Just wanted to drop you a quick note again thanking you for attending my daughter’s delivery. C*** is up and around, healthy. Little A*** (just can’t do A***** yet, maybe later…) is nursing well, sleeping well, peeing well– all the marks of a wonderfully brilliant baby and for that we are so grateful.
Displaced by you!??? I cannot tell you the immediate panic I felt when I entered C***’s room and only the sister and a nurse were there (you had gone downstairs to get a drink—why I didn’t think to offer to bring you food is so beyond me now!) The nurse was starting the epidural push– then the doctor came in with the same push for epidural — then the sister chimed in with “nothing wrong with that” spiel. You bounced into the room and it was like finally sanity had returned!! In lieu of getting my own epidural, I was contemplating going out and getting my own gunpowder and starting my own fires right there in the room!! I was not really sure what a doula did before C*** entered the hospital– it was clear to me at that moment certainly that you were critical to the smooth delivery of my grandson and I thank you again for that.
I have recounted my princess warrior’s determination and success in naturally delivering after almost 33 hours and have included in each telling the incredible abilities of her “mommy whisperer”. There is not a woman I have spoken (unfortunately most moving through menopause as we speak) to that hasn’t expressed the wish that you had been there for them as well. If it had just been dad, sister, me and the other grandmother, I can only guess at the mess that would have made. So, again, I thank you for all that you have done for C*** and A***.
By KARLA JACKSON email@example.com
Published: Mar 3, 2005
TAMPA – The contractions felt pretty darn strong to Gabriela Bell, no matter what that stupid strip of paper from the uterine monitor indicated.
“They looked like nothing on paper, but they really hurt,” said the 27-year-old teacher from Brandon.
You should be more dilated by now, the obstetric residents at Tampa General Hospital told her. They began talking about drugs and surgery. After hours of labor, Bell was tired, hurting and overwhelmed.
“You need to ask them for more time,” said Lilia Cruz, 37, a labor doula hired by Bell and her husband, Paul, to coach them through the birth of their first child.
“Give your body a chance to rest,” Cruz advised.
She asked Bell to wait before getting an epidural for the pain.
“Give me half an hour,” Cruz said.
“You’ve got 15 minutes,” Bell replied.
Cruz, who has helped laboring mothers through more than 120 births, knew her client had reached her breaking point. Bell got the epidural.
About two hours later, after more than 17 hours of hard labor, Noah James Bell was born, weighing a healthy 9 pounds, 7 ounces. No drugs or surgery were required.
Bell and her husband, a captain at MacDill Air Force Base, are thrilled with their new son, who will be a month old on Tuesday. They say the $500 they spent to hire Cruz was money well spent.
“She was worth every cent,” Bell said.
“Having Lilia there was such a relief, especially her knowledge of how labor and delivery works – what’s normal, what’s not.”
Numbers Are Increasing
Cruz is one of a small but growing number of certified doulas in the United States. A doula is different from a midwife, who is qualified to deliver a baby. The doula’s job is to offer physical comfort and emotional support for the laboring mother during childbirth. “Doula” comes from an ancient Greek word meaning “woman’s servant.”
“We might be telling the mother to get on all fours for a backache or to get into a squatting position to help soften the pelvis,” said Cruz, who operates Special Delivery Doula from her Valrico home.
A doula for five years, she also teaches childbirth education classes for expectant parents.
“We use hot and cold packs, a lot of massage, a lot of talking and telling the mother how well they are doing.”
Women have been helping women deliver babies since the dawn of time, but it has only been in the past two decades that organizations have formed in the United States to train and certify doulas. There are at least nine such organizations nationwide. One of the largest, Doulas of North America, had more than 4,600 registered doulas in 2004 (up from more than 3,800 in 2002). Florida has about 260.
Unlike midwives, doulas are not medical personnel. They are not required to have any type of licensing from the state department of health.
Fewer Drugs, Shorter Labors
Studies suggest that using a doula during labor can decrease the need for drugs and reduce the incidence of Caesarean sections. Doula-assisted labors tend to be shorter in duration, with fewer complications. Mothers and babies often bond more easily, which helps with breast-feeding.
Because of those benefits, Achieve Tampa Bay, a local nonprofit organization, started a program in 1999 to match doulas with low-income mothers.
