One of the valuable components of doula care is “continuous labor support”. Let’s briefly discuss what that may entail.
Most births average 15 hours of labor. Some will fall on the short end or the long end of the spectrum but even if it’s right on the nose of 15 hours and you have been at the hospital for that period of time, you will experience a staff change in nurses and possibly providers. A doula can be there for the entire time or at least a good portion of it when you and she have agreed for her to join you. A birth that goes faster can be more intense and involve less breaks in between contractions and more focus on comfort measures. A longer birth can be more tiring and need suggestions for keeping you and your partner’s energy up as well as coping with suggested interventions, sticking to your birth ideal, and allaying nervous energy.
Most people who have heard of doulas know of the above mentioned benefits but perhaps still have concerns about having another person involved with their birth experience. Many doulas have been trained to focus on that “continuous” labor support and anticipate multiple hours of work and caregiving. So I am here giving everyone permission to discuss this frankly with the doulas you interview and the one you end up choosing.
Your doula would love to step out and give you private time if you wish. This isn’t usually possible or a good idea with a fast intense labor or one with medical complications but for average, normal labors it can even be beneficial for some scenarios involving just you and your partner. If you are able to get in the shower this is a great scenario for your partner and you to work together in a secluded and dimly lit room. The oxytocin will flow! If walking hospital halls is recommended for mobility and getting labor moving, again, this is a very bonding experience for you and your partner. Sometimes it’s even nice to walk with a mom or sister or friend, too. Examples like this are short moments you can have some alone time with those who matter most to you. Your doula will still be there to orchestrate and gathering resources and reserves for the more demanding times of active labor, transition, and pushing.
Doulas are trained for long days but remember they are human, too. The vast majority of my clients have been extremely considerate and understand I need food, bathroom breaks (I drink a lot of water at births, and coffee), or to call my daughter and tell her good night. So continuous labor support does not ever mean a doula cannot walk down the hall to use the bathroom. I have heard of doulas holding their bladder and apparently a rumor went around one doula said she wears bladder control underwear so she doesn’t have to leave to go to the bathroom? Not only is that pretty gross it is completely uncalled for. That sort of continuous labor support is too extreme. When a labor continues for 20 hours or more everyone needs to take turns keeping their energy up and their bodies rested to the extent possible. A partner can trade off with the doula for a brief stretch/rest on the couch. If an epidural is utilized this is a good time for everyone to rest up. Family or friends may bring a real meal that can be eaten in the family waiting room or cafe. Ask your doula if she would like to order something. I’ve shared many snacks with a partner when things are progressing quickly and we can only stuff a cheese cracker in our mouth.
The definition of continuous is: forming an unbroken whole. To me that is a perfect definition of what a doula does. As a whole the support will be unbroken. Unless there are extraordinary circumstances where a backup doula may be there early in labor or called in for a very long labor your doula will be there as your unbroken whole. No shift changes or switching of doctor on call. Your doula with your birth ideal in mind. Any potty breaks, eating, calling her family, stretching is done for everyone’s benefit so she can serve you at her optimum.
As you interview your doula ask her how she handles breaks or if she reserves the right to have a backup doula come relieve her for a few hours past a certain amount of labor support. Maybe you want to have some private time with your partner or maybe you don’t and possibly you will change your mind in labor either way. Have a frank discussion and remember we as doulas have been trained to be flexible and work long and hard hours. A good doula would never leave you for extended amounts of time or for frivolous matters. She will always have her phone and be close by and her client will ever be on her mind.
Doulas are invested in your experience and that is truly the magic of continuous labor support.
All Rights Reserved, Kimberly Sebeck, Knoxville Doula, 2014