Mommy's first helper
POSTED: Tuesday, June 01, 2010
One of the new questions being asked during birth center tours at hospitals across Hawaii is, Can I bring my doula?
From Tripler to Queen's to Castle Medical Center, expectant moms are bringing in their doula — a trained birthing coach — who arguably could be a more important presence than Dad on the day they go into labor.
Hospitals also are more willing to accommodate these emerging professionals who assist women with all the nonmedical aspects of labor.
Tammy Uva, a doula for 30 years and owner of Labor of Love, says demand is growing. She already has bookings into September.
“;The more informed women get, and decide they want to be actively in charge of their prenatal and postpartum care, the more they start looking at their options,”; said Uva. “;When you're an active participant in your labor and birth, it makes the experience more enjoyable and satisfying.”;
A doula — “;woman's servant”; in Greek — is a birthing coach as well as mother's assistant.
Doulas offer their services before the birth by helping clients draw up a birth plan, for instance; during the birth by offering relaxation techniques and massage; as well as postpartum, by doing light housework and helping the mother adjust to the baby at home. Some also assist with breast-feeding.
They do not, however, offer medical advice, perform medical procedures or checks, do the actual delivery or replace a doctor, nurse or midwife.
Uva, a mother of six grown children (including a set of twins), is certified with DONA International, which requires course work and an evaluation by a panel of parents, doctors and nurses. A doula certified with the organization must follow certain standards of practice and a code of ethics.
Once the domain of Hollywood stars, such as Nicole Kidman, Demi Moore and Cindy Crawford, doulas are now a mainstream option.
In 2009 about 7,000 doulas were certified with DONA International, which launched with 750 members in 1992. In Hawaii there are about 26 DONA-certified doulas, and there are others certified by other organizations.
Connie Carreras, a first-time mom from Haleiwa, didn't plan on hiring a doula, but kept stumbling upon the word while reading maternity books.
Carreras decided to give birth naturally using the Bradley method. She was referred to Uva through a friend, met with her twice to go over a birth plan and is glad she did.
“;It definitely enhanced our birthing experience,”; she said.
The commute from Haleiwa to the Queen's Medical Center is about one hour, so Carreras' plan was to labor as much as possible at home instead of at the hospital. She was glad to be able to call Uva for advice.
“;It's a different relationship,”; she said. “;There's more of a familiar relationship than with your doctor. It's nice to have both but totally different.”;
Carreras gave birth to her son, Kai, on Feb. 20 and spent only about two hours at the hospital.
It went as planned, and through it all, Carreras said, she was calm. Given the chance, Carreras said she would hire a doula again.
For Brandi Medranos of Mililani, having a doula at the birth of her third baby made the process go smoothly.
Medranos, originally from San Diego, does not have family in the area, so she considered her doula to be her support system.
Through word of mouth, she met doula Brynne Caleda, who is also a prenatal, mom and baby yoga instructor.
“;I wanted an all-natural birth,”; Medranos said. “;I didn't want to be hooked up to IVs, and I wanted to do what I needed to do. If I didn't have (Caleda) there, I probably would have given in at some point.”;
Medranos said she wanted her husband to be present at the birth but that she preferred coaching from Caleda because her voice was more soothing.
She was in labor for seven hours at Castle Medical Center and said Caleda brought a whole bag of props — from an iPod system to a birthing ball — and techniques that helped her get through it.
“;I never felt like giving up, because she always had something new to try,”; said Medranos.
When searching for a doula, Medranos said, chemistry and personal connection are important.
Caleda kept her relaxed and focused, she said, and it resulted in a smooth delivery. Her son Abraham (nicknamed “;Nacho”;) weighed 9 pounds, 13 ounces.
Tricia Brookover hired doulas for all three of her children's births. Uva was her doula for her third baby, Matthew, at Tripler Army Medical Center. Matthew weighed 9 pounds and was delivered naturally.
“;It's nice having someone who's focused solely on me, and who knows so much about the labor process,”; she said.
Prices for labor doulas range from $350 to $700, depending on years of experience, according to Uva. For postpartum services, doulas typically charge about $25 an hour.
While more moms-to-be are interested in hiring doulas, there is also a growing interest in the profession.
Linda Herrick, director of the Academy of Certified Birth Educators Inc., said interest is growing. She travels to Hawaii once a year to host workshops.
To become a doula, candidates must understand that birth is a normal, natural and healthy process, said Herrick, who also is a registered nurse. Doulas might or might not be mothers themselves.
Studies have shown that women aided by doulas have shorter labors, she said, feel less need for pain medication and experience more positive outcomes.
Uva said while there is a perception that doulas are only for moms wanting to give birth with minimal medical intervention, she also has assisted those who wanted the epidural, or anesthesia, as well as those undergoing C-sections. Home births also are becoming a more popular option.
Her role, she said, is not to tell the mom what to do, but to assist her in making choices and staying true to that plan.
As for dads, Uva said they usually are glad a doula is there because it takes the pressure off of them.
Doulas also make themselves available for lower-income moms.
Many doulas volunteer for various groups like the PATH Clinic, run by the Salvation Army for women with substance abuse problems.
Uva volunteers for Operation Special Delivery (which assists military spouses) and the Kalihi Family Health Center.
“;I think what inspires me is watching as a woman goes from this beautiful journey of pregnancy into becoming a mother,”; said Uva. “;Through your whole pregnancy, you're gearing up for that, but when you go through labor and birth, that's when you become a mother.”;
WHAT IS A DOULA?In Greek, “;doula”; means “;a woman who serves.”; A labor doula assists a client during labor and delivery. A postpartum doula assists a client with light housekeeping at home or running errands after the birth.
QUESTIONS TO ASK A DOULA » What training have you had? » What is your experience with birth, personally, and as a doula? » What is your philosophy about birth and supporting women and their partners through labor? » May we meet to discuss our birth plans and the role you will play? » May we call you with questions or concerns before and after the birth? » Do you come to our home or meet us at the hospital? » Do you meet with us after the birth to review the labor and answer questions? » Do you work with one or more backup doulas? » What are your fees and refund policies?
Source: DONA International
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