With COVID-19 regulations sweeping the world – and those regulations varying from state to state and even hospital to hospital – a lot of parents who have spent time planning and preparing for their birth are finding those plans turned upside down. If you find yourself without the support you expected, here is a quick reference guide to being your own SUPER DOULA!
Birth Plan
Make sure you have a written birth plan with a short, bullet point list of requests that you have for your labor and birth. For guidance on what to include and how to use your birth plan, see my post Do I Need a Birth Plan? Having a birth plan will help ease communication with the nurses at the hospital, and if you have a partner with you, they can reference the plan during times of your labor that you don’t feel up to answering questions.
6 Key Phrases to remember
While every labor is different, and every parent and baby are different, there are some common needs. As a doula, there are a few phrases that I find myself saying to nearly every client at one point or another. If you are laboring on your own, take note of these. Consider writing them down or printing this page so you can refer to them in labor. If you will have a support person in the room with you, they can remind you of these things especially during active labor and transition.
#1. “Just breathe.”
There are all kinds of things you will be doing during labor to cope with contractions – walking, swaying, sitting on a birth ball, making low sounds, drinking plenty of water. But reminding yourself to breathe, slowly and controlled, with every contraction will be the foundation of everything that you do.
#2. “You are safe.”
Feeling a sense of safety has a huge impact on labor progression. When stress hormones rise, labor slows down. Remind yourself that you are safe, you are in good hands, you are strong, confident and powerful, and your body was made for this. Bringing those stress hormones down will allow your contractions to be more effective and your labor to progress more quickly!
#3. “This is normal.”
I often say that 90% of my job as a doula is to encourage parents that what is happening is normal. In fact, quite a few things happen during labor that in day-to-day life would be a sign of something going wrong. But in labor, they are a sign of great progress! Most of these happen toward the end of active labor and in transition, and they mean that you are getting closer and closer to meeting your baby! This includes shaking, nausea, vomiting, back to back contractions, bloody show, and feelings of self-doubt, frustration, even a bit of panic. All normal! All signs that things are moving along as they are supposed to! Remind yourself that you are safe and to slow down your breath.
#4. “Go to the bathroom.”
This one sounds funny, but making sure you are going to the bathroom at least once every hour will ensure that you that you are drinking enough water. If you were feeling “stuck” in one position, it will give you an opportunity to try a new position when you return. Plus, each time you go, you can try staying on the toilet for a couple of contractions. Our bodies have been well trained to relax our pelvic floor muscles when sitting on the toilet. So, a lot of progress can be made in this unexpected place!
#5. “Stay on top of the wave.”
If you look at the contractions on the hospital monitor, it has the shape of a wave. The goal is for you to stay on top of that wave. Ride that wave! Don’t let it crash over you. Get back on top, because once you get over that peak, you’ll be on your way back down, and it will get easier.
#6. “You never have to do that contraction again.”
This is a reminder to take each contraction one at a time. Use the breaks to let go of any tension from that last contraction and start the next one fresh. Continually reminding yourself of this is one of the biggest keys to managing labor well.
Comfort measures to engage all 5 senses
I’m going to let you in on a secret doula trick! When we are racking our brains trying to think up new ideas for pain relief or comfort measures, we often go through all five of the senses. Engaging the senses allows the analyzing part of the brain to rest while the body’s innate responses take over. Many of them also activate the body’s natural calming responses to reduce stress hormones, slow your breathing, lower blood pressure and relax muscles.
Sight
Something to make your hospital room feel like home. You favorite pillow with a colored pillow case (to make sure it doesn’t get grabbed up with the hospital pillows). Your fuzzy bathrobe (just make sure it’s washable). Slippers. A framed picture to put on the table by your bed. A tapestry to hang on the wall or throw over the couch. Battery-operated tea light candles. Anything that makes you feel cozy!
Sound
A nice, relaxing playlist. Make one from scratch or choose a premade list called “spa” or “yoga”. You may want upbeat music at the beginning of your labor, but make sure you have something slow and calm, possibly without words, for the end of active labor and during transition.
