Serving Washington D.C., & Maryland (Baltimore city & co., Montgomery co.) and surrounding areas, with Professional Birth Support Services
E: | P: 410.433.1103

Frequently Asked Questions

What is a labor support doula, and what does a doula do?

A doula is a woman trained to provide an expectant mother and father with continuous spiritual, physical, emotional,educational and informational support before, during, and in the immediate postpartum period following childbirth.

What are the benefits of having a doula?

In 16 publicized, randomized, controlled studies involving over 5000 women comparing outcomes with and without continuous support from a birth doula; the following obstetrical discoveries were made:

Physical Benefits for Mother

  • Reductions in the length of labor.
  • Reductions in Cesarean Births.
  • Reduction in the mother’s need for narcotic pain medication.
  • Reduction in the need for epidural anesthesia.
  • Reduction in maternal fever.
  • Reduction in forceps deliveries.
  • Decrease in women using pitocin.
  • A highly significant overall increase in women birthing without interventions.

Emotional Benefits for the Mother

  • Women felt better prepared for the emotional aspects of birth.
  • Women felt nurtured and cared for.
  • Women were highly satisfied with the individual care they received.
  • Women’s individual perception of their labor was much more positive.
  • Mothers who were supported by a Birth Doula spent more time with their baby.
  • Women bond more easily with their babies.
  • Women feel better prepared to be mothers.

The Psychological Outcome at Six Weeks Post-Partum showed:

  • Highly significant decrease in anxiety and depression, and a highly significant increase in self-esteem.
  • Increased self-esteem and belief in her ability to navigate the challenges of labor and birth.
  • Feelings of control and active participation in decisions regarding her medical care and participation in her birth.
  • Significantly less fear, tension, stress, self-doubt, and anxiety.

Physical Benefits for Baby

  • Shorter hospital stay for baby.
  • Mothers who were supported by a Birth Doula spent more time with their baby.
  • Babies had fewer septic work-ups.
  • A report of Infant Health Problems at Six Weeks showed: Highly significant decrease in reports of vomiting, colds or runny nose, cough, and poor appetite and a significant decrease in reports of diarrhea.

Benefits to the Breastfeeding and Mothering Relationship

  • Breastfeeding relationship is easier and without as many complications.
  • Six weeks post-partum showed: A highly significant increase in the amount of women breastfeeding exclusively, and feeding on demand; A highly significant decrease in the amount of feeding problems and supplemental feeding.
  • Maternal outcome at six weeks showed a highly significant increase in mothers responding to their babies crying. Mothers also spent significantly less time away from their babies, felt that their baby cried less than others, was special, easy to manage, clever, beautiful, and regarded their baby as a separate and sociable person.
  • Women breastfeed longer.
  • Benefits to the Couples Relationship

    • Women are pleased with their partners support during birth.
    • “At Six Weeks Post-Partum mothers in the doula- supported group reported a great increase in satisfaction with their partner since the birth of the baby, and a much greater percentage of mothers reported that their relationship was better right after the birth.” “Continuous support from a Birth Doula during labor provides physical and emotional benefits for mothers and health bonuses for their babies. With less medical interventions, fewer complications, and shorter hospital stays, there may be financial savings as well.” –HARVARD HEALTH LETTER
    • “Labor pain, like all other pain, is a function of the whole person, and we can go even farther than that and say that the experience of pain in labor is profoundly influenced by the values of the society in which the woman grew up.” –SHEILA KITZINGER, The Complete Book of Pregnancy and Childbirth
    • “At six weeks (post-partum) the doula-supported mother’s perceptions of themselves and their babies were clearly more favorable. They were more positive on all dimensions involving the specialness, ease, attractiveness and cleverness of their babies.” –THE DOULA BOOK
    • “Women in general have . . . (Much) to gain from the presence of a female companion who is not just sympathetic but is informed as well, and therefore in a much better position to provide the sense of firm reassurance which is so sorely needed at this time.” –DRS. KIERIN O’DRISCOLL AND DECLAN MEAGHER, &NBSP Active Management of Labor
    • “Continuous labor support reduces a woman’s likelihood of having pain medication, increases her satisfaction, and chances for spontaneous birth, and has no known risks. Supportive care during labor may involve emotional support, information and comfort measures. Such care may enhance normal labor processes, and thus need for obstetric intervention. Women who received continuous labor support were less likely to use pain medications and were more likely to be satisfied and to give birth spontaneously(with neither cesarean nor vacuum nor forceps). In general labor support was more effective when it was provided by women were who not part of the hospital staff.” –The New Cochrane Review study on the effects of continuous support for women during childbirth. View Full Study “Continuous Labor Support Offers Big Benefits for Mothers and Babies, with no downsides” –The Maternity Center Associations study of Labor Support View full study (Statistical information from Mothering the Mother: How a Doula Can Help You Have a Shorter, Easier and Healthier Birth; Klaus Kennell & Klaus, 1993)

How can the presence of a doula help labor to progress and to realize the achievement of good labor outcomes?

