As a birth doula, I accompany women in labor to help ensure a safe and satisfying birth experience.  I have completed training approved by DONA International.  I draw on my professional training, knowledge and experience to provide emotional support, physical comfort and, as needed, communication with the staff to make sure that you have the information you need to make informed decisions as they arise in labor.  I can provide reassurance and perspective to you and your partner, make suggestions for labor progress, and help with relaxation, massage, positioning and other techniques for comfort.  I am independent and self-employed.  As your doula, I am working for you, not your caregiver or hospital.

----------

Before Labor

I will meet with you and your partner at least once before labor to become acquainted, to explore and discuss your priorities, to discuss your birth plan and to plan how we might best work together.  I also want to know your own best ways of coping with pain and fatigue and how you and your partner foresee working together.

I will also inform you of times when I am unavailable for labor support.  To cover those times, I will arrange one or more qualified back-up doulas whom you may also meet.

We may also decide on other meetings and will certainly want to remain in touch by telephone and/or email.

----------

During Labor

I prefer that you call me when you think you are in labor, even if you do not yet need me.  I can answer questions and make suggestions over the phone.   We will decide if I should come right then or wait for further change.  I usually need approximately one hour to get to you from the time you ask me to come.  We will also decide where to meet  at your home, the hospital or birth center.  Except for extraordinary circumstances, I will remain with you throughout labor and birth.

----------

Postpartum

I usually remain with you for one or two hours after birth, until you are comfortable and your family is ready for quiet time together.  I can also help with initial breastfeeding, if necessary.

I am available to answer questions about the birth of your baby and would like to get together with you within a few weeks to see how you and your baby are doing, to review the birth, and to get feedback from you about my role.

As a doula, I do not:

• Perform clinical tasks, such as blood pressure, fetal heart checks, vaginal exams, and others.  I am there to provide only physical comfort and emotional support.
• Make decisions for you.  I will help you get the information necessary to make an informed decision.  I will also remind you if there is a departure from your birth plan.
• Speak to the staff on your behalf.  I will discuss your concerns with you and suggest options, but you or your partner will speak directly to the clinical staff.

Fees are available upon request.

Q: What does "VBAC" stand for?

Vaginal Birth After Cesarean

Q: Is the adage "Once a cesarean, always a cesarean" true?

No, this is outdated medical thinking. There wasn't enough information available 40 years ago on the risks of labor after a cesarean birth. Also most cesareans done then were classical incisions whereas now almost all cesarean incisions are low transverse or "bikini" incisions. Studies now prove that VBAC is indeed a safer alternative to a scheduled cesarean birth for mother and baby after a low transverse uterine incision from a prior cesarean delivery.

Q: I have had more than one cesarean. Is it possible for me to have a vaginal birth?

Absolutely. Studies have proven that two or more cesareans do not significantly increase the uterine rupture rate compared to having one prior cesarean in the absence of induction medication. There is a correlation however to an increase in placenta accrete with each cesarean surgery, a condition in which the placenta imbeds into the muscular layers of the uterine wall. This can cause problems with retained placenta which often results in hemorrhaging and even a hysterectomy may be needed to stop the bleeding. Another strong reason to avoid repeat cesarean births.

Q: I can't find a doctor willing to support a vaginal birth after cesarean.

Finding a doctor to be supportive can be difficult. Do not take someone's word that there is not a doctor in your area willing to support your birth. Take the time to make an appointment and go in a see several doctors and/or midwives. Ask questions and listen to their answers.

Q: Wouldn't a cesarean be safer than a vaginal birth after a cesarean?

A cesarean section is major abdominal surgery with all that entails. The surgery itself, as opposed to medical problems that might lead to a cesarean increases the risk of maternal death, hysterectomy, hemorrhage, infection, blood clots, damage to blood vessels, urinary bladder and other organs, postpartum depression, post traumatic stress syndrome, and rehospitalization for complications. Potential chronic complications from scar tissue adhesions include pelvic pain, bowel problems, and pain during sexual intercourse. Scar tissue makes subsequent cesareans more difficult to perform, increasing the risk of injury to other organs as well as placenta previa, placenta accreta, infertility, ectopic pregnancy, uterine rupture in subsequent pregnancies and the risk of chronic problems from adhesions. There are also risks to the baby such as respiratory distress syndrome, prematurity, lower birth weights, jaundice, lower APGAR scores (APGAR is the means of assessing the health status of a newborn), and finally in 1 to 9 percent of cases the baby is scarred or even maimed by the scalpel.

Q: My baby is breech. Will I have to have a cesarean?

Not necessarily. It depends on how your baby is positioned and the experience of your doctor/midwife. With a skilled caregiver a breech vaginal delivery can be as safe or safer to mother and baby as a cesarean birth. Turning the baby is the best way to avoid a cesarean however and there are many techniques available to turn breech babies to a vertex, or head down, position.