About Us: Birth Roots In The Media

What Is A Doula?

Midwives aren't the only ones experiencing a surge in demand -- the same is happening for doulas across the province.

Doulas are professional labour support -- women who are present at home or hospital births regardless of whether they're considered low or high risk. They don't offer medical services, but often work in conjunction with midwives, obstetricians and general practitioners.

Doulas get to know expectant mothers and their families before the birth, and work with them to see what their hopes are for their birth. They're on call 24 hours a day, and stay with the woman throughout her labour to provide everything from emotional support and guidance, to information on what she can expect at various stages of the birth and how to handle medical intervention.

Deanna Momtchilov, one of the founding members of Birth Roots Doula in Winnipeg, said the demand for doulas has grown every year since they began offering service as a group in 2000. Seven years ago, doulas took on about six cases a month.

Today, they take between 10 and 20 new clients every month.

"It seemed to really take off and become more popular," Momtchilov said. "And it's continued to become more popular over the last few years."

Birth Roots Doulas are trained and certified through Doulas of North America (DONA) -- an international body that regulates the profession. Momtchilov said many other local doulas have also taken local training courses or been certified by other international bodies.

Doulas also offer non-medical measures that can help make a woman in labour more comfortable, including massage and position changes. Sometimes, Momtchilov said women want doulas because their partner might not be able to handle being their sole emotional support throughout the birth.

"The dad is often overwhelmed with having the baby, and wants to help but doesn't exactly know how," she said. "And there's a lot of pressure put on him -- you have to be the one to do all the right things and say all the right things."

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New Father Becomes Doula Promoter

Wednesday, April 28th, 2004

By Robert Arnason

ATTENTION pregnant women: If a man approaches you and starts talking about doulas, do not be afraid.

"When I see a pregnant woman, I ask her if she is using a doula for the birth. If she isn't, I tell her right away to hire a doula," says Stephen Penner, whose wife Audra gave birth to their son Samuel with the help of a doula.

Doulas are women who "mother the mother." They provide information on birth options prior to labour, support during labour, and post-partum help. A recent study from the University of Toronto nursing faculty indicates that using a doula results in higher satisfaction in the birth experience for the mother-to-be and less need for pain medication during labour.

Penner became a doula promoter this year after Tara Laba, a doula from Birth Roots Doula Collective Inc., helped his wife get through a 33-hour labour to deliver their first child.

"After 15 hours we were delirious," he says.

Despite the extremely long labour, with no drugs, Audra Penner describes her birth experience as extremely positive.

"It was unbelievable," says Audra, who eventually gave birth to Samuel on New Year's Day. "When things were stressful, Tara slowed us down so we weren't panicky and reminded us of our birth plan."

Doulas meet with the parents a few times before the due date for pre-natal education and to discuss a birth plan. The plan lays out how you want to have your baby, and whether to use pain medication.

"People hear 'doula' and they think drug-free. But I'm not there to promote an agenda," says Laba, who acts as a consultant, explaining the pros and cons of drugs and other birth options. "We don't make decisions for the parents."

Doulas are often confused with midwives, but their jobs are different. Midwives are trained to do medical procedures and to make medical decisions that ensure the health of the baby.

The focus of the doula is on the mother's mental, emotional, and physical health. Their biggest job is labour support and they go to the hospital to help the mom through the hours leading to birth. They also provide post-partum support at home, especially if the mom has had a rough delivery or post-partum health problems. Some women hire doulas to help out in the first weeks after birth if they don't have any relatives handy.

"Having a doula there really frees us up to focus our care on the baby, like doing the vital signs," says Kassandra Swerdyliak, a nurse in the Labour Delivery Recovery Postpartum Unit at St. Boniface Hospital.

"The number of moms who come with a doula is few and far between," says Swerdyliak, who estimates one out of 30 mothers come to the hospital with a doula. "Definitely, they should be used more."

Swerdyilak says having a doula in hospital means consistency of care.

"With shift changes, you may not have anyone there who knows your birth plan. The doula is someone you trust and already have a relationship with."

Audra had done some research prior to Samuel's birth and found out that when supported by a doula, women are less likely to have a caesarean birth and less likely to use pain medication.

But when Audra first put forward the idea of a doula, Stephen's reaction was not positive. He felt it was his role to be the support during labour.

"I said, 'Absolutely not. I can do the job,'" says Stephen.

He was swayed after he met Laba and witnessed her calm manner and listened to her knowledge of birth options. He was convinced after witnessing his wife go through labour.

"You think you are prepared, but when it actually happens you're like a deer caught in headlights," says Stephen.

When difficult choices arise during labour, the doula is there to help panicking parents make a decision that is right for them.

For example, the nurse might suggest speeding up labour. A doula can explain the pros and cons of taking an IV drug to augment labour.

