This slideshow provides a comprehensive look at what a doula is and why they are needed. It is the first unit in the certification course from New Beginnings Doula Training.

1. Introduction to Labor Support Presented by New Beginnings Doula Training Rachel Leavitt RN, BSN, CD For more information on doula certification visit www.trainingdoulas.com

3. Describe the different roles various professionals play

4. Become familiar with the Cochrone Library

5. Describe the benefits of having a doula

6. Introduction into labor support for nurses

7. Understand the role doula's play in medicated/c-section births

8. Understand how doula's can become agents of change

9. Explore your feelings about being a doula

11. The Birth Partner chapter 3

12. All included material given in introductory e-mail

18. Holistic care(pertaining to the physical, emotional, spiritual, and social)

19. Provides information

20. Continuous labor support

21. Facilitates communication between her clients and the medical staff

23. A doula provides non-medical, holistic care to the childbearing family. Prenatally, she provides information to help a family plan what they would like for their birth. During birth, she provides continuous labor support and helps the laboring family work smoothly through the process of labor and birth. She also helps facilitate communication between the laboring family and the medical staff.

25. She stays with the mom from the time labor starts(or starts and stops and starts:)) to a few hours after birth.

26. She usually meets with the mom before and after the birth.

27. She is trained specifically in labor support techniques.

29. This may include taking the blood pressure, checking the cervix, giving medication

30. Diagnosis medical conditions

31. Pre-eclampsia, dystocia, failure to progress etc.

32. Determines the best medical decisions to make along with the client

34. Pain intensity scale: scale used to quantify pain. 0 is no pain and 10 is the worst pain.

35. BM: bowel movement

36. Rebound pain: pain felt after the removal of pressure

37. Palpation: using the hands or fingers to feel to exam a certain body part

39. Dilation: the opening of the cervix. It is measured as 1-10 cm. Once it is 10 cm, the baby's head is able to come through.

40. Pyelonephritis: a urinary tract infection that has reached the kidney.

41. Straight Cath: a tube is inserted into the urethra from the outside in order to get a sample of urine. It is then removed.

43. WBC: white blood count. Done as a part of the cbc. Normal values are 4500-10000. This can be elevated normally during pregnancy.

44. Appendicitis: infection of the appendix

45. Purulant: pus like drainage

46. Chorioamnionitis: inflammationo of the fetal membranes, usually due to a bacterial infection.

48. Unaysn: an antibiotic used to treat certain infections.

49. Pitocin: synthetic form of oxytocin(which is a hormone) that will start labor or increase contractions

52. Her pregnancy has been uneventful and her previous pregnancy was also uneventful, resulting in a full term delivery. She has no significant medical or surgical history.

54. Her cervix was noted to be dilated 1 cm, and 2 cm thick, with the presenting fetal head at a -2 station. There was a foul odor coming from the vagina and there was a purulent drainage present in the cervix.

57. I considered appendicitis to be very unlikely in view of her enthusiastic hunger.

58. With the foul-smelling purulent cervical drainage and tender uterus, chorioamnionitis seemed the most likely diagnosis.

60. Case study used with permission from www.obgynmorningrounds.com

63. Inserted a straight catheter

64. Ordered and performed labs

65. Monitored fetal heart rate

66. Prescribed medication

67. Started IV, pitocin and epidural

69. This is not something that doula's are trained to do, but during this course, you will be taught to understand and identify different needs that a doula may help with.

70. For this scenario, these are described below.

71. Nurses training in labor support may use these in conjunction with their training in disease and disease process.

89. List what others did that you would consider labor support

90. For extra help in seeing what the difference is, read chapter 3 of The Birth Partner by Penny Simkin

92. It is important to keep in mind why your client hired you, which include some of the reasons listed earlier.

93. A medical professional is hired to safeguard the safety your client.

94. No matter what situation, it is always appropriate to ask your client if they feel they have enough information or have questions.

96. One woman wants a warm compress with oils on her perineum during crowning. Her care provider is used to being in charge during pushing, and does not want you to help.

101. http://www.cochrane.org/about-us/newcomers-guide

105. This is something you should become familiar with to help you look for abstracts on research about birth.

106. This will help you keep up to date as well as educate our clients.

107. http://www.thecochranelibrary.com/view/0/index.html

108. Type in labor support into the search button

112. This should take you to an abstract of the review I've given you to read.

113. The abstract is a brief description of the review and it's conclusions.

116. Find one cochrane review. E-mail me the topic, name of the review and the conclusions that were drawn. [email_address]

117. If you have any questions let me know.

118. Play around in the cochrane library for awhile. There is a lot of information to explore.

120. In current history, this is no longer true and is more the exception rather than the rule.

121. This particular review was done to look at the effects of continuous support versus the usual care.

122. They also wanted to look at what effects certain variables may have on continuous support.

124. Less likely to have intrapartum analgesia

125. Less likely to report dissatisfaction

126. Labors were shorter

127. Less likely to have c-sections

128. Less likely to have instrumental deliveries

129. Less likely to have regional analgesia

130. Less likely to have a baby with low apgars.

132. When the labor support was not a part of the woman's social circle

133. In settings where epidural analgesia was not readily available.

136. “Support from a chosen family member or friend appears to increase woman's satisfaction with their childbearing experience.”

139. High rates of intervention

140. Unfamiliar personnel

144. Helping to effectively use gravity

145. Supporting women in whatever position they choose

146. Recommending specific positions for specific situations

149. Information and advice

150. Comfort measures

151. advocacy

153. They also have to spend a large proportion of their time managing technology and keeping records

154. They may begin and end shifts in the middle of the woman's labor.

155. They may lack labor support skills.

157. They themselves may need support when working with the laboring woman

159. A family physician-44%

160. Midwife-66%

161. Husband/partner-88%

164. You may use any of the slides I have presented, or you may make your own.

165. Specifics for this project should be sent to you.

166. There is no deadline for this, but you must finish this before you move on.

167. If you need help finding a venue e-mail me, and I will help you look for one.

169. This course will help you to find strategies to help you provide support when you can, and to advocate for policies that help promote the abilities of the nurse to provide labor support.

173. More inductions and cesareans

176. AWHONN staffing recommendations are a good place to start.

178. C-Section

179. Pre-term labor

181. Provide the opportunity to discuss with care providers

182. Minimize pain if still felt before, during and after the procedure

183. Minimize the complications of the side-effects

184. The specifics of each of these will be taught later in the course.

186. Pick one situation that you agree with and how her situation could have been better with the use of a doula.

187. Pick three situations which contain choices made that you wouldn't have chosen. Describe how you would have served these women as a doula.

190. We have the opportunity to work with all birthing professionals to provide the best care for women and their babies.

193. Anticipate crisis and working together to solve them

194. Educating yourself, so that the paths available to you are more open

197. In this course, you will learn to identify and focus on the labor and birth as a life process specific to each individual.

198. In this way, you will be promoting health rather than treating disease.

200. There will be various assignments that will stretch you to do so. By doing this, you will learn to work with others who may think differently, but you can also help them to see things differently.

202. You also be taught skills to help women in many different situations, from the very few interventions to numerous interventions being used, as well as how to help women make the choices they desire.

203. You will be provided with the information that will help you form your own opinions on what should be changed.

206. Chapter 2 of The Nurturing Touch at Birth has some good ideas of what some of those reasons may be, but feel free to add whatever you feel is important.