What is a doula, anyway?

A doula is a non-clinical birth attendant who is there to help guide you through pregnancy, birth, and the early postpartum period by offering physical and emotional support. Doulas provide a range of comfort measures, such as massage, counter pressure, reading affirmations, etc., to support you and your partner in labor.

A doula is there by your side for the entirety of labor, regardless of length and outcome. You have the power to choose your doula, interviewing her in the last few months of pregnancy, and meeting with her two or three times before you are due and usually two to three more times in postpartum. For many women, having this level of support made a world of a difference in their birth experiences.

Studies have shown that women who choose to have a doula present during labor: 

* tend to have shorter labors with fewer complications and interventions;
* request pain medication less often;
* have lower incidence of operative delivery including c-section;
* and have more positive opinions of their birthing experiences.

Having a doula can help ease your tensions and fears around birth, physically as well as emotionally. During prenatal visits and throughout labor, a doula can demonstrate techniques for relieving pain, calming and massaging away tension and fear, and reassuring the mother of her awesome ability to deliver her baby safely. Though many women choose to have a doula to assist them through natural (un-medicated) births because of this strong support, this service is not exclusive to women who have made that particular decision. All women can benefit from a knowledgeable support person who remains with them through the prenatal and postpartum weeks ahead.

Doulas are also great support for your partner, too! Some women are told that doula will replace the partner by making him feel unnecessary. To the contrary, doulas are there to ensure both mother and partner are able to fully participate in the labor and enjoy this amazing experience with the guidance of a professional labor assistant.  Many partners feel that they were able to be fully included in the birthing process and felt better informed of what was happening because of the additional prenatal education and this constant support.  

There are so many choices to be made in the journey to motherhood and doulas are there to educate and empower you to make meaningful decisions that work best for you, your partner, and your baby. 

 In the prenatal visits, doulas educate expectant families of their options, the benefits and potential outcomes of some standard procedures as well as helping discuss the alternatives. They can recommend books, movies, articles, and professionals in your community who specialize in certain areas of pregnancy and birth to help better guide you through your decisions, too. A doula will never make a medical decision for you and regardless of the decisions your choose to make, a doula stays by your side to support you through your birth.

MOM vs. MOM

This past July, my new idol, Congresswoman Lucille Roybal-Allard (D-California), brought before Congress the Maximizing Optimal Maternity Services (MOMS) For the 21st Century Act. This groundbreaking proposal to vastly change the way maternity care is handled in the U.S. has the potential to change the lives of millions of women, making childbirth safer and more satisfying for all expectant moms.


This act has been supported by Amnesty International, who earlier this year released a shocking report on the rising maternal mortality rate and the overall disparity in care amongst racial and socioeconomic groups. The MOMS Act specifically addresses these issues, while promoting an overall change in maternity care to a more holistic model. The bill proposes an increase in midwife-attended births as well as a broad-reaching educational campaign to educate women on their options in childbirth.


Not surprisingly, ACOG has jumped in with a bill with an almost identical name, with similarly worded content that nonetheless, would keep the level of maternity care in the U.S. at its current, dismal status. The bulk of this initative is to focus on research on why there has been a rise in complications in pregnancy and thus the rise in interventions, citing obesity, and poor record taking as some of the main causes. As PushGirl Friday of the Unnecesarean put it, it's, "[b]ecause as we all know, the problem with maternity care in the US is with the women who receive it, not with the care they receive," and if you look at the slew of recent studies regarding these trends--the "Too Posh to Push" meta study in the UK and the flurry of obesity studies--it seems like the obstetrical community really does look to the women first to find the problem. 


Midterm elections are fast approaching and what better time to write or call your representative and tell them that you hope they will support Rep. Roybal-Allard in her effort to reform maternity care. I promise I'll have a template letter written by early next week, but an impassioned phone call will certainly serve more for the cause than any formal letter I can muster. Visit OpenCongress.org to find your local Reps and send them a letter directly from the site!

The 10 month-old fetus

An interesting article from our neighbors up north:

Lobbying grows for the 10 month-old baby

Just how long does it take to make a human baby? Nine months is the going answer, but a small lobby of women believes that it’s more like 10 months and beyond.

Guardian columnist Viv Groskop gave the debate some gravitas with her Oct. 1 story of giving birth to her third child 20 days after his due date. “My first two babies were 15 days late,” she wrote. “But a day shy of week 43? That is virtually record-breaking – and, some would say, slightly mad.”

Generally, a baby is considered full-term when it reaches a gestational age of 37 weeks. A “post-term” baby is one that been gestating up to or beyond 42 weeks...

Read more

I've heard a lot of women tell me that their due date is not what they think it should be, knowing for sure the date they conceived, but they still go along with the doctor's estimates. When they reach 38 weeks, they start being pressured into having their membranes swept or being scheduled for inductions. I have to think that this standard adjustment is part of why I see so many women who are not at all in labor walking to their hospital rooms while I'm attending other births. Are they all considered "late"? And are the ones who are told that they're "overdue", are they at 38 weeks? 42? 40 and 3 days?

I was a three week late baby and was born with no complications and minimal interventions. No one was pressuring my mother to induce when she hit 38 weeks. I know many other people who have a similar story. Interestingly, since becoming a doula, my mother has shared more of her birth story with me than I had previously ever known. After a lengthy talk on due dates recently, she realized that the doctor's due dates for her were most likely off due to a number of factors that she never had the chance to even bring up with her OB when they took out the gestational chart and circled September 2. I was born September 29 without a sign of post maturity...unless my whopping 9lbs 10 oz were solely the result of a few extra weeks.

