Doula Training?

I have an opportunity to participate in a training course that would give me all the classroom time necessary to become a DONA certified doula.  This may seem a little out of left field for many reasons, not the least of which is the fact that I wimped out and got an epidural in my own birth, however I have interest in doing this for other reasons.  I am trying to decide if it makes sense to give up an entire weekend plus almost $700 to embark on this and my gut keeps telling me it is.

First, I dream of being a labor and delivery, postpartum or fertility nurse.  I know these preferences may change as I go to nursing school and participate in the clinicals in all the different areas of the hospital, but for now these are the areas where I have so much interest and passion that I cannot get enough exposure or information.  It seems like doula training would be a mini-fast track into that world.  Even if it did come in a different "flavor" than the normal nursing curriculum would.

I also would think that having this training could only be helpful to my future patients.  I have no intention of ever changing a patient's true wishes when it comes to her birth plan, but if someone came in on my shift who was a lot like me (just wanting to experience labor and see how my body managed it), I think I could be more supportive to those women and offer them tips and tricks that would allow them to better attain whatever goal they had.  The hospital I delivered in was very "natural childbirth friendly" so I never really felt pressured to get an epidural from the staff, but I also didn't feel any real support or guidance from the doctors or nurses that could help me.  If I hadn't hired a doula of my own I would have been hooked up to an IV and an epidural 4 hours after I arrived, but with my doula, I experienced real, raw active labor (with water broken) for almost 12 hours before getting an epidural and starting to talk c-section.  I know I couldn't have done it without her, but I'm so proud of myself for doing it.  I wonder if I could help women who didn't have doulas make it just slightly longer in the process.

Another big reason that I think this could be an interesting use of time and money is that I do have a minor underlying fear that I might not have the guts to be a nurse.  I have a tendency to panic in situations where I have no idea what to do.  Now, with that being said, if I DO know what to do, I can be remarkably calm, so I think as I gain the knowledge that is necessary to be in this role, I should be able to calmly, confidently and effectively perform.  The problem is, there really isn't a good way to do a "trial run".  I can't shadow a nurse today and know if I would be able to handle it, because today, I don't have the skills, so of course I wouldn't' feel comfortable.  On the other hand, by the time I obtain the skills and training, there is no longer any value in the trial run because I have already spent the years in school, the money on classes and left my full time job to pursue this dream.  If I find out then that I don't have what it takes, then I'm kind of screwed.  Enter the mini-trial-run.  The thought assisting a laboring woman in the hospital is not all that intimidating because you're surrounded by so many medical professionals who know exactly what to do, but the thought of assisting that woman in her home before she goes to the hospital is slightly more concerning.  Doulas, by definition, are not medical professionals and do not perform medical tests or procedures, but the laboring woman is looking to the doula to help guide her through the process.

Finally, I just think it might be a fascinating class and I can't imagine that learning more about anything related to the body would be a bad idea at this point.  So, now I just need to decide how to convince my husband that he needs to be on his own with the 2 year old for the entire weekend and I need to spend all this money on this class that won't actually go towards my nursing degree...it's still a tough decision.

34/35 Weeks

I’m starting to get really excited about this baby actually coming. I am 34.5 weeks, and although I definitely do not want him to come anytime soon, I do feel like there is some excitement now that I can start to look for signs of impending labor. Of course, so far I’ve had none.

As far as my symptoms, I’m feeling pretty good. I continue to struggle with constipation and heartburn (although the heartburn has been curbed by Prilosec OTC, for which I am so grateful). I am starting to notice some swelling in my ankles, but it’s still pretty minor. I get so overly full after every meal, particularly if I eat too much or too late. I will be glad when the baby drops, because I’ve heard that one of the noticeable changes you’ll have when the baby drops is less bloating after eating. I also now have to pee at least twice in the middle of the night. This really isn’t a big deal (and pales in comparison to a middle of the night feeding and diapering session), but getting up always makes my cat think that it’s time to eat, so then I have to either listen to him cry for an hour or shut him out of our room so he can’t bother us, and the whole ordeal is annoying. The cat has also found that our pack and play with the changer installed makes an awesome hiding place. I am NOT a cat person, and really have no interest in this cat, so if he knows what’s good for him, he will quit with the shenanigans and stay away from the baby’s things. He could end up living in the barn if he keeps it up.

We are meeting with our doula again tonight to go over our birth plan. I’m excited to talk with her again and start to do some planning for the birth. Having this meeting makes me realize that things really are starting to get close. I feel like the weeks do go by more quickly ever since our third trimester began. I’m not usually one who enjoys lots of attention, but I have to say the bigger my belly gets, the more people who stop me and talk to me or try to help me or just give me knowing smiles and understanding faces. I think it’s all very special. Don't get me wrong, I will be very happy to shed this basketball from my frame, but I really think the third trimester gets a bad rap. I’ve enjoyed it so much. It’s like people finally recognize that you are carrying this special package inside you, and they roll out the red carpet. It’s fun.

