Doulas in the Hospital

We have begun a new column where our readers can write in with their questions. We’ll field the questions to one or more experts in the subject and post the responses typically within 2 weeks. Write Us with Your Question!

Shelley Scotka

Shelley Scotka, Birth Doula and Childbirth Educator


Our expert for this question below is Shelley Scotka, an experienced doula and childbirth instructor in Austin, Texas.  Shelley is a mom of two and has been helping women and their partners since 1995. Read more about Shelley here.

Q: How does a doula work with my physician and the nurses in the hospital where I am delivering?

A:  A birth doula works alongside medical care providers but does not provide medical care. Instead, a doula provides emotional, physical and informational support for the laboring woman and her partner. Medical care providers, including your doctor and labor nurses, are really “lifeguards” who oversee the safety of the mother and baby. A doula is there to offer continuous support, to make sure the woman feels cared for, safe and respected. A doula listens and reassures, offers suggestions for positioning and comfort, uses touch and massage, and encourages communication between a woman and her medical care providers. After the baby is born, a doula stays in touch with the family and offers additional support with breastfeeding, newborn care, and making sure the family transitions well during postpartum.

 

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Expert Voices: Christina G. Hibbert, Psy.D.

Pregnancy & Postpartum Emotional Health: What Every New Parent Should Know

 

Dr. Christina Hibbert

Dr. Christina Hibbert

Most families excitedly prepare for this “beginning of all things” expecting the “wonder, hope, and…dream” of bringing a new life into the world. For women of advanced maternal age and their partners, these “possibilities” may be even more “hoped” for. Yet while deciding to have a baby a little later in life can certainly be a joyful event, it can also bring many unexpected emotional changes, and mothers may find themselves wondering, “Why didn’t anyone warn me it could be so hard?”

“A new baby is like the beginning of all things—wonder, hope, a dream of possibilities” (Eda J. Le Shan).

Emotional Changes in Pregnancy
We’ve all seen the cartoons and heard the jokes of the “emotional” pregnant woman, and let’s face it—they can be pretty accurate! Pregnancy is known for its ups and downs, and despite a woman’s age, changes in emotional health are usually part of the pregnancy process.

During pregnancy, hormone levels are at an all-time high—30 times greater than normal. Hormones such as estrogen are actually precursers to the neurotransmitters in the brain that make us feel “normal”. Thus, when our hormones shift, the neurotransmitters shift, and our emotions shift too. For some women, pregnancy hormones can be protective, improving emotional stability and mood. But for many other women the shifts in hormones make them weepy one moment, elated the next, feeling frustrated and wondering, “What is going on with me?” (For more on hormones and the brain, read the “Women’s Emotions” series,

Postpartum Emotional Changes: The Baby Blues
Once the baby is born hormone levels drop below “normal” and then slowly begin to regulate again. These extreme shifts can trigger what many women describe as an “emotional roller-coaster” in the first days or weeks postpartum. Called “The Baby Blues,” these shifts in mood are a normal consequence of fluctuating hormones, lack of sleep, and the many physical and psychological demands faced by a new mother.

Up to 80% of new mothers will experience the “Baby Blues”. Symptoms include fatigue, sadness, irritability, anxiety, or feeling overwhelmed, but for most women these symptoms should improve in a few days or weeks. (For more on The Baby Blues, read “The Baby Blues & You”.)

Preparing for Emotional Changes
We tend to spend most of our time preparing for the physical aspects of pregnancy and childbirth, but it’s just as important to prepare for our emotional well-being. The following suggestions can help:

  • Learn all you can: Educating yourself and your partner on the emotional changes of pregnancy and postpartum is one of the best ways to be prepared.
  • Create a Plan: A “plan” for emotional well-being is a great way to decrease external pressure and remind yourself that “this is normal”. Your plan should include a solid system for emotional and practical support, and discussing your emotional health with your doctor.
  • Set up your support system: Research shows that moms who have good social support have better emotional adjustment. Your partner or spouse can be part of your “support team,” along with friends and family. Allow others to help with the baby, household duties, or help you get a little extra sleep. A postpartum adjustment group is another great resource for new moms. (Visit www.postpartum.net to search for a group near you).
  • Talk to your doctor about your emotional health: Start during  pregnancy and continue the discussion postpartum. Ask questions, and if your doctor doesn’t know the answers keep looking until you find them.
  • Seek professional help if your symptoms persist or intensify. If it’s been longer than two weeks or if your symptoms intensify you may be experiencing a Perinatal Mood Disorder like Pregnancy or Postpartum Depression. Seek help from a mental health or medical provider who is trained in these disorders in order to reduce symptom severity and duration.

Resources:

Dr. Christina Hibbert is a Clinical Psychologist, Founder of the AZ Postpartum Wellness Coalition and Producer of the DVD Postpartum Couples. A 4-time Postpartum Depression survivor, Christina had her most trying experience in 2007, when her sister and brother-in-law died, she and her husband inherited their two children, and she gave birth to their fourth baby, going from 3 to 6 kids practically overnight (an experience she shares in her forthcoming book, This Is How We Grow) A speaker, blogger, and singer-songwriter, Dr. Hibbert keeps her practice, her family, and her heart in Flagstaff, AZ. Visit Dr. Hibbert at www.drchristinahibbert.com or www.postpartumcouples.com.

Be sure to join me for Part 2 of this series as we discuss Perinatal Mood Disorders and treatment options. In the meantime, remember: Having a baby really can be a “dream of possibilities,” especially when you’re emotionally prepared.