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Mother's Little Helper: In childbirth, doulas deliver peace of mind 

click to enlarge MATTHEW THORSEN
  • Matthew Thorsen

Genevieve Bogdanowicz snoozes blissfully on a recent sunny afternoon, unaware of how she came into the world seven days earlier. Her mom, Joanne Beaubien of Burlington, decided to rely on the services of a doula: Sally MacFadyen eased the way before, during and after the February 13 birth of Beaubien’s daughter.

“Doulas have existed since the beginning of time,” explains MacFadyen, who has two children of her own. “They were considered wise women who had been around a while and seen a few things. My job is to make sure the mother is physically and emotionally supported.”

Although it sounds exotic, the Greek word doula is the equivalent of “labor assistant” or “labor companion,” despite the fact that practitioners tend to be involved with each expectant client for several months. Whether in a hospital or home birth, doctors and midwives are responsible for delivering an infant and handling all medical issues; a doula focuses primarily on the mother’s well-being throughout the entire process. It can be a demanding profession.

“You never know what kind of birthing situation you’re going to walk into,” says MacFadyen, who has worked as a doula for about 75 families over the last few years. “It can go on for three days. That’s why I only take on two clients a month. You have to pace yourself.”

The grassroots notion of doulas is regaining popularity in an era when “taking charge of your own health” has become a mantra. Two national organizations, Doulas of North America and the Association of Labor Assistants and Childbirth Educators, or ALACE, assess on-the-job training in their certification programs. Doulas attend workshops, but largely learn by reading and simply doing.

An unknown number of women work as labor assistants in the state, but about 70 of them belong to Doulas of Vermont, says 24-year-old Gwyneth Carsten, arguably the area’s youngest practicing doula. “Giving birth is the hardest work a woman will ever do,” she suggests. “Doulas help create space and comfort around them, even in the midst of all the chaos.”

Chaos was just what Joanne Beaubien and her husband, Ken Bodganowicz, wanted to be prepared for. The birth of their son, Adam, five years ago, was an exhausting ordeal. “I had a really long labor then, 20 hours, and my husband was wrung out,” she recalls. “This time it was so great to have Sally standing by, in case I had to rush to the hospital in the middle of the day while Ken was at work. And it was easier for me to take directions from her; she’s trained and more objective. Things are more emotional for husbands.”

Beaubien was also anxious to avoid another Caesarian section, a necessity with Adam.

The couple met with MacFadyen midway through the second pregnancy. They took some of the birthing classes she offered and called her whenever they had any concerns. A few days before the big event, Beaubien was bothered by leg cramps late at night. She called her doula, who advised taking a hot bath. Things calmed down. “It saved Joanne a trip to the hospital,” surmises 36-year-old MacFadyen, a Burlington resident and former elementary school teacher who founded the BirthCare Collective with three other doulas.

The contractions began in earnest at 10 p.m. on February 12. Beaubien thought she might be in “early labor.” MacFadyen once again recommended she get in the tub. “After the bath, at first I was relaxed, but then I knew things were happening,” Beaubien recalls. “I woke Ken and he timed them; the contractions were getting closer and closer together. At about 2 a.m., he called our doctor, a friend who could stay with Adam, and Sally.”

Beaubien and Bogdanowicz raced to the hospital, “trying to avoid the speed bumps,” she remembers with a laugh.

“I got to the house at 2:30 and they had just left,” MacFadyen says, “so I followed them.”

After her water broke in the Fletcher Allen Health Care parking lot, Beaubien was rushed into the labor and delivery ward. “I was already at seven centimeters,” she notes. “Sally was right behind me. She flung off her coat, got out her oil and started massaging my back and reassuring me.”

Instead of the daylong ordeal she’d encountered with Adam, Beaubien suddenly realized Genevieve’s debut was going to be “fast and furious.”

“It was a whirlwind,” adds MacFadyen.

But the doctor determined that a vaginal birth would be problematic, due to the baby’s position, and recommended another Caesarian. “My role was to help Joanne change gears,” MacFadyen says.

“Sally helped me stay positive and not be afraid,” Beaubien explains. “You never know what your body is going to do. Mine was just going like gangbusters.”

Genevieve faced the new morning as a beautiful, robust C-section girl. “When birth doesn’t turn out as expected, people always tell you to be glad you have a healthy baby,” MacFadyen muses. “But you have the right to mourn the loss of your choice.”