"We explain the benefits and drawbacks of each choice," says Laba, who together with Deanna Momtchilov and Julia Allen, founded Birth Roots Doula Collective Inc. in Winnipeg in 2000 after they attended a doula training course together.

Doulas are educated by doula associations -- the most recognized being the Doulas of North America. Official certification as a profession is a goal for the future in Manitoba.

"We are finding that as people learn more about doulas, they want to include us as a part of their birth," says Laba. She adds that two years ago Birth Roots saw four clients per month, and now they have close to 20 clients per month.

"People are glad they can find this kind of service here in Manitoba," says Laba, who recently hired another doula to meet demand. They now have nine doulas on staff.

"Each month that we are around, we find that we're more and more popular," she says.

Up to this point, word of mouth is driving the surge in doula popularity here in Winnipeg. And with Stephen Penner stopping every pregnant woman who crosses his path, the word on doulas will continue to spread.

© 2004 Winnipeg Free Press. All Rights Reserved.

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A Labour Of Love: Doulas And Midwives In Manitoba

For centuries, women have been helping other women through childbirth. That's the philosophy behind two ancient practices that are making a big comeback as more women seek out alternate forms of care during pregnancy and through delivery.

The use of midwives and doulas is on the rise. And while the two are different, they are not mutually exclusive. Midwives are trained to do medical procedures and evaluate the well-being of both the mother and child, while the doula's focus is on providing emotional support and physical comfort to the mother. But the two work hand- in hand to ensure a positive birth experience.

The word 'doula' is derived from an ancient Greek term describing a woman who helps other women. Today, it has evolved to mean a woman who supports other women through birth and beyond. "The whole idea behind doulas is 'mothering the mother,'" says Deanna Momtchilov, one of three Winnipeg women behind Birth Roots Doula Collective Inc.. After meeting in a study group, she and her partners Tara Laba and Julia Allen established Birth Roots just over a year ago.

Trained in the physiology of birth and the emotional needs of a woman in labour, doulas help women have an easier, safer birth. The statistics are impressive. Studies show that women who use a doula are 25 per cent more likely to have a shorter labour, 50 percent less likely to have a c-section and 60 percent less likely to want an epidural.

So what exactly does a doula do? Essentially she works with the mother through pregnancy to make sure she is prepared for labour and delivery. That means providing information on everything from nutrition to medical intervention to breastfeeding, answering lots of questions and assisting the woman and her partner to prepare a birth plan. "It's a lot easier to make decisions about drugs and interventions when you're informed ahead of time," says Julia. "We give women options so they can make their own choices."

Most importantly, the three or four prenatal visits are the time to get to know each other. It's critical that the woman feels comfortable with her doula and trusts her to be with her during labour. "That's what sets us apart from the medical community," says Deanna. "You're a person we want to develop a relationship with and we are committed to being there with you."

Although they provide woman-centered care, doulas do involve the woman's partner. The doula takes care of the woman so the partner can take a break when necessary and fully enjoy the whole process. "It's the doula's role to explain things as it happens so the partner is more relaxed," says Tara. "A doula really balances things out."

Doulas also offer consistency of care. During a 24-hour labour, Tara says nurses may change shifts as many as five times. Regardless of how long labour takes, the doula stays with the woman until she is well through delivery. Post-partum, she provides information and emotional support to the mother.

"Each birth is a new learning experience," notes Julia, who along with her partners is hoping to one day be a midwife. "Aspiring midwives make the best doulas because we are always learning."

Like a doula, a midwife is a trained specialist who cares for women throughout pregnancy and childbirth. Midwives work with their clients to prepare birth plans, provide childbirth education and talk about things like nutrition and medical intervention. But they also perform many of the roles of an obstetrician. A midwife is an alternative choice to an obstetrician, as long as the pregnancy is low-risk and doesn't involve complications like heart disease or diabetes.

Midwives schedule the same visits as a physician - monthly visits until 28 weeks gestation, biweekly from 28 to 36 weeks and then weekly until delivery. The difference is the length of visits. Instead of five to 10 minutes, each appointment with a midwife is about an hour. "We pay attention not only to the woman's physical well-being, but also to her emotional and spiritual well-being," says Jennifer Scaia, who works for Midwifery Services of Winnipeg, a division of the Winnipeg Regional Health Authority. "It's more comprehensive, individualized care."

That kind of care is exactly what made Jennifer change career paths midstream. En route to becoming a doctor, Jennifer learned more about midwifery when she was taking pre-med courses at McGill University. "Midwifery was much more appealing to me as a care giver - the continuity of care, informed choice and longer visits with patients," she says.

Although midwives in Manitoba work out of the community and not in a hospital, they do have hospital admitting privileges like a doctor if a woman chooses a hospital birth. Midwives also have prescriptive authority so they have access to all the medication a woman might need. But Jennifer says they try to look at more holistic ways of healing before the more conventional. "Everything about midwifery is about the woman's choices," says Jennifer, who is currently president of the Midwives Association of Manitoba. "It's about respecting her wishes and giving her freedom of choice."