A labor doula can be a calming influence, allowing the woman to let go and surrender to the wisdom of her body, and the assistance of her birthing team, so her body can successfully birth her baby. When a woman is stressed, fearful, and tense, her body reacts with a fight or flight response and releases chemicals and hormones, which can slow the production of oxytocin, the hormone that produces contractions in labor.

If a deer is laboring in the forest and she hears someone approaching, perhaps hunters, signaling to her that she and her baby may be in danger, she will experience a fight or flight response, causing her body to release hormones which will stop her labor, allowing her to flee to safety. When she once again feels safe and relaxed, her body will begin to produce oxytocin again, and her labor will resume. Our body works the same way, and a good doula knows this, and can employ methods to help the mother remain calm and relaxed so she experiences instead, what Herbert Benson MD called the relaxation response, allowing her labor to progress easily and effectively.

We also believe that well before you reach the labor room, the relationship you share with your doula will allow you to let go of fears, drop anxiety, and know that there is someone there who understands, who you can call anytime you need to. The time you spend together before your labor even begins is very important in allowing you to have a calm, relaxed, and joyful birth. Through phone calls, emails, text messages, in person meetings, your doula will be by your side to share the joys of anticipating your babies arrival, and to help answer questions, offer information, point you toward resources and birth related professionals. She will assist in assessing your level of coping skills, and together you will create a system for how to hone, sharpen, and build on existing skills, and how to become educated about, and learn new skills which will support your ability to let go of fears, get your over thinking and anxious mind out of the way, surrender and say yes to labor which allows your body to do what it knows how to do, and to look forward with joy toward reveling in the beauty and miracle of the birth of your baby. Your doula also desires both laboring mother and her husband/partner will revel in the joys of your birth. Toward that end, she will also discuss how your partner wishes to participate in your birth, how she might assist and support him,and how they will work together to be the most rockin’ birth support team ever! Knowing your doula is always near by if either of you have questions, need information, or just need to talk, is an invaluable tool toward setting you on the road to achieve the peaceful, loving birth you dream of having.

What is the doula’s role in the labor room and will midwives/obstetricians, and labor nurses be accepting of having a Kairos doula attend my birth?

Kairos doulas work as part of the maternity care team, in cooperation with obstetricians/midwives, and labor nurses. Our presence supports and enhances the medical care they give by adding continuous, one-on-one physical¸ emotional, and educational support, keeping lines of communication open, and helping to ask the right questions which will give you the information you need to make informed decisions. Although doulas do not provide medical care, it can be a great help to a busy labor nurse, attending multiple patients, to have the constant presence of a professional birth doula, attending to your support needs, and able to alert medical staff in the event a problem or emergency should arise when they are out of the room. Working together, the team of midwife/obstetrician, labor nurse, and labor doula can provide the very best in care toward a safe and joyful child birth experience.

Kairos doulas are committed to working with your medical care providers as a part of the maternity care team, with an attitude of respect, professionalism, and diplomacy. We feel there is never a good reason for creating an antagonistic atmosphere in the labor room, and causing the mother to reap the negative consequences. The doula is there to support the mother, and to alleviate fears, allowing her to relax and surrender to the process. If a doula were to create an atmosphere of mistrust and suspicion, turning the laboring mother against her chosen doctor or midwife, we have done the mother a great disservice, and caused her to remain hypervigilant and unable to relax, which could impede her labor progress, and  actually providing support or serving her at all. We believe in enhancing communication and trust, and creating a birthing team atmosphere wherein everyone does their part to serve the laboring mother. It is our hope to help to create a beautiful birth celebration and precious memories of the day your child is born. We at Kairos have worked very hard to establish good professional working relationships with the doctors whose patients we support, which allows us to offer a much higher level of service, as all your caregivers work in cooperation and mutual respect. Most of the doctors we work with refer their patients to us on a regular basis, and we all know each other very well, and work together as an especially capable team. We are still first and foremost your staunch advocate, but we at Kairos do not believe that we have to work in opposition to your medical care team to achieve this. Please see the professional reference section of this site to read recommendations and references we have received. You may be surprised and pleased to see your own doctor’s name among the list.

There are so many unknowns in birth and this makes me feel anxious. How can a doula help?

