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You are here: Home - Pregnancy - Labor & Childbirth

Creating a Positive Birth Environment

by Karen Kilson, Certified Doula |
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Labor and birth, of course, are very physical. Not only will the mother expend much energy during this time, but also her senses can be heightened. These perceptions, although sometimes overlooked, can add to or detract from her comfort and well-being, and therefore can even affect her progress. The following are some points to consider when preparing your birthing environment. A doula can help you add some of these considerations to your birth plan, and will also help you to achieve the environment you wish to have. These considerations apply whether you are birthing in a hospital, a birthing center, or even at home.

OVERALL ENVIRONMENT

Privacy - Consider whether you would like the door closed or open. If open, the door curtain can be closed. Window shades and curtains can be closed or open according to your choice. If you need to use the bathroom and wish total privacy, don't hesitate to say so.

Minimal Traffic - You may choose to have family or close friends with you while you labor. This is often fine unless it begins to interfere with your comfort or with the staff's ability to perform their duties. It is usually best to keep company to a minimum as labor progresses, to aid in your concentration. Children may even be permitted in the labor room, but it is best if someone is present to personally take care of each child and remove the child from the room when necessary.

Mobility - Remaining as mobile as you can greatly aids your progress in labor. Movement and gravity help to bring your baby down quicker than staying in bed. Keep this in mind when presented with interventions that will cause you to remain in bed for long periods.

Personal Items - Bring with you small personal items that will make you more comfortable. Consider a favorite photo or other item to use as a focal point, music you have chosen to hear, a favorite pillow, robe, slippers, etc.

Room Temperature - There is much that can be done to bring the temperature to your comfort. Ask to have the thermostat adjusted, if you are uncomfortable. A doula can also use hot packs, cold packs, warmed blankets and towels, cool cloths, even an overhead warmer if you wish.

Creative Positioning - Doulas are trained to help you with positioning during labor. We can suggest many positions that will help you during different stages of labor or during back labor. There are also positions that can help you rest while upright, or even while using the shower. Your doula will make recommendations for you and you can decide for yourself if they are accomplishing their purpose.

Music - You may decide to bring tapes and CD's with you, or the doula may provide you with relaxation music. Keep in mind that as labor progresses, your state of mind may change also. Music that sounds great in early labor may not be appropriate later on when you need to actively concentrate and relax between contractions.

Quiet Conversation - Those with you during labor should keep conversation at a comfortable level. Birth partners and doulas will need to offer verbal support and encouragement to you. Affirmations can be important to you at this time. If you use affirmations in your life, ask your doula to help you find an expecially appropriate one for you.

Familiar voice/s - Your birth partner's voice may be the one you want to hear most often, or your doula's voice may be the most comforting. Your needs may change as labor progresses.

Vocalization - It can become difficult to tolerate a contraction in complete silence as you breathe. This is not necessary, and making sounds can actually help you. Your doula can help you experiment with labor sounds. It is generally agreed that high-pitched sounds signify resistance, while low sounds or groans from deep in your throat can be beneficial to you.

Negatives - If certain sounds do bother you, your doula will help to remedy the situation. You may be bothered by noises from other rooms, the television, or normal hospital sounds. The solution may be as simple as closing a door. Simply let her know.

Lighting - Rooms have a variety of lighting sources, and these can be dimmed or intensified as you wish. Even in the daytime, your doula can adjust the blinds, drapes or lights to give you lighting as restful as you desire for concentration and relaxation.

Eye contact - Focusing your eyes toward a person or focal point during contractions can help you cope and concentrate deeply on what is happening. Try keeping eye contact with your partner or your doula. If you have been practicing with a focal point such as a photo, have her place it in a convenient spot for you to use. If you wish, bring a familiar item from home to keep within your line of vision.

Visualization - This type of guided imagery can be extremely helpful to you during contractions or between them.Your doula can suggest appropriate images during contractions to help you visualize what is happening inside your body. She may also quietly talk to you in between contractions, guiding your imagery to a place that is particularly restful for you.

Negatives - Sometimes an untidy room can interfere with your comfort or concentration. Your doula can help by straightening up the room or simply by moving your personal items to a more convenient place for you or for the staff.

