Doula Services

A doula is a woman experienced in childbirth who provides continuous physical, emotional and informational support to the mother before, during and just after childbirth. A Joyful Beginnings Doula does not perform clinical tasks such as taking your blood pressure. Joyful Beginnings doulas are certified by either Doulas of North America (DONA) or International Childbirth Education Association (ICEA). DONA was founded by premiere researchers/authors Dr. John Kennell, Dr. Marshall Klaus, Phyllis Klaus, MSW, and Penny Simkin, PT. ICEA sets the standard for childbirth education around the world.

Why You Should Consider a Doula
How Can a Doula Help During Labor?
Doulas and Dads

Why You Should Consider a Doula

There are several reasons to consider a doula, including the following. A doula

• Recognizes childbirth as a key life experience that the mother will remember all her life;
• Understands the physiology of birth and the emotional needs of a woman in labor;
• Assists the woman and her partner in preparing for and carrying out their plans for the birth;
• Stays by the side of the laboring woman throughout the entire labor;
• Provides emotional support, physical comfort measures and an objective viewpoint, as well as helping the woman get the information she needs to make good decisions;
• Facilitates communication between the laboring woman, her partner and clinical care providers; and
• Perceives her role as nurturing and protecting the woman's memory of her birth experience.

You may want to read the books Mothering the Mother by Klaus, Klaus and Kennell; Maternal Infant Bonding by Klaus and Kennell; The Birth Partner: Everything You Need To Know To Help A Woman Through Childbirth by Simkin; or Special Women: The Role of the Professional Labor Assistant by Polly Perez, RN, FACCE.

For more information about the Joyful Beginnings Doula Program, call 865.305.9300.

How Can a Doula Help During Labor?

Your doula will help you in four ways during your labor. She will help you emotionally, with information, educationally and physically.

• Emotionally-Your doula will be a patient and wise companion during labor. She will give you undivided attention, reassurance, encouragement and guidance. A gentle, warm touch and a soft voice will help you focus throughout labor.
• With Information-The doula can help with communications. Your doula will help you to remember to ask the questions that will keep you informed on your progress during labor and help you make the best informed choices. You may have questions about certain procedures and she may be able to answer them for you. If not, she will be able to identify the right member of the team to answer the questions for you.
• Educationally-The doula can help you remember what was covered in childbirth education classes such as positions to use during labor, relaxation techniques, breathing techniques, helpful hints if you should have back labor and positions and techniques for pushing.
• Physically-Labor and birth are very physical events. Your doula will give back rubs, assist you with changing positions, apply hot or cold packs, give counter-pressure, and many other comfort measures to increase your comfort level during labor and birth.

For more information about the Joyful Beginnings Doula Program, call 865.305.9300.

Doulas and Dads

Some women feel that if they have a partner involved in the birth of their baby, the services of a doula are unnecessary. The expectant mother's partner may not always be the baby's father. It can be a sister, mother, friend, etc. The doula's role applies with any partner the mother chooses. The doula is sometimes thought to be needed only by women without partners. Likewise, some fathers may feel threatened by the presence of a doula, worried that she will somehow prevent him from total participation in his baby's birth.

Before Labor
The doula can enhance the birthing experience for both the mother and the partner/father. During pregnancy, a doula meets with the couple to discuss the birth of their child. Both partners' thoughts and feelings are addressed. Their wishes, worries and concerns are discussed as thoroughly as they want. During a woman's pregnancy, questions usually are addressed to her. However, the partner/father is given a chance during a prenatal meeting with a doula to talk about his own concerns for the birth. The depth of discussion is dependent on each partner's comfort level. The doula can answer almost any question the parents ask, without pressing the couple for more information than they are comfortable revealing.

The Beginning of Labor
At the onset of labor, some doulas will come to the couple's home and help them through the beginning of labor until the time arrives when they must leave for the hospital. Upon departure, the doula can help the father prepare the mother, pack suitcases into the car, make phone calls and any other final tasks to be done.

Once at the hospital and as labor increases in intensity, the doula's role with the father becomes significant. The deepening pain of the contractions the mother experiences can spark new questions and feelings in the father. Doulas are experienced in childbirth and have a good understanding of what is normal in labor as well as options to consider if their labor does not follow typical patterns. She will be in constant attention to the parents, and can readily assure them that their labor is progressing "normally." She can explain certain medical procedures or gather further information from the doctors and nurses if they desire. When a couple goes through labor for the first time, they have a partial conception of what typically happens during the birthing process, based on childbirth classes and books they may have read during pregnancy. Of course, they also have heard the birth stories of their friends and family. However, this labor will be different from all other births.

During Labor
A hospital is an active place. The labor nurses and doctors have several patients they are attending, therefore they commonly are in and out of the labor rooms. On less busy days, they may spend more time with each individual patient.

Fear of the unknown plays a part during labor for parents. They study the demeanor and facial expressions of the professionals attending them for signs that all is well or for signs of trouble. A doula's countenance and manner also can be looked on by fathers as additional assurance; a more personal assurance, since they usually will have formed a relationship earlier in the pregnancy. A father can feel comfortable being candid with the doula.

As a father might look to a doula for assurance, the mother looks to the father (partner). She can better relax and help her baby out if she has the confident, unwavering support of her partner. If he appears nervous and unsure, she feels it. She may interpret his behavior as confirmation of her fear that something must be wrong. (The first-time mother can feel this readily, although things may be going quite well.) If the father appears encouraging and strong, she feels it. She may interpret this behavior as confirmation of her hope that everything is all right.

The doula helps the father to attend to the mother, sometimes just by her presence. A doula will have some one-on-one contact with the mother, massaging her into relaxation, talking her softly through the pain, encouraging her to vary positions, which speeds labor and can lessen pain, and expressing support between contractions. Sometimes the father will learn how to better help his partner by observing her reactions to the doula.

Fathers and doulas can team their efforts in helping the mother as well. (i.e. "You massage the right leg, I will do the left.") They may use their strength together to help the mother walk during labor, which also can speed progress. When the time comes to push the baby out, a common position for the mother is sitting up, with each knee bent into her chest, supported by two people. There are many positions the mother may use that require the physical support of two people. In this, the combined efforts of both father and doula can be very effective.

At Delivery
Upon delivery, Dad may want to observe his newborn child's first medical assessments. The doula will remain by the mother unless instructed otherwise. This enables the father to marvel at the new life, make phone calls or visit the restroom while the mother continues to receive support. If he wishes, their doula can make the calls while he stays with his partner.

After Delivery
A few days after the delivery, the doula will return to the couple for a postpartum visit, and to assist with breastfeeding and newborn care if needed. This is a splendid opportunity for the parents and their doula to exchange thoughts on the birth. It is important for the couple to understand what went on during their birth experience. In the midst of the pain and excitement of delivery, understanding can be hard to gain until afterward. During the doula's postpartum visit, any questions the parents have about their birth will be discussed and, hopefully, each will be left with understanding and contentment about their child's entrance into the world.

For more information about the Joyful Beginnings Doula Program, call 865.305.9300