How to choose your birth attendant

2023 Author: Anita Thornton | [email protected]. Last modified: 2023-08-25 11:16

You want to punctuate your childbirth with informed choices, experience a birth that looks like you, and offer your baby the welcome you dream of: you are thinking of using a birth companion.

A choice that deserves exploration and reflection

You will place your trust in a previously unknown person at a time of great strength, but also great vulnerability. You will open the space of your intimacy to him and give him the privilege of attending one of the greatest moments of your life, personal, marital and family. In other words, no small feat!

Conscientious birth companion and concerned about the free will of my clients, I share here the questions that a couple would benefit from asking themselves to identify the one who, in the very heterogeneous mass of birth companions in circulation, will accompany them with heart, but especially with professionalism in the birth of their child. They should allow parents to assess whether their expectations and needs are knocking at the right door.

First of all: get startedEARLY

The sooner you do business with a companion, the sooner you benefit from her services! She will know how to help you overcome first trimester nausea, put Braxton-Hicks contractions into perspective or take them seriously, and she will give you lots of reading and movie tips that you will taste at your own pace rather than in a panicked sprint in the 9th month. A companion is a mine of information, referrals from therapists, and wise words. You pay for it, so enjoy it as long as possible!

The second reason why you should start early is that a valued companion lives in a rush of deliveries. Her schedule is often filled months in advance, and if your baby is also announced for the summer or for the end of year celebrations, the pool of available companions will be considerably reduced. First come, first served!

Will it be available? Does she have a replacement?

A human companion (who puts her family first rather than yours, a sign, it seems to me, of a balanced and credible personality in the profession she has chosen) can difficult to ensure more than four deliveries per month, less if she has another job at the same time. Some do more. They surely have superpowers that I don't have, like sleeping in a chair with the snap of a finger or breaking out of shape by chaining sleepless nights in the arid hospital air conditioning. Orthey do not/no longer have a family to support them. Or they require, as a condition of taking you, to join you after only 6 centimeters of dilation.

An honest companion must assure her clients that they will be accompanied no matter what. Even Superwoman has gastro sometimes! And with 4 deliveries per month, statistically, there is always a 5% chance that two will occur simultaneously. And Superwoman-who-never-sleeps doesn't have the gift of ubiquity. She must therefore talk to you about her successor, sharing the same vision and ethics of support, and familiar with your file (to the exclusion of any other person).

Does it click?

During the free approach meeting - offered by most doulas - the accompanying person will listen to your expectations, and present the scope of her services and the methods of her practice. Unofficially, but it is essential, this meeting is used to check your compatibility. And this must be reciprocal: will you want to be accompanied by a person who hides his enmity under the guise of professionalism? The key to successful support lies in the bond of trust that is established during the essential prenatal meetings. If you've thought about cutting costs by skipping one, two or all prenatal meetings because you've already given birth, because you don't have time, because you've already read everything, think again seriously. If you have any reservations, continue to meet companionsuntil you fall in love.

Does she have a written service agreement?

A contract protects both parties. A lucid and experienced companion is aware of the specific risks of a profession that mixes with the unpredictable, and particularly lends itself to retrospective "what ifs…". She knows the human limits of her practice, she considers the consequences and protects the stakeholders. A valid service agreement must stipulate the nature of the services rendered, the terms and conditions (fees, cancellation and refund policy, respite, special cases) and the responsibilities of each. A respectful companion takes the time to ensure that each point has been understood.

Even if the verbal contract has legal value in Quebec, a signed service agreement is a pledge of seriousness and a sense of responsibility.

How does she see her role?

It must be very clearly circumscribed. A companion provides physical and emotional support to the laboring couple. She received training in counseling and not in obstetrics. Even if her experience of childbirth gives her a certain flair and she is well placed to decipher what is at stake and she can guide you, she does not make any medical decisions, and does not assume yours. She does not pose any clinical gesture (a vaginal examination is one). A companion is not a midwife, and if she were inanother life, she must revise her role.

What training(s) did she receive?

A good companion must above all be able to balance empathy and sensitivity in a birth that belongs to you, with absolute respect for the rhythm of birth as well as the choices that govern it. She must know how to step aside, decode moans and movements, push aside a strand of hair and apply a beneficial compress in the right place and at the right time. And that is not learned in books or in a class, but in the births to which she is invited. Ultimately, it is her conviction that you are capable of giving birth, the feeling of security she inspires in you and your bond of trust that will make the difference. What do you care if your companion is a shiatsu pro or a seasoned osteopath if she can't get you back on track if you slip up (and we slip up, believe me, sometimes more than once) or if she appears to you suddenly like an intruder?

But being a beautiful person full of humanity or having been there yourself is unfortunately not enough. Basic training is aptly named and essential. Personally, I can't be satisfied with it, and I complete it year after year with more specialized continuing education modules, exchanges between peers, conferences, readings…

Finally, pay attention to the banner under which your companion works if she wears several hats. If she recommends youraspberry or nettle tea is fine. But if she talks to you about blue cohosh and pennyroyal without being qualified in herbalism, beware… A good companion refers you cautiously when she does not know she is competent.

What place does she leave for the father?

A companion must immediately reassure the dad if he fears being replaced: that is not his role, on the contrary! She allows him to take his place. She provides him with prenatal tools, informs him of his spouse's possible reactions so that he knows how to best support her, relays him if his whole being cries out for hunger or exhaustion, and she supports him morally and physically (yes, the massages, it's not just for the mother). She is the guardian of the couple's intimacy and disappears when the baby is born to return a little later, at the time of the first feeding.

How does she fit into the medical team?

Relations with hospital staff sometimes require a lot of tact. We must project the image of a helping relationship professional who is very clear about her field of expertise, and very respectful of that of the medical staff. We don't want to see the bedroom turn into a boxing ring. Collaboration tastes much better.

Is she an Ayatollah of natural childbirth?

If she demonizes any medical intervention and threatens to leave the room if you accept the epidural, then youcame across one of these specimens. We can be convinced of the benefits of a physiological childbirth, and recognize the adequacy of medical tools in certain cases. 85% of deliveries can take place naturally. 15% require expertise and medical tools which we are very lucky to have.

Above all, a companion must be able to put aside her own choices to accompany you in yours, with the greatest respect and without judgement.

When and where does she reach you when labor starts?

The subject is controversial. Sleep is a rare commodity that must be saved at all costs before and during a birth. It is normal for a companion to try to delay the departure of her cozy bed to join you, in order to maximize her strength for the moment when you will need her crucially: end of active labor, transition, pushing and delivery. Accompanying customers in their latency is to burn cartridges for afterwards. We therefore seek to feel the atmosphere and the stage of work on the phone to leave at the right time. Some doulas wait until their clients have been screened at hospital triage to arrive after four centimeters of dilation. I prefer to join my clients at home, at the start of active labor and even sometimes in latency, even if it means sleeping a little on the spot, to help them establish a solid bubble that we will be able to transport to the hospital.

Is she formed inbreastfeeding?

This is undeniably a big plus! The bond of trust is already there, she knows exactly how your birth went and can therefore offer you ways of understanding and solutions to the problems you may encounter (obstetrical interventions are likely to have an impact on breastfeeding), and as you will breastfeed for a dozen hours a day postpartum, as long as it goes well and you are surrounded.

If this is not the case, she should advise you to ask for a breastfeeding godmother from the organization Nourri-Source, tell you about breastfeeding drop-ins, La Leche League and Dr Newman, and suggest readings.