Doulas' comfort measures for labor, and what to do if you can't afford a doula.

July 04, 2011

Are you preparing for your baby’s birth?  Looking for comfort measures you can use for labor and birth?

Having a doula (a trained support person for birth and the postpartum period) present during your labor and birth can make it a much more comfortable experience.  Doulas have long been associated with shorter labors, less interventions, fewer c-sections, and more positive birthing experiences.  They’re also great for breastfeeding support.

We asked Ananda Lowe, doula and co-author of The Doula Guide to Birth: Secrets Every Pregnant Woman Should Know, to share some comfort measures for labor, as well as some tips for finding a low-cost or free doula if you can’t afford to hire one.

What are some comfort measures that any mom can use in labor, whether or not she has a doula?

Studies show the most effective form of natural pain relief is to take a warm bath, and the rate of epidural use goes down when baths are used.  Stay in a long time, up to 90 minutes for the best effect.  Warm water provides relaxation by stimulating the skin on your entire body (like a water “massage”), increasing blood circulation, and reducing blood pressure and muscle tension.  A shower can provide similar effects.  However,  only 10 percent of women report they used warm water in labor.  At one of our hospitals in Boston, there are no showers in the birthing rooms,  so you have to walk down the hall to a shower room.  I remember standing in the hall while my client was showering, and another woman in labor walked by.  I told her there were two showers and she could use one.   She said, “No thanks, I don’t need a shower.”  I realized afterward that she thought I meant she could take a shower to get clean, but she had no idea it was a type of pain relief.

What are some lesser known comfort measures that a doula might use with a laboring mom?

When a woman is having her first baby, I tell her to expect to be in labor overnight.  She might not experience it, but most likely labor will be long enough that she will.  Sleep is very important so she will have enough stamina to finish labor.  Believe it or not, a doula might inform a mother that a glass of wine is known to be a tocolytic, or labor-inhibiting agent.  It usually slows down labor for the few hours it takes to by metabolized by the body.  A woman can sleep a bit, and she will wake up in labor again.  (Doctors formerly gave alcohol to women by IV injection to stop premature labors.)  A mother can ask her doctor or midwife about the option of drinking a glass of wine at home.  Alternately, taking a warm bath for more than 90 minutes can have the same effect, due to the way the brain responds after a long period of immersion of the body.  Doulas believe that sleeping in labor is possible, and a very good idea!

If a mother wants a doula but can’t afford to hire one, what can she do?

Most doulas-in-training offer a reduced fee until they are certified.  A trainee has enough education in birth to be a valuable presence at a woman’s labor.   Contact the national doula organizations to find a trainee or an experienced doula, at www.cappa.net, www.dona.org, www.ictcmidwives.org, and www.tolabor.com.   Otherwise, ask a friend who had a positive birth experience or a natural childbirth to be at your birth.  Our culture thinks of birth as a private event between a woman and her mate, but hospitals are full of staff who are strangers.  In past eras, it was a woman’s experienced female friends who guided her through birth.  I strongly encourage women to bring a friend or two to their labor.  Birth is such an intense experience, and hospital procedures can seem so overwhelming, that it is probably asking too much of a pregnant woman and her mate to get through labor alone.

Tags: ananda lowe cappa.net cesarean section choices in childbirth comfort measures for labor dona.org doula epidural the doula guide to birth




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