Kairos doulas understand that mothers, especially first time mothers, face a lot of unknowns in childbirth, which can tend to make them feel helpless, fearful, and out of control. It is our desire to help you relinquish fears, and regain a sense of control through educating you to understand available choices and options both before and during labor. We believe when faced with a large life transition, as childbirth certainly is, intelligent women seek to educate themselves in order to understand, accept, and safely navigate the changes to come. Your doula can recommend books, articles, research, and other sources for you to read in order to become informed. In addition, your doula will provide you with a large amount of information which includes evidence based research on topics relative to pregnancy, labor, birth, breastfeeding, and your transition into parenthood, as well as all the information you will need to learn about, practice, and become proficient at your own mindfulness meditation practice.

We believe mindfulness to be one of the best pain management skills, as well a means of working with the unknowns, fears and anxiety of impending labor and birth. Mindfulness is also an and all around life skill you can learn now,which will benefit you during your pregnancy, labor, and birth, and also assist you toward developing your loving, mindful parenting style. To support you in starting your own mindfulness meditation practice, we offer our Mindful Birth and Beyond Childbirth Education Playshops, you doula will email a good amount of information on mindfulness to give you everything you need to understand and begin your practice, and we have also developed our Mindful Birth Preparation Daily Lesson Plan. Our Mindful Birth lessons take the guess work out of what relates to what, what do I read first, what are the best resources, where do I find explanations for things I don’t quite understand, and breaks everything down into simple, easy daily lessons. Our daily lessons include research, stories, videos, guided meditations, poetry, music,various internet and area resources, and basically all you need to get your daily mindfulness mediation groove on! LOL All you have to do is commit time to reading and doing the short exercises and meditations daily, and by the time your labor begins, you will have developed mindfulness coping skills that will assist you in having a peaceful, calm, joyful, fully present, and beautiful birth. You will be well equipped to work with pain, rather than trying to escape it, to surrender and even welcome the birth waves that are bringing your baby closer to your arms, and to be present and aware of all the awe, miracle, and majesty of your birth, rather than allowing fear or anxiety take you captive, enveloped in worrisome thoughts of past challenges, or potential future problems which may never even materialize. You will be well adept at taming the what if monster, and an expert at letting him go, and coming back to right here, right now, fully inhabiting your birth, and master of the feminine well of wisdom, power, and strength we all possess, and can draw from, if we mindfully choose to do so.

Your doula is always available by email and phone as well, if you should have questions, or just need to talk. She can refer you to other birth related professionals for further supportive services, or offer other birth related resources. She is available to discuss your midwife/obstetric appointments , and help with explanations if anything happened you did not understand. She can assist you to create a question list to ask your care provider at your next appointment, and she can keep you apprised of what you might expect at future appointments, such as testing and other procedures to come. You can call your doula if you think you may be experiencing signs or symptoms of complications, or labor. She can help you decide if you are experiencing something worrisome for which you should call your care provider right away, or if not serious, she may be able to make helpful suggestions. She can also discuss signs and symptoms to help assess whether labor has begun, and remind you of the plan for what to do next.   Through our Kairos website you also have access to information, resources, and blog articles, as well as our Facebook and Pinterest pages where we post helpful information for our clients.

We also meet with our clients at least two times prebirth, to allow you to get to know and to feel comfortable with your doula, and to allow her to get to know you, and all the dreams and desires both of you have for your birth. When you call for services, we can help to determine what type of meetings you will need, a get acquainted visit,or an initial visit to get you started on honing, sharpening, and learning coping skills and techniques, and also a lengthy prebirth conference appointment. During a prebirth conference appointment, your doula will go over a client history to learn more about you, about any health related or other issues which might have an impact or bearing on your labor and birth, she will explain all your birthing options and alternatives, point out any coping skills you already have which you may not know will assist you in labor, and discuss how you can ensure that not only are the laboring mother’s physical comfort needs attended to, but also her psycosocial and emotional needs as well. She will discuss new skills that will support your successful labor, and discuss with your partner how they wish to participate in your birth, what support she can offer to them, and how partner and doula can work as a loving support team. Your doula can recommend the resources you will need to prepare for labor and birth, and work with you both to develop a strategy for how you will come together to make the dream birth scenario picture you painted, to become reality. Your doula will offer a great deal of information during your prebirth conference, and she will also assist you in creating a mindful birth preference outline, (not a rigid birth plan), which will assist you in knowing what you can expect during labor, what things might potentially change and what that may look like,what are normal hospital protocol and procedures, what is your ob or cnm role, what is the nurses role, what to prepare and bring to labor, and point out things ou need to discuss with your ob or cnm prior to your birth. One of our biggest goals in educating and helping you to prepare for your birth, is to alleviate as many unknowns, point out strengths and skills you already possess to support yourself, and to alleviate as many fears or as much anxiety as possible, and help to point you instead, in the direction of the joy, love, and miracle of your birth, so you don’t miss sight of it by letting fear steal it away. We help our mamas to determine that nothing will steal away the beauty and joy of their birth!

