Partners & Doulas

July 23, 2007

by Jane Weideman

Are doulas and partners mutually exclusive? Read on and then you can decide…

It is true, that the birth of your baby is a very private event, so you might be wondering if a doula will replace or exclude your partner and his (or her)* role.

I think, especially first time moms, have a concern that their birth will not be the intimate and bonding affair, they have dreamed about, if there is a doula present. However most moms having their second or more babies understand that they are actually more likely to achieve that intimate and calm birth with the help of a doula.

So while it is common for partners, and mothers-to-be, to be concerned that a doula will be a “third wheel” or will exclude the partner from sharing in the birth, in reality the opposite usually turns out to be true. A good doula knows how to support your wishes and help the two of you to maintain your physical and emotional resources to share the birth together.

The doula is not meant to sideline or replace the partner – unless no other partner is present. The role of the partner and doula are similar, but the differences are fundamental. The partner may be very emotionally attuned to the mother, but may be distressed by ‘seeing the mother in pain’ and unable to stay calm through, what is to him a new and frightening expereince. He may be well prepared and able to provide good continuous support, but typically has little actual experience in dealing with the often-subtle forces of the labour process. Even those partners who have prepared well are often surprised at the amount of work involved (more than enough for two people) – the process isn’t called “labour” for nothing! Even more important, many fathers experience the birth as an emotional journey of their own and find it hard to be objective in such a situation. Studies have shown that partners usually participate more actively during labour with the presence of a doula than without one. A responsible doula supports and encourages the partner in his support style rather than replaces him.

According to studies, rather than reducing the father’s participation in the process, a doula’s support complemented and reinforced the partner’s role. Partners felt more enthusiastic and that their contribution to the labour and birth was meaningful and helpful. Not only did partners report higher levels of satisfaction after the birth, but mothers reported feeling more satisfied with their partner’s role at birth too.

– 71% of moms were satisfied with their partner’s role in birth – with a doula present
– 30% of moms were satisfied with their partner’s role in birth – without a doula present

 

The partner and doula are complementary to one another in providing optimal support to the labouring mother. A doula can never love the labouring mom as much or in the same way as her partner can. He knows her and loves her intimately, he is the father of the baby she is working to birth, and he is one of the main figures in the event taking place – his role is vital. However, her partner has never given birth, nor is he usually very experienced in providing labour support in the same way a doula is.

Through the presence of a doula, the partner is freed from needing to remember every idea mentioned in childbirth class. The doula is able to help him to help his beloved. He can relax into experiencing his journey into parenthood, because the doula is there to support both parents. Working together, the father’s knowledge of the mother, and the doula’s knowledge of birth, can give the ultimate level of comfort and support to the labouring woman and best provide her with the opportunity for a birth experience she will remember with joy for the rest of her life.

As Penny Simkin states, “While the doula probably knows more than the partner about birth, hospitals and maternity care, the partner knows more about the woman’s personality, likes and dislikes,and needs. Moreover, he or she loves the woman more than anyone else there.”

If you and your partner feels unsure about having a doula, talk about it together. Be honest about what you are feeling. If your partner wants to be your only birth companion, he may feel that if you want a doula, it must mean you don’t think he will do a good job supporting you. Usually that’s not at all true, but it helps to talk it through. As mentioned many partners actually find they are more actively involved in the birth when an experienced professional supporter is present.

If, however, your partner feels uncomfortable about being present at the birth – he may be squeamish or just plain scared – a doula’s presence means you will have continuous support while your partner is free to respect his own limits and be as involved as he can manage, but will be free to take a break if he needs to – and you won’t have to worry whether HE is ok.

When you first meet with your prospective doula, discuss any specific expectations you have for the birth, or things you want her to do or not to do. Be clear about what you want her role to be so there are no misunderstandings on the day. This is your birth and you are paying for a service. Make sure it is what you want!

During the birth, if you see something the doula is doing that you want to be able to do — maybe massage or a pressure technique, ask her to show you how. She will gladly involve you as much or as little as you like… don’t feel timid.

Don’t be afraid to ask for some privacy if you would like, at any time during your labour. Privacy and intimacy helps labour progress! And a good doula respects your needs and won’t feel put out in the slightest.

Some of the ways that doulas can help partners:

  • Stepping in to help when the partner needs a short break. Labour is hard work, not just for the woman, but for those supporting her!
  • Offering suggestions, when asked, about strategies that might be comforting or helpful during labour and possibly role-modelling or demonstrating these.
  • Freeing the partner to take photos, or taking photos for the couple while the partner supports mom.
  • Providing reassurance to the partner as well as the woman giving birth. If a partner has never seen a woman in labour before, it can be very reassuring to have someone focused on his needs to answer questions, give an encouraging smile, and put everything into context! This is an amazing journey for partners too!
  • Providing information and an objective sounding board when you have questions or decisions to make.
  • and more.

