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Birth Doulas

Maximizing the Power of your Breath in Labor

By Meredith Ashton Cohen

I approached my first birth excited and engaged in the process and largely “muscled” my way through labor. I said to myself, “I am doing this!” and while my body progressed naturally (without intervention), I forced it along with gumption and energy to “make it happen.” My breathing was a series of pants and forceful exhales, I marched my feet through my contractions or forcefully swished my hips in the bathtub relying on rhythm to ease the intensity. My movement during labor came from my doula training and experience thus far, I knew how to “do birth” in my mind, but I failed to simply tune in to my body and respond accordingly. 

Meredith in labor with her 1st child.

As my second pregnancy progressed I picked up Marie Mongan’s Hypnobirthing book for the first time. I came to the breathing techniques chapter and read this passage, “…when your uterus surges, it rises. Slow breathing helps you to work in concert with that upward movement of the uterus as you breathe your abdomen up to the highest possible height–like filling an inner balloon. This maximizes the wave of vertical muscles, causing them to work more efficiently in drawing up the lower circular muscles, and thinning and opening the cervix. The assist that this gives to both sets of muscles shortens the length of the surge, as well as the length of labor.” (124)

Meredith laboring with her 2nd child.

Could I really create a shorter, easier labor/delivery by simply breathing? The scientific piece of aligning with my uterine muscles for maximum efficiency combined with the possibility of a shorter, easier birth intrigued me and I decided to put it to the test. For my second  birth the only thing I was going to do was breathe. I wasn’t going to waste any energy “doing birth” or “making it happen,” I was going to match my breathing with my contractions the best I could and surrender all else. Surrender every muscle and simply support my uterus to do its thing. 

The proof is in the pudding. I did in fact create a shorter, easier birth the second time around with a baby who was two pounds heavier. My second labor was five hours total (11 hours shorter than my first) and pushing went from 2.5 hours to ten minutes! I came away from my second birth experience with questions and curiosity about why the process worked so well. It was these questions that propelled me a little further into the anatomy of the uterus and science of labor. 

Below are two illustrations of the uterine muscle fiber patterns. As you can see, the myometrium, the muscular layer of the uterus, has three variations of muscle fibers; longitudinal, figure-eight, and circular.

During contractions, the muscle fibers at the top of the uterus (fundus) get shorter and thicker, while the muscle fibers at the bottom of the uterus lengthen and move up. This all corresponds with the baby moving down towards the birth canal. YouTube: Mini Lesson 002: The Uterus in Action illustrates this well. 

Since “Oxygen is the most important fuel for the working muscles in the uterus.” Hypnobirthing 123, the best way to support the uterus is to inhale as it contracts and take in as much breath as possible, as slow as possible–oxygenating muscle fibers and baby, followed up with a slow exhale. The way to do this and maximize lung capacity is through abdominal breathing. Abdominal breathing has many names: slow breathing, belly breathing, diaphragmatic breathing, Ujjayi/Yoga breathing, etc. The concept is the same, using the diaphragm to inhale and expand the belly and allowing the belly to shrink with the exhale, it is slow and controlled. This method of breathing fills the belly rather than causing the shoulders to move up and down. When breathing makes the shoulders move, it is shallow breathing that uses only the upper lobes of the lungs while abdominal breathing maximizes all five lobes of the lungs.

During labor, researchers suggest that breathing for pain relief works by interrupting the transmission of pain signals by providing something positive to focus on. It may also release endorphins, and help the laboring person reframe their thinking about labor to be positive, productive, and manageable.

Like most things from Mother Nature, one gift has multiple remedies. Breathing is no different. In addition to transforming how we engage in delivering our babies, Rebecca Dekker of Evidence Based Birth reports in her article Breathing for Pain Relief during Labor, “Electroencephalography (EEG) studies on this type of abdominal breathing have found that even just a few minutes of using this type of breathing alters your brainwaves in a positive way, increases your relaxation response, decreases your stress hormones, decreases your blood pressure, and increases your oxygen levels.”

Inside the birth community we talk about the importance of breath and breathing through labor, but I want to emphasize that when we use it to support the uterus, we transform it from a nice thought in to a powerful tool for faster, easier labors. And we are in the business of supporting faster, easier labors. 

Resources:

Evidence Based Birth, Breathing for Pain Relief during Labor

Stress Management: Breathing Exercises for Relaxation

Clinical Anatomy and Physiology of Female Reproductive System. Assessment and health promotion. 

Layers of myometrium showing the three layers of smooth muscle fiber

YouTube: Woman Explains Contractions with a Balloon

YouTube: Mini Lesson 002: The Uterus in Action

Take a Deep Breath

Hypnobirthing by Marie Mongan

About Meredith:

Meredith Ashton Cohen CD(DONA), is a birth doula who specializes in supporting unmedicated births using Hypnobirthing techniques to create efficient and positive outcomes. She is passionate about educating and “holding space” for each birthing person, baby, and birth partner to find connection during the pregnancy/birth process for a faster, easier, more comfortable birthing experience.

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Birth Doulas Postpartum Doulas Pregnancy UDA Membership Uncategorized World Doula Week

World Doula Week

By Dezarae Weyburn

Lindsay Dougal, doula, offers laboring mother support.
(Photo by: Mandy Hawkes)

The term “doula” is a relatively new one. Although the Greeks used the term “doula” to mean a female slave, or handmaid, it wasn’t until 1969 that the term was first applied to birth work.

In the half-century that followed, doulas went from completely unknown to a household name. With the formation of DONA in 1992, Ricki Lake’s documentary, “The Business of Being Born” in 2008, and the Facebook series, “Romper’s Doula Diaries“, people were exposed to a new part of the birthing world.  There are now hundreds of doula certifying bodies and organizations. In addition to birth support there are antenatal/prenatal, postpartum, bereavement, abortion, adoption/surrogacy, and even death/end of life doulas.

