Tuesday, March 20, 2012

Kaitlin Lee ~Doula in Training

Last week my friend Amber posted this on facebook.
My sister is training to be a doula, and is currently offering many services (emotional support, information, advice, etc.) and will attend births free of charge, to gain further experience. So if you're pregnant, or think you might be, or plan to one day, or know someone else who is, or if you still don't quite understand where babies come from - She is here to help :-) Feel free to pass along.

And that is how I cyber-ly meet Kaitlin Lee. I immediately thought this would be a perfect post for N.V. & a great way for Kaitlin to spread the word about doulas. Since right about now you might be asking, What the hell does a doula do? Kaitlin is going to answer that for us. Along with a few other questions that will come to mind when you find out.

1. What is a doula? (please be as specific as possible with this one)

The word "doula" is an ancient Greek word that translates as "a woman who serves". Now, it is a trained and experienced professional who provides continuous physical, emotional, and informational support to the mother before, during, and just after birth; or provides emotional and practical support for the postpartum period. (This description I grabbed from DONA.org, which is an organization that trains and certifies doulas, but any source will describe nearly the exact same thing. And I would explain it just this way for myself).

2. What is the difference between a doula and a midwife? And depending on your answer here.... Can a doula work alone or does a doula work with a midwife? ( if the second part doesn't apply just ignore it. haha... i have limited duola knowledge)

A doula and a midwife are NOT the same. They CAN work together, but one does not work FOR the other.

Your midwife is a primary healthcare provider. She sees you throughout your pregnancy. She assesses the overall health of mom and baby; performing vaginal exams, monitoring fetal heart tones, and assessing contraction patterns. She checks blood pressure, temperature, and urine. She will attend the birth, catch the baby, assess the baby, deliver the placenta (afterbirth), and examine it. She checks the mother's birth canal and perineum for damage, and stitches any tears that may have occurred. She does not typically stay with the mother throughout her labor, or after the birth into the postpartum period.

A doula helps the mother in a non-medical way. I work for the mother and her partner, not for the midwife/OB/hospital. I can be available for the mother as early as she needs me during her labor. In the early stages, I can answer questions about 'Is this really labor?', and as it progresses, I give suggestions on different positions to labor in and techniques to encourage the baby into position to be delivered and lowering into the birth canal. I help the mother be more comfortable, at times offer massage, verbal support, relaxation exercises, and encourage her to move to keep contractions regular and changing her cervix. I also help the partner find ways to help the mother so that he/she is also involved in the experience. I am available after the birth to see that the mother is comfortable, that the couple are doing well, and help the mother establish breastfeeding if that is what she chooses. I am her personal cheerleader, of sorts. And provide all that I can to ensure that she has the best birth experience she can have. Her birth is something she will remember for the rest of her life...

The midwife's first priority is the safe delivery of the baby, and the doula's is the mental well-being of the mother and the support to her family.

3. What made you decide this is what you wanted to do? (i know you delivered your 2nd child at home. i don't know if you had a midwife for your first birth or you gave birth in a hospital. in this question i would love if you could explain that & give a comparison)

I delivered my son in a hospital setting with a midwife. I went to a practice that had both OB/GYNs and midwives, but chose to see the midwives.

While I labored in the hospital, I had a nurse that was very discouraging. I had gone in not wanting an epidural or pain medications. Early in my labor, I expressed how I was afraid of the epidural, but I would get it if labor was more than I could handle. She told me I couldn't do it, and that I would be begging for it. Also, she told me 'You're not having this baby until tomorrow night at dinner time'. It was about 12:30 AM, I delivered close to 11AM. Touche!

Several times I had wanted to get up to walk, or move to a new position/labor on the birthing ball to get more comfortable during contractions,. This particular nurse would huff and puff because the monitors were falling off of my belly, and she only wanted me laying down in my hospital bed. A few hours went by, and my midwife would not be there to check my progress until morning. I was getting uncomfortable with contractions, and the nurse suggested giving me a dose of morphine. As a laboring mother, I did not think to ask what are the side effects, etc. She simply said 'We call it the morphine-induction. It should help you to sleep, and by morning you will have dilated'. My husband did not want to see me in pain, of course, so between the two of us I suppose we decided to get the shot of morphine thinking I could get some rest. WRONG!! Not long after, I was shaking uncontrollably. The same nurse comes in, puts me on oxygen. My blood pressure had dropped, and the baby was now in distress. She said she didn't know why I was shaking because that is usually a symptom of transition (last part of active labor where you dilate from 8-10cm). I was NOT in transition.

( I found out over a year after my birth from a nurse friend that I likely had an allergic reaction to the morphine.)

Finally, some time later her shift ended and another nurse was on duty. This woman, who very well could have been a doula if not a nurse, was a GOD SEND. She knew exactly how to support me throughout the rest of my labor. The morphine had worn off now, and she allowed me to labor in the jacuzzi, where I ultimately experienced transition and vomited in a towel that she held. THAT is SUPPORT! Haha. She showed my husband how to apply counter pressure to my lower back, as I had horrendous back labor. She had me laboring in different positions, told me how well I was doing.. I have never forgotten her, and all the support she gave me and my husband.

I know that is a long explanation to a short answer that, basically, the first nurse gave me such a horrible impression. And I don't want what I experienced that first time for ANYONE (regardless of the fact that I did, thankfully, get another nurse). Because of that experience at the hospital, I opted for a home birth with a midwife who specializes in home birthing for my daughter a year later. Although, my midwife did not make it to the delivery (I labored hard and fast), but my husband caught her on our living room couch. Something about the way my second birth went just really set this whole thing off.