“We wanted to increase the bonding and attachment,” said Karen McDonald, doula coordinator for Tampa General.
“If these women were empowered by having a good birth, then they would love their babies more; they would take them back for their [pediatrician] visits; they would get their immunizations; they wouldn’t abuse their children.”
The program served nearly 500 mothers in 2004. It has been so successful, it was replicated in Osceola, Brevard and Miami-Dade counties.
“So many of these moms come in feeling like birth is something that happens to them. But they learn it is something they can have control over,” McDonald said.
That positive effect carries over from childbirth to child rearing, McDonald said.
Most mothers who hire doulas are like Bell, middle- or upper-income, first-time mothers who want the reassurance of a veteran by their side during labor.
“My parents live in Texas, and my husband’s live in Ireland,” Bell said. “It’s nice to have a friendly face who had been through all this before.”
Though the mother is the doula’s main concern, first- time fathers also factor into their duties.
“My role varies from birth to birth,” said Dee Pullen, 46, a doula who operates Better Birthing from her north Tampa home. “It depends on the involvement of the father. Sometimes I just stand back and hold the space for the two of them to do what they need to do.”
If the father is faltering or seems uneasy, Pullen may gently guide him on how to help.
“I tell him it might feel good if you brush her hair or that a cold cloth might feel good to her now.”
Fathers tend to be “fixers,” which isn’t always the best mind-set for labor, Pullen said.
“Husbands don’t want to see their wives cry. Daddies are worried about that. They think, `If she’s in pain, give her drugs.’ ”
Mothers usually want pain medication only as a last resort because of the possible effects on the baby, she said.
Pullen likes the idea of mothers laboring drug-free, preferably at home.
“Both my children were born here in my living room, so I know what a completely natural birth feels like, and I know that women can do it. In the absence of a major problem, there’s no reason to go to the house of sick people.”
Even so, she doesn’t push any particular birthing method on her clients.
“We talk about my philosophy of birth, and I try to elicit what the mom’s philosophy is,” said Pullen, who is also a childbirth educator and a lactation consultant.
“I only have two rules,” she said. “I don’t catch babies, and I don’t allow babies to be born in toilets.”
Nurses Welcome Doulas’ Help
Hospital labor nurses appreciate the extra help a doula can provide, said Amanda Vargas, labor assistant coordinator at St. Joseph’s Women’s Hospital.
“Being a nurse, you have two or three patients, and you just don’t have that quality time that you can sit with a patient one on one,” Vargas said. “They love when the doulas are there because they know that [the mother] is being taken care of.”
Doctors can be less receptive, doulas say.
“I have worked with some who actively dislike doulas because we’re giving the mom information and we’re a source that is not [the doctor],” Pullen said.
The key to handling doctors is to be diplomatic, she said.
“You have to know when to speak up and when to shut up. They’re the boss. I can’t step on their toes. There are some I can work with. I know the doctors I can make suggestions to and the ones I can’t.”
Once the baby is born, a doula typically stays with a client until the baby has started nursing. They will check back in person and by telephone several times over the following week.
“Usually, about two to four weeks after the birth, we schedule a final postpartum appointment, and I give them a copy of my birth notes so that they have a written record of the birth,” Pullen said.
“I write down what music was playing and if anyone said anything particularly funny or sweet. I write that down so that they can remember how much love was in that room.
“Those are the things that moms are going to want to remember.”
Reporter Karla Jackson can be reached at (813) 259-7606.
The birth of my daughter started out as a quest to just have options. I wanted a doctor who would let me try to have a vaginal birth after my cesarean, if it was possible. Of course, I would use adequate pain relief like an epidural. No need to be in horrible pain if it wasn’t necessary. After all, I wasn’t trying to be a hero, just give birth. I didn’t have faith in my body to be able to give birth after I had my son. It looked likely that I had something called CPD (basically my pelvis was too small). I’ve always been super skinny, so maybe my insides were, too. However, I hated every moment of my c-section. From the time I was cut open; I was angry. Children weren’t supposed to be born this way. I wasn’t in an emergency situation. My son was born gorgeous. I was told this was because we were lucky to have the technology nowadays to “save my life” and the “baby’s life.” I couldn’t let go of the fact that I carried my first pregnancy so well and felt great. When the doctors gave me a guilt trip so I would have an induction at 41 weeks, I often wondered, how did I start off being a healthy, glowing pregnant woman and go into being “an emergency” just because “my fluid was too low?”
