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Birthing Language by Tara Thompson, BWI Birth Doula Student

Words are powerful, so it is important to consider what words to use around a laboring mom. Her senses are already elevated and she is on high alert, and she is perhaps now in her “primal brain”. What is said to her or in her presence is sure to have an impact on her labor and possibly even her labor progression. Words are not always necessary at birth, and even kind and encouraging words may inhibit the mother from fully being in her labor state of mind which could possibly interrupt her labor. Not all women enjoy listening to others during their labor. It is important to know when to talk and when not to. When language is needed or wanted, how we talk is of great importance. Please allow me to explain this further.

The volume at which we speak should be considered. Is the mom vocal herself, perhaps moaning loudly? Is the room full of distractions? Are you trying to assist her in finding something to focus on? She may appreciate a loud, direct tone, but often, I think it is more so the case that a woman needs a soft voice spoken to her. A whisper in an ear can be received stronger than a yell. The loudest voice in the room isn’t always the most impactful. It is important to evaluate the situation, know the mother and follow your intuition when deciding on how to speak to the laboring mom.

Where we are when we are talking to mom is also important. Are we across the room or are we near her and close to her in her laboring space? Depending on where a woman is in her labor, she may only be aware of the bubble around her. To properly communicate with a laboring mom, you must be near her and in her space, while being respectful of that space as well. It is hard to whisper across a room to someone who may not even see or feel you.

Once respecting the importance of volume of our voice and location of ourselves in relation to the mom, we must carefully craft our words. As a doula, I am careful to not interrupt a mom’s labor as sometimes silence is needed and wanted. With that said, I also know when to use words to encourage, reassure, inspire and affirm. I would not want to mislead her by using arbitrary words. I must also be careful to not give subjective medical advice if she asks
questions on what she should do if given options by her provider. These words could easily derail a mom from her labor.

A carefully crafted sentence is important and how we phrase what we are trying to convey to mom should be considered before speaking.
Nurse: “You are 4cm dilated.”
Mom: “JUST 4cm?!”
(insert pause to think, consider her feelings and gently touch mom while looking at her)
Me: “You are making great progress! Your body is working to open so your baby can
come out.” (Refrain from analyzing numbers)

In that exchange of words, I wanted to be careful not to mislead her. I didn’t want her to feel as if she had so much more to progress, but I also didn’t want to convince her that the next part of her labor would be fast. I simply wanted to support her by giving her well-earned credit for her hard work and remind her that her cervix is not a crystal ball.

“This is hard!”, says the mom. My reply would be simple, “…and you are strong! You are doing good work to meet your baby.” I would be careful not to choose words that give herself doubt. I want her feel confident herself. Labor is of course hard work, but it would not be helpful to affirm that or remind her. What would be helpful is to remind her that she is strong enough to birth her baby.

What if mom says, “I can’t do this.” I can recall saying this when in labor with my first. I also remember hearing, “You have to, sweetheart.” Maybe the reply was said with empathy and some endearment, but it did not leave me feeling confident, positive or optimistic. I felt helpless. A better reply would have been, “…but you are already doing it. I am right here with here with you.” I think it would have been helpful to be reminded that I was doing it and that I
wasn’t going to be alone.

These are several examples of what can be said to a woman in labor, but ultimately it is important to remember the timeliness of our words, the volume at which we say those words and where we are communicating them from. If we remember to speak from our hearts, we are more likely to speak what is perfect at that moment in time.

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Virtual Doula-ing During Covid-19 By Amara Minnis, CCE(BWI), CD(DONA)

These are unprecedented times. Have you heard? Of course you have. And you have probably
said that same thing yourself. We are throwing this phrase about so much with the COVID-19
pandemic that it is becoming alarmingly normal to be living in unprecedented times. Everyone
has been impacted by the adjustments that have been made to preserve health and safety. And
right about now, if it hasn’t already, it’s become a struggle. I’ve got to be honest, when I first
learned of the restrictions at our local hospitals, I was angry. I was upset that the women who
had chosen to have doulas at their birth would be forced to decide between having their
partner present or their doula. But when I took some time to reflect on the severity of the
situation, my heart was settled knowing that the restrictions were made for the health and
safety of everyone, including me. So I changed my thinking and jumped on board with my doula
sisters in being creative and inventive during the pandemic.
At the heart of the matter, my work as a doula is the same as it always has been. We have our
prenatal visit and our postpartum visit, only now it occurs virtually using Facetime or Zoom. It’s
important more than ever that we connect and discuss fears and worries about the upcoming
birth. It’s coming together as a team, and an opportunity for me to reassure and encourage
during what is such an uncertain and to some, scary time to have a baby. I am present for my
clients, offering reassurance and nonjudgmental support. And then postpartum, when stay in
place mandates have limited or eliminated the option of postpartum help from family and
friends, it’s critical that I check-in with my clients to see how they are doing and to answer any
questions or give any encouragement I can. It’s easy to feel isolated after giving birth in
ordinary times. In a pandemic, it’s pretty much a guarantee.
While the current situation has made it so I am not physically present in their birth space, I’m
still a presence at their birth. Let me elaborate. Some clients have chosen to have steady
support by way of video, using Facetime or Zoom. We are in touch in early labor same as
always, by phone or text. Then when their labor intensifies to the point that they would
summon me to join them, we setup the video connection and I am there. The words are the
same, the questions are those I would ask in person, and the recommendations are as the
situation warrants (cold cloth, position changes, comfort measures). Sometimes I am quiet,
assessing, watching and listening, ready to help when the need arises. But we know that
women are made to birth and as such staying silent is as important or more so, than speaking.
Some clients have preferred steady connection the whole way through with text and phone
calls and so I have honored that preference too.
I have been so very pleased with the reception I have received as a virtual doula in our area
hospitals as well. The nurses are working so hard to take care of their patients with the added
stress that comes with working in the medical field during a pandemic. And they have
graciously welcomed me to the birth space virtually. They have helped to incorporate me by
moving the laptop when the partner has forgotten, so I have a better view of my client. I have
had conversations with the nurse, midwife, or doctor when there is reason to talk about options and to encourage the birthing woman as a team. We are all still connected, still have the same goal, and still have a job to do.
While the current situation has its challenges, I am grateful to still have the opportunity to
serve my clients. There is more need for doula support more than ever, with such a feeling of
uncertainty day by day, and the fear about bringing new life into a world that feels so unsafe.
As doulas we can still do what we do best—support our clients, offer reassurance and
encouragement, and to be a lifeline when they feel disconnected from the world. Hopefully, we
can return to being a physical presence sooner rather than later. But for now, this will work. We
have a job to do. And our clients are counting on us.

