“If a doula were a drug, it would be unethical not to use it.”
-Dr. John H. Kennell
I’m missing Dr. John Kennell, who died recently after a long illness. I met him when he came to speak at our 2003 doula conference. My family was lucky enough to have dinner with him and talk to him, about birth among other things. He co-wrote The Doula Book and was a founder of our current doula movement. He was an indomitable spirit who encouraged me and Jan Mallak in our quest to write our own doula book. When we did, he graciously wrote our foreword and endorsed our book. He was a founder of Doulas of North America and a great believer in the helping hand of a doula in labor. As a doula myself, I know he will be missed.
DONA’s website says this about Dr. Kennell:
“It is with great sorrow that we share the news of the August 27, 2013 death of one of our beloved founders, John H. Kennell, MD. A pediatrician, Dr. Kennell and his colleague, neonatologist Dr. Marshall Klaus, conducted the earliest controlled trials examining the effects of continuous support on labor outcomes. They noted impressive results.
In 1992, Drs. Kennell and Klaus, Phyllis Klaus, Penny Simkin and Annie Kennedy founded Doulas of North America (now DONA International) to train and certify labor support companions. His famous quote about doulas has inspired families and birth advocates worldwide: “If a doula were a drug, it would be unethical not to use it.” (1998)”
Here is a link to the short video, The Essential Ingredient,: Doula, which has Dr. Kennell speaking about the doula movement.
Doulas can’t check a laboring woman’s cervix, or perform medical procedures, but knowing where a woman is in labor is a very helpful skill. Experience with laboring women helps us figure it out. Nicole D. who writes the blog, Bellies and Babies, has a very helpful article that describes multiple ways to help a woman figure out her labor progress.
Some methods that can help a caregiver or doula know how dilated a woman is during her labor include:
- Teach self exams
- Sounds she makes
- Smell of the room or the mom
- Bloody Show
- The bottom line
- Physical Make-Up
- Fundal height
- Symphysis Crease
- Mexican Hot Legs
Her article is nicely descriptive and helpful. I had a birth recently during which I used the Mexican Hot Legs technique. It worked for me! I was able to gauge her labor progress very well. Nicole describes this:
“As the birthing woman’s body works harder, blood is withdrawn from the extremities to be utilized by the womb. Thus, the woman’s legs get progressively colder from the ankle to the knee as labor progresses. At the start of birth, the whole leg will be warm. At around 5 cm, the leg will be cold from the ankle to around mid-calf than it is above the calf. Once the whole leg feels cold up to the knee, then the urge to push should shortly follow.
This technique is less reliable if the woman is having an epidural, as the drugs will also affect the temperature of the hands and legs. If a woman is birthing in water then she’d need to be on dry land for around 20 minutes to allow the temperature in her legs to be measured accurately. “
Penny Simkin, one of the founders of the doula movement, has a YouTube demonstration on why delaying cord clamping at the time of birth, makes sense. Watch it and see what you think.
Normally, I’d talk about how beautiful it is for a mom to have doula support during her birth and beyond. But today, I’m talking about the support we doulas get from our families so that we can function. We are on-call for a particular woman’s birth and go whenever she is in labor. In order to do that, we must have a lot of support in our own homes. Our families and friends make sure that our children are safe and looked after. They make sure that we can be available to women whenever they need it.
I know my own family has supported me throughout my doula career. In November, I’m going to help by supporting my husband as he reaches to write a novel of 50,000 words in one month. Together we are participating in National Novel Writing Month. I’m going to give him whatever support he needs. I’ll be his researcher, his muse, his drill sergeant. Together, I know we can succeed, because support can be beautiful!
I’ve been working on my texting skills lately. Some of my clients rely on texting often in their daily lives. They feel the doula-mom relationship should also involve texting for fast communication. I agree, but there are some limits that I am discovering. It’s difficult to have a meaningful dialog while texting. When a mom asks my opinion about some birth- or breastfeeding-related idea, I usually feel there are several options for a particular situation. Normally, I would offer them all to her. They don’t often fit into a short burst of information. More importantly, while we’re talking on the phone, I can hear not only the words of her response but the tone of it. “Ugh” doesn’t translate well into a text. She could possibly type “ugh,” but did she mean a strong “ugh,” a weak “ugh” or an in-between “ugh”?
This is even more important when I”m trying to answer the question “What should I do now?” I can offer a triage of solutions using a dialog and her voice as my guide. When she’s calling to ask if I think she’s in labor, I rely on listening to her breathing, her voice and her silence to help me decide where she is. If she texts me information like “I’m having contractions,” she’s giving me her opinion, but she isn’t getting the benefit of my experience. My experience is part of why she hired me.
A doula-mom relationship should be built using several kinds of communication, but shouldn’t rely too heavily on one. Emailing and texting shouldn’t take the place of phone conversations and private meetings. What I’ve discovered is that texting ≠ nuance. Every relationship is full of nuance. I need that nuance to make the woman-to-woman connection we need so that I can support this new mother.