Hi y’all,
I had the amazing privilege of interviewing Suzzie, who is an amazing doula and woman located here in the Greater Seattle area. I really wanted to make sure we helped moms answer the big questions, including finding where a doula might fit into their own birth plans.
Hi, I am a doula and childbirth educator located on Mercer Island. I serve moms anywhere within an hour of the city, and attend births in all of our local hospitals, birth centers and even home births. A doula offers continual emotional and physical support during birth. Basically, we are the one right there with you to help you remember everything you learned in your childbirth class. We help you cope with contractions, notice the signs of progress, and help you overcome the moments when you feel down, or it feels impossible. It’s not. It might not be easy getting a little baby out of your body, but, mothers are designed to birth and we help you embody this power. When you have a doula by your side, you don’t have to take any steps alone.
My own two births inspired me to become a doula! I had a rocky and turbulent birth with my first daughter that ended in an emergency c-section. To be honest, the birth thing seemed wild and I was happy to put it behind me. But then, when I joined a new moms group, I became dear friends with a midwife. She opened my eyes to the ways that I didn’t receive respectful and individualized care. I also was detached from the experience and didn’t see the emotional and spiritual gifts that come with giving birth.
Joy, accomplishment, tenderness, closeness, trust, spirituality, self-realization, conscious development, and safety. These are all potential gifts of becoming a mother.
Like many, I was blind to these in my first birth. For my second birth I wa much more prepared, and much more supported. I initially became a doula as a stepping stone to midwifery school. Only, I fell in love with the hands on and practical support a doula gives. When you’re called to something you feel it every day and it brings you joy day in and day out. I’m truly lucky to have found the place where I can contribute to the world best.
Yes! Usually we meet a few months before birth. We begin by talking through your hopes and dreams for birth, then we go through all the options and choices you have to make. This part is a lot about learning the options, and which ones support your goals. Then we work on strategies to cope with labor and handle contractions. When labor starts, as a doula, I am sometimes the first part of the birth team to meet them. Usually at their home. I help them time contractions, work through contractions, stay hydrated and fed (which sounds simple but can be more difficult than expected) and know what is normal and what is not normal. I am by the family’s side throughout birth helping them navigate what to do when. After the baby is born, I help the mom get her first breastfeeding latch with her baby and teach her a few basics about baby feeding.
Once a family returns home, I get to continue to support them. As a postpartum doula I come to their home to help with the baby, assist with feeding questions, prepare meals for the family and even do a bit of housework since families are usually struggling to keep up with everything on the demanding newborn schedule. I love getting to see moms through the entire cycle of pregnancy, birth and postpartum, bringing a sense of ease and helping take care of the practicalities that can so often become overwhelming in that time.
My doula helped me so much in my second birth. Having her by my side helped me stay out of my head and not get overwhelmed by the labor process itself, despite how intense it was. Between her and my friend the midwife I already mentioned, I just really wanted to do for others what they had done for me. Given me power, helped me find my voice, and ultimately develop resilience so that a very challenging experience could be a very positive experience. What they did for me changed my life, and I wanted to do that for others. I stay because i see the difference it makes to have support. So many families in our area do not have family to help postpartum. Not everyone has any exposure to positive births. And even those that do, often need someone by their side who can help them in the physical and emotional ups and downs of labor.
Doulas do so many different things, it can be difficult to pick just one way we impact a birth. But that’s just it. When you have a good doula, you have a specialist, who has also taken the time to build a relationship like a friend. Sometimes the most helpful thing we do is help advocate for a mom. I remember one time when a c-section was recommended, and after asking a bunch of questions to make sure the mom understood the recommendation, it became clear the recommendation was more about time and convenience than about a medical need. Because she had that support in having a deeper conversation with her provider, they were able to come to the same page to give her labor a bit more time, and she went on to have a healthy vaginal birth, avoiding a c-section.
Other times, the birth process feels so overwhelming and it feels impossible. Not only can we hold space for the tears, and make space for the struggle, but we can also help you find the next thing that can help a mom cope. Hopefully pulling her back up to where the process is productive and purposeful, not something that leaves her suffering. Sometimes it’s that you have our phone number directly. I remember one mom texting me at 11 PM saying “I took my blood pressure and it seems really high. I don’t know what to do.” She didn’t have her doctors after hours number, or know that you could walk into Labor and Delivery even without an appointment if there was a sign something could be wrong. I was able to help her find that information, and was by her side as she went to the hospital to get checked out, and then went on to have her labor induced. When I look back at that moment, I’m glad that she had me on speed dial, and that she didn’t wait to get the care she needed. Birth can bring a variety of challenges. Doulas can help you navigate them, not matter which ones pop up on your path.
Did you know research shows that partners are actually more involved when doulas are present? It’s true. I am very fortunate to get to work with very loving families where most partners want to be involved in the birth. But, they don’t always know what to do. And, in labor, not all moms can answer the question “what do you need from me?”. As a doula, I’ve been through labor hundreds of times, where a partner may be witnesses a birth for the first time. It’s easy to anticiapte and figure out what a mom might need, that she might not be asking for based on her body language. And, I find dads are quick learners. When they notice I’m handing a drink after every strong contractions, they stay close with the drink. When I do hip squeezes for a while to help with the contraction pain, they ask questions and learn the exact spots that bring the most relief. When I’m quiet and present, they mimic. And, when I speak words of encouragement instead of asking questions like “are you sure you’re okay?” They are quick to follow.
One study asked mothers to compare their relationship with their partners before and after their baby’s birth. Seventy percent of the mothers who had a doula reported feeling more satisfied with their relationship at six weeks postpartum. Only 30 percent of the moms who did not have a doula felt their relationship improved after birth.
