I'm often asked during interviews, "what are some things you do to help a woman that is in labor?", and my answer is essentially the same: it depends. It depends on a variety of things, really, because not every woman needs the same type of support. Some laboring mothers really need hands-on support; perhaps her back is aching with every contraction and she needs counter- pressure to help cope through her contractions. Sometimes a laboring woman simply wants an experienced support person who can reassure her or simply be present. And sometimes a laboring mother and her partner want someone who can remind them of their preferences during their birthing experiences. I watch and listen to a laboring mother and respond to those words and body language.
The things I do to support a laboring woman may not sound profound, and it may not even seem like you need to hire another person to do those things. But in talking with my previous clients and other families that have also worked with birth doulas, I'm repeatedly told how helpful it was to have a doula present.
So what do I do?
- provide hands-on support: massage, gentle touch, counter-pressure to her back or hips
- attend to her physical needs by providing items to bring comfort: warm blanket, cool compress, fan, rocking chair, extra pillows, a cold drink, snack, lip balm, hair elastic band, clean bed linen, socks, clean gown or underpants
- answering questions and providing information: reassurance about current stage of labor, reminder to ask questions (when applicable) to care provider (midwife, nurse, doctor), information about common interventions, suggestions re: laboring positions and movements which may facilitate the birthing process
- emotional support: positive statements concerning how mom is working through the stages of labor, emotional reassurance if medical interventions become necessary, support and loving presence if a laboring mother changes her preferences during the birthing process
I also tend to the needs of a laboring woman's partner or other support person. Often times the partner and I work together to provide support to the laboring mother; I might bring a fresh cool compress to her partner so he can remain bedside holding the cold cloth to the mother's head. I might provide back massage while the partner is able to maintain eye contact with the laboring mother, helping her through the contraction. I remind the birth partner to stay hydrated and nourished. I might provide counter- pressure to a woman's lower back while her partner slow dances with her, supporting her need for rhythmic movement. Sometimes labor lasts longer than the partner is anticipating and my presence allows her to take a quick break, knowing that that I will contact her if the laboring mother needs anything or if anything advances in labor during her absence.
Essentially, my role is anticipate and respond. When I accompany a laboring woman and her partner to the hospital to be admitted, right away I begin setting the room in a way that may provide comfort and relaxation. I make sure there are plenty of pillows, drinks for the mother and her partner, and assist the mother change into a gown or whatever she chooses to wear in labor (sometimes it's a reminder to the mother that she wanted to avoid wearing a hospital gown, which she may be suggested to wear, simply part of the routine admittance process). If the mother wanted to have certain tools available, I remember to ask for these items (birth ball, peanut, squat bar, etc). I can handle the physical environment while her partner may be supporting her emotional needs, as she is admitted to the hospital system. And of course, if the mother doesn't have another support person present, then my role is usually even more essential.
Part of laboring is getting out of the "thinking" part of the brain and moving into the "being" part, so my role as birth doula means anticipating what a laboring woman needs. Is she licking her lips, because they are dry from breathing heavily with each contraction? Is she moving her mouth and tongue in a way that shows she's thirsty? Is she struggling to get into a hands and knees position with each contraction? I am there to help before she even has to ask, and she may not even be able to verbalize her needs because of the intensity of labor. And often times, a partner learns to anticipate the laboring mother's needs, but it can be challenging or possibly overwhelming as labor intensifies because the partner is not only having to respond to the laboring mother's needs, but the partner also has his/her own needs. The partner may be worried about the intensity (is this labor normal?), wondering what s/he can do to support the laboring woman (I feel helpless, or I don't remember what to do), or the partner may simply need an extra pair of hands so s/he can remain with the laboring mother at all times (I can't reach her water or I don't know where to quickly find a new pillowcase).
As a birth doula, I see my role as being secondary to the partner. I want the partner and laboring mother to look back at their baby's birth and see it as an intimate and special experience. I support that and I like to slip into the background, as each experience dictates. I like to think that I can set the stage and provide the necessary support while helping keep the experience between the mother and her partner. Sometimes I am very much part of the laboring process, and it is "the three of us" type of feeling. And that's okay! But I don't ever want to have a partner feel like I'm replacing him or that she is not needed to support the laboring mother.
So what do I do to support a laboring mother and her partner? Basically, anything! And also, it depends on what she is needing.