During labour, the midwife is present at all times. Not only does she deliver the baby, she stays for several hours after the birth to ensure both mother and baby are doing well and help establish breastfeeding. The post-partum care is also quite comprehensive. Jennifer says she visit her clients on days one, two, three, five and seven following delivery and again at two, four and six weeks.

In Manitoba, demand for midwives is growing. On June 12, 2000, the word 'midwife' became a protected title. All midwives must be trained and registered with the College of Midwives to practice in this province. To keep up with the demand, there are plans to offer a four year degree for midwives at the University of Manitoba.

"We have been really well received in the medical community," notes Jennifer. "There is a shortage of obstetricians in Winnipeg and midwives have been a real help."

This article originally appeared in Winnipeg Women Magazine, Winter 2001. Visit Winnipeg Women at www.winnipegwomen.net.

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Fair Highlights Birth Options

Is your family growing?

You may want to check out the upcoming Parenting and Birth Fair. The event takes place from noon to 5 p.m. at the Robert A. Steen Community Club Sept. 16.

The free event for families and expectant parents is the inspiration of the Birth Roots Doula Collective Inc.

Doulas are trained to provide pregnant women and their families with support before, during and just after childbirth.

One of the doulas roles is educating parents, says Birth Roots' Julia Allen. The Birth Fair is an extension of that role, she says. Expectant parents "should be aware of their options," says Tara Laba, also a doula with Birth Roots. "The options are so much more broad than you may think," she says.

The fair will feature displays from Winnipeg businesses and services available to help a growing family, and guest speakers on birth and parenting issues including child safety, breastfeeding, co-operative play, and midwifery care.

A doula is not the same as a midwife, points out Allen. They do not perform any medical exams or procedures. Instead, doulas offer emotional and physical support, working to ensure a safer and easier birth.

One of the biggest misconceptions about the role of the doula is that they take over the role of the dad or birth coach. "That's so far from the truth," says Allen. Having a doula on hand "puts dads at ease," adds Laba. Dads may have another advantage. "It's like having a ready-made cheat sheet," says Allen. The doula may make suggestions for ways the father can help to ease his loved one's discomfort.

The doula is also available to offer information to help the couple make decisions regarding the care of mother and child.

Becoming a doula has been a rewarding calling, says Laba. "You see a couple at steps along the way, and then you see them become a great family." Allen agrees. "There's a rush around every birth. You're floating," she says.

For more information, call Birth Roots at 792-6769, or check out their website at www.birthrootsdoulas.com.

This article originally appeared in The September 5, 2001 issue of The Metro.

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New Option In Maternity Care

As long as women have been bearing children, they have turned to other women for one-on-one support and guidance. However in this era of cutbacks and hospital bed shortages, this valuable element of maternity care has been lost. Now, this support is once again available to the women of Winnipeg thanks to a new service called Birth Roots Doula Collective Inc.

While an unfamiliar term to most, the word doula identifies what is coming to be known as an integral part of the labour and delivery caregiving team. A doula is a woman trained and experienced in childbirth who provides the mother and her partner with emotional and physical support in labour, alleviating pain and helping the mother to cope. As well, she is an advocate for the couple and their preferences for their birth. She also provides information and guidance before the birth and then later during those tough first few weeks postpartum. Most importantly, it works; labours attended by doulas have been found to be 25% shorter, 50% less likely to end in a Cesarean birth, and moms supported by a doula are 60% less likely to want an epidural. The result is a happier and healthier mom and baby, and a better birth experience.

So why might you choose a doula? Perhaps, you’ve had a Cesarean birth and would like to avoid a second (or third). You might be a single mom needing some skilled and experienced support for your birth, or a couple nervous about communicating with your caregivers. Maybe you were thrilled that mom and baby were the healthy result of your first birth, but something still seemed to be....missing. Or maybe you’re expecting your first baby and really want a natural childbirth. Whatever your reason for choosing to have a doula supporting you at your birth, you will be one of many Winnipeg women turning to a doula for support during labour and part of a growing body of mothers more satisfied and empowered by their birth experiences.

The three women who make up Birth Roots Doula Collective Inc. met in a 1999 doula training course, and soon discovered that they shared a similar view of birth as a healthy and natural life event. They also discovered their common desire to help women and their families have the birth experience they want, and formed Birth Roots Doula Collective Inc. as a way of making this essential service available to as many Winnipeg women as possible. Consistent with this commitment, their fee is flexible for those who cannot afford it.

In operation since July 2000, these women have found the demand for their service to be overwhelming, and the response from other caregivers to be very positive. For more information about Birth Roots Doula Collective Inc. or to book a doula, phone (204) 792-6769 or visit their website at www.birthrootsdoulas.com.

This article originally appeared in the December 2000-January 2001 issue of Winnipeg Parent Newsmagazine.

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