Just after moving to Palm Harbor last year, I met a friend who I knew was lead to me for many reasons. She was pregnant at the time and wanted a second VBAC (vaginal birth after c-section). She ended up doing a home birth. I thought she was strong and crazy at the same time. Home births are so dangerous, so I thought. My husband and I talked through the options. We decided a hospital birth was the only way to go. After all, I was probably too thin, the baby could likely get stuck and nothing is worth losing this precious miracle. Also, I heard your uterus could rupture! Scary stuff. My friend referred me to a doctor who oversees a lot of the midwives, Dr. Dinsmore. My friend really liked her. I made an appointment. Dr. Dinsmore was very pro-VBAC and positive. I really loved her and her staff and soon felt more confidence that I COULD have a VBAC. Her staff encouraged me to do a lot of research. I did. In the meantime, I found a local chapter of ICAN and a supportive mom’s group. Women from both groups were encouraging and informative. I couldn’t believe what I was learning. Through tons of research I discovered how rare uterine rupture was. After all, any birth can have complications. I realized this CPD everyone talked about was often a way to say “we don’t know what went wrong”, and it was also not that common. My hopes for a vaginal birth soared. Through coaching from numerous friends and ICAN members, I became more confident. My quest through time became more than a desire to “try and have a vaginal birth” – it became a fight for women’s rights. I became so angry that Dr. Dinsmore is one of the only doctors in a huge city like Tampa that will “allow you to try a VBAC.” After all, each pregnancy is different. Why should you automatically be cut open just because you were once cut open? In a “free” country, when did we, as women, just hand over the rights to our bodies to the medical community? Who voted for them to be able to ”force” us into surgery? Oh, yeah, they will tell you that nobody will “force you”, but when you can’t find a doctor who will let you try to give birth vaginally or if you go into a hospital and the staff will tell you that if you don’t sign the papers to have a c-section, they will get a court order to take custody of your unborn child (this probably doesn’t happen often, but I’ve personally heard of three cases), what do you call that?
I had so many blessings throughout my pregnancy like the other supportive moms, my encouraging friend, and a great doctor. I felt further encouraged through the other people God put in my life; the doula I received, my wonderful HypnoBirthing® instructor and fellow classmate and several Bradley class teachers who offered to share their knowledge. Everyone gave so freely and with such optimism. I was pumped! God was blessing me beyond my hopes. I wanted to do this soooo badly now! I was doing it for all c-sectioned women!
At 36 weeks pregnant, Dr. Dinsmore shared with me that due to some legal issues, she might not be able to deliver my baby. I was crushed! Oh no! After all these blessings and all this work. Where would I go? I was stressed. I made a lot of phone calls and discovered I was down to two real options; a practice of doctors an hour away from my home with a group of doctors I didn’t know or a midwife. My husband and I struggled. Me? Give birth at home? Was I crazy? I was told I could very well be too thin, I have severe asthma, I’m an older mom, and I’m a VBAC; how could I do a 180 and go the complete opposite direction and deliver without a hospital? How risky. My husband looked at me and said he didn’t think I could do it. After all, there would be no epidural. It’ll have to be all natural, That scared me, too. I’m the wimp that still cringes when she gets shots! How could I go natural? Yet, I couldn’t let go of my desire to give birth the way God intended me to. My husband and I agreed that we thought if I went to the hospital, I’d probably end up in another c-section. So home birth it was. Enter our midwife, Jill. When I met Jill, I really liked her and she was “real” with me. We were both concerned that Dr. Dinsmore expressed her concern about my asthma. This is where I was strong. I knew my asthma very well throughout the pregnancy and birth of my son. I knew how it would be. I knew a hospital staff was never able to have my asthma in control for any length of time. So, I “sold” myself despite being an older woman, a first time VBAC and an asthmatic. Against the advice of others, I was going for the home birth. I was comforted by all the encouraging people God put in my life, all the knowledge I gained, hiring “the VBAC Queen” as my midwife (as Jill is known) and by my faith in God.