It is true that it is a 'calling'. You feel compelled to want to help women, and empower them and remind them that this is so primal and ordinary. Your body knows what to do, you just have to let it. It hurts like nothing you've ever felt before, but don't let anyone tell you you can't do it, or that you will be 'begging for the epidural'. And if you are, SO WHAT?! It's all about having a positive experience, and more.

4. You are still in training, is it a school setting or more like an apprenticeship?

It's not a school setting in that I attend classes weekly. I do have to attend a workshop in late June 2012 with the ToLabor organization. I have several books I have to read, and be familiar with their content. I have to attend six births, and observe child preparation classes. I need to have 3 written evaluations of people I have assisted or worked with. And I need to complete a written exam, all for certification. http://www.tolabor.com/

Not every doula is certified. And a certified doula does not make a good doula. I think it is a good thing to have on your resume, and you certainly learn a lot through the program. But you learn a lot through experience!! I do plan on getting certified, but I just want to point out that there are hundreds upon hundreds of uncertified doulas that have attended hundreds of births, and make a difference.

My home birth midwife for my daughter is looking to bring me to births with her to gain experience, and get comfortable working with laboring women. I have not done so yet, but there are a few births coming up that I hope to attend.

5. Is there any medical training that you need?

No, it is not required for certification. As a doula, I won't be learning things like how to suture vaginal/perineal tearing. I won't be administering shots of pitocin. I won't be doing vaginal exams, or performing ultrasounds or using a fetal heart doppler. I won't be delivering babies. Doing any of those things would be practicing midwifery, which is illegal in the state of New Jersey without a license. In the future, my main goal is to be a home birth midwife where I will be doing these things. But it is years down the road still..

6. (this i have to ask because i know many people will wonder this) What if during a home birth there are complications during birth or complications with the baby? Is there a risk involved?

It is incredibly important to have a licensed and trained professional midwife or obstetrician when having a home birth. In the event of an emergency, these are the people who know how to act fast if the mother is hemorrhaging, or if the baby is non-responsive. These professionals have the equipment for mother and baby if there are breathing problems, and are trained in resuscitation. If the mother and baby need to go to the hospital, they set up a calm, quick transfer. You wouldn't run any more risk having a home birth than delivering in the hospital, given you are a low risk mother, etc. But that is all to be determined by the midwife or obstetrician.

7. The U.S is now catching up to other countries as far as alternative & homeopathic medicines, midwives & doula's are concerned. Do you think the medical industry & insurance companies try to make something as natural as having a baby scary? Or do you feel it has to do with overall limited knowledge that a majority of people have with their own bodies & childbirth? Maybe a combination of the two?

I think it'd be fair to say it's probably a combination of the two. I think the medical industry and insurance companies try to make birth out to be a big procedure, when it's not. Or it doesn't always have to be... And I think they take advantage of the limited knowledge that the majority of people have with their own bodies and child birth. The less mothers know about what their bodies are doing during labor and birth, the more control the medical industry can have. Isn't that what's scary? I'm not sure if this answers your question at all...

8. Do you involve any homeopathic treatments to your clients routinely?

Currently, I do not. But this would be another thing I would want to study, or take a class if available. I'm a supporter of homeopathic treatment.

9. To gain experience you are offering your services for up to $10. How much does doula services usually run?

Right now, I am not charging any fee since I am not certified, and am simply trying to gain experience. In reality, I just want to work with mothers THAT BAD. It's not even about the money for me right now. But an experienced doula, depending on the location, can vary greatly from $450 to $2000. Some doulas provide more than just labor support. They provide a lot of postpartum care, or are also lactation consultants or placenta encapsulation specialists, among other things. Depending on what the doula can provide before or after the birth, or what the mother chooses she wants, that particular doula may charge more or less.

10. Doula's are there for you before, during & after giving birth. You live in New Jersey. How close, location wise, do you feel you need to be to your clients?

I think an hour distance would be the max. I don't think it would be fair to the client to be too much further in case I can't get there right away. I don't want to delay providing my services when they need me.

11. Do you feel there is a limit to the number of clients you should have at a time? For instance, would you have to give a client to another doula if you already had a client with a close range due date?

Right now, I would not want to take more than one client a month. Of course, I'm so new and no one knows me that I'd be lucky to have one client every few months. I'm ready to book my calendar though! If I booked a second client in a month, I would only do so if I had a backup doula to attend their birth if I was not able to be there myself. I don't currently have a backup doula, so I wouldn't put myself or the mother in that situation.

Those were all the questions I asked Katlin. If you have questions or would like Kaitlin's services you can find her here. Kaitlin Lee Birth Doula Services .

Katlin also added this when she emailed me back her answers...

"I hope this has answered your questions, and that I gave an accurate description of what my goal is and how I want to help women. It's so important to be informed, and know that you have a choice and a say in your birth experience. Hospitals tend to put a time limit on labor, and labor can take days! Sometimes you just have to let it be.. If there are no complications, there is no need to intervene in the natural birth process (breaking the bag of waters, pitocin, forceps/vacuum, cesarean). I can't say that specifically to the mother's health care provider. But I can give her the knowledge, and lend her the voice to speak up for herself and what she feels is best for her and her unborn child."

Kaitlin, you most certianly did! And thank you for all of the information.
xoxo Nicole

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