Who needs a doula?
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Who needs a doula?

Any birthing mother who would like acceptance and support throughout her pregnancy, birth and postpartum.

One of my teachers Dr Michel Odent (world leading obstetrician and founder of the Primal Health Research Centre) sums it up this way:

In the time surrounding birth, women need to feel secure. They need the sort of protection that is provided by the presence of a mother. But for many reasons special to our time, many women cannot rely on their own mother and the father of the baby cannot also be a mother figure. That is why they need a doula.

Yes doulas have also been shown to lower interventions (Epidural rates by 60%, Cesareans by 50%, length of labour by 25%, Pitocin usage by 40%) but my main focus is on the birthing couple and their emotional and physical wellbeing. Ensuring that this very special time in their life receives the attention and loving preparation it deserves. Ensuring that your partner can be the best possible help throughout this journey. Ensuring that the birthing mother is in her most optimal physical/ emotional/ mental state as she meets her baby.

With a doula you’re receiving personalised support meaning you only receive what is most helpful and useful for you and your partner. That is why you get a lot more out of working with me for example than you would if you’d only attend an antenatal class. This is a great start but personalised care can take you so much further. Someone who knows you well can simply provide better care.

I look after mums in the most vulnerable moment of their life while simultaneously celebrating their strength and birthing power.

What are your questions about working with a doula? Please get in touch, I’d love to hear from you!

Love,

Nat

Nathalie Solis
How to prevent a primary Cesarean

Reasons for a Cesarean

⁃ 34% of Cesareans are performed due to ‘labour dystocia’ (= lack of progress/ descent/ dilation or difficult labour)*. These are common scenarios: Baby is floating high above the pelvic inlet and not engaging in spite of regular contractions. Or baby might descend into pelvis but labour stalls once baby has reached a certain level (such as midpelvis or pelvic outlet) due to poor flexion of the head or malposition for example. A labouring mother might even fully dilate but if baby is not coming down into or through the pelvis a Cesarean becomes necessary.

There is no magic formula for all women but most women will save themselves many hours/ days in labour (and much pain!) by receiving personalised chiropractic care in pregnancy and learning exercises and techniques to encourage optimal fetal positioning (Spinning Babies®) so that there is a higher chance that baby engages well. (If you’ve had any accidents or trauma around the pelvic region/ lower back/ pelvic floor this is especially important for you to know.)

Dietary and lifestyle choices also play a big role in avoiding labour dystocia as well as choosing a care-provider who offers evidence-based and women-centred care that is not only hands-on and continuous, think midwife who knows you well and is there for you throughout your entire pregnancy, birth and postpartum journey (we’re not meant to give birth with strangers!), but also skilled in facilitating physiological birth. This is not the same as having a ‘minimising risks’ approach which is largely based on fear (Adrenalin/ stress/ fear inhibits normal labour and birth!)

⁃ ‘Non-reassuring fetal heart tones’ is the second most common reason (23%) for first-time Cesareans*. “Cochrane researchers combined the results of 12 randomized, controlled trials with more than 37,000 participants. Mothers were randomly assigned to receive either continuous EFM or hands-on listening during labor (ie. fetal stethoscope/ doppler). The researchers found no differences between groups in Apgar scores, rates of low-oxygen brain damage, admission to the neonatal intensive care unit, and stillbirth or newborn death. They also found that people in the continuous EFM group were more likely to have a Cesarean and more likely to experience the use of vacuum or forceps when compared to those in the hands-on listening group.“
(Source: Evidence Based Birth)

So more technology does not make birth safer. In fact, there is research showing that home births are as safe as hospital births (maybe even safer).
Dr. Neel Shah, MD, MPP, FACOG says that

The greatest influence on whether a birthing person has a cesarean is which door they walk through when in labor. It’s not baby’s size, being due or overdue, or even if they have a risk factor, such as gestational diabetes. The variation in hospital cesarean rates is so great that the hospital itself becomes the risk factor for major surgery. The variable for whether a vaginal birth is possible has become the address where the labor occurs.


⁃ The third most common reason to perform a Cesarean is ‘fetal malpresentation’ (17%). As I said above there is not one solution for every motherbaby but most women will be able to resolve this issue with appropriate bodywork and optimal fetal positioning when started early in pregnancy (so if you’ve been thinking about a doula please get in touch now!).

⁃ 4% of all Cesareans are performed due to ‘suspected big baby’ (> 4kg). Many babies that seem ‘too big’ are actually simply unengaged according to midwife Gail Tully, founder of Spinning Babies®. To prevent gestating a big baby conscious dietary and lifestyle choices are crucial during pregnancy. Dr. Gowri Motha’s ‘Gentle Birth Method’ protocol for example has helped many mothers give birth in under 5 h to normal sized babies. 