Kairos doulas will never take any measure of personal control away from you by making decisions for you, or by asserting any personal agendas about birth.   We believe it is important and empowering for you to assert your own voice, thoughts, opinions, needs and desires, and to make your own decisions. Our goal and focus is to see you empowered, uplifted and glorified by your own wise and courageous choices. We gain immense satisfaction from watching the mothers we serve realize their greatest power and potential, inner fortitude, and ability to achieve their dreams and goals. In so doing, we believe your life as a new mother is started in a healthy, supportive and loving fashion, which will strengthen and encourage you to believe in your ability to mother your new baby.

How do you view pregnancy and birth preparation?

Pregnancy is not a to-do list that you have to push, strive, and work to get done before the baby arrives. Pregnancy is an honor, a gift, a sacred trust. It is a time to take great care, a time to nourish and foster miraculous potential and growth, physically, emotionally, spiritually. Pregnancy is an invitation to flourish, blossom, and grow. It is a time meant to be fully immersed, and consciously reveled in, not hurried through blindly, on the way toward the end of a list of things that clamour to be accomplished and crossed off before your due date comes about.  The creation and birth of your baby began at the moment of conception, continues throughout pregnancy as his body, brain, and organ systems are being formed, and culminates with his/her miraculously bursting forth into life at the end of labor. It is essential therefore, that a mother be mindful of protecting this sacred time of co-creating with her unborn child, by caring well for herself. She can begin by reading, reading, reading, and educating herself about what lies ahead. She should also be sure to get proper nutrition, hydration, exercise, and rest, lessen daily stress, be mindfully awake and aware in each moment, and joyfully welcome, embrace and revel in all the changes and joys of this sacred time. Self- care during pregnancy is not being selfish or indulgent. It is a necessary ingredient in creating a healthy and peaceful environment for your baby to grow, develop, and thrive in. We highly recommend yoga, swimming, dance, or exercise classes, as well as our Mindful Birth and Beyond classes and playshops. These classes will help to prepare both body and mind for the birth and parenting challenges ahead. They can also provide a source of valuable time to connect with other expectant mothers, and sisterhood support from other fellow members of the “­­Moms Club”, which can be a nurturing, nourishing, inspirational, fun, and supportive blessing.

How important is it to be active during labor?

Our pregnancy, and the birth of our children, is not simply a one day affair of laboring. This is also an enormous transition from the role of a single woman who can come and go as she pleases, into the life and role of a mother. From the day you learned you were pregnant, you were forever more responsible for the very existence of another human being. As a mother, you became one whose every word, thought, and deed impacts not only yourself, but your precious child as well.

Throughout pregnancy we do our best to ensure the optimal environment for our baby’s formation, growth and development. We try to get proper nutrition, sleep, exercise, health care, education. We begin to prepare our homes to safely and lovingly receive our new baby. We begin to become more aware of the larger world that our baby is being birthed into and becoming a part of. We realize now, that things like environmental toxins in our air, land, water, and food are important, becoming actively informed, and working toward social and environmental sustainability and justice to ensure a safe world for our children. This is also a time when we prepare our hearts, minds, and spirits. We strive to identify, and become aware of any old, negative, personal or family habits or patterns, believing we must first know ourselves in order to know and to raise our children in a healthy, loving fashion. We awaken to the importance of actively becoming aware and mindful people, so that as parents, we will not simply fall into what we learned from our own parents, which in some cases may not have been healthy. We begin thinking about developing our own parenting style and family values. We realize that with the birth of our baby, our lives will be forever changed, in many joyous and glorious ways, and in some challenging ways as well. We take firmly to heart the truth that our lives are no longer simply our own. As we become parents we are blessed with a sacred obligation to put our children, their needs, and best good, always, before our own.

Our initial assignments then, are ensuring our children’s best good during pregnancy and during our labor and birth. Toward that end, I believe we must commit ourselves to practicing comfort measures, coping skills, breathing techniques, mindfulness meditation, yoga,and other forms of preparation that will ready us for an ACTIVE BIRTH, wherein we are fully taking part and helping our labor to progress, as well as creating the most gentle, peaceful, and loving welcome for our precious baby to enter and join our family.

Birth is a glorious, miraculous event, and though there is pain, it is intermittent, pain with positive purpose, and we can learn to navigate it safely, effectively, comfortably, even joyously, and triumphantly. I believe it is called labor, (and not picnic) for a reason. Birth is sacred woman’s work, and it is not a passive experience. Our husband/partner, doula, labor nurse, midwife/obstetrician, and other friends and family members in attendance, can walk beside us, but the journey is ours alone, no one can do it for us. Labor is an adventurous, demanding, and extraordinary path toward motherhood, and after pregnancy, it is the next big challenge along the trail to putting self aside, and showing up fully and devotedly for our baby.

