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Growing Yourself as a Doula
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Hospital Tours for Doulas
I've had requests from several new doulas this year for guided tours of the Labor & Delivery areas of the local hospitals.
I am happy to announce that we will have such tours at Cooley Dickenson (Northampton) and Holyoke Hospital, with one of the Nurse-Midwives from each facility. Dates are being set for January and February of 2010. Spaces are quite limited, and priority will be given to those who have completed a Doula Training Workshop with Warm Welcome. Please email if you are interested.
This is a great opportunity to meet some of the area midwives & nurses, to get familiar with the facility and with the staff's expectations of doulas working at their hospital.
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Michelle L'Esperance, Certified Professional Midwife
(413) 203-4479
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Counterpressure - Why, When, & How
Counterpressure can be a dramatically effective comfort technique for women in active labor. However, it is also very physically demanding for the doula. Here are some tips on identifying situations that truly call for the use of counterpressure, some variations on the technique, and ways to conserve your energy while supporting the birthing mother in this way.
The main indication for offering counterpressure is when a mother who is having regular contractions is experiencing back pain or ache along with the typical strong 'crampy' or pulling sensations of the contractions themselves. The basic technique is to apply pressure on the woman's lower back and sacrum.
The typical situation that calls for counterpressure is when the mother is experiencing 'back labor,' a nearly unrelenting sensation of pain in her lower back, which does not subside with the rhythm of the contractions. Usually back labor is caused by pressure of the bony back of the baby's head (occiput) being positioned against the inside of mother's  sacrum. The more favorable position for labor has the baby facing towards the sacrum; the occiuput posterior or 'OP' position contributes towards irregular, less effective contractions and the signature pain of back labor.
There are quite a few techniques to encourage baby to turn into a more favorable position, thereby relieving the mother of the cause of the back pain, and facilitating a more effective labor. For those of you who have taken the 4 -day training, refer to your Doula Training Notebook for a refresher on these techniques.
Sometimes, though, babies don't cooperate with our efforts to encourage them to rotate, and the mother continues to suffer with unremitting back labor. In that case, I offer counterpressure. Almost always, the mother expresses great relief within a minute or so. She also demands that I keep pressing, and press harder!
Over the years, I have developed a good way to give maximum pressure while protecting my wrists and preserving my strength as much as possible. (click or scroll down to continue....)
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 Upcoming Workshops with Warm Welcome Birth Services
Full Four Day Doula Training Workshop- Birth Focus
Jan 30, 31, Feb 6 & 7, 2010
Hampshire College, Amherst, MA
Tuition $500- Earn $300-$800 per birth as a doula.
Register Soon for Early Bird Discount!
Traditional Postpartum Doula Care Workshop
Sunday, March 28, 2010
Cradle- A Maternal Wellness Center in Northampton, MA
Tuition $108- earn $15- $25 per hour as a postpartum doula.
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.( - continued from above)
1)
Starting from the foundation: hopefully you are wearing comfortable,
well-soled shoes. Sneakers or running shoes are best in this situation.
Space your feet at least two feet apart, as though you were a runner at
a starting line.
2) Make your hands into fists with thumbs
outside, not tucked (well-trimmed . fingernails are a plus here). Apply
the flat of your fist - the lower joint of your fingers- to the
mother's lower back. She will give you clear instructions on exactly
where she wants the pressure. Mother can be standing, leaning, or lying on her side. This mom is lying on her right side.
3) Grounding well through your
feet, and keeping your back and neck straight, press very hard into her
lower back with your fists. You'll get extra leverage by keeping elbows
close to your rib cage, or bracing them into the bed, as in the photo on the right.
 4) Breathe. Seems obvious, but it is not easy to do as you are exerting a lot at this point.
5)
Take a break if you can. Sometimes the mother can tolerate you taking a
minute or two to rest your arms in between contractions. If not, see #6....
6) Enlist
the help of her partner or family member. Show them the posture that
works best, and the spot on her back that wants the pressure. Keep in
mind that the placement of the fists will change as the baby descends
(and hopefully rotates out of OP into OA- baby facing mom's sacrum). Have fists in place and start applying pressure as soon as she feels the contraction starting.
Using variations on this technique can give additional relief to the mother, as well as reducing your muscle fatigue. Try pressing a hot pack or ice pack against her back- alternating between the two can be very effective. You might do counterpressure with your hands during the contraction, and heat or cold in between- this will give the mom ongoing relief, while giving your arms a break. Grasping a tennis ball in each hand and using that to firmly roll and press her lower back is a good variation- if she finds the tennis balls scratchy, drop them into cotton socks. (The odd things we end up with in our birth bags!) Finally, keep in mind that the baby's position is the likely cause of her back pain, and continue to use your techniques to encourage rotation, alternating these with the counterpressure.
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Free Birth or Breastfeeding Book! |
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Offer Expires: Dec. 9th, 2009
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