By: Cheryl Thomas Orengo
“I have never felt so much joy and accomplishment in my life… and I am sure I won’t ever have that same overpowering feeling again,” Alice, a doula client, shared her feelings with us about the amazing day of her birth, which was the culmination of a two-day labor, which ebbed and flowed from Christmas Eve until the early morning of December 26th. “It was the most intense moment of my life. I will forever be grateful to my labor and birth team for such a wonderful experience. I felt completely supported and confident throughout the entire journey. I have such wonderful memories of the entire experience, even those times of uncertainty, because we were prepared and well-equipped to combat the challenges that mothers face in the labor and delivery room every day.”
Historically, laboring women received support from female companions. Women gathered around the laboring woman and provided support for her family and brought warm liquids, a soft touch or a hug for the laboring woman. They did not try to rescue her from the pain of childbirth because they knew that normal labor meant pain and intense work but at the end of labor came the joy of a new baby and a strong mother. More recently female support for normal birth has become the exception rather than the norm. Women wanting natural birth are concerned about the dehumanization of a woman’s birth experience because excessive medical procedures are often used during labor and birth throughout the US even with healthy women.
Doulas are available to help women and their partners create a special memory with a more normal and joyous birth. They are trained to help with special labor techniques and are knowledgeable of labor positions and comfort measures. The word doula is a Greek word, meaning “woman’s servant” and has become a familiar term for expectant couples. Many of the labor positions and comfort measures were conceived by Penny Simkin, a physical therapist, childbirth educator and doula who, with a study completed in 1991, discovered that if women are supported during childbirth they will experience a more positive birth experience. She created special methods to make labor easier and was a founder of DONA International, the premier doula organization.
Unfortunately, doulas provide support for only about 2% of births in our area. Most couples seeking a natural experience either prefer to work with labor and birth on their own or with the addition of family and friends. Wanting women to be able to look back on their birth experience with a positive memory and knowing that many couples wish to have a natural or normal labor and birth is why we decided to offer FREE Labor and Birth Forums to expectant couples in the Asheville area. The forums are held the last Thursday of each month in a lovely exercise/yoga room located in a one-story building adjacent to Mission Hospital.
Normal birth allows a woman to use her own resources to bring her child into the world; family and friends of the laboring woman as well as health professionals can shape a woman’s birth experience with feelings about herself, her birth and her part in it. We have all succeeded if women are able to verbalize a lovely memory of their labor and birth no matter how it takes place.
As a couple walks into the Birth Forum room on a Thursday night, they see chairs and large balls, often used for exercise, in a circle. There are tables around the room with brochures to help connect the couple to other local pregnancy/birth support services in the area. A doula/childbirth educator opens the forum leading everyone in a peaceful relaxation exercise designed to help attendees leave their busy day behind. After the opening everyone introduces themselves and with an agenda in hand the facilitors begin the discussion for the evening. Expectant parents, area doulas, nurses and other maternal health professionals join in to lend their own tips to those in attendance. The forum leaders guide the evenings so that participants take with them: knowledge, encouragement and confidence in the female body’s ability to give birth.
The labor and birth forums are based on the Six Care Practices for Normal and Healthy Birth by Lamaze International. The Lamaze method remembered by those of us in our 50’s and 60’s was a method that focused primarily on breathing techniques and information about labor. Today’s Lamaze promotes normal and healthy birth with labor positions and special comfort techniques to normalize labor from a belief that, “the experience of birth profoundly affects women and their families.”
The information presented during the forums includes typical doula methods to support natural birth. Some women have to have a medical induction because pregnancy is usually not allowed to exceed 41 weeks, so it is important to support a more normal birth even if a medical induction is necessary or there are labor or birth complications.
Medical interventions used during childbirth are procedures or treatments done to find, prevent or fix problems. All interventions have risks and many can make labor and birth more complicated. At the Labor and Birth Forums suggestions are made for effective communication with the woman’s medical caregiver about common interventions they may want to avoid and how to have a healthy and satisfying birth if medical procedures become necessary. Practice for this would include methods to relieve back pain, the use of a wireless monitor, and learning positions to encourage descent of the baby.
Comfort measures for pain are offered during the forums including practice of acupressure points to help labor begin and to help the release of endorphins, our body’s natural pain medication. Movement techniques such as swaying with the birth partner and different ways to move on a birth ball are offered to help an unborn baby descend. Comfort techniques such as squeezing the hips to reduce back pain and vocalization to ease the pain of late labor are taught to help contractions work more efficiently. Special positions are practiced to help labor progress such as a slow dancing movement with the father (or partner) and lunging to encourage a baby to descend into the pelvis to assist labor progress. Lack of labor progress is often a reason for cesarean surgery and pain and suffering are the primary reasons for the high use of epidurals.
The forums also promote active participation of the father, or partner, to provide continuous support to the laboring woman. Labor often surprises expectant couples with its power and strength. Fathers and partners are with a woman throughout labor, which can last for 12 to 25 hours or more for first babies. Studies show that women who have continuous support have fewer complications and report satisfaction with their childbirth experience. Taking a childbirth class series together and/or having a doula can help the birth partner provide even more effective support and can reduce the chances of a cesarean and/or the use of pitocin for induction or augmentation.
A lactation consultant who is part of the group, a soft-spoken young woman who has been working with new mothers for over a decade, brings up the topic of bonding with a newborn for the last care practice. “The healthiest place for a new baby is skin to skin with its mother right after birth”, she explains. “This way, the baby begins to breathe more easily and stays warm.” She leads the circle of participants in a discussion about the values of breastfeeding and offers practical tips for success.”
The Peaceful Beginning Doulas welcome all WNC expectant women and their partners to attend the FREE Labor and Birth Forums anytime during pregnancy whether it is a first baby or a third. The forums do not replace a childbirth class series but offer additional information and practice. The discussions are open, non-judgmental and confidential. Doulas, nurses and other maternal care professionals are also encouraged to attend and share in the discussions. Maternal Care Professionals are welcome to bring a supply of their business materials and/or coupons for tables located around the forum room. Forums are currently held the last Thursday of each month from 6:30pm to 8pm at the WRC building on the Mission Hospital Campus at 50 Doctor’s Drive. Please see www.peacefulbeginning.org/Labor-and-Birth-Forums–FREE.html for more information, updates and directions.
Cheryl Thomas Orengo is a retired Public Health Educator of 30 years and currently works as a Birth and Postpartum Doula, Doula Trainer and a Childbirth and Parenting Educator, teaching part-time at Mission Hospital. She is one of six doula business partners with Peaceful Beginning Doula Services, www.peacefulbeginning.org. Thurs. Dec. 29 at 6:30pm will be “Tips for Successful Breastfeeding Including Skin to Skin”, the sixth Lamaze Carepractice for Normal and Healthy Birth.