Doulas and Childbirth

Creating A Labor Environment - Touch

Clothing - In a hospital environment, it is probably wise (but not necessary) to wear hospital gowns during labor, because they are plentiful and always available. They can be worn two at a time, one to cover the front and one to cover the back. Your favorite nightie or T-shirt can be saved for after the baby is born, when there is less chance that it will be soiled. But if you want to wear your own personal things during labor, by all means do so. In fact, if you choose to be naked during labor you may do that too! Walking is wonderful for labor, and you may want to bring a robe for walking in the halls, although you can use a hospital gown worn backwards for that purpose also. Your birth partner should, of course, dress comfortably for what may be an extended period of time. If you have gone into labor quickly or unexpectedly, your doula can obtain for you anything you may need.

Showers and Tubs - Your doula can provide you with soap and towels for the shower, if you wish., although most women in labor simply enjoy the hydrotherapy benefits. But by all means bring with you your favorite soap or shower supplies for after delivery. Using the shower during labor can be very beneficial, and you may be encouraged to do so. However, if you are in a hospital setting, the towels are usually quite small and you will need a few of them at a time. Feel free to bring a large towel or two from home if you wish. Your doula can also bring you a heated blanket to dry with or cover yourself, very comforting when you come out of the water into the room air.

External Monitors - At some someone will need to listen to the baby's heart rate. This may be done with a hand-held doppler device or a fetoscope. The caregiver will simply hold it against your abdomen and listen to baby's heartbeat during and beyond a contraction. If baby needs to be monitored for more than that you wil be attached to an electronic monitor near the bed. Elastic straps will be placed around your abdomen to hold the sensors in place. These are not usually uncomfortable, but they will restrict your movement to an area equal to the cords' length. The monitors sometimes use gel for conduction and the gel can be cold at first, but it rapidly warms to your body temperature.

Exams - It is fairly predictable that you will have at least one vaginal exam to determine your progress in dilation. If this is uncomfortable for you, try to concentrate on relaxing your pelvic muscles. You can also use your favorite breathing pattern during this time or ask your doula for guidance.

Massage, etc. - For most women, touch is essential during labor. This may be in the form of massage, acupressure, stroking, effleurage, or even simply holding someone's hand. Your doula can perform all of these for you, or can instruct your partner. There are methods of touch to comfort, to assure, to soothe, to counteract back labor, to help you relax. She has been trained in all of these and, with your permission, will use them as you need them. If you choose not to be touched at all, or during certain moments, simply tell your partner and your doula.

These have been considerations for planning your physical labor environment. There are many other aspects of labor and delivery for you to discuss with your birth partner, doula, or obstetrician. The doula that accompanies you is not part of the medical staff, and will not make medical decisions for you. She can, however, see that you have the necessary information to make your own decisions when something unforseen arises. Spending time well before labor begins to discuss general medical preferences or choices will eliminate the need to make difficult decisions under difficult conditions.

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©Karen N. Kilson