using doulas

I've encountered doula's after delivery but sometimes find the info they are feeding these moms does not quite jive with medical practice, so I listen carefully to what is being said--the last one I encounterd sat on the edge of the bed and massaged pts uterus for hours(?) When I went to do my assessment and checked her uterus she was deffinately firm but so high and off to the right I asked her about voiding (no, hadn't done it yet) and the doula said that it could have been food in the intestine that I was feeling!! Amazing, tho, that after emptying a very full bladder her fundus was firm and centered at the umbilicus!! So just remember to coordinate your care w/ the nurse and doula and we each have our own agendas.

I have a friend that just became a doula, and she's very excited about having her first patient. She asks a lot of questions, and I try to steer her in the direction of reliable information and put her in touch with good resources.

I did have a patient that had a doula attend her delivery during my senior preceptorship. Her doula was very supportive of both the patient and her family. She was very helpful in relaxing the patient. She was very knowledgeable and was an excellent patient advocate. My preceptor and I provided care as you would for any other patient with a strong labor coach, and answered her technical questions as complications came up.

It is important to make your own assessments and evaluations and provide appropriate teaching when working with a doula. I do think that doula's can be very valuable to the patients that use them.

At our hospital we have nurses at 1-1 during the labor acting as doulas with interventions to speed progress and relax the laboring mom. It cut our Csection rate by about 7%. Moms love it, and it's much more satisfying for the nurses. Of course there are always some nurses that would prefer to give lots of drugs and sit reading a magazine.

I witnessed a delivery where the family hired a doula for the labor and certainly the RN and the doula need to be in sync or it just increases the stress. However it was the most relaxed and happy labor I have seen.

Greetings All Nurses,

As a Nurse and a Doula I think I give valueable assistance and insight for my clients. I do alot of pre-natal education and help develope a birth plan with the client so that she may have the best possible birth experience that she is capable of having. My care is symptomatic and supportive. I work as her aid one to one and will advocate if the need arises! Most of the time I prefer her to speak to get her needs met. It results in a more empowered birth. I too, use natural methods to promote the progression of labor. It is more holitic and better for both mom and baby.

Peace,

Have a Blessed Day,

Jami