By Sherri Wilkerson, LCCE, CD(DONA)
Statistically speaking, most expectant couples will go through labor before the birth of their child, and a rising number of those couples will hire a doula for labor support. And the reality is that some of the births will, due to various reasons, result in a cesarean. So how does doula support morph in those situations? It’s important for expectant parents to have a conversation with their doula before labor ever begins in order to have a solid plan of support in place going forward.
How can a doula support parents during a cesarean birth?
Honestly, the finer details of that answer will depend upon location of birth. Some hospitals/practices allow an additional support person in the OR, but most do not. So then what? The following provides ways in which a doula can support a birthing family through cesarean.
• During preparation for surgery (prior to leaving the birthing room for the operating room), a doula can help hold the birth space amid the chaos. If the parents and doula have been working in a soft, ambient environment, that will likely change shape with staff preparing for surgery. A doula can help a laboring mother maintain focus and push away fear with affirmation and encouragement.
• A doula also will help encourage parents to ask questions about anything that needs clarification. Some parents want a play by play of what to expect in the OR; others want facts without much detail. Both scenarios are perfectly legitimate!
• During a cesarean, a doula can communicate with additional family at the hospital, if that’s what parents want. Family members who haven’t been privy to the events of labor may be confused or need assurance that all is well. A doula can relieve some stress by passing on any information the parents allow.
• If a doula does not join you in the OR, she can transfer belongings to and help prepare the postpartum room. Many hospitals will have a postpartum room number ready prior to surgery. If that’s the case, a doula can transfer bags, pillows, toiletries and other things to that room to make it more welcoming to the new parents after post-operative recovery. With my clients, I usually go ahead and make up the guest bed with fresh linens/pillows so dad/partner can enjoy a restful space too.
• Depending on hospital policy, a doula also may join parents in recovery. This is a great opportunity to attend to the parents' needs. Do they need someone to snap family photos? Do they need a support person to stay with mom if dad/partner needs to go elsewhere with the baby? Does the mother want help to initiate breastfeeding?
• Once the transfer from recovery to postpartum takes place, a doula can help parents settle into the postpartum room. What happens here will largely depend upon what the parents want and need. Some partners need nourishment and/or coffee, which a doula can provide those things. If breastfeeding didn’t happen in recovery, and mom wants help, a doula can devote calm and confident guidance. Most importantly, a doula will also know when it’s time to take her leave for the parents to enjoy some alone time as a new family.
It can be a stressful time when birth plans change drastically and unexpectedly. A good doula can help expectant couples make the transition to parenthood -- even when the process doesn't happen as planned. It's important not to wait for labor to think about alternative doula care scenarios -- have the conversation during your doula interview, and talk further about it during prenatal meetings with your doula. Doing so will allow you to go into your labor and birth experience with confidence and ample support!
Sherri Wilkerson LCCE, CD(DONA) is a Lamaze childbirth educator, a DONA birth doula, and a placenta encapsulator. She currently serves as the Director of Publications for DONA International, and she is the owner of A Better Birth Doula Services in the metro Atlanta area. You can contact her at www.sherriwilkerson.com.