We all want the most comfortable, fastest, least painful, intervention free birth possible. In order to achieve this ideal birth we will need to begin our lives as mother tigers when the first contraction appears. We must rise up as mother tigers, fiercely committed to upright and multiple laboring positions, movement, mindful, present moment awareness and breathing, relinquishment of fears, being active, active, active, and stronger than we have ever been before.

Our baby is a story or a poem that a couple has been writing for all their years together. Our children are the embodiment of the separate music of a man and a woman, being harmoniously combined into a glorious symphony of life, and as such, mother and father/partner must work together to dance them lovingly into life. The gift in an active birth (besides the greatest we will ever receive, our precious child), is an unparalleled mountain top high, a triumphant euphoria from having kicked the rear end of one of the biggest challenges a woman will ever face, and a never ending sureness that we are strong, courageous, capable, and have all it takes to successfully mother our child.

There is also a beautiful deepening of the loving bond between husband/partner and wife, and an immense feeling of elation from having worked together, breath by loving breath, to bring forth the fruit of your love into the world.

Active birth is heroic and sublime, don’t cheat yourself of this magnificent rite of passage.

What is Mindfulness Meditation?

Meditation Science defines it as:

“Mindfulness Meditation is a non-sectarian, research-based form of meditation derived from a 2500 year old Buddhist practice called Vipassana or Insight Meditation. It is a form of meditation designed to develop the skill of paying attention to our inner and outer experiences with acceptance, patience, and compassion.”

The University of California Center for Mindfulness, part of the medical school’s psychiatry department, defines Mindfulness Meditation this way:

“Mindfulness is a quality, which human beings already have, but they have usually not been advised that they have it, that it is valuable, or that it can be cultivated. Mindfulness is the awareness that is not thinking but which is aware of thinking, as well as aware of each of the other ways we experience the sensory world, i.e., seeing, hearing, tasting, smelling, feeling through the body.”

“Mindfulness is non-judgmental, open-hearted, friendly, and inviting of whatever arises in awareness. It is cultivated by paying attention on purpose, deeply, and without judgment to whatever arises in the present moment, either inside or outside of us. By intentionally practicing mindfulness, deliberately paying more careful moment-to-moment attention, individuals can live more fully and less on ‘automatic pilot,’ thus, being more present for their own lives.”

Mindfulness meditation teaches us to take a moment to pause and reflect in highly charged moments, allowing us to respond with awareness, rather than simply reacting out of habit, or high emotion. “Consistent daily practice promotes the development of stability, inner calmness, and non-reactivity of the mind. In turn, this allows us to face and embrace even the unpleasant or painful aspects of daily life. The stability and non-reactivity we cultivate in formal practice supports our ability to become more compassionate human beings, experiencing the joys of pure non-reactive presence. By developing a simple and pure awareness, we learn to disentangle ourselves from our habitual thoughts, emotions, and behaviors and connect with our experience, with ourselves, and with others in a healthier and deeper way.

As human beings, it seems it is natural for our minds to wander frequently. We are often lost in daydreams about the past or the future, or even thoughts about the present moment. Most of these mental distractions aren’t very useful and quite often produce stress, anxiety, fear, worry, and all sorts of emotional suffering. Regular daily practice of Mindfulness Meditation develops our ability to pay attention to our immediate experience – The Now – helping us to overcome such pre-occupations so that we can clearly see what is happening in our actual lived experience of the present moment. Instead of finding ourselves at the mercy of worry, fear, anger, and the like, we grow in our ability to choose how we want to act in situations, often in ways that might have been out of our reach before.” (

We believe Mindfulness Meditation to be one of the most effective labor tools, and also know that it is not merely a birth skill, but rather a life skill. Once you begin to practice it in preparation for birth, you will notice this quality of mindful awareness begins to spill over into every aspect of daily life. You will find it allows you to dwell in a stillness and spaciousness, right here, right now, even in the midst of the business and challenges of your days. You will discover that mindfulness awakens you to your natural, loving presence, and in that presence you will find freedom and peace. In life, just as in birth we learn that the way to peace is not to fight the waves, but rather to enter into and entrust ourselves to them, being still yet awake and aware, allowing the drifting waves of sensations and thoughts to simply wash over us, and pass away, while we remain at the center, anchored safely to the present moment, making a conscious choice to be calm and unaffected.

