Doulas and Childbirth



Creating A Labor Environment - General


Many people underestimate the influence your immediate environment can have on your labor. The conditions around a birthing mom can actually affect the way she labors and her ability to cope with contractions.

I'll use the commonly cited example of a gravid deer who is ready to deliver her fawn in the forest where she lives. She has found an area where she is comfortable to stay and have her baby. She has contractions, her labor progresses, and her baby will be born very soon. But she hears a noise. Could it be a hunter? A coyote? Something that means to harm either her or her baby? This mother deer's body immediately produces adrenaline, rousing her "fight or flight" reflex. She runs away from the possible intruder, and seeks a safer place to have her baby. It may take a few moments, or it may take a much longer time. But the production of adrenaline has actually slowed her labor or may even have brought it to a complete halt as she seeks a safer area. When she finds it and is again comfortable and secure, the production of adrenaline decreases and is replaced by the production of endorphins, which allow her contractions to resume and the birth to proceed. Mother Nature is amazing.

Mother Nature is no less amazing in us human beings. When a birthing mother is emotionally or psychologically uncomfortable, insecure, or distracted where she is, her body produces adrenaline. Not only will her contractions slow and be less efficient, but the boost of adrenaline makes her even more sensitive to them and she will have more difficulty coping. Creating the right labor environment can help her relax physically and emotionally, and cause her body to produce endorphins. Ever hear of a "runner's high"? The good feeling a runner gets after a long training run? That's endorphins at work. Endorphins will not only allow a mother's body to proceed with labor as it should proceed, but actually makes her feel the contractions much less than if she was under the influence of adrenaline! Isn't it great how that works?

So how can we control a mother's labor environment to enhance her endorphin production? Labor and birth, of course, are very physical activities. Not only will you expend much energy during this time, but also your senses can be heightened. These perceptions can add to or detract from your comfort and well-being, and therefore can affect your progress. The following are some points to consider when planning and preparing your birthing environment. A doula can help you add some of these considerations to your birth plan, and will also help you to achieve the environment you need. With very little modification, these considerations can be applied wherever you are birthing -- in a hospital, a birthing center, or even at home.


OVERALL ENVIRONMENT


Discussion - Plan your practical preparations ahead of time so that your birthing area will be free of the distractions of everyday life. The labor environment is no place for you to be arranging pet care, or who will take your four-year-old to nursery school in the morning. It is definitely not the place to argue with your partner over where the camera should have been packed or whether or not your mother will be present when you give birth. Try to resolve as many of these concerns as possible before labor is expected, or appoint a member of the family to handle them for you. Problems of this kind are not at all compatible with a feeling of safety, security or freedom from worry, and can hinder your progress.

Privacy - Consider whether you would like the door closed or open. If open, the door curtain can be closed. Window shades and curtains can be closed or open according to your choice. If you need to use the bathroom and wish total privacy, don't hesitate to say so (or you may decide you'd someone to stay with you at that time).

Minimal Traffic - You may choose to have family or close friends with you while you labor. This is often fine unless it begins to interfere with your comfort or with the staff's ability to perform their duties. It is usually best to keep company to a minimum as labor progresses, to aid in your concentration. Children may even be permitted in the labor room, but it is best if someone is present to personally take care of each child and remove the child from the room when necessary.

Mobility - Remaining as mobile as you can greatly aids your progress in labor. Movement and gravity help to bring your baby down quicker than staying in bed. Keep this in mind when presented with interventions that will cause you to remain in bed for long periods.

Personal Items - Bring with you small personal items that will make you more comfortable. Consider a favorite photo or other item to use as a focal point, music you have chosen to hear, a favorite pillow, robe, slippers, etc.

Room Temperature - There is much that can be done to bring the temperature to your comfort. Ask to have the thermostat adjusted, if you are uncomfortable. A doula can also use hot packs, cold packs, warmed blankets and towels, cool cloths, even an overhead warmer if you wish.

Creative Positioning - Doulas are trained to help you with positioning during labor. We can suggest many positions that will help you during different stages of labor or during back labor. There are also positions that can help you rest while upright, or even while using the shower. Your doula will make recommendations for you and you can decide for yourself if they are accomplishing their purpose.


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©Karen N. Kilson