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BIRTHWORKS FOR NEW ZEALAND’S YOUNG PARENTS

By Rosemary Joyce                                                                                                                                                                                                                                                                                                       January 2015

New Years day saw people celebrating a fresh start the world over. But in Canterbury, New Zealand, the birthing community was celebrating for a different reason. The 1st of January 2015 marked the first day of district health board funding for young expectant parents to do BirthWorks with The Birthing Room, through The Youth Alive Trust. And this is worth celebrating for multiple reasons! Whilst The Birthing Room has been facilitating BirthWorks in Canterbury since 2013, it is the first time the NZ government has actually funded a completely different kind of antenatal education (i.e. one that differs from the medical model). So it is the first time parents in NZ have been able to do BirthWorks for FREE. And BirthWorks changes lives!

The excitement and support from the midwifery community has been wonderful. Midwives are really looking forward to young expectant parents receiving positive, empowering messages about birth. They believe this not only sets up young people for a positive birth experience, but also on a life altering path of good self esteem and gentle, loving parenting.

In February midwives, family doctors, and school and sexual health nurses will be welcomed to an introductory evening of BirthWorks. This will be a special opportunity for key health professions to ask questions, hear from other’s experiences of BirthWorks, and see what the future holds for Cantabrian young parents.

The Youth Alive Trust’s antenatal education for young expectant parents is called BUMP. As well as BirthWorks with The Birthing Room, the BUMP journey includes antenatal exercise, budget advice, nutrition and cooking skills, breastfeeding support, postnatal playgroups, and a mentor throughout each parent’s pregnancy and early parenting journey. The first BUMP course begins on March 31st.

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Value of a Doula

by Tiffany Hare
When people ask me what I do, I always respond by saying, “I’m a doula and a childbirth educator.” And then I wait. I wait for the look of uncertainty to fill the face of the person who asked me the question, or for them to say, “What’s a doula?” The word is still a very unfamiliar one in some parts of the country, and even though I live in a large suburban area outside of Philadelphia, many of the people I come into contact with outside of the birth-world have never heard of a doula.

And that makes me a bit sad.

I think back to a time when women were surrounded by other women during their labors and their  births; a time when by the time a woman had reached childbearing age, she would have seen birth happen so many times that she was well-prepared for it herself.
But we don’t live in that time. We live in a time in which birth is unknown and frightening to many women. It is during this time that we need doulas.
We need doulas to help us get the information that we need so that we are empowered to make the right decisions for ourselves and for our babies. Doulas can help us make decisions by providing us with information and guidance. Doulas help us through our labors and our births by offering constant companionship .

The value of having a birth doula cannot be underestimated. As anyone who has given birth can tell you, giving birth is one of the most life-alerting events that one can experience. Birth is an intimate event. It is an event that does not come with a do-over button. And while we can never predict an outcome, especially in an event as unpredictable as birth, we can take steps in order to achieve the birth experience that we dream of.  Doulas are one step you can take in order to get the birth that you hope for.
Since the beginning of human history, birth took place in the home, with family present, and with a midwife who was experienced in normal birth. Girls and women witnessed birth and experienced it long before they gave birth to their own children. Today, in a culture in which birth typically takes place outside of the home, most women have no experience with childbirth until they give birth themselves. It is a new and foreign experience for most of us.
On average, the length of time a woman who giving birth for the first time spends in labor is about eighteen hours. During most of that time, she and her partner are left to blaze this unexplored trail on their own. It can sometimes be a scary experience that is full of unknowns.
However, studies have shown that having a doula present at your birth can greatly increase your chance of having a birth outcome that you feel good about. Doulas can help to increase positive birth outcomes and decrease the use of medications such as Pitocin and epidural anesthesia. Doulas can decrease the total length of labor by about 25% and decrease the incidence of cesarean delivery by about 50%. Overall, doulas can help you avoid unnecessary interventions and they can help you get off to a better start with your baby and increase your chances of having a successful breastfeeding relationship.
A doula is present during the entire labor and her knowledge and experience can help the mother find confidence and security throughout her birthing experience. When a woman feels safe, confident and secure, oxytocin (“the love hormone”) flows freely and facilitates the progression of her labor. Feeling safe reduces the presence of adrenaline, the hormone responsible for fight or flight syndrome, which can slow or stall a labor. When a woman is supported by a doula, she feels that she has better control of her birthing experience, can make decisions with confidence, and is free to trust what her body is telling her. 
Birth is an event that is not forgotten. The experience stays with us throughout our lives. In birth, as in life, there are no guarantees, but having a doula present at your birth can help get one step closer to realizing the birth that you hope for.