The choice is yours to make but doulas and partners can and do work very well together.
*Note that this article refers to the partner as he, for simplicity sake, but the partner could of course be female too.

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Technology in Birth: First Do No Harm

July 13, 2007

Technology in Birth: First Do No Harm

By Marsden Wagner, MD. Article from Midwifery Today

There is a very good, detailed article on this topic on the Midwifery today web site. Follow the links below to read more…

Excerpts:

“Caesarean section can save the life of the mother or her baby. Caesarean section can also kill a mother or her baby. How can this be? Because every single procedure or technology used during pregnancy and birth carries risks, both for mother and baby. The decision to use technology is a judgement call—it may make things either better or worse.”

“There is not a single report in the scientific literature that shows obstetricians to be safer than midwives for low-risk or normal pregnancy and birth. So if you are among the more than 75 percent of all women with a normal pregnancy, the safest birth attendant for you is not a doctor but a midwife.”

Copyright © (2007) Midwifery Today, Inc. All rights reserved.

Midwifery Today


Sensual Birth

July 9, 2007

By Anastasia Stephens

London – For Katrina Caslake, giving birth was not the terrifying, painful ordeal most women experience. Far from it. The midwife, from Wallington, south London, says she found it blissful, even orgasmic. “I found giving birth very sensual,” says Caslake, 44, who didn’t take painkillers for the birth of either of her sons, Aaron and Tomas, now 18 and 17.

“All my erogenous zones were stimulated. I was making sounds very similar to a sexual climax. And it was a very definite climax. I was doing the most feminine thing a woman can do and it felt fantastic.”

It’s a sentiment with which Frederika Deera, a PR officer at John Lewis in London, would agree. She had a similar experience giving birth to her two-year-old daughter Delphine.

‘The most indescribable euphoria’

“Giving birth filled me with the most indescribable euphoria,” says Deera, who gave birth at a midwife-led unit in Portsmouth. “Of course there was pain, but my overall sense was of peace and happiness. I was on a complete high, so much that even having a major suturing afterwards did not bother me at all.”

It was her “pleasurable experience” that led Caslake to train as a midwife. “I knew I wasn’t unique,” says Caslake, who helps run Yours Maternally, an independent midwifery service. “By encouraging other women to trust and relax in their bodies, I felt I could help them experience less painful, more pleasurable births.”

sensual Birth 2It’s an approach that’s also encouraged at the Birth Centre in south London where midwife Nathalie Mottershead actively encourages sensual birth.

“If couples are willing, nipple and clitoral massage can be used to bring on labour contractions, open the cervix and vagina and help with pain relief,” she says.

More to the point, the approach is capable of transforming birth – perceived by most women to be terrifyingly painful – into a pleasurable, even, ecstatic experience. “We work closely with women so they can give birth at home, in intimate surroundings. If mothers-to-be are open to feeling sexy, labour can be pleasurable, not painful, and it sometimes builds up to a crescendo at birth.”

‘Useful trick for pain relief’

It’s not as if the techniques used at the Birth Centre are isolated or rare.

“If a woman is comfortable enough to do nipple or clitoral stimulation during birth, it’s a useful trick for pain relief and inducing labour,” says Andrya Prescott, spokesperson for the Independent Midwives Association.

A visit to the Unassisted Childbirth Organisation’s US website confirms just how erotic childbirth can be. The site describes in graphic detail women’s fantasies in which romantic and sexual union leads to “blissful waves of pleasure”, and “cosmic orgasms” at the point of birth. More women, it seems, get turned on by birth than you’d think. When Ina May Gaskin, a US midwife, conducted a poll of 151 women, 32 reported experiencing at least one orgasmic birth. ASensual Birthdmittedly, these were home births by women who were “open” to the experience. The plus points are pretty significant – a single orgasm is thought to be 22 times as relaxing as the average tranquilliser, while sexual arousal widens the vagina significantly.

“Women might think twice about having an epidural if they knew that, but nobody talks about these things,” points out Gaskin, a natural childbirth pioneer who was the first midwife to openly acknowledge that women could climax at birth. It almost sounds too good to be true: a touchy-feely labour followed by an earth-shattering orgasm at the moment of birth.