To tackle that period of mourning, seven days later MacFadyen is recounting details of the birth in a postpartum session with her client. The thoughtful doula has brought along sandwiches and bags of chips.

“In the days following, you want to tell anybody who’ll listen what you’ve gone through,” Beaubien says, sitting at the dining room table while her newborn sleeps nearby. “The whole thing took me by surprise and was very disappointing, so I need to process it.”

In addition, she’s experiencing some trouble with the way Genevieve “latches on” when nursing. “A good latch means the mother’s comfortable and the baby’s satisfied,” says MacFadyen, who has also worked as a lactation consultant.

“Having a doula you’re already connected to, who has gone through everything with you, makes it much easier to deal with breast-feeding problems,” says Beaubien, who nursed Adam for 14 months but feels she needs to learn new tricks for Genevieve. “Every baby is different.”

Beaubien’s own mother, Joyce, is a Montréal resident who came to spend time with the family in the days after her granddaughter’s arrival. “I felt very secure knowing Joanne had a doula,” she says. “All in all, birth is a big mystery when it comes right down to it.”

Studies have demonstrated that fewer complications occur when a woman’s “emotional and psycho-social needs are met during childbirth,” says Gwyneth Carsten, a newcomer to “doulaism” who has attended four births in the last year. An ALACE brochure cites statistics that show significant decreases in Caesarians, length of labor, use of forceps and pain medication, among other possible consequences, in a controlled trial of more than 1000 women aided by doulas.

“I can explain things a doctor or midwife might say,” MacFadyen points out. “Your body works better when there are fewer unknowns. It helps a woman feel empowered. There’s nothing worse than a mother regretting, ‘I wish I’d done that differently.’”

“I really enjoy supporting the family in every way,” confirms Carsten, who is en route to certification by ALACE and hopes to open a nonprofit doula center one day. “I give the mother back rubs and juice, help her sit up. There can be long waits for anesthesia, and then it takes time to actually kick in. That can be very trying for a woman in labor. In a hospital setting, nurses change with the shift. A doula provides continuous care, no matter how long it takes.”

Carsten’s first doula birthing came last May, when Stephanie Walp of Essex Junction was awaiting the arrival of Joshua, now 9 months old. “I met them in her 38th or 39th week,” says Carsten, a University of Vermont graduate. “The day after our prenatal meeting, she paged me because she was going through early labor for several days. That weekend, Stephanie had a natural childbirth. She showed such strength and love and courage.”

Another doula had been on hand for the birth of her first child five years ago, when Walp was a single mother. But as a married woman, she was initially wary about approaching Carsten. “I thought she’d be stepping on my husband’s feet,” she explains.

Quite the opposite, as it turned out. When it seemed she was ready to pop at 1 p.m. on May 12, Walp paged Carsten, who arrived in about five minutes. “My husband, Brian, was at work. She helped me get dressed and even did my dishes. We all left for the hospital together,” Walp recalls. “I had a lot of back labor, so she suggested positions to make me more comfortable. My husband is hearing-impaired, so she communicated with him when I was in no shape to. She remained with me throughout the whole thing. I had Joshua at 7:04 p.m., but Gwyneth didn’t leave till 9.”

Carsten didn’t forget about the dad. “They’re being ‘born’ as fathers,” she says. “I often see partners in a lot of pain. Doulas really support them, too.”

MacFadyen’s presence in the delivery room made all the difference for Ken Bogdanowicz. “It took a lot of pressure off, just to have someone experienced in birth who knows how to work the [hospital] system,” he says, adding that the doula’s involvement allowed him to take a break in the aftermath of the birth. “It gave me a chance to come home to be with Adam.”

Although doulas are paid — usually between $250 and $400 — the bond they form with parents goes far beyond money. Carsten visited the Walps when the baby was two days old, then once every week for a month. “Gwyneth still keeps in touch,” Walp says. “I’ll invite her to the party for Joshua’s first birthday.”

In fact, letting go of a doula can be as difficult as weaning a baby from breast milk. In MacFadyen’s view, “it’s a business that really involves you in the emotional part of someone’s life. Each time, you’re having a mini love affair with a new family. I get a lot out of it vicariously, but I don’t have to wake up with the baby in the middle of the night.”

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