Dr. Dinsmore’s staff checked me at 37.5 weeks and I was 3cm dilated and 70% effaced! I don’t like checks, but I was so encouraged by this! I never dilated on my own before and I was 2 cm dilated last time when I got an epidural. I was already ahead of the game…Plus, Dr. Dinsmore gave me a big hug and her blessing as I left her office, which meant a lot to me. She understood my feelings and honored them, without thinking I was crazy.
Since I went late with my son, my husband I decided not to stop life, even around the due date. We decided to go visit some friends for Sukkot an hour away. We drove up Friday, spent the evening with our friends and got a hotel for the night. When we went to bed that night (maybe around 10pm), I felt strong Braxton Hicks contractions. They weren’t that painful, though and I casually made the comment to my husband that I might go into labor in a few days. He grunted and went back to sleep (later he told me he didn’t remember this). I was up most of the night since my 17 month old son was cuddling next to me and slowly pushing me off the edge of the bed. Around 6:00am I awoke to find my son totally cuddling in my arms. What a great moment since I don’t get many of those since he became a busy little toddler. Just then I felt some contractions. Hum…They were strong enough I needed to walk around. I quickly tried to ignore them because I was anxious to cuddle again. I got into bed, got comfy and had another contraction. I walked some and noticed they were coming every 5-6 minutes. My husband asked if he could sleep more and I said we better go. I wanted to be home for the labor. We had a quick breakfast before we left (I didn’t want to labor on an empty stomach). I just remember how hard it was to sit still as my husband grabbed a second cup of coffee and we checked out. However, the pain wasn’t bad. I just didn’t want to look “in labor” to anyone. We drove an hour home and I called my birth team. My friend told me to prepare for another 14-15 hours of labor. My doula had a funeral that day in Sarasota and I urged her to go because this could be a long day. I was talking through contractions, my husband said I looked good and my son was saying “yes” ‘yes” “yes” in the backseat for the first time. First cuddling, now “yes” instead of “no” in the backseat…Everyone was feeling good.
We walked in our apartment and instantly the contractions got stronger. We had a lot to do! I got our my bathing suit to labor in and tried to get little things done, but the contractions kept coming. My husband begged me to contact the birth team. I refused. After all, I was only in labor for about 2 hours at this point. I didn’t want to be a wimp. I was going to be tough! I was just so annoyed by the fast contractions. I had things to do! I had to call my friend to take my son, get more things out, get my HynoBirthing CD, etc. etc. However, those darn contractions were messing up my plan! Soon, things went so fast. My husband told me firmly to call the birth team. I refused again. Thank goodness for Jill. She had sense enough to leave me a message and check up on me. She didn’t ask to come over, she said she was coming over to check me. Now I felt ready to call my doula. Things went so quickly from there! We put our son in his crib, filled the tub and my doula walked in. I had 2-3 more contractions, decided I hated the tub and got out. Jill came in and didn’t even bother to mention the word dilation. She just told me the baby’s head was at a plus 3 station and right there, ready to come out. Wow! That’s when it hit me, I am going to do this! I went on the bed and Jill asked if I wanted to push. I first said no then I said OK (because I just felt the need). I decided to lean on Tim and squat. It wasn’t pleasant, but it was do-able and I talked between pushes. The doula was there, reminding me how to push and putting oils on my back. It’s what I needed. Jill placed her finger where I needed to focus my pushes, which also helped greatly. I did this for what seemed like forever (it was actually less than an hour) and then I was encouraged to push on the toilet. This helped and I soon felt the baby almost crowning. My friend walked in around this time to cheer me on. The timing was perfect because she soon validated my feelings; she said “this is the worst part.” I agreed. It wasn’t that painful…it just felt weird. I pushed and had to slide my bottom off the toilet since I thought the baby might drop in. I was asked where I wanted to deliver and I said the bed, but the baby had other ideas. I had to push while walking and out she came.
After all the excitement wore down, I became elated. I did it! It wasn’t horribly painful like some women said thanks to the circumstances and the grace God gave me. I had a great, fast VBAC when doctors would say it’s too risky and I needed surgery. Here I was; happy, energetic, surgery and drug-free with a healthy, beautiful child. Why shouldn’t it have happened? Does my birth story look like I am broken and I am not capable of giving birth without surgery? Sad to think if I didn’t have all the support in my life, I would have been an automatic surgery patient. I’m so thankful for all my blessings, including my new beautiful blessing named TS.