We believe Mindfulness Meditation is the most important skill you can cultivate toward a gentle, peaceful, and joyful birth, as well as conscious parenting, and happy, healthy, family life. To assist you in developing a mindfulness practice and skills, we offer our Mindful Birth and Beyond Childbirth Education Playshops,as well as sending our clients information they will need to begin a regular practice. New in 2017 is our Mindful Birth Preparation Daily Lessons, which break down mindfulness meditation and mindfulness practice into quick, easy daily lessons, complete with a short reading, videos, music,poetry, gathas, Mindful Birth journaling prompts,and guided mindfulness meditations. We have taken all the guess work and research out of starting and maintaining your mindfulness practice, so you don’t have to spend time figuring out a plan, and can simply participate in an easy and enjoyable daily lesson.

Has there been research done on Mindfulness Meditation?

Since 1967, over 1500 studies have been conducted by over 250 independent research institutes showing Mindfulness Meditation to be clinically effective for the management of stress, anxiety and panic, chronic pain, depression, obsessive thinking, strong emotional reactivity, and a wide array of medical and mental health related conditions. Mindfulness Meditation programs are being conducted in hundreds of hospitals, healthcare facilities, schools, corporate wellness programs, in the military, and prisons all across the United States, and around the world. We invite you to take a look at our Kairos Doulas Facebook and Pinterest pages for mindfulness articles, information and research.

How do Kairos doulas feel about pain management? My sister had an epidural ,my best friend went totally “natural” and both say their way is best. How do I know what is right for me? What are the best support measures to use to help me get through labor and birth?

We believe that pain is a very subjective experience, it is what it is to the person experiencing it. Everyone has different pain tolerance levels which can be affected by past experiences of pain, whether one has slept and is well rested, if they are well hydrated and nourished, the context in which the pain is experienced, if they are currently facing any emotional upsets, and the perception, interpretation, and labels each individual assigns to their pain. The only one who can tell us what your pain feels like, or if it is manageable, is you. It is not possible for anyone else to make pain management decisions for you. We are happy to help educate you about all the options available to you, both non-medicated and medicated, but you are the only one who can make the choice of whether or not to use pain medication. We are committed to supporting your choices whether you choose to have a completely unmedicated birth, or a birth which includes the assistance of pain medications.

During your prebirth conference your doula will go over a client history with you to learn about past pregnancies, miscarriages, births, any medical conditions that may impact your labor and delivery, as well as your desires for your birth. She will ask you a series of questions designed to help her learn more about how you react and respond to stress and challenges day to day. Your answers will allow her to assist in devising a personally tailored plan of support techniques, coping skills, comfort measures, and relaxation and pain management techniques that will be best suited for your personal style.

We also recommend that you have a Beginner’s Mind. In Zen philosophy they say, in the beginner’s mind there are many possibilities, in the expert’s mind there are few. In other words, if you think you already know it all, there is no room to experience or learn anything new. Be open to trying new things in labor. Adopt the try everything rule I used with my children when they were little and mealtimes could be a challenge. I did not force them to eat everything, but they were not allowed to say they did not like something unless they tried it first. Do the same in labor, try everything, every possible position, comfort measure and technique, because you don’t know what may be helpful. If you decide you don’t like it, just like my kids, who did not have to eat food they hated, you don’t have to do any technique that does not appeal to you. If you try it though, you might find something is unexpectedly and delightfully helpful.

How does a doula work with expectant fathers/partners?

Our doulas respect the significance of the birth of a new child, and subsequent life changes for all family members. The presence of our doulas will in no way infringe on the father/partner, or diminish his/her role or participation in the birth. Kairos doulas are there primarily to support the laboring mother , but will also do all they can to help the father/partner by offering suggestions for ways he/she can support the mother, explain the mothers progress and stages of labor, be sure he/she knows that his wife and baby are safe at all times, call the staff if there are signs of possible trouble, remind him/her to eat and stay hydrated, keep watch if he/she needs to get some rest, stay by the mother’s side if he/she needs to take a break, help to know what questions to ask the staff so the couple can stay fully informed in order to make important decisions, and ensure the father/partner is never left feeling helpless, wanting to support their loved one, yet not knowing what is the best way to do so. It is our hope that the presence of a Kairos doula , will allow the father/partner to participate in the birth of their child at their own chosen comfort level, whether that be hands on, actively participating in providing comfort measures, or simply to be there with hi/hers wife, to hold her hand, support her lovingly and emotionally, and witness the beautiful and miraculous birth of your baby.

I have a great Obstetrician/midwife, and I have heard the labor nurses at my chosen hospital are wonderful. Do I still need a doula?