Absolutely. Doulas are really helpful in each of those scenarios, but you’re right, they are quite different experiences. In a natural birth, it’s really about helping a mom cope with contractions. That is her main focus. A lot of that is protecting her space, buffering any distractions, advocating for time and giving her lots of encouragement and ideas for positions, breathing techniques and other coping ideas. When a mom has an epidural, we do all of that until the epidural.
After the epidural, movement is still really important to the birth process. Laying on your back, or mostly on your back is not an ideal position to labor in, but it is the most natural after an epidural. However, this can limit blood flow to a baby and sometimes lead to a baby’s heart rate dropping. As a doula, I can help a mother find lots of different positions to labor in after the epidural which both help the baby navigate the pelvis and helps her stay off her back to make labor a bit safer for her little one. We also help a lot with pushing after an epidural. While a mom without an epidural will receive really strong urges to push, a mom with an epidural might not get any at all. She has to learn how to use muscles that are literally numb. We talk her through the process, helping her know what to do when.
A c-section is also a very different situation than labor. But, it tends to be very emotional, and a lot of moms can find the effects of anesthesia and the idea of having a surgery awake overwhelming. Most Operating Rooms in our area allow doulas into the OR. We can sit by your head with your partner and again give you encouragement. If you’re worried something is wrong, we can help amplify your voice and make sure it gets heard by the right people. We can walk you through relaxation techniques and encourage you when the normal feelings of surgery feel overwhelming and scary. After birth, we can help you breastfeed, make sure the baby gets skin to skin with you as soon as possible and make sure you get pictures at that moment you are with your baby for the first time!
Birth is very emotional, and women can go through a lot in their birth. Adding postpartum services to my packages really helped make the work more sustainable. It was really hard seeing people go through birth, and then checking in on them later and finding out they were still struggling. When I get to take care of a family after, I get to see their recovery process and even help nurture the recovery process that is necessary after an event as demanding and intensive as pregnancy and birth. That has been incredibly healing for me as well.
It’s never too late to find a doula. However, the best doulas usually fill up about 2-3 months in advance. Because of that, early second trimester is the best time to connect with a doula you trust.
Doulas are continuous support, meaning we barely leave your side unless you are doing extraordinarily well, or are sleeping for some reason (like after getting an epidural.) We’re there to take care of your very human needs, words of encouragement, making sure you eat, helping you work through contractions.
What we don’t do is the medical side. We don’t take your blood pressure, we don’t do vaginal exams. We don’t catch the baby. This is the job of the medical provider. A midwife is more like a doctor. In fact, they actually do the same job as a doctor, only they don’t work with mothers in extremely high risk situations, and they don’t perform surgeries (although sometimes they assist in surgical births.) One way I like to think of it, is that the midwife and doctor are there to catch the baby, while the doula is there to catch the mother.
If you are near Seattle, you won’t have this problem. Doulas are covered through many healthcare plans via the fertility benefits. We are also covered by medicaid. All of our hospitals are friendly to doulas and appreciate the extra help. Nurses are often too busy charting and taking vitals to care for all of your other needs. Not to mention, many of our hospitals struggle with staffing, so it’s not uncommon to have nurses that have a higher than ideal patient load. Having someone by your side that isn’t hospital staff helps the staff a lot. If you’re not from the area, and you have run into this problem, I would just tell your doctor you are bringing a doula. It’s not really their choice, it’s yours.
We make a big difference. In one study assessing the cost effectiveness of doula care in women in Oregon it was found that in a population of 18,000 women, if everyone received doula care there would be 219,534 fewer c-section, 51 fewer maternal deaths and 382 fewer uterine ruptures and 382 fewer hysterectomies. You can read the whole paper here.
Another study concludes this: “This scoping review presented data that support the presence of a doula; doulas have been found to reduce cesarean section frequency, low birth weight, and premature labor. Evidence shows that decreased cesarean sections have led to better outcomes for the mother and the child. Doula intervention has also been correlated with a decrease in epidural use during delivery, increased rates of breastfeeding, and the use of safety precautions for the child. The advocacy that doulas provide can increase well-being and satisfaction concerning the birthing process, and it provides education and support. This support may reduce mental health morbidities, such as PTSD, in mothers without a support system. The implementation of doulas as a common healthcare entity could be helpful, particularly for women who experience healthcare disparity.”
Take really good care of yourself. Eat enough whole food vegetables and protein. Stay active. Look up the c-section rates at the hospitals in your area so you can be at the best one. (I’ll show you how to in this article.) And take a comprehensive childbirth class. The annoying ones that take commitment and time. Because that really protects you in labor. In fact, one study found that almost 90% of women who took a comprehensive class went on to have a vaginal birth, while only close to 50% of moms who did not take a class ended up with the vaginal birth they planned on. Your preparation does make a difference.
If you like studying online, I would LOVE to have you take my childbirth class, but it is only one of the very good ones out there!
I am currently working on my first book. It’s all about inductions and what it means to use medications to start labor. My editor and I are cruising through chapters now getting them clear and concise and trying to find that balance between too much information and too little. I am really excited to bring it into the world. Carreer wise, I don’t expect much to change in the coming years, as I love my jobs. One exciting thing that has happened recently is that a lot of the moms I worked with through their first labors are starting to have second and third babies. It has been really rewardign to get to go to these second and third births and see families expand in such joyful ways.
Thank you again to Suzzie, who I just love to pieces. If you’re considering a doula for your birth, definitely consider having Suzzie at your side, she is a wonder to work with.