There is so much you can do to avoid an unnecessary Cesarean. Being educated and informed is key. Having someone work with you one-on-one is vital also.

Published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula. A Cochrane meta-analysis of 12 trials and more than 15,000 women demonstrated that the presence of continuous one-on-one support during labor and delivery was associated with improved patient satisfaction and a statistically significant reduction (50%) in the rate of cesarean delivery.*


If you’d like to maximise your birth satisfaction and minimise interventions please
get in touch. I offer free initial consultations in Byron Bay as well as worldwide virtual sessions.

Preventing a primary Cesarean is important but it’s also vital for you to know that there is so much we can do to make a necessary Cesarean beautiful and family-centred. I’m here to support you fully- however labour unfolds.

* Source: American College of Obstetricians and Gynecologists (ACOG)/ Society for Maternal-Fetal Medicine: ’Safe Prevention of the Primary Cesarean Delivery’ (2014)

Nathalie Solis
Infant sleep, breastfeeding & breastsleeping.

There is no such thing as infant sleep, there is no such thing as breastfeeding, there is only breastsleeping.
- James McKenna, PhD


James McKenna is the director of the Mother-Baby Behavioral Sleep Laboratory (University of Notre Dame), Anthropologist and world-renowned expert on infant sleep.

Here is what he shares with us:
“At birth the human infant is the least neurologically mature primate of all, and the most reliant on physiological regulation by the caregiver for the longest period of time.

Until recent historic periods in the western industrialized world no human infants were ever separated from their caregivers– most human infants know only constant contact, exclusive breastfeeding and proximity, made necessary by the infants extreme neurological immaturity, lack of ambulatory abilities, and need for frequent breastfeeding both day and night. “

What exactly is infant-parent cosleeping? “A generic concept referring to the diverse ways in which a primary caregiver, usually the mother, sleeps within close proximity (arms reach) of the infant permitting each to detect and respond to a variety of sensory stimuli (sound, movement, smells, sight etc.) emitted by the other. Cosleeping is the universal (species wide) sleeping arrangement.

For the human infant contact with another body is love…in the most profound and scientific sense…nutrition, transportation, immunity, body warmth, calorie absorption, hormonal levels, heart rate, sleep architecture, neuronal proliferation.”

There is no such thing as a baby, there is a baby and someone. - D.Winnicott

The benefits of cosleeping

  • Baby remains at a more stable body temperature and breathes more regularly

  • Baby uses energy more efficiently, grows faster, and experiences less stress

  • Babies who are not necessarily breastfed, as in the case of adoption, will also naturally reap the many other benefits of such close contact

  • When babies are artificially put into deeper sleep through formula-feeding and the sensory isolation of a separate room, they not only are deprived of this close interaction and its attendant physical and emotional benefits, but the risk of SIDS rises. (By contrast, in cultures where co-sleeping is the norm, incidents of SIDS are far lower or even unheard of).

  • Not all cosleeping arrangements are safe: Parental smoking, drinking, and drug use make parents insensitive to their babies. The presence of other children and/or heavy duvets that can smother, are also are dangerous. So are places where a baby can get trapped, like gaps between beds or in couches or recliners. (Here you can find guidelines for safe cosleeping)

  • Mothers who breastfeed wake more often but have a better quality and duration of sleep

While there’s no one-size-fits-all strategy in regards to sleeping arrangements it’s important for parents to receive information both on safe bed-sharing, co-sleeping and separate surface sleeping so you can make an informed choice that is right for you and your family.

Nathalie Solis
Will my partner feel left out if I use a doula?
 
Photo credit:  Kathy DiVincenzo

Photo credit: Kathy DiVincenzo

 

My role as a doula is to bring you two closer together during birth (if this is what you wish). This is your birth, your once-in-a-lifetime experience as a couple. So if it’s mum’s wish for her partner to be her main support person I will gently guide your partner to be the best support he can be and free him of the stress and worry he might otherwise feel. Relieved from any emotional responsibility for you he can then relax into the process of birth and be freed to have his own experience of becoming a dad.


