe for disaster. The good news is, once
the disaster strikes, the hospital staff can look
heroic, rescuing a laboring woman from calamity
caused by interfering with a natural process
which is, in most cases, best left alone.
So short of having a home birth (which of course,
is becoming a growing option for healthy, strong
women with uncomplicated pregnancies,) what

Oxytocin Molecule

can we do in a hospital or birth center to mitigate

the effects of some of the stressors which can lead
to increased stress hormones which of course,
decrease oxytocin and slow or stop labor?
1) Hire a doula. Doulas are women who are trained
specifically in ways to lessen the stress and pain of
labor, and to create an environment of peace,
privacy and calm. Doulas can also negotiate and
speak up for the laboring woman, who has enough
to do without having to worry about speaking up for
herself. A doula meets with a woman before labor,
typically several times, to get a good sense of what
the woman wants, what makes her feel calm and
secure and to talk about how they can work together
as a team to create the kind of environment which
will lead to the best birth possible for her. Numerous
studies support the use of a doula in labor. In fact,
some birth philosophers and educators have said
that if a doula was a drug, it would be unethical not
to offer every laboring woman the use of one.
2) Bring family and friends in to support you. Make
sure the team you assemble to support you
understand that hormones of labor can only flow
smoothly in an environment of peace and calm, and
assemble people who will help you achieve this
environment. Besides the doula, bring family and
friends who make you feel loved, comfortable, calm
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Continued
page
4
example,
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hospital. And remember, it is never too late to
switch care providers, until the baby is actually
coming out.

Mothers Love

Page 5

Upcoming Events
Breastfeeding support
With Maureen Weidman
Mondays 1pm-2:30pm
Pregnancy Care Center
551 Exchange Street Geneva, NY
Call to sign up 315-331-8415
Baby Caf
Teresa Kennedy, CLC
Joan Diaz, CLC
Child & Family Resources Inc.
1st & 3rd Wednesdays 10am11:30am
514 S. Main Street Canandaigua,NY
585-919-2476
Child Birth Education Classes
With Tara Rice, IBCE
Fairport and Famington NY
More info at www.joyfulbirth.net
Call to sign up 585-398-3008