When people hear the word doula, they often respond with "Oh, I have heard of those. They are like midwives?"
Doulas are like midwives as far as working with expecting and new families but their roles are very different. Choosing to have a midwife or to have a doula, is not a one or the other, like it would be when choosing a midwife or a doctor. A midwife is a primary care provider, just like a doctor. Expecting mothers need a primary care provider, either a midwife or doctor. Doulas on the other hand work with families who have midwives or doctors.
Midwives are experts in normal, low-risk health pregnancy, birth and early postpartum (6 weeks). They care for healthy women throughout pregnancy, attend to them in birth and check in often during the first 6 weeks as the primary care for the mother and the baby. Midwives are paid for by the provincial government. They offer, order and interpret all prenatal tests and screening, just as a physician would.
Midwives can prescribe medications and recommend supplements in pregnancy, if needed. This includes pain management options in labour. (Yes, you can have an epidural if you have a midwife!) They can attend home births and hospital births, where they will monitor mothers and baby (babies), assess the labour and do all vital checks and exams. If concerns arise at home, they know when transfers to hospital should be recommended and made, and they continue the care once at the hospital. They are in charge of all clinical tasks and procedures. They can collaborate care with obstetricians if and when needed, to ensure the best care of everyone. Midwives have a very defined scope of practice in each province they practice in. You can see more info on midwives on the Saskatchewan College of Midwives website.
If that is what midwives are all about, what are doulas all about?
In contrast doulas are not the primary care providers but rather focus on non-medical, no clinical topics. Doulas focus on the emotional, physical & information pieces of pregnancy, birth & postpartum period. While doulas are accepted in the medical community and the evidence for improved outcomes exists, the fee of a doula is not paid for through provincial health. The fee is paid for by the family. There are some extended health plans that cover the fee. There are also some programs for financial supports for families if the cost of a doula is prohibitive. In Regina, the Doulas of Regina, have a relief fund. A doula is going to get to know their clients on a different level and help them plan for their birth and postpartum that matches their desires, needs and ideas. Doulas will direct all medical concerns and questions back to the primary care provider. If a client is concerned with something the primary care provider has suggested or misunderstands, a doula will help the client communicate more effectively with the care provider, but not on behalf of the client. Doulas are often in the know about other resources families would benefit from so they will guide clients to resources as needed. Doulas focus all their energy into the emotional and physical supports during labour without the distractions of clinical care needs. They also ensure the partner is supported and taken care of in the process. Doulas want to ensure mothers feel confident, informed, supported and comfortable during all aspects of pregnancy, birth and postpartum.
When you are from the Queen City it is hard to not love the Royal family. With the birth of Prince Louis Arthur Charles everyone is talking about Kate and her beautiful baby, her stunning hair and makeup and that adorable red dress, honouring Princess Diana. What we talking about?
What does our team at Queen City Doulas & Co think about Kate, her birth, her experience and her appearance? Quite a bit actually, and the best part is, we have varied opinions. We are talking about the variations of normal. I think this is quite telling to how unique we all are in our experiences, how individuals relate to Kate, how they might not relate to Kate and if that even matters!
Now day 3...oh day 3, I wanted to hide in that lion den and not come out. I am sure Kate has a day 3 that many can relate to. There is crying and leaking milk and inflammation in the nether regions and tender breasts. She is likely at home, snuggled into bed, feeding her baby, recovering from pregnancy and birth, being a protective mama bear as long as she can be.
It is not a contest, that is for sure. So many variations of normal, but I actually think seeing Kate and believing that Kate is a real mother like every other mother, vs just believing it is a team of lady maids only making her appear that way, actually shows birth doesn't have to leave us wounded and broken and scared. In fact, part of why I wanted to share my experiences of births 4 and 5 was because 1-3 were hard pregnancies, challenging births and challenging postpartum times and I felt broken and scared. 4 and 5 were not like that and I wanted to tell everyone how damn proud I was of creating my own amazing experiences.
You might be asking, did I do something different with 4 and 5. Yes, I sure did. I did a lot different, but one of the key differences was HypnoBirthing. It is well known that Kate also used HypnoBirthing. Here is a short video clip discussing HypnoBirthing and the benefits it has to birth.
Earlier this week Anna Baker was able to share some of her thoughts with CBC. You can have a listen to the conversation here. There are a lot of good tidbits in there - such as "do you and don't worry if it isn't what others do", or pointing out how it took a team to make Kate look that way. I would like to add she also had a team of care providers supporting her, not just a hair and makeup team! You can also read a piece that Anna wrote for CBC as well.
If you are preparing for a baby, what our team hopes for you is that you have a positive experience and that you are supported to have the experience YOU want. That is truly all that matters. This is why we exist, to be the support you need. If you have the desire to have a HypnoBirth, we have that class to give you those tools. If you need someone else on your birth team, we have doulas for that. If you need more practical in home support post baby we have doulas for that have that, too. As Anna mentions in her interview, breastfeeding struggles occur, so we have help to get back on track ASAP (and we have a class for breastfeeding, too).
