How Doulas Can Help You Avoid Unnecessary Inductions: An Interview with Tara Brook
Hi Tara, it is such an honor to have the chance to speak to you. You are a leader in the modernization of doulas and spokeswoman for bringing natural birth into the mainstream eye. Today we are going to speak about unnecessary inductions, doulas, and how doulas can help mothers avoid unnecessary inductions. First of all, let’s begin by defining the terms themselves. We have extensive information on our site about what a doula is, but can you give us a short explanation, in your own words?
A doula is a person who is trained to assist women during pregnancy, birth and the early postpartum period by providing the birth mother with information as well as emotional and physical support.
And what do you consider an “unnecessary induction”?
An induction is when providers start labor artificially instead of waiting for labor to start spontaneously on its own.
An unnecessary induction is one that is recommended or scheduled due to reasons that are not medically necessary.
This may be for a matter of convenience, whether requested by the birth mother or the provider. This kind of induction is considered “elective”.
There is also another kind of induction happening more and more. One that is harder to avoid. We are seeing so many inductions happen for reasons that are often not medically necessary – however, each provider may disagree with the next, about an induction being needed or not. Why? Because we don’t have evidence based information supporting that women should be induced for situations such as presenting with a large baby, or even for having twins. This is where it is important for birth mothers, partners and doulas to explore all options with the rest of the birth team. If parents want an induction only under strict medical guidelines then that should be requested and permitted.
What are the potential dangers of unnecessary inductions and taking a “one size fits all” approach to birth? (Depending on your responses we can combine this question with previous.)
The last weeks of pregnancy may be uncomfortable and the birth mother may have the desire to “get things going”. However, many things are developing for the baby during this time that are important for the best of outcomes for all babies. For example, during the last few weeks lung development matures to prepare the baby for her first breath and the babies brain activity increases for critical function. The baby is also adding fat to keep warm outside of moms uterus which will help the baby start to regulate body temperature sooner rather than later.
From a birth perspective, and one that doulas are great at explaining, is that during those last few weeks the birth mothers body and baby are preparing for labor. Even though labor hasn’t begun yet, the baby is working on getting in the perfect, or most optimal, position to be born. If the baby is not in an optimal position, moms body may be contracting and pushing down on a baby that is not positioned in a way to dilate her cervix efficiently. Simply put, that translates into a long, often painful labor that has a high likely hood as being labeled “failure to progress”.
It is so important for parents to know that the labor process is just that–a process! It starts way before a woman is having strong, rhythmic contractions. Our bodies, and our babies, are very wise and are making great progress during those last few weeks. This progress is often not able to be seen, so it may be overlooked. The discomfort a woman feels during those last few weeks may cast a shadow on this. We as providers and supporters of birth must be patient enough to allow this process to take place.
A woman who is nurtured and supported through this process (and a partner who also understands what the birth mother needs ie, encouragement and love) will get there.
How does having a doula help you avoid unnecessary induction?
A doula will be sure that her clients have access to evidence based childbirth education classes, research, and are in the know about providers that support evidence based care. Doulas are also likely to have been at many, if not all of the birth facilities, in your area and may be able to help find the best match for their clients.
If you have a doula, you will be pointed in the direction as to which pregnancy, birth and developmental baby books to read. This is important to normalize the birth process, understand what is happening to your body and your baby and help avoid fear based stories and information. Surrounding yourself with positive birth stories will help you to go into labor with ease.
A doula will also talk to you about exploring your own unique mind/body connection. Understanding who you are in your everyday life, and figuring out how this piece will translate on the day of your birth, will help start to prep for labor. These conversations also prepare the partner to best support the birth mother.
Doulas will be able to assist you with best ways in talking to your providers about options. Knowing when something is medically necessary, or not, is key. Your doula will advise that you ask some telling questions. For an example:
- What is the medical reason for suggesting the induction?
- Are there any alternatives to try speed labor along?
- Am I in immediate danger if I don’t go into labor now?
- Is my baby in immediate danger if I don’t go into labor now?
- How long may I have to make a decision? May I think about this overnight and discuss with my partner?
You will be nurtured and supported emotionally through this process. Your partner will have a coach in how to support you as well.
Doulas know a lot of tips and tricks on how to help prep your body for labor. Some things doulas may suggest and info they may share may include: acupuncture, essential oils, massage, nipple stimulation, sex, evening primrose oil, chiropractic care, posture to promote optimal fetal positioning and so on. Your doula will help you navigate your own unique journey and will be sure that you know all of your options.
Doulas help you find resources within your own community to other providers that may help your body get ready for birth ie chiropractors, acupuncturists etc. Doulas are great “connectors” and will have a long list of resources for you should you need them.
Do you have any advice for fellow doulas about how to work with hospital staff to make sure their clients’ induction wishes are respected?
Being as clear as possible with communication is important. Often, conversations need to happen more than once and reminders need to be made to the hospital staff.
Check in with your client often too because they may have questions or they may change their mind about something.
Help the client(s) reiterate their preferences and make a sincere effort to be a team player with the hospital staff. Be sure that they know you are there to help in any way that you can, in supporting your client, and hospital staff, as a member of the birth team.
Ask questions when they come up. The doula is the perfect person to help advocate for more clarity. Ask questions (that you may even know the answer to) in an effort for the hospital staff to engage with your client in helping her make the best decision for her.
Can you give me a bit of information about the training you offer in your school, DTI, about this subject?
In our program we spend an extensive amount of time talking about why inductions happen, the current “culture of induction” and how to help navigate all of this information with clients. We believe in the autonomy of the women we are serving so first and foremost we are always dissecting what that means for informed consent and how information is given to the parents, discussed as a birth team, and how decisions are made in relation to this.
DTI also offers a tele-class that focuses on navigating induction for DTI doulas during DTI’s 9 month program. This tends to be a favorite, especially for the more seasoned doulas joining DTI, who have a lot of experience with the complexities of induction.
Tara Brooke has attended hundreds of births and has been working with pregnant women since 2000. She helps new families in major cities and small towns across the U.S. with a mindful, holistic, evidence based approach through her company Power of Birth.
Tara’s love of business surfaced through her work as a doula. Her passion for birth work called her to also create a sustainable doula practice backed with solid business acumen. She mentors other birth professionals to build out their businesses with a program she coined BirthPods which mentors and inspires birth workers across the globe to launch and grow their birth based biz into long lasting careers.
Tara also offers a corporate wellness program bridging the gap between maternity/paternity leave and helping executives transition Back-to-Work.
Tara is one of the co-founders of DTI and a doula trainer and mentor. She is the mother of three children, the wife of a corporate anthropologist and a native New Yorker that now lives in the San Francisco Bay Area.
Doula Trainings International is known for re-imagining the role of the doula and rethinking the way in which doulas are trained and mentored. Their training program is extensive: Lasting 9 months with continued support and mentorship the entire time. DTI believes that doulas are at the forefront of changing the culture of birth and the way in which they train doulas is ever evolving and committed to change making. To see more about DTI visit www.doulatrainingsinternational.com