Coaching the Movement Into Motherhood


By Chelsea Kouns and Cheryl Orengo


The call comes at 4:30 in the morning.

“My contractions are getting stronger!”

“When did they start? Is there a consistent pattern that you can pick up?”

“They started last night just before I was about to lay down for bed. They weren’t that strong, so I was able to sleep for a few hours. But they woke me up early this morning and now all I want to do is MOVE!”


“That’s great that you got some sleep! Now, listen to your body and what it wants to do to help you flow with these contractions. I’ll get my things together and be right over.”


“OK, hurry.”


At this point I only have time to take a quick shower, eat a little something, grab my doula bag, and head out the door. I center myself in the quiet of my car– breathe, mentally prepare for the adventure to come, and always smile at the thought. It is a blessing for me to get these early morning phone calls. As a birth doula, it’s my job to coach women and their partners through what will probably be the most physically, mentally and emotionally exhausting experience of their lives.


Birth doulas are labor coaches. As with any coach, birth doulas encourage movement and focused endurance. Labor is sometimes likened to running a marathon. While the physical and emotional demands between labor and running a marathon may be comparable– the big difference between the two is that at any point, an athlete can choose to stop running a marathon. That baby, on the other hand, has to come out. A laboring woman has no choice– she has to keep running no matter what, until the race is over. Like the strongest athletes, laboring women push their bodies to the limit. They must exhaust every ounce of themselves to bring new life into the world. Birth doulas are there every step of the way, providing continuous care from early labor at home until after the birth, no matter how long it takes. Doulas are the only hospital birth professionals that stay with their clients throughout the entire birth process.


Birth is all about movement– the physical movements of the mother to help move the baby downward during labor, the movement of the labor support team to execute comfort measures for the mom, and the emotional movement of transitioning into parenthood. Birth doula trainees learn and practice labor positions and movements that achieve optimal positioning and decent of the baby, and help ease the pain of labor.


Studies have confirmed that the presence of a birth doula can help a woman have a shorter and easier labor and birth. The majority of these positions and movements keep the woman upright, meaning we use gravity to assist the downward movement. A doula might suggest taking a walk around the neighborhood during early labor or walking up and down stairs. As labor progresses, a doula might suggest lunging with every contraction for a short period of time to encourage a baby to descend into the pelvis by giving the baby more room. Doulas provide various comfort measures for laboring women, like “hip squeezes”- compressing Mom’s hips to help reduce back pain, or providing a solid sacrum press. Labor is not only athletic for the mother, the doula gets a hardcore work out as well.


“Slow dancing” is another technique that is used with clients. It involves the woman putting all her weight on her partner or the doula and slowly rocking back and forth- This takes the weight off of her back. An exercise ball, known to doulas as a “birth ball” is used during labor for a woman to sit on, lean on, rock on, or kneel on. These balls are great for relieving discomfort and provide a firm, yet forgiving place to sit. It also forces good posture while decreasing muscle strain.


All these positions are used to help labor progress and encourage optimal positioning of the baby by helping the baby descend properly into the pelvis.


Second stage labor is truly an athletic event and pushing can take one to two hours, or more. Doulas also help women push in many different positions to help the baby descend in the birth canal and ultimately to shorten the pushing stage. Standing, kneeling against the back of the bed and squatting with a special “birth bar” all help to use gravity to welcome the baby into its mother’s arms.


In response to stress and pain, our bodies produce calming and pain-relieving hormones called endorphins. In un-medicated labors, the level of endorphins continues to rise steadily causing a somewhat altered state of mind that helps women cope with the challenges of childbirth. Maybe you’ve heard the phrase, “runners high”? Well, we can consider this a “birth high”. Another hormone released during labor is oxytocin which contributes to the immediate love and bond a woman feels for her new baby, strengthening the mother-infant bond. It is imperative that women have a coach, like a doula, alongside their familial support team, to empower them to understand the nuances of these biological shifts and make positive decisions around them.


Enhancing the positive aspects of the birth experience and the transition to motherhood is usually reserved for families fortunate enough to be able to afford it out of pocket. However, at Start From Seed (SFS), a new not-for-profit volunteer doula program based in Buncombe County, we are providing high risk, low income women the opportunity to have the care of a doula at no monetary charge. SFS is rooted with the intention of increasing the quality of care women receive before, during and after pregnancy.


At SFS, we witness life-changing transformations within our clients because they uncover the innate wisdom and intuitiveness that all women have regarding childbirth. So often, as a society, we focus on the end result of a labor– the baby’s birth. But the role of the doula is to bring intention to the birthing process– prenatally, and of course the many hours spent laboring. This is where positive birth experiences are born. Controlled, randomized studies have confirmed that the presence of a well trained birth doula can help a woman have a shorter and easier labor and birth, can help establish breastfeeding and bonding, and help the woman have a more positive memory of her birth.


The intense emotional and physical movements of labor and birth help doulas and families, tap into wells of strength that we may not have known we had before. Ultimately, a woman’s newly realized strength from a positive and empowering birth experience can be translated to other facets of her family and community. At SFS, we believe that the foundation of our community can be made stronger and more healthy with each positive birth experience.


SFS takes referrals from local Public Health Programs, such as, the Nurse Family Partnership Program at the Buncombe County Department of Health, Mountain Area Child and Family Services, Mission Hospitals Survivor Services, and Western North Carolina Community Health Services. SFS holds the vision that ‘every woman deserves a doula’.  SFS volunteers are dedicated, highly qualified women that are trained birth doulas and postpartum doulas. SFS also focuses on three other areas: doula certification and training, doula mentoring, and community building.


On May 12th, Start From Seed will be having a pancake breakfast fundraiser at the Grey Eagle from 10am to 2pm.  Please come help us celebrate Mother’s Day, International Doula Month and Start From Seed. Your donation of $10 will get you a plate of homemade pancakes and a beverage. The money raised will be used to start a lending library of books and DVD’s about childbirth, breastfeeding, postpartum care, and parenting for the volunteer doulas and SFS clients. Donations will also be used to purchase Moby Wraps for the SFS clients to encourage family-infant bonding and other materials needed by the doulas.


Please visit the Start From Seed website for more information about the Program and the event on May 12th at


Chelsea Kouns is the Program Director for Start From Seed and is also a certified birth doula and postpartum doula. She has dedicated the majority of her time as a doula working with under-served women and their families in Buncombe County. Chelsea also takes private birth and postpartum clients.

Cheryl Orengo is the Program Advisor for Start From Seed. Cheryl implemented and coordinated the Buncombe County Health Department’s Volunteer Doula Program for 12 years and is a retired Health Educator after 30 years in Public Health. She is also a private birth and postpartum doula, a doula trainer with DONA International and a prenatal educator at Mission Hospital on Wednesday nights.

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