Are there similar stories out there? This article came from Canada and as far as I know, their induction rate is somewhat lower than ours (which was reported to be 20.6% in 2003, but some smaller recent surveys are showing rates closer to 40%) and it may be likely that the pressure to induce in Canadian hospitals for post-term dates could be even less significant than in the U.S. I don't know of very many women who are allowed to go even two weeks past their due dates in the U.S., let alone to 43 weeks. Am I wrong?

National Health Services Releases Video on Birthing Options

A new birth center in a local hospital prompts a video sponsored by the NHS (UK) to release a video on the various options afforded women in that area. Could you imagine a video like this being released in the US? Where homebirth is seen as a safe and viable option, where one-to-one nurse care is standard, where laboring in a birth tub is the norm, and where midwifery care is given to all low-risk women? Let's hope so!

Mother's Blessing

Jaz and I recently helped host a Mother's Blessing for a friend and it turned out to be a really beautiful, wonderful experience for the mama and all involved. It was a day of pampering Alyx, belly casting, and sharing stories of strength and guidance.

Mother's Blessings can be alternatives to the traditional shower, or supplemental to them. There are some unique traditions to be made up and some long-standing ones to be celebrated during the event. There are no gifts to buy, but the time spent helping the mother prepare for the journey she will soon take is worth so much.

For Alyx's ceremony, we made an intentions banner and left it blank for everyone to fill in with pictures, drawings, affirmations, and messages to mama and baby for labor. Alyx can bring the banner to the hospital on the birth day and hang it in the room for some added cheer and to remind her that although she is the only one that can deliver this new life into the world, she is not alone.

These ceremonies are really about celebrating the journey of motherhood and honoring this mama's entry into the world of motherhood. There are no set guidelines for these events, but some wonderful activities could be cooking food to freeze for the postpartum period, belly casting or painting,  belly henna, giving mama a massage and a foot bath, sharing birth stories, writing and sharing affirmations, making a calming birth playlist together, making a quilt or afghan for mama and baby, or sharing beads or other collected items for a labor necklace. The possibilities are endless! Just get creative and think of ways that you can show the new mama you care!

Article on homebirth from the Huffington Post

"Why Homebirths are Worth Considering" by Melissa Cheyney

Some highlights:

"The answer among the U.S. medical establishment has been to throw more expensive technology at the problem rather than retracing our steps to see where we went wrong. Instead of admitting that something is fundamentally broken with the system, organizations like the American College of Obstetrics and Gynecology continue to endorse the idea that medicalized hospital births are the only safe route for women."

"While maternal mortality rates decreased among our peer nations between 2000 and 2005, they increased by more than 54 percent in the United States during the same time period. The two major differences between the U.S. and other nations, which have superior maternal and infant health outcomes, are that the latter offer universal health care and rely more extensively on cost-effective midwives as a public health strategy."

There is a critique (one of many) of the Dr. Joseph Wax study on homebirths published recently in AJOG, siting faulty research methods and accusing the study of deepening our nations overall distrust of midwives.

It's a good read. Thanks, Melissa!

Afghan Midwifery Training

This was passed along through one of the Bay Area birth doula groups. Please donate if you're able and spread the word about this amazing organization!



Dear Friends,

I try not to send these requests out too often, and appreciate you reading this! As president of Afghans4Tomorrow, and especially when I have an opportunity to help the women and babies in Afghanistan, I hope you won't mind if I tell you about it, and ask for your help too.

We want to provide training for several women who live in Wardak Province (just southwest of Kabul, and heavily controlled by the Taliban) to become Skilled Birthing Attendants in their respective villages. There are no female obstetric doctors in this region, and due to Taliban influence, we are no longer able to find female doctors living in Kabul willing to travel to Wardak to practice. Some women will not go to male doctors, if they are even available. Many instead rely too often on old wives tales, and receive no prenatal care nor have the birth attended by a doctor or midwife or anyone with any training at all.

Afghanistan is one of the most dangerous places to be born, or give birth. A woman dies in childbirth every 27 minutes in Afghanistan, that is 1 in 8 women who give birth. One in five children die before they reach the age of 5.

The formal Midwife Training program in the country is a two-year program that requires the women to live in Kabul for the entire time. We have already trained two midwives and will likely fund more as we find women able to live in Kabul for the two years, which is not so easy.

This program is a way to help bring more skills to the region to help provide safer childbirth and baby checkups to the region now, while we wait and hope for more calm encouraging more doctors to move to the area and while more fully trained Midwives and doctors become available. Our Skilled Birthing Attendant training starts with an intensive 4-week program (to be held in December) conducted by a volunteer American doctor, and is in conjunction with another organization; Mountain to Mountain, who is funding some of the expenses for this training as well as ongoing financial and training for the next three years for the group of women.

Afghans4Tomorrow's responsibility in this program is $20,000, of which we have already raised about $8000. I know things are rough for many of you out there, but if you can't help with a donation yourself, maybe you know someone who would be excited about helping such a program, or know people involved in the Midwife movement that might we willing to share with their friends?

I have attached the actual proposal for those who are interested. I will have more info in the next several days, but feel free to reach out with any questions, and feel free to share this email with anyone you think might be interested in learning about our efforts in helping women to deliver healthy babies in Wardak Afghanistan.

Thanks everyone for taking the time to read this far!

And for those celebrating Ramadan-- Eid Mubarak!

Cheers,Kim

Kimberly O'ConnorPresidentAfghans4TomorrowP: +1 415.282.8281M: +1 415.608.1260Skype: kiminsanfranciscokim@afghans4tomorrow.orgkimoco@mac.comwww.Afghans4Tomorrow.org