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Doulas and Epidurals

7/9/2015

1 Comment

 
Your doula's  role is to assist you during birth. With or without pain medication, you are giving birth, and your doula will be there to comfort and support you.

Giving birth to your baby is much more than a medical procedure. It is a physical as well as emotional journey, and having a doula with you can help smooth the crucial transition from pregnancy into parenthood. Both parents will benefit from the nurturing care a doula provides.

It is best to get an epidural once active labor is well established (usually after 5 cm dilation) you might need a doula to cope with contraction waves to get to that point. Often an epidural can slow down or stop contraction all together, and pitocin is introduced to the cocktail to bring them back. Waiting longer to get an epidural can help reduce the amount of drugs going into your body and potentially changing the outcome of your birthing experience.

Epidurals do not usually take all the pain away. You will still be required to use some other forms of comfort measures at times. Although good to excellent pain relief is obtained in 90% of epidurals, few epidurals take away all the pain.

The administration of an epidural requires you to sit without moving for several minutes, and generally through a few contractions. Having a doula, who is both familiar to you and experienced with the procedure, can help you remain calm and relaxed during the placement of the catheter. This can help the anesthesiologist achieve a good placement faster, allowing you to have the comfort of an epidural faster.

After the epidural has taken effect, you will be greatly limited in your ability to move. An expert doula can help preventing one of the most common complications of an epidural (a cesarean birth) by making sure mom’s position in bed is often changed facilitating the baby’s descent into the pelvis.

As much as I don’t like horror stories here is an article you should read about epidural and consequences, having a doula with you will bring an extra pair of eyes monitoring what is been given to you and how.

A common problem with epidurals is the mother’s inability to push effectively. A doula can assist you by offering several alternative positions for the pushing phase. Above all having someone who understands what is going on with you emotionally can be very comforting. Often partners rest once you get your epidural misinterpreting your apparent comfort with the absence of anxiety or fear of the incumbent delivery, a doula is there to keep you present through this miraculous rite of passage and support you emotionally throughout.

1 Comment

Evidence Based Research on the benefits of a Doula Community Program

5/21/2015

2 Comments

 
The Evidence BasePublished ResearchHealthConnect One. (2014).

The Perinatal Revolution: New research supports the critical role Community-Based Doula Programs can play in improving maternal and child health in underserved birthing populations

http://www.healthconnectone.org/pages/new_study__the_perinatal_revolution/362.php

Edwards, R.C., Thullen, M., Korfmacher, J., Lantos, J.D., Henson, L.G., and Hans, S.L. (2013).

Breastfeeding and Complementary Food: Randomized Trial of Community Doula Home Visiting

Pediatrics, 132:Supplement 2 S160-S166; doi:10.1542/peds.2013-1021P

Abstract / Full Text / Full Text (PDF)

Hans, S. L., Thullen, M., Henson, L. G., Lee, H., Edwards, R. C. and Bernstein, V. J. (2013).

Promoting Positive Mother–Infant Relationships: A Randomized Trial of Community Doula Support For Young Mothers

Infant Mental Health Journal, 34: 446–457. doi: 10.1002/imhj.21400

http://onlinelibrary.wiley.com/doi/10.1002/imhj.21400/abstract

Altfeld, S. (2002).

The Chicago Doula Project Evaluation Final Report

The Ounce of Prevention Fund: Chicago, IL.

http://www.healthconnectone.org/filebin/pdf/altfelddoulareportfinalcomplete.pdf

Additional Resources
Romano, A. (2014, November 14).

Care Models That Work: Community-Based Doulas

Maternity Neighborhood

http://maternityneighborhood.com/care-models-that-work-community-based-doulas/

Lombardi, J., Mosle, A., Patel, N., Schumacher, R. and Stedron, J. (2014).

Gateways to Two Generations: The Potential for Early Childhood Programs and Partnerships to Support Children and Their Parents Together

Ascend at The Aspen Institute - Promising Approaches, p. 16

http://ascend.aspeninstitute.org/pages/gateways-to-two-generations

HealthConnect One. (2012)

What are the Outcomes of Using a Doula?

http://www.healthconnectone.org/filebin/pdf/DoulaResearchSheet_HC_One.pdf

 Cawthorne, A. and Arons, J. (2010, January 5).

There’s No Place Like Home: Home Visiting Programs Can Support Pregnant Women and New Parents

Center for American Progress: Washington, DC.

http://www.americanprogress.org/issues/women/report/2010/01/05/7221/theres-no-place-like-home/Gentry, Q. M., Nolte, K. M., Gonzalez, A., Pearson, M., and Ivey, S. (2010).

Going Beyond the Call of Doula: A Grounded Theory Analysis of the Diverse Roles Community-Based Doulas Play in the Lives of Pregnant and Parenting Adolescent Mothers

The Journal of Perinatal Education, 19(4): 24–40. doi: 10.1624/105812410X530910

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2981190/

Amnesty International Publications. (2010).

Deadly Delivery: The Maternal Health Care Crisis in the USA

Amnesty International Secretariat, London.

http://www.amnestyusa.org/dignity/pdf/DeadlyDelivery.pdf

Brown, M. H. (2008, April 11).

Chicago Project Delivers Support to Young Mothers-to-Be

Robert Wood Johnson Foundation Local Funding Partnerships: Program Results / Grant ID: 29806

http://www.rwjf.org/content/dam/farm/reports/program_results_reports/2008/rwjf16985


Value of Breastfeeding
Bartick, M. C., Stuebe, A. M., Schwarz, E. B., Luongo, C., Reinhold, A. G., Foster, E. M. (2013, July).

Cost Analysis of Maternal Disease Associated With Suboptimal Breastfeeding

Obstetrics & Gynecology: Volume 122 - Issue 1 - p 111–119. doi: 10.1097/AOG.0b013e318297a047

http://journals.lww.com/greenjournal/Fulltext/2013/07000/Cost_Analysis_of_Maternal_Disease_Associated_With.17.aspx

Bartick M. and Reinhold A. (2010, May).

The burden of suboptimal breastfeeding in the United States: a pediatric cost analysis

Pediatrics. 125(5):e1048-56. doi: 10.1542/peds.2009-1616.

http://www.ncbi.nlm.nih.gov/pubmed/20368314

Centers for Disease Control and Prevention. (2014).

Breastfeeding Report Card 2014

http://www.cdc.gov/breastfeeding/data/reportcard.htm

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