We feel that communication and trust between patient and caregiver is very important, and we work to help enhance and deepen this communication and trust, which helps allow the laboring mother to relax and have an easier birth. Kairos doulas work with your doctor/midwife and labor nurses as part of your maternity care team. The doctor/midwife is your chosen caregiver in charge of your pregnancy, and labor and delivery medical care, and your nurse is there to care for your medical needs during labor and birth as well, while your doula takes care of your emotional, physical,social, and educational needs. Each member of the maternity care team has their own useful role in supporting the laboring mother. In a busy hospital, the doctor/midwife and the nurse most often are responsible for multiple patients, and cannot stay in the labor room throughout your entire labor, providing one-on-one continuous care and support, the way a doula does. The doula never leaves your side, through shift changes, or long births, the doula is the one trusted presence you can count on to remain by your side throughout your entire labor and birth.

A study reported in the journal of Maternal Child Nursing, in September of 2001, examined the amount of support being provided by labor and delivery nurses to women during childbirth, states:*

“ Nurses spent only 12.4% of their total time providing supportive care to laboring women. Interviews with nurses suggested that perceptions of the components of supportive care were comparable to the study’s operational definition of support namely: physical, emotional and instructional/educational support and advocacy. Although nursing support has been identified as an important aspect of nursing care in childbirth, this study demonstrated an incongruity between what nurses perceived as being supportive care and the amount of support that was actually provided. Nurses sited some of the barriers as being lack of time, the need to spend a large amount of time charting, preparing and maintaining medication and equipment used during labor, as well as multiple patient responsibility and high patient load.

The Society of Obstetricians and Gynecologists of Canada, prescribe intrapartum support as a key intervention in enhancing maternal and fetal outcomes during childbirth. It does not replace family support but is complementary to it. The presence of a support person providing encouragement and comforting touch has been shown to significantly increase the mothers’ satisfaction with the birth experience. Given the benefits of intrapartum support, and its importance to most laboring women, birthing units must facilitate implementation of this valuable resource.”

Can my husband act as my doula, and will he feel pushed out of the way if a doula is present?

Kairos doulas understand that this is not just the glorious birth of a baby, but also the birth of a mother, a father, and a family. We are committed to supporting both expectant parents. We know expectant fathers love their wife and wish to do all they can to assist her during labor, but many worry they won’t know what to do. We believe that even first time fathers really do know what to do. Your doula may have training, education and experience that the father does not have, but the expectant father has a loving, intimate knowledge of his wife which the doula does not have. He supports her every day when she is going through stress and challenges. Each of us then, is only half of the support team. So, if we put a doulas training and experience together with a fathers loving, intimate knowledge of his wife, our different but combined skills, make a rocking birth support team.

During your prebirth conference, we ask the father/partner to tell us about the level of participation he feels comfortable assuming. We discuss ways that he and your doula can work together as a team, to support and care for the laboring mother. The presence of a doula at your birth will complement and strengthen the father’s role, and allow him to participate at his chosen comfort level, so he can truly experience the joy and wonder of watching his baby come into the world. We can offer suggestions for support techniques if he runs out of ideas, show him ways we can work together as a supportive team, suggest appropriate laboring positions to help keep her pain comfortably managed and labor progressing, make runs for supplies while he remains at her side, remind him to eat, drink and take rest breaks, as fathers may not realize how emotionally exhausting labor can be, help him know what questions to ask of the staff, offer information and explanations to assure him his wife and baby are safe at all times and that everything that is happening is normal, or conversely, we can let him know when things are not going well, things we might be able to do to help, and times we may need to call for staff assistance. As labor progresses we can help explain to both parents what stages have been successfully passed through, and what to expect ahead.

In the study: Realistic expectations of the labor coach. J Obstet Gynecol Neonatal Nurse 1988 Sep-Oct;17(5):354-5 (ISSN: 0884-2175) Berry LM Dalhousie University School of Nursing, Halifax, Nova Scotia, Canada. This descriptive, retrospective survey (part of a larger study) employed a questionnaire to determine the behaviors of 40 expectant fathers to the stress generated by their spouses’ labors and deliveries. Results indicated that the experience was stressful for all the expectant fathers, and expectant fathers only coached their spouses with their breathing exercises at labor’s peak. Fathers spent more time trying to hide their feelings and worrying about their usefulness. These findings have significance for the prenatal education of couples, the education of health professionals, and the practice of labor and delivery nursing. When there is an emotional tie involved, it can be very challenging to see someone we love in pain, and to not know what to do to help them. If complications should arise during labor, the father can be even more challenged. A trusted professional doula, with a cool head and childbirth experience, can act as a guide to help not only the mother, but the father as well, to navigate the challenges of labor and childbirth.