Smell
Do you use any scents when you are trying to relax? A favorite lotion or bubble bath? Maybe a linen spray or scented candle? If you already use a particular scent for bedtime or relaxation, then your body is already trained to relax to that stimulus. Using an essential oil or lotion or spray with that same smell will put you 10 steps ahead in the relaxation game! If you can’t think of one that you already use, try lavender for a sleepy calm or sweet orange essential oil to take the edge off anxiety without adding sleepiness. To use essential oils in labor, put a couple drops on a paper towel and wave it in front of you a few times. Set it somewhere nearby where you can smell it, but won’t touch the oils by accident. If you stop liking the scent, you can ask the nurse to take the paper towel and throw it away outside of your room. For more details on which oils to use and how, check out my free Essential Oils Cheatsheet PDF download.
Taste
Though eating during labor is still not allowed in most hospitals, there are a few options that fit within their “clear liquids” guidelines. Bonus if you already have some of these tucked away in a kitchen drawer! Honey sticks (or packets) provide a bit of sugar energy. Sour lollipops can help keep nausea at bay. Call and ask if your hospital allows fresh fruit. A few places are starting to include soft fruits like grapes and melon in the list of approved foods. You can precut your fruit and bring it with you in a small cooler bag. Hospitals will also offer you jello, popsicles and sometimes apple juice or clear broth.
Touch
There are a few super simple comfort tools that you can use whether you’re by yourself or with a support person. Do a scavenger hunt around your house, and see how many of these things you can find to pack in your hospital bag!
A list of labor positions
You can find these in books, google searches, and your doula can provide you with a list of their favorites.
Parents – click here for a low-resolution version of my labor positions sheet that you can print and take with you to your labor.
Doulas & Educators – click here to purchase a high resolution version that you can copy and distribute to your clients
Rice Sock
Although fancy options abound, I prefer the homemade, disposable variety (in case it gets yucky during labor). It is literally a sock, filled with cheap, white rice, and tied off with a knot. That’s it!!
* For a knee sock, microwave 2 minutes (1 minute to reheat).
* For a shorter, crew-type sock, microwave 1 minute (30 seconds to reheat).
Tennis Balls
Use one on it’s own or use two in a sock. (Can you tell I love socks?!) These are great for massage on the low back or to use as counter-pressure. If you are on your own, place the tennis ball(s) behind your back and lean into the bed/chair/wall.
Ice Pack
This is not something you need to bring with you, but I wanted to list it here so that you know it’s an option! Nurses make ice packs with gloves or newborn diapers all the time to place on the mom’s perineum after birth. If you want an ice pack for your back or your low belly (where we often feel cramping during contractions), be sure to ask your nurse!
A long scarf
There are so many uses for a long scarf in labor! You can tie it around you to hold a rice sock or ice pack in place. You can also use it to hold the tennis balls in place so you don’t have to carry them around as you move from one place to another. Many moms like spreading the fabric to cover their belly and tying it tightly for abdominal support. By tying knots in the ends, you can also use a scarf to support you in a squat position. Standing at the foot of the bed, throw it over the squat bar, hold onto both ends and lower into a partial or full squat. Spread the fabric out over your partner’s shoulders, hold both ends and squat. Throw a knotted end over a door, shut the door *securely*, and hold the exposed end of the scarf to support your squat (see picture).
Choose a Code Word
No matter where you stand on epidurals right now, we all know that labor is unpredictable. There are times when they are overused, but there are times when they are needed and fully appropriate. However, we also know that we all say (and feel) some crazy stuff in labor!! Having a code word can save the day. With a partner: let them know what the code word is so they will know when to encourage you to keep going and when to call the nurse and get you your epi, stat! Without a partner: put your code word in your birth plan. Ask the staff to not offer you, ask you, or pressure you to get an epidural if you haven’t said the code word, but that if you shout “Hibiscus!!” – you really mean it! Even if you choose not to put it in your birth plan, just knowing the code word yourself will help you make a conscious decision whether to continue on or to make a change in your plan.
The induction question
I would be remiss if I ended this post without a word on induction, because that is how the vast majority of labors begin in this country. If you go to a prenatal visit, and your care provider recommends induction, first – call your doula! They are there to help you navigate questions like this and to let you know what other options might be available for you. Also, take a quick look through this post:Â Should I Be Induced?
Remember – you are never alone! There are generations of women before you, coming after you, and laboring alongside you today. You are strong! You are amazing! And you can do this!!!
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