Thursday, May 9, 2013

Here is Penny Simkin's take on Partners and Doulas

 

Myths about (Partners) and Doulas

by PENNY SIMKIN PT
One Question heard a lot is what about Dad? Will a Doula take his role? I hope to be able to answer those concerns with the below information:
Photo courtesy of Whatever Photo

Myth # 1 - If a woman has her partner, the Doula becomes redundant.

Reality - The Doula may be the only person at the labour besides the partner who is there solely for the emotional well-being of the woman.

The nurse the doctor the midwife have other priorities that compete with the emotional care of the woman: for example, breaks, shift change, clinical responsibilities, office hours and hospital policies. The doula has few or no other priorities. She stays through shift changes, and until after the baby is born. She is not just another stranger with the couple. She has the woman's needs as her sole priority. In some cases, the couple will bring several other friends or family members into labour with them. Sometimes these people can be uncertain of how to help which leads to confusion and actually adds to the woman's stress. The doula can direct and coordinate the efforts of a group of people, giving them all something to do, so they work as a team on the woman's behalf.

Myth # 2 - The doula "takes over", displacing the partner and interferes with their intimate experience.

Reality - The doula can actually bring the couple closer.

By making sure that the partner's needs are met (food, drink, occasional back rubs, and reassurance), the woman and her partner can work more closely together. The doula allows for the partner to participate at his own comfort level. Some partners prefer to be there only to witness the birth of their child and to share in this experience with the woman that they love. They may not want to play an active role and do not want to be responsible for the woman's comfort and emotional security. The doula can fill in and allow the partner to participate as he wishes, without leaving the woman's needs unmet. When the partner chooses to be the major source of emotional support, the doula can supplement his or her efforts by running errands, making suggestions for comfort measures, and offering words of reassurance and comfort. During a long tiring labour, she can give the partner a break for a brief rest or change of scene. While the doula probably knows more than the partner about birth, hospitals, and maternity care, the partner knows more about the woman's personality, likes and dislikes, and needs. Moreover, he loves the woman more than anyone else there. The combined contributions of partner and doula, along with a competent, considerate and caring staff gives the woman the best chance of an optimal outcome.

Myth # 3 - The doula has her own beliefs about how birth should go and imposes it on the woman or couple.

Reality - The doula's true agenda is to help ensure that the woman's or couple's agenda is acknowledged and followed as much as possible.

If the doula is thoroughly familiar with the couple's wishes and their plan, she may actually think more about it than the couple, especially when labour is intense and things are happening rapidly. The doula can remind the staff or the couple of some items on the birth plan that are forgotten, but which might later be important. Sometimes if a birth plan is not followed, the couple later looks back with regret or disappointment. The doula helps with decision making by asking questions that will ensure that the right information is given to the woman or couple so that they can make an informed decision. She may also suggest alternatives for the couple to consider. She does not, however, make decisions for the couple.
In summary, the doula helps make the birth experience to be as rewarding and satisfying as possible. As one father said, " I heaved a big sigh of relief when she (the doula) walked in. I hadn't realized how much pressure I had been feeling. She not only calmed my wife, she calmed me down."
Penny Simkin, PT, is a physical therapist who has specialized in childbirth education since 1968. Among her books are Pregnancy, Childbirth and the Newborn: The Complete Guide , now in its third edition, The Birth Partner: Everything You Need to Know to Help a Woman Through Childbirth, Episiotomy and the Second Stage of Labor, and most recently, The Labor Progress Handbook: Primary Interventions to Prevent and Treat Dystocia, with Ruth Ancheta. She has written chapters for three major medical textbooks, and a series of materials on pain medications and comfort measures for childbirth has recently been published by Childbirth Graphics.
Currently, Ms. Simkin serves on several boards of consultants and editorial boards, including the journal, Birth: Issues in Perinatal Care; the International Childbirth Education Association; and the Seattle Midwifery School, where she also teaches. She is a founder of the Pacific Association for Labor Support (PALS), Doulas of North America (DONA), and trains doulas and doula trainers. Her practice consists of childbirth education, birth counseling, and labor support, combined with a busy schedule of conferences and workshops.
Copyright 1999 Penny Simkin.