Raquel Alfaro, postpartum doula, cares for baby while parents rest and recover after cesarean birth.

Although doulas provide strictly non-medical support, science backs their efficacy. Studies show consistently better birth outcomes with doulas than without including shorter labors, less reported pain, fewer interventions and a higher rate of satisfaction with the birth experience. While serving prenatally or in the postpartum period, doulas are perfectly positioned to notice and provide resources for perinatal mood and anxiety disorders such as postpartum depression and anxiety.

Doulas help bridge the gap by providing a unique support to their clients. Here’s what some local parents had to say about their experience working with a doula:

“For me I felt like a doula was a big support for the role of my spouse. As a woman you read and study a lot about labor and delivery, but I feel like my husband just wasn’t prepared. So having a doula out there to help him and help him to feel part of the labor and delivery was awesome. I also think an acting voice for when you are in full labor was super helpful along with the different types of calming and soothing techniques”. (Thompson)

“I don’t know how we did it last time. I really don’t think we could have done it without a doula. Why doesn’t everyone get a doula?” (Orton)

“Having a doula at my birth gave me the fortitude to push through all the opposition I felt. The thoughts that frequently come up of, ‘I can’t do this’ were negated immediately by the female companionship of an amazing supportive doula.” (VBAC mom, Nance)

“Having a doula brought a needed calm and supportive presence into my labor. Her attention to detail was spot-on and she came prepared with ideas and tools that eased my labor and made the experience one to remember.” (Zitto)

The Utah Doula Association (UDA) has over 150 members consisting of doulas and local community partners. The non-profit strives to provide a community of support, opportunity, and education to both doulas and families seeking a doula. Happy World Doula Week to its members and all doulas who are changing the world one family at a time!

UDA Annual Conference
(Photo by: Nathan Caulford)

Need a doula? Find one now.

Learn more about the role of a doula here: What is a doula?

About Dezerae:

Dezerae found her interest in birth while pregnant with her oldest. She attended her first birth as a doula in 2013. In addition to being a birth doula, Dezarae is also a trained bereavement doula helping parents during miscarriage and stillbirths. In 2015, she took a breastfeeding training through the World Health Organization and found a second passion in supporting parents in their chosen feeding method.  Dezarae loves cheering for parents, especially when they feel like they can’t do it, and is honored to witness the birth of mothers, fathers, grandparents, and babies!

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Birth Doulas Postpartum Doulas

The UDA’s New Program to Fulfill Its Mission

By: Angie Rosier, UDA President


As the doula profession grows and more doulas are trained, the public becomes increasingly aware of what doulas are and what they do. The position of a doula is now often recognized as an important and integral part of a birth team. Through the professional services offered by many outstanding doulas, obstetricians, registered nurses, and midwives alike often refer their patients to doulas they have enjoyed working with. This is great news for those of us who work as doulas. The local price of a doula has also increased in recent years. While the rate for doula services varies widely by state and region, prices have continued to climb. In Utah we have seen as much as a 75% increase in doula fees in the past 15 years. This is also great news for doulas. Many doulas enjoy earning a decent wage while doing work they are passionate about.

What does this do, however, for women and families who cannot afford doula services? Currently doula services are viewed as a luxury item in our medical system. Insurance does not cover doula fees (a topic for another day), and many families who could benefit from the services of a doula are unable to afford paying a few hundred extra dollars at a time when additional expenses are already expected. Many doulas offer discounted services when situations of need arise. That’s the beauty of owning your own business—being able to listen to your doula heart and give back to the community. Many doulas feel drawn to certain populations such as teens, incarcerated women, single mothers, or refugees. While there is currently little to no financial benefit to serving these populations, this is very possibly where doula services can be most valuable.

The Utah Doula Association has continued to grow over a period of over 25 years—has striven to be fiscally responsible—and has been able to build up some funds beyond operating costs. Membership dues, conference fees, community partners, and our doula retreat are some of the main ways the organization had been able to grow financially. The board is always looking for additional ways to raise money so that, as a group, we can fulfill the mission of the UDA, which includes community awareness, continuing education, marketing for its members, and supporting at-risk, low-income, and under-served families.

We are excited to announce the Utah Doula Association’s new program for serving underprivileged women and their families while offering pay to doulas for their services. From funds raised through donations, memberships, community partner memberships, the retreat, and conference we have the funds to pay our doulas to help these underprivileged women have support through their pregnancy and labor. This year, the UDA board has discussed and approved paying $599 for 5 individual birth clients. We are piloting this program and hope to grow it next year. We are working with a local provider to seek women in need of services and we are open to assessing other situations in the community. Eligibility requirement for doulas serving in this program is that she has been a UDA member in good standing for at least two years. Fees will be paid through the treasurer of the UDA.

The client in need will be matched up with a qualified doula who is available around her estimated due date, has expertise surrounding the mother’s pregnancy situation whether it be high-risk, multiples, teen mom, etc., and has been a UDA member for at least two years.

We are happy to send anyone who needs doula support an application to see if they qualify. Situations will be reviewed by the president and president-elect and the board will be notified of each of the five paid births available this year.

The board has also approved funds this year to pay for postpartum doula services for a woman in need. We are so excited to be able to help fill this gap in care in our community and look forward to growing this program and be able to adequately reach out to those who need a doula.

About Angie:

Angie Rosier

Angie Rosier has been a doula since 2003 and has attended over 1,000 births.  She lives in Salt Lake with her husband and 5 children and is the current president of the Utah Doula Association and owner at birthlearning.com.