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Doulas and Unassisted Births

July 1, 2010 28 comments

Having an unassisted birth can be a hard journey to take for many women. Often, if you discuss your plans with family and friends, you are bombarded by arguments trying to sway you into having an attended birth, talks of “what if”, or they may choose to avoid any contact with you for the duration of your pregnancy. There are very intense feelings regarding unassisted birth, and many do not want to listen to why you are going unassisted, and definitely do not want to support it in any way. “What if the baby dies?!”

Women who choose to have a UC sometimes want to have an extra support person there, just as they would want one there for an attended birth, but they are afraid to ask around. Most doulas do not feel comfortable serving women who are going unassisted. Some doulas do not believe that women should be able to have unassisted births at all. That, to me, is a sad thing to see in a community of birth workers who support women, yet deny and criticize those who choose a different way. We should giving unassisted birthers respect, just as we give respect to all other women who are giving birth. Isn’t it a bit hypocritical to say that you support women, yet only if they do it “the right way”? If you feel uncomfortable with someone else’s birth choices, you can still give them the respect that they deserve as a person.

How can a doula serve a women at an unassisted birth?

A doula can provide all the services she normally provides at any other birth. She can be there to offer support for you, a possibly nervous partner, and siblings. She can prepare food, help set up your birth space, and just be there, present and calm. She will understand when you want to be alone, especially during the birth. Having a doula at your UC means having someone there who truly believes in you and your decision, and is there to help you have the birth you want. Having that trust and relationship with another person can be a great thing at a UC, when often you are left alone to fend for yourself.

After birth, she can help clean up, make sure every one has what they need and help with settling in. She can be a person to look to for resources, advice and postpartum support. Having a doula on your side can ease the worries about not having anyone to turn to postpartum, because you are afraid of what they will think of your decisions. Women should not have to be afraid after their births, because they have no outside support.

Is it still unassisted?

Sure, you can talk semantics about what unassisted birth really is (some will even say that having your partner there means you did not really have a UC), but in the end, almost any UCer I have met online or in person is not really worried about having a UC just to say she had one. Personally, as a doula and someone that has had an unassisted birth, I believe that if a doula is there to serve you and your family at your UC, then yes, you can still say you had an unassisted birth. A doula is not providing any medical care. She is there as a support person, just as she would be at any other birth. A doula does not hold any responsibility for the outcome of your birth, you and your family do.

Gloria Lemay’s “7 Tips for Creating a Calm, Joyous Homebirth”

Wonderful post by Gloria yet again! Just love what she writes.

As cesarean and induction rates in hospital climb to astronomical levels many women are turning to homebirth. When interventions become excessively high, the risk/benefit ratio of being in a hospital swings more dramatically into the “riskier” zone, and even physicians and nurses begin choosing homebirth. Just removing your birth from a hospital setting doesn’t guarantee that it will proceed in a natural, flowing manner. Too many women learn the hard way that a midwife can bring a hospital mentality and interventions right into the home and negatively affect the course of the birth. How can you assess the type of midwifery practice that you are purchasing? Here are some tips to help you assess the care that will be provided by midwives:

1. Ask to see a video of some births your midwife has attended. This is the modern age. Many people videotape their births and an experienced midwife will have been given many copies of videos with permission to share them with other families. Videos tell you a lot more than photo albums. Be wary of the midwife who won’t give or show you videos. Watch the videos for things like: Is the father playing an active role in the birth? Are the attendants quiet when things are normal and healthy? Is the cord left to pulse until the placenta is born? Does the baby breathe spontaneously without routine suctioning? Are the baby and mother locked in eye contact with no disturbance? Is a water tub part of the birth?Watch the time clock on the video to see whether the birth of the placenta occurs in a leisurely way or whether the midwife wants it out in under 30 minutes.

2. Tell your midwife that you don’t wish to have any pelvic exams during your pregnancy. This avoids introducing bacteria and also avoids some routine interventions like membrane stripping (painful and ineffective). Making assessments of the readiness of the cervix to give birth at the end of pregnancy is inaccurate and largely discouraging to the mother. Remember that you were made to give birth—you’ve had menstrual periods, you conceived and you grew a baby; therefore you can have faith that your cervix will perform just fine. PAP smears can be done after the baby’s birth, if you so desire.

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