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Saturday Mornings with The Sarahs

a blog about pregnancy, labor, love, delivery and life. 

Do I Need A Birth Plan?

So let's talk about the “birth plan.” There are those who say you MUST make a plan to achieve the birth you want, and there are those who say making a plan practically jinxes you, and guarantees that nothing will in fact go to plan.

First and foremost, the main goal is a healthy mommy and a healthy baby. The end....but lets talk about unpack what most birth professionals believe about parents making birth plans. 

 After about a decade of experience with birth plans in the hospital setting: the majority of the issue lies in the name itself. The word "plan" often seems to imply, both to parents and hospital staff alike, a certain inflexibility that often creates more problems than it solves. A better term might be "birth preferences" or "birth ideals," with the understanding that it is a breakdown of the mother's plan A birth, but that she is also educated and prepared (and supported, hopefully!) to handle a plan B or plan C delivery as well!

At Doulas of Lima, our birth planning guide is viewed first and foremost as a discussion guide. It's purpose is to comprehensively walk our clients through the wide variety of different scenarios that may arise throughout labor, delivery and postpartum, and help explain the options and choices that will arise with them. We can offer pros, cons, the most up to date evidence and statistics on different labor management approaches, and discussion tools to help you more accurately decide how you feel about those options. We will also discuss different decision making tools and stress/pain management techniques, and help you practice and experiment with what works best for you. 

This conversation itself is the most important part of the birth "plan" in our opinion- it helps parents clarify their options and choices, think through scenarios before they actually arise, and helps us as your doulas to be fully informed as to how best we can help YOU personally at delivery. It also clarifies that everything about birth is subject to change and improvisation! Along with a plan A, our birth discussion guide helps you figure out what your plan B and plan C might look like too!

From this discussion Parents usually write down their thought out wishes (which becomes the birth “plan”), and this then helps to both facilitate conversation with your care provider before your delivery and to allow the staff at your birth place to quickly familiarize themselves with your wishes once you're in labor. But you may also choose never to put any of these desires on paper, and that's perfectly fine as well. The conversation itself, and the subsequent exploring of options and clarifying of preferences, is ultimately the desired outcome.

So call it a plan, call it a preference, call it a wish list, call it whatever you like! At Doulas of Lima we help you communicate to your birthing team all your desires. Then with everyone on the same page, coupled with flexibility and thoughtfulness, we believe a birth plan can be a great tool for both parents and caregivers.

Thanks for hanging with us on this Saturday Morning! 

~Sarah Stover


Some Truths to replace a few Myths

When we say the word "Doula," what words or images come to your mind? 

 A Midwife? “Natural”? Homebirth? Perhaps a hippie even? 

Modern Doulas come from every walk of life, train and certify with a wide variety of organizations, and operate in many different ways, from solo practices to large multi Doula agencies to hospital employed Doulas and everything in between. At Doulas of Lima, LLC we have no specific birthing agenda for you. We do wish to serve you and your family in a tailored way that will leave you knowing you were empowered and supported every step of the way. We want you to have your birth, your way.

To best help you understand what we at Doulas of Lima can offer you and your family, we'd first love to unpack some common misconceptions about the work of Doulas and replace them with truths.

So, let get started. 

Myth: Doulas are only for women who want an unmedicated birth.

Truth: The fact is that Doulas are thoroughly trained in how best to support, facilitate and improve your quality of experience in ANY kind of birth, from completely intervention free to high risk and extremely medicalized. A professional Doula is unbiased and nonjudgmental, and is there only to provide you with information, options, resources and support as you navigate every twist and turn throughout your pregnancy and delivery. At Doulas of Lima, we have no goal other than to support and empower YOU in your kind of birth, whatever that may be.

Myth: Doulas will replace or exclude my other birth partners.

Truth: In fact, most Doulas will tell you that by the end of a birth, the partners and families love us just as much as the mom does! ;) We are very well versed in how to include and involve everyone on your birth team to the extent that they wish to participate so that any birth-day chaos or confusion is avoided. We are also great at helping your support team identify the areas in which they are best suited to help you, and then filling in the gaps ourselves, as we are trained in EVERY type of support, physical, mental, emotional, educational, etc. We are there to bring out the best in everyone and to help facilitate communication, all the while making sure that all of the birthing mom's needs are being met. We are also there to make sure your support person's needs are met as well, so that they are well rested, well fed, and better able to take care of you and baby upon returning home and settling into life with a newborn!

When your partner, is able to help take care of you, while being rested themselves, it brings about a hormone called, Oxytocin. This hormone is essential to laboring and the more of it, the better the labor and experience. (More about this in another blog 😉 ).

