Monday, January 24, 2011

A doula might do ya good

Ancient tradition improving birthing experiences for area women

Giving birth to babies.

It is undeniably painful. A raw and gritty exploit.

It is a rite of passage for pregnant first-time moms to endure birthing tales of humiliation, blood and agony from women who have gone before them.

Birthing mothers have been portrayed in film as women gone berserk — screaming, out-of-control creatures who are not above inflicting verbal and physical injury to nearby loved ones.

But a growing number of women in and around Washington County are envisioning and seeing through a kinder, gentler, more-controlled birthing experience.

Their calm in the chaos is the doula.

Translated from Greek as "a woman who serves," doulas are trained professionals who provide physical and emotional support to mothers before, during and just after birth. According to the website of doula organization DONA International, research shows that when doulas attend births, labors are shorter with fewer complications, and babies are born healthier and breastfeed more easily. The number of DONA certified birth doulas worldwide has risen from 31 in 1994 to 2,636 in 2009.

Amy Miller, 33, of Funkstown is working toward doula certification through DONA. She has completed her studies, and is required to provide doula services at three births before being certified. Miller, who operates Red House Childbirth Services, said she hopes to change women's negative notions of giving birth.

"I love giving birth. I've done it five times and I'd do it a hundred more," she said. "I want to empower women by helping them understand how their bodies work so they are working with their bodies and not against them. That's an important thing."

Doulas meet with their clients at least two times during pregnancy.

"I'll discuss with the mom what her hopes are for the birth, do a little bit of education, go over some comfort techniques," Miller said.

They typically are on call 24 hours a day from two or three weeks before a mother's due date until the delivery. Doulas stay by the mother's side through labor until several hours after the birth, helping with breastfeeding, newborn care and other needs, then provide at least one post-partum visit at home.

Services are provided for a flat fee, ranging from $400 to $600 in more rural areas to $1,200 and more in cities.

Miller is serving as doula to Christi Vaughan, 33, of Funkstown who is due with her seventh child in July. She recalls her first four labor and deliveries at a hospital in Montgomery County, Md., as negative, nearly devastating, experiences. Vaughan said overworked hospital staff gave her an unnecessarily large dose of epidural anesthesia, causing her baby's heart rate to drop to "near death." During another of Vaughan's pregnancies, she went into labor near a holiday. A doctor told her if she wasn't dilated in four hours, she would perform a technique to physically manipulate dilation, then proceeded to so do.

"I was screaming, hysterical. When (my daughter) came out, I was in so much pain I couldn't even bond. I was like, 'What just happened?'" Vaughan said.

Vaughan never returned to that hospital, and her next two birthing experiences were satisfying. Having recently moved to Funkstown, she said she plans to deliver her seventh child at Meritus Medical Center, with Miller assisting. She believes having a doula present gives women more confidence to be involved in choices. She observed a birth during which her friend used a doula, and said the doula was soothing and in tune, performed massages and helped keep her friend focused.

"It gave my friend control over the process," she said. "I was very impressed."

The role of doula

Christie Cooper, 40, of Hagerstown, operates Mommacoop's Doula Services. A certified doula since 1998, Cooper said it is important for clients to understand the role and limitations of the doula.

"I am there as an assistant for you and your family. I am not there to control the birth; I am not there to tell you how to have your baby. I am only there to help you find your own individual way to give birth," she said. "We do nothing medical or clinical."

Cooper said most area nurses and obstetricians seem "very open" to doula assistance. Birthing units regulations usually allow two or three people to accompany the mother, and a doula is considered among them.

"On a busy day at the hospital, most nurses seem very appreciative to have someone to be with the patient while they are with another," she said. "And it reassures the mom, too, because a doula is there by their side with 100 percent attention, no shift change."

Cooper served as doula to Vikki Shank, 37, of Hagerstown, during the birth of all three of Shank's children.

"(Cooper) gave me insight as to what would be happening next, like following contractions on the monitor. She'd tell me, 'This one is gonna be a big one' or 'This will be coming down soon,'" Shank said. "She had knowledge and expertise that my husband and mother didn't have."

Doula B.J. Kettermen, 36, of Martinsburg, W.Va., said fathers often are as relieved to have a doula present as mothers are.

"It gives them a sense of relief from some of the pressure of not knowing what to do or what to say at what time. The doula usually knows what's coming next and can pass that on. Dads seem to like that," Kettermen said.

A growing trend

Though she has only been a doula for about one year, Kettermen said she has provided services for a range of women from married mothers with multiple children to a teen mom. She has assisted with natural birth as well as births involving induction, epidurals and the Hypnobabies technique — a relaxation method for birthing mothers. She looks forward to assisting with a Caesarean birth.

People have used doulas in various cultures for centuries, Kettermen said. It's a basic idea of an experienced woman assisting another. But Kettermen said the doula concept just recently seems to be gaining momentum in the local area.

"Some of my clients have interviewed other doulas," she said. "Women are hiring doulas and having a great experience and telling friends, so it's growing in popularity. It's picking up on the national level, and it's up and coming here, too.",0,1843052.story

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