Food - Most likely you will not be allowed to eat once you are admitted. You will be allowed to have ice chips or fluids, according to your doctor. You can, however, bring lollypops or popsicles and ask your doula to keep them in a freezer for your use during labor. In most cases, a tray of food will be ordered for you after delivery, at any time of day.

Dry Mouth - Ask your doula to keep you supplied with ice chips, or to give you a cold wet cloth for your face or mouth. Consider adding lip balm to your packing list for the hospital.

Vomiting - Although everyone doesn't experience it, vomiting is a very normal part of labor. You can be provided with a toothbrush and mouthwash afterwards.

Pillow - If this is important to you, bring a bed pillow from home that smells like your familiar laundry detergent or fabric softener. Or consider bringing with you a favorite cologne to have nearby.

Aromatherapy - If you use aromatherapy in your life, bring with you cotton balls scented with a few drops of the essential oil that you feel will most benefit you. Lavender is most often suggested but certainly decide this for yourself. It is recommended that you don't bring the bottle with you, as the oil is very concentrated and would cause a major problem if spilled. Doulas sometimes carry their favorite oils for labor purposes. Remember, though, that your senses will be greatly heightened, and you may choose not to confuse them with strong scents.

Food - Other people in the room should consider the laboring mother's situation. You may be very hungry or may not want to smell food at all. If your partner/guest needs to eat, it should be done outside the room, away from you.

Childbirth smells - During your labor and delivery you may detect the smell of blood or feces or vomit. Be assured that these are all a normal part of labor, There is no need to be embarrassed, and the staff will take care of things quickly, maybe even before you realize it.

Clothing - In a hospital environment, it is probably best, but not necessary, if you wear hospital gowns during labor, as they are plentiful and always available. They can be worn two at a time, one to cover the front and one to cover the back.Your favorite nightie or T-shirt can be saved for after the baby is born, when there is less chance that it will be soiled. Walking is wonderful for labor, and you may want to bring a robe for walking in the halls, although it is not necessary. Your birth partner should, of course, dress comfortably for what may be an extended period of time. Your doula can provide you with hospital slippers, or you may want to bring your own.

Showers - Your doula can provide you with soap and towels for the shower, if you wish. But by all means bring with you your favorite soap or shower supplies for after delivery. Using the shower during labor can be very beneficial, and you may be encouraged to do so. However, the hospital's towels are usually quite small and you will need a few of them at a time. Feel free to bring a large towel or two from home if you wish. Your doula can also bring you a heated blanket to dry with or cover yourself.

External Monitors - At some point you will probably be asked for monitor readings. Elastic straps will be placed around your abdomen, although these are not uncomfortable. The monitors use gel for conduction and the gel can be cold, but it rapidly warms to your body temperature.

Exams - It is fairly certain that you will have at least one vaginal exam to determine your progress in dilation. If this is uncomfortable for you, try to concentrate on relaxing your pelvis. You can also use your favorite breathing pattern during this time or ask your doula for guidance.

Massage, etc. - For most women, touch is essential during labor. This may be in the form of massage, acupressure, stroking, effleurage, or even holding someone's hand. Your doula can perform all of these for you, or can instruct your partner. There are methods of touch to comfort, to assure, to soothe, to counteract back labor, to help you relax. She has been trained in all of these and, with your permission, will use them as you need them.

These have been considerations for planning your physical labor environment. There are other aspects of labor and delivery for you to discuss with your birth partner, doula, or obstetrician. The doula that accompanies you is not part of the medical staff, and will not make medical decisions for you. She can, however, see that you have the necessary information to make your own decisions when something unforseen arises. Spending time well before labor begins to discuss general medical preferences or choices will eliminate making difficult decisions under difficult conditions.

Karen Kilson
I'm a 49 year-old mother of three children in their twenties. I'm proud to be a Certified Doula with Doulas of North America, and practice in a hospital-based doula program at Danbury Hospital in Danbury, Connecticut. Joining this profession was one of the best things I've ever done in my life, and my husband has been extremely supportive. I also enjoy anecdotal writing and have managed to combine my passions into creating my own informational website, and one for the hospital as well. In the past year, two of my articles have been published in a quarterly publication for the profession, called the International Doula. Visit karens Website
KAREN'S PLACE - DOULAS AND CHILDBIRTH


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