Myth: A Doula? Like a Midwife, right?

Truth: A common misconception is that a Doula is the same thing as a Midwife and is there to help physically deliver your baby or to help you assess your and your baby's health during labor. Professionally trained Doulas are very clear on their scope of practice, which is one hundred percent non-medical. During your pregnancy, we are there to provide you with options and resources, unbiased information on any topic you have questions about, and an entirely nonjudgmental and neutral sounding board as you work out your feelings and desires regarding your delivery. During birth, we are there to provide continuous physical, mental and emotional support and encouragement during your labor and birth to you and your birth team. We absolutely DO help you feel empowered, listened to, loved and informed, but we are absolutely NOT there to interfere with your provider, the nurses or hospital staff. We are here to help the process, not hinder it.

Myth: Only first-time moms need a Doulas.

Truth: Something any doctor or nurse can tell you (and every experienced mom as well) is that EVERY pregnancy and birth is different, whether it's your first or your fifth. Birth support is valuable at every delivery, and as Sarah Beth will tell you, even while trained as a Doula herself, she wanted her own Doula for the birth of her last and forth child and found the support and help invaluable! Having a Doula at your side, empowers you during this vulnerable time and it’s proven to significantly improve the mother’s emotional health following the birth (more on this in another blog as well 😉). New circumstances and challenges arise with each new baby, and we at Doulas of Lima would love to help you handle each one.

So now that you've spent a few minutes with us, we hope you have a wonderful day and we thank you for joining us on this grey, but beautiful Saturday morning!

~Sarah Stover


Benefits of hiring a Doula

So let's talk stats! A Doula sounds nice and all, but is there any solid data to back up the idea that hiring a Doula is WORTH it?

Numerous studies have been done regarding the effects of Doula support. In 2011, a Cochrane review (which summarized the experiences of over 15,000 women who participated in 21 randomized controlled trials)concluded:

"Continuous support during labor has clinically meaningful benefits for women and infants and no known harm. All women should have support throughout labor and birth." (Hodnett and colleagues 2011)

The physical benefits were impressive: Overall this review found that mothers who had a doula present were:

          • 39% less likely to have a cesarean section

          • 31% less likely to use synthetic oxytocin, Pitocin, to speed up labor

          • 9% less likely to use any pain medication

The review found that, in comparison with women who had continuous support, women who labored without continuous support had longer labors and were less likely to have a "spontaneous" birth (with neither cesarean section nor vacuum extraction, nor forceps). Women without support were more likely to:

          • have an epidural or other "regional" analgesia to manage pain

          • use any type of pain medication (including narcotics)

          • give birth by cesarean section

          • give birth with vacuum extraction or forceps

          • give birth to a baby with a low Apgar score rating of well being 5 minutes after                birth

          • be dissatisfied with or negatively rate their childbirth experience

Okay, so we've sold you. Support is important! But does it matter who provides this support? Couldn't your nurse, husband, or best friend act as your Doula? We're glad you asked! While we absolutely believe that partners(and moms and friends) have a very important place at the birth if the mother wants them to be there, a Doula's support differs in many ways. Let's take a look a a few,

1) Continuous

Your nurses, no matter how awesome, cannot provide constant attention as they have several patients typically, and many clinical tasks to perform. Even your partner, friend or mom may need to come and go to handle work or family situations, get meals, tend to other children, run last minute errands, or get a nap so that they are better equipped to help you and baby postpartum!

2) Unbiased

Doulas have a very specific and professional relationship to you and your birth, whereas someone within your family or social network cannot help but have feelings about your birth because it is a meaningful event in THEIR life too! It's one that a Doula allows them to fully experience, without needing to be mom's sole source of physical, mental and emotional support as well.

3) Informed

A certified Doula is trained and up to date on all things pregnancy and childbirth. We are here to help you navigate your birth experience with practical and reliable information and resources for your physical and emotional well-being. This training and education is something that no friend or relative, no matter how well meaning, can offer.

The Cochrane review confirmed the benefits of Doula care specifically- their overview found that "Effects of continuous support were strongest when the person was neither a member of the hospital staff nor a person in the woman's social network, and was present solely to provide one-to-one supportive care."

All of this clinical study can be summed up more simply, perhaps, with a quote from Dr. John H. Kennell, who observed, after analyzing all the available data, that “If a Doula were a drug, it would be unethical not to use it.”

We're ready to serve you. It's totally worth it. You are worth it.

It's a snowy Saturday morning here for us, Stay Warm!! 

Also, Happy St. Patrick's Day!

~Sarah Stover





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