IS A BIRTH COACH RIGHT FOR YOU?
March 1st, 2009 by Jane Schneider
Mom Beth Best served as a doula to the Roudnev family (right) and Amy Risley and Joe Jansen. Best and Risley are pictured here with Amy’s newborn daughter.
Mary Roudnev used a doula for the birth of each of her two children. She lived in Chicago when her 7-year-old daughter Maria was born. But when she relocated to Memphis and became pregnant a second time with son Andrei, she knew she wanted another doula and hired Mary Beth Best.
“I thought about going it alone, but then I realized I needed this,” says Roudnev. “My mother was 80, so it would have been too stressful to have her there. My husband Dmitri is very supportive but not the type to sit in the room every minute. So I felt I needed one other support person.”
Mary Ruodnev with 18-month old Andrei
Providing support and knowledge of the birthing process is precisely what doulas offer. Doulas (pronounced doo-lahs) are professional labor coaches, women trained in the psychological, physical, and emotional aspects of caregiving during labor and delivery. Most receive training and certification through groups like Doulas of North America (DONA) or smaller, regional practices. Best apprenticed at Birthworks, a midwife and doula practice based in Little Rock, Arkansas.
Doulas are not licensed by the state of Tennessee and are not qualified to make medical recommendations or perform medical tasks. Rather, they are part of the support team of doctors, nurses, midwives, and husbands that are on hand during childbirth.
Doula is Greek for “a woman who serves.” The role of women assisting other women through pregnancy goes back to ancient times, when women routinely took part in the labor and delivery of babies born into the community. It’s only been since childbirth moved from the home into hospitals that the role of midwives and doulas have become more diminished.
At their dance studio with husband Dmitri and daughter, Maria
When Roudnev, the director of Children’s Ballet and Dance School, told her friends she’d hired a doula and wanted to experience childbirth naturally (i.e. without an epidural, pain medications, or pitocin, a labor inducing drug), her news was met with skepticism. “My conservative friends thought it was weird and didn’t quite get it. ‘It’s insane to go natural,’ they said, ‘why wouldn’t you want to use drugs?’ ”
That type of response is fairly common in Memphis, where the epidural rate hovers between 80 and 85 percent. Unmedicated births are far less common here than elsewhere nationally, in part because of the conservative viewpoints and guidelines of the medical community, which favors more medicated births.
“Using doulas or midwives is a departure from the norm since you’re using fewer medications,” notes Margaret Taylor, CNM, a longtime midwife. “The thinking is, ‘Why wouldn’t you have an epidural?
Many women elect to have an epidural because they’re afraid of, or don’t want to deal with, the pain of natural labor. Laboring without medication requires more attention from nursing staff, notes long-time midwife Kim Mosney, “It’s easier to monitor a baby on a monitor once mom’s had an epidural. You’ve got her in the bed watching TV because she’s not allowed to get up.”
The Risley/ Jansen family
Concerns also arise around doulas being too insistent as a patient’s advocate. Dr. Claudette Shepherd, a pediatric OB-GYN at the MED, says the role of the doula is to be a support person, “not someone offering a second opinion. It’s important for me to develop a rapport and establish those boundaries. It’s not usually a problem, but if you butt heads over who’s managing a patient, the doula is not, the physician is. If you meet as part of the prenatal care and establish those roles, then you’re open to [the patient’s] preferences, as long as those don’t compromise the best medical care.”
“We want docs to see us as assets and allies, not liabilities,” says Best. “When nurses who know us see us coming, they know they don’t have to come into the room nearly as often because we don’t leave the patient’s side.”
Experienced doulas like Best have been through the birth process many times and can help their patients relax and work with their bodies as labor progresses. Best views her job as “helping women learn that birth can be the most powerful experience in your life,” she says. “It’s transforming.” She charges a flat rate of $625 for her services and will participate at anytime during pregnancy. Doula services range between $400 to $600 per birth.
Roudnev hired Best when she was in her third trimester, working out a birth plan, asking questions, and once at the hospital, relying on Best for everything from massages and ice chips to verbal encouragement.
“She was a calming person to have in the room, says Roudnev. “If you’re doing natural childbirth or not, she’s there to coach you along. Her soothing, calming words, her coaching, saying ‘You can do it,’ all made a difference.” Husband Dmitri also found Best’s presence helpful.
“New parents are apprehensive, they don’t understand the birth process,” acknowledges doula Annette Scott, who has been assisting women for 15 years. “We work as a team. Our role is to be there 100 percent for the mom and dad. I’m there to massage, change [labor] positions, monitor times between contractions, and keep her relaxed.”
Best stays by her patient’s side throughout labor
Amy Risley, an assistant professor of international studies at Rhodes College, knew she wanted to have a natural birth and sought out doula services for the extra coaching and encouragement they provide. She also used Best and appreciated “her advice, knowing what was coming next and what was going on with my baby,” she says.
Because their child came early, she only met Best a few days before going into labor, “so we had no dry run,” she says with a laugh. “I labored standing up, so she was coaching me and other times was doing massage and warm compresses. At the pushing stage she was also critical. I really leaned on both her and my husband.”
She also appreciated that “in the post-partum haze, Mary Beth came to our home. They don’t leave you after the hospital, they check in on you.” Risley says that was particularly appealing for her and her husband, Joe Jansen, since they moved to Memphis from Austin and didn’t have family in the area.
“In the past a doula was probably your mother or sister,” says Riley. “It might seem weird to hire someone to do this, but it made everything more manageable, both the labor and post-partum care.”
What is the doula’s role?
Before labor:
• Help formulate birth plan
• Answer questions and educate about birth options
• Attend doctor visits (if requested)
During labor:
• Massage and touch therapy
• Verbal coaching
• Breathing and relaxation techniques
• Preparation for each stage of labor
• Emotional support
• Facilitate communication between mother, partner, and clinical staff
To learn more, go to Doulas of North America, dona.org.
Considering natural childbirth?
Memphis birth providers
Doulas
Mary Beth Best • 603-1627
birthnetworkmemphis.org
Sarah Newstok • 338-2280
Annette Scott • 277-5249
Amelia Tummalapalli • 502-8458
BirthSpiral Doula Services
Midwives
Chosen Birth Midwifery, Lynda Hoskins
867-7125 / chosenbirth.com
Full Circle Midwifery • 729-2949
memphismidwife.com
Martina Benson, Melissa Stalling
(at First Congregational Church)
Regional Midwifery Services, Jackson, TN
(731) 668-0548
Sharon Holley, Sheridan Skarl, deliver at Regional Hospital of Jackson, no home births
Margaret Taylor, CNM, MSN • Christ Community Health Services
458-0584
christcommunityhealth.org
Trillium WomanCare • 292-5354
trilliumwomancare.com
Amy Stewart-Banbury, Andrea
Christianson • 233-2107
Childbirth Educators
Sarah Stockwell, Bradley Method
instructor • 734-9735 or
Bradleybirth.com
For a complete listing of local birth
providers, go to birthnetworkmemphis.org
Tags: birth coach, doula, midwife