Does a doula replace the partner?
Having a third person involved may raise concerns that doulas will come between the parents. Doulas are, in reality, a support person for fathers as well, ensuring that the partner’s physical and emotional needs are also met. Just as doulas see to the comfort, hydration, nutrition, and calm of labouring mothers, they also see to these needs for fathers. When doulas and partners work together, they are a very powerful support system combining knowledge of birth, labor, breastfeeding and newborns, with intimate understanding of this particular mother and her needs, desires, communication styles, and emotional responses. The doula’s training and knowledge are available to fathers and are shared via suggestions, examples, or referrals allowing the partner to be a greater participant in providing support and decision making.

A doula doesn’t replace anyone. She is another member of the birth team and supports everyone in their own role. A doula’s presence helps partners participate at their own comfort level, showing them how and when to use various comfort techniques, providing information, and in some cases, looking after them as well. Partners are often grateful to be able to share the “coaching” responsibility with someone more experienced and can therefore enjoy the birth experience more.

Aren’t the roles of the doula and partner so similar that only one is needed?
The doula’s role is unique because she is not going through a personal transition like the father is. She is there simply to provide support to the mother and father. The doula’s training and experience allows her to bring a wider perspective to the birth or postpartum period, tips and tools for coping with labour, recovery, newborn needs and breastfeeding in addition to information to help the couple make decisions. A doula cannot provide the same level of emotional support and connection a partner can, just as the partner cannot bring the same objectivity a doula can. Some fathers, while they want very much to be involved and supportive of their partner during birth and the postpartum period, feel a great deal of pressure to remember everything from childbirth class. Doulas bring a fountain of knowledge with them to the birth and postpartum period and this knowledge is available to both parents.

Doulas and partners
The father-to-be is expected among other things to become familiar with the process and language of birth, to understand medical procedures and hospital protocols and advocate for his partner in an environment and culture he is usually unfamiliar with. A doula can provide the information to help parents make appropriate decisions and facilitate communication between the labouring woman, her partner and medical care providers. 

Your partner’s comfort level
At times a father may not understand a woman’s instinctive behaviour during childbirth and may react anxiously to what a doula knows to be the normal process of birth. He may witness his partner in pain and understandably become distressed. The doula can be reassuring and skilfully help the mother to cope with labour pain in her unique way. The father-to-be may need to accompany his partner during surgery should a cesarean become necessary. Not all fathers can realistically be expected to "coach" at this intense level.

Many fathers are eager to be involved during labour and birth. Others, no less loving or committed to their partner's well being find it difficult to navigate in uncharted waters. With a doula, a father can share in the birth at a level he feels most comfortable with. The doula’s skills and knowledge can help him to feel more relaxed. If the father wants to provide physical comfort such as back massage, change of positions, and help his partner to stay focused during contractions, the doula can provide that guidance and make suggestions for what may work best. 

Your partner’s gifts are unique and irreplaceable
The father's presence and loving support in childbirth is comforting and reassuring. The love he shares with the mother and his child, his needs to nurture and protect his family are priceless gifts that only he can provide. With her partner and a doula at birth a mother can have the best of both worlds: her partner’s loving care and attention and the doula's expertise and guidance in childbirth. 

Resources: DONA.org

Nathalie Solis
Interview with Nadine Richardson from She Births®

Nadine Richardson is a mother and has been a childbirth educator, doula and prenatal yoga teacher for over 20 years. She is the director of The Birthing Institute and creator of the She Births® program. She Births® is her own holistic and evidence based birth course for pregnant couples that was developed within her local community of Bondi Beach, Sydney.

In this episode we speak about birth as a profound teaching of compassion and love. Nadine shares how she facilitates more optimal birth and mother-child bonding experiences. Through her passionate work she helps us understand how an empowered birth and parenting experience also has profound cultural and societal impacts.

Nathalie Solis
Peri and Postnatal Support for Mothers with Doula Nathalie Solis

If you'd like to find out more about me tune into this lovely conversation I recently had with Annalee Atia on the Pregnancy Birth and Beyond radio show. In this episode we talk about what doula support can look like and why it is such a vital element of care in pregnancy, birth and postpartum. We discuss the moment of moving from fear to power in birth, why choosing the right care-provider is vital, the concept of matrescence, and how to create a village for support in parenthood. Press play below to listen to our chat.

Nathalie Solis
How We Birth: A course for parents and birth professionals with Dr. Michel Odent and Liliana Lammers
 
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My beautiful friend Camalo Gaskin has created an incredible course for both parents and birth professionals with one of the most renowned birth pioneers in the world.

It is not only enlightening for anyone interested in childbirth but also shows the profound relevance that birth practices have for the future of humanity. Dr. Michel Odent and Liliana Lammers' wisdom and knowledge have had a profound impact on my own doula practice and they continue to greatly inspire my work.

 
Nathalie Solis