I believe you might not be as far off as having an experience like Kate, as you might think you are. You are just spared the pressure of having to present your baby to the world, 7 hours post delivery.
The Next HypnoBirthing Class starts Tuesday May 22nd and runs through June 19th. This is the last class until fall. Get more information here.
The next Your Breastfeeding Experience class is May 5th. There are a couple spots still open in this class.
The next Your Life with Baby class starts May 12th. There are spots still available in this class also.
If being a good doula was based on what is in our doula bag, Mary Poppins would be the greatest doula.
Mary Poppins had quite the bag and all things considered it could make a fairly decent doula bag! There are a few items I would leave out of my doula bag, if I was Mary Poppins. The first one would be her coat rack. I am quite certain I can find a place for my coat at the hospital or a clients home. I can probably do without a plant, but hey, if you want a plant in your hospital room to make it a little more homelike, you can bring one…I won’t complain. Although, keep in mind, you might get some flowers gifted to you after you deliver your baby, so take up more than you need to.
Mary Poppins even brought her own lights. Lights are important, but again, I am not worried about the lighting at the hospital or your home. If you want dim lights, the doctors and midwives have flashlights - really, they do! Speaking of lights, some people like to have some flameless candles to create a nice ambience. I do have some in my doula bag, but as an FYI, they are a few dollars at the $1 Store.
Now, of course, I know some moms would want to but in my experience it is not super common. Again, if that is something you think you might want to try in your birth, lets chat about it and make a plan about who should bring the mirror, just like the plant.
That tape measure Mary Poppins has in her bag is amazing and I would love one! I mean imagine being able to measure people I am going to work intimately with and be told all about their personality. Wow, what a benefit that would be to me and to my clients. Wait, hold on! I do often have a tape measure in my doula bag…with my knitting. Yes, I pack knitting into my doula bag. What? Why on earth would I have knitting? We can talk about that later in another blog post.
Back to this tape measure idea. I don't have a tape measure that will tell me easily what your personality is, but I do however have a tool that will help me discover more about your personality and help me connect with you to make our work together easier and a little more flawless. The “Your Birth Experience” (YBE) program allows me to connect with you, identify your needs and then equip you with the resources necessary to achieve your goals. This leave mothers and their families empowered to envision their ideal birth, prepare for that birth and ultimately achieve the birth experience they desire. That’s pretty close to the magical tape measure, right? It is close enough for me.
So far you now know my doula bag has a few tea lights, running shoes, knitting and a tape measure. That tape measure isn't the good personality one - that comes from our prenatal meetings. That is all I have in my doula bag? Don't I have a rebozo, massage balls, TENS machines, birth balls? Nope. I do have some gum, some cash for parking, some hair ties and some snacks. Why so simple? Largely, infection control. For real, I don't want to disinfect birth balls and I surely don't want to clients sharing “dirty” ones. I don't want to have to wash beautiful fabrics from Mexico in harsh chemicals made for industrial disinfection standards. I can do some neat stuff with a hospital sheet instead. Bonus is that I can get that at the hospital and then leave it at the hospital to have it cleaned properly, just like the birth balls. Massage balls and TENS machines…what can be bad there? Nothing is really bad, but I prefer to not place an object between my clients and I. I find a better connection with direct contact and that increases endorphins which are great for labour. Again, if clients know they want to try a TENS machine or like the porcupine balls, I can help them use ones that they likely already own.
What I do have that cannot be packed into a bag is my years of experience and my confidence. Relief comes to my clients simply by my being present, much of the time. Clients know they can count on me to be present for them. I am a familiar face they know already and our relationship is solely focused on me helping them have a positive experience. They are presented with a bendy straw in a cup of water to juice, before they even knew they were thirsty. I am leading them to the washroom to pee and get that bladder out of the way of babies path because they didn’t realize they needed to pee. I am lightly touching and stroking their feet to remind them to relax their WHOLE body. I am that voice in their ear telling them that they can and are “doing it” when they feel like you are not being strong.
The thing is, people don't give birth every day, (truth be told, I don't attend birth everyday), but I do support women giving birth more often than the average person will give birth. I have been alongside many others before. Each experience is different and no path looks the same, but they are similar enough that I can follow the flow and go alongside and help women through it. They can say things like “Is this normal?” or “what else can I do?” or “what did that nurse/doctor/midwife mean?”. I will reassure them things are normal and they are doing great, I will make suggestions about what else they might want to do, or reassure them what they are doing is perfect & I will help them understand what the care providers are doing or saying. I can help the partner and encourage them just as much (maybe more, maybe less) as I do a labouring woman.
My doula bag started out full of items, and honestly, I could have taken a small suitcase on wheels to births when I first started because I felt like I needed to bring it all. I now know that to "bring it all", we need to do more work in the time before labour, and when I “bring it all” now, I am bringing our conversations, unique goals, unique desires, unique choices and my confidence, my experience and can be “tricky” just like Mary Poppins. I am confident I can pull stuff out of thin air that will help me meet your needs without carrying a lot of baggage.
~Written by Kim Smith, Doula, IBCLC