Unfortunately, this is very far removed from most women’s description of childbirth. A major hitch is that, as with any sexual activity, the amount of pleasure gained – for women at least – is closely related to the degree of relaxation, trust and safety she feels.

Most women anticipate with dread the “birth ordeal”, a state of mind that will make muscles contract and adrenalin levels rise before it even begins. And then, most women can only feel sexy in intimate surroundings, with people they know well. Hospitals and doctors don’t really do the trick.

“Adrenalin inhibits sex drive and labour contractions,” says midwife Andrya Prescott. “You become tense and are more prone to feeling pain. It’s why women can have trouble with labour and birth at hospital. Surrounded by strangers, their adrenalin levels are high. They can’t relax. Even if they were open to getting aroused, at a hospital, they may as well forget it.”

Sensual Birth 2Part of the problem, it seems, is the way sexuality around childbirth has been denied. In her book, Ina May’s Guide To Childbirth, Gaskin points out that doctors had to downplay female sexuality for medical men to be admitted to the birth chambers of women in the 18th and 19th centuries. This “denial” was later institutionalised when hospital births became routine.

Even today, it’s a pretty taboo subject. “Lots of women would worry they’d be seen as abnormal or deviant if they admitted to feeling sexual at birth,” says Carolyn Cowan, a yoga teacher and doula based in south London, who herself had an ecstatic birth. “It’s something lots of women feel ashamed to talk about,” she adds. “I run erotic dance classes for pregnant women to try to get rid of these inhibitions. I should know a thing or two – it took giving birth to my son to discover my G-spot.”

The tide is clearly turning. A growing number of obstetricians and midwives point out what seems pretty obvious, yet has been somehow forgotten – that since sex leads to pregnancy and birth, they’re pretty closely linked.

“When you look at sex, birth and lactation, the same hormones are involved,” says Michel Odent, the obstetrician who pioneered the use of birthing pools in the Seventies. “It seems obvious that childbirth is a part of a woman’s sexuality.”

Many parents-to-be, for example, find that making love and nipple stimulation are one of the best ways to get labour going. That’s because sexual arousal releases oxytocin, a love and bonding hormone, which triggers orgasmic and labour contractions in the uterus. Conveniently, this hormone is an endorphin, meaning it has an opiate-like effect – inducing pleasure while acting as a highly effective painkiller.

Aside from the pleasure and pain relief, the advantage of a sensual birth is less physical damage. “Women who are relaxed and feel good, undergo easier, smoother births, so suffer less tearing and bruising,” says Caslake. “Fear makes a woman more tense and this holds the baby back.”

The baby gets a pleasure hit too – bathed in “feel-good” hormones, they’re more likely to come out feeling relaxed and content.
Further reading:www.michelodent.com (for more information on love hormones); www.unassistedchildbirth.com (for more info on sensual birth); www.birthcentre.com ; www.independentmidwives.org.uk; For sensual prenatal exercises contact Carolyn Cowan ; www.mooncycles.co.uk); Yours Maternally Independent Midwives, Wallington, south London (www.yoursmaternally.co.uk )

How to have a sensual birth

Why some women achieve a “birth climax” while others endure excruciating pain is likely to be due to differences in environment, genetics, expectations, and psychological factors. Trust and the level of emotional support you feel from your husband is critical in inducing a feeling of safety and relaxation needed to get the “pleasure hormones” going.Women are generally more likely to have sensual birth experiences during home deliveries in an intimate environment.

Midwives who have witnessed women who’ve been physically aroused during childbirth believe the following techniques could make the experience more likely:Before and during childbirth, become intimate with your body. Look at yourself naked in the mirror, noticing any areas that trigger uncomfortable emotions. Send loving thoughts to that area until the difficult feelings pass. Ask your partner to look at your body and compliment you.If you feel comfortable with it, aim for a home birth.

Work closely with a doula or midwife to build up a sense of trust with her, in your body and in the birth process.Ask yourself if you can believe that your body will be doing the right thing, to the best of its ability, to give birth successfully. The more you can believe this, the more you’ll be able to trust yourself and relax.

Pick a special room or area where you want to give birth. Light candles to create atmosphere and evaporate lavender essential oil in an oil burner to induce relaxation.Learn a relaxation method such as abdominal breathing to use during childbirth to curb the release of stress hormones.

Create the expectation that childbirth could be pleasurable, even if there is pain: while pregnant, spend time imagining how it could trigger warm tingling sensations in your body along with feelings of love.

If you feel it is appropriate, ask your partner to kiss you, stroke you gently or even caress your nipples as labour contractions come on.