I don’t believe that I’ve experienced any noticeable Braxton Hicks contractions except maybe for today. I can’t even be sure about today’s experience but it did feel slightly different from any other contraction-type feeling I’ve had. For a long time I thought I was having BH contractions that lasted just a couple of seconds, but now that the baby is bigger, I really think that feeling is him stretching across my uterus. I get a butt up in my upper left uterus area and a hand or something in my lower right area. It’s uncomfortable, but I really do think it’s movement, not a contraction. Today, however, I did have a feeling that was a bit uncomfortable and reminded me of a ligament being pulled or something and it went on for probably a minute. I’ve been wishing for another feeling like this all day to see if I can better diagnose it, but I haven’t had one yet.

In baby prep news, our beautiful nursery furniture is delayed and isn’t likely to arrive until July 18th (and even then, who knows). This timing should be just fine. I don’t expect to go into labor early, but it really annoys me that something like nursery furniture can take 13+ weeks. Most of us just don’t have that much time. I ordered this furniture at 24 weeks, and I didn’t feel that comfortable ordering prior to that. Luckily, they had the crib in stock, so we do already have that, which would get us through if baby did come early. I just want to put everything away and organize all his things BEFORE he arrives.

Childbirth Class

We attended an awesome prepared childbirth class at the hospital last weekend. I always assumed that this class would be primarily review, and I planned to go for my husband’s benefit more than my own. I couldn’t have been more pleasantly surprised with the content. The class did have a great deal of review. My husband kept whispering that I should be taking notes, but I reminded him that the things that were being discussed were things I could recite anytime without notes, but I was so happy that he was engaged enough to be listening that way. So, we went through the obligatory informational part of the class, and got that out of the way, which is when I feel the real value came in.

I went into this class pretty scared of the idea of getting this baby out of my body. I had plans to get to the hospital when it was appropriate, manage through the pain until it seemed like an epidural would be welcome, and then get the epidural and chill through the rest. I knew pushing would be exhausting, but I didn’t really expect it to be terribly painful, and I was just hopeful that I could handle the whole process without a great deal of pain, trauma or fear.

The other idea that I had before I went into the class was that it would be extremely convenient to simply schedule an induction for the birth. This would allow me to give my family dates that they could come visit and I could schedule the time off work appropriately. I also wouldn’t have to worry about going into active labor at 1am or my doctor being unavailable at the time. Of course, there is always the chance that the baby would decide to come earlier than the induction, but I’ve always had the hunch that he would come late. My mom was 2+ weeks late with all three of us and my sister was induced about 12 days past her due date. My doctor won’t allow me to go more than 2 weeks late, but I figured I would just schedule the induction for about 2 days after my due date.

After an 8 hour class with a lovely doula/nurse/lactation consultant at the hospital, I have changed my mind completely on both of these items. Melissa gave us so much information about the benefits of allowing labor to begin on its own. I could write pages if I tried to go through it all, but it made so much sense to me. Here is an article that covers many of the items she discussed.

http://www.lamaze.org/ChildbirthEducators/ResourcesforEducators/CarePracticePapers/LaborBeginsOnItsOwn/tabid/487/Default.aspx

I am now very much dedicated to letting labor begin on its own. In fact, I will be disappointed if I must induce because I’m going so late, but not disappointed enough to put the baby at risk. My hope is that if we’re already 2 weeks late, then the baby won’t be too terribly unwilling to come out, like he might have been if we induced a week early.

The other thing I have really changed my mind on is the epidural. Now I’m not suggesting that I’ve committed myself to a drug-free birth. I wish I was brave enough to commit to that, but I’m not. What I am saying is that I am committed to trying to do this birth without an epidural, but if I need it at some point, I won’t beat myself up for “caving in”. I used to think inducing and epidurals gave me the largest amount of control that I could have in my birth experience, but after reading all this information, I feel just the opposite. Being hooked up to IV’s, monitors and catheters put me in a position where I am completely powerless to use my own body to help get this baby down and out. I’m totally at the mercy of the doctors and nurses. I still am very trusting of medical professionals and I’m not in any way trying to say that I would prefer to run the show rather than them, but the fact is, this is not a malfunction or a sickness in my body that needs to be treated. My body was designed to perform this function. I feel that giving my body the chance to actually participate in this without immediately stripping myself of all control makes sense for both me and for baby.

For this (still intimidating) process, my husband and I have enlisted the services of a doula. We feel that there is no downside to having her there and she can help us carry out our plans the way we want them and also provide me with a great deal of support.