In Mothering the Mother, How a doula can help you have a shorter, eaiser and healthier birth, they say this about fathers as main support persons:

“In asking fathers to be the main support, our society may have created a very difficult expectation for them to meet. This is like asking fathers to play in a professional football game after several lectures but without any training or practice games. Couples sometimes get the mistaken impression from childbirth classes that by using a number of simple exercises, the father can be the main source of support and knowledge for the entire labor when the nurse is unavailable. This is true for a small number of fathers, but most fathers, especially first time fathers, do not get enough opportunity in classes to observe and practice. In no other area of the hospital is a family member asked to take on such a significant caretaking role as in childbirth. When working in the obstetrical unit we have often been struck by how relieved fathers are when an experienced nurse or midwife enters the room and remains with them. This feeling of relief enables the fathers to be much more relaxed, loving, and emotionally available than when they bear the burden of responsibility alone. As one father put it, I’ve run a number of marathons, I’ve done a lot of hiking and with a heavy backpack, and I’ve worked for forty hours straight on call; but going through labor with my wife was more strenuous and exhausting than any of these other experiences.”

“For first time fathers, the labor and delivery unit of a hospital is a strange place with strange smells, sights, and sounds, including the cries of women in labor. Even more stressful are the changes occurring in the mothers, the people they love most, obvious pain, anxiety, unusual sounds, and fluid discharges never seen before. The changes in appearance of laboring women can be extremely distressing to new fathers, as can the woman’s sometimes dramatic changes in behaviour – becoming alternately overwhelmed, demanding, desperate, and even antagonistic. Fathers also face the dilemma of what to do and where to stand, how much to touch, and what kind of touch to offer, and how much loving affection to show in front of strangers. The stress is increased by the father’s feelings of direct responsibility for the woman’s distress, and the added responsibility in some cases, of making significant decisions about the medical care during labor. It is difficult for father’s to be objective; there is too much at stake. There is anticipation and excitement, mixed with concern and anxiety about the potential danger and the unknown. No matter how much experience a father may have had with childbirth, he cannot remain emotionally distanced enough to meet both his own and the mother’s needs at this intense time. In suggesting the support of a doula, our intent is not to diminish the role of the father, but to enhance it, to free him up to stand by the mother. With the doula present, the father is never left as the sole, isolated, responsible person caring for the laboring mother. This vital ingredient, the support of an experienced woman, has been lost in modern obstetrical care.

I’m not sure I can handle “natural” childbirth. If I have a doula, can I also have an epidural?

All birth is “natural” but some women choose to use medications, and some do not. We realize that we are all individuals with different pain tolerance levels, and what is right for one person is not necessarily the best choice for another. Our clients make various choices. Some choose not to use any pain medications, some begin laboring without pain medications but reserve the right to change thier mind if the pain becomes too challenging; and some know from the start that they want to use pain medication, but just need help in deciding what is the best time to get it. None of these decisions are wrong, just different. Kairos Doulas believe the choice of whether or not to use pain medication is strictly up to the mother. A labor support doula is there to support your decisions, not to make them for you. Your doula will help to educate you about your pain management options, both medicated through the use of IV narcotics, or epidural, or through the use of non-medicated methods like massage, hydrotherapy, heat and cold techniques, guided imagery, music therapy, change of laboring positions, distraction and relaxation techniques, mindfulness meditation,the use of birth balls and labor tools, or a combination of all of these.

During your labor, should you feel a need for a change in your pain management choice, your doula is there to assist you, by educating, helping you to gather information, understand and choose the best option for you at that time. Either way you go, medicated or unmedicated, your doula is there to inform, support, and assist you to reach your goal of a safe, and joyous birth, a happy, healthy baby and mother, and a positive birth experience.

I want to have a completely non-medicated childbirth. Can I do that? And can I have that in a hospital setting?

Absolutely. When you create your birth preference outline with your doula, she will discuss and explain all the pain management options available to you, and help to create a plan that best serves your needs and desires for an unmedicated birth. We discuss pain management, comfort measures and support, as well as how we can plan to create an atmosphere as close to your dream birth as possible, in your chosen birth setting. Once your birth preference outline is completed, we ask that you share a copy with your OB/midwife, to get his/her thoughts about your choices, and to allow you to discuss your wishes and desires for your birth with your doctor/midwife.

We feel that an unmedicated birth is an active birth. In order to achieve this goal, we recommend that you commit to setting aside time daily, during your pregnancy, to learning and practicing some form of technique which will assist you in taking control of any runaway anxious or fearful thoughts, so they do not control you. We believe that mindfulness meditation is the best pain management, labor coping skill, mindful parenting and life skill you can invest in learning. Our female body knows what to do, we just have to find a way to get our over thinking and sometimes anxious and fearful minds out of the way. Mindfulness helps us to have the ability to work with pain, rather than fearing or resisting it. It gives us the skills to let go of control, let go of over thinking, let go of fears and anxiety, and to say yes, welcome, and surrender to the process of birth, so that it unfolds more smoothly, more efficiently, more quickly, easily, less painfully, and with great joy. Kairos doulas offers many ways for our clients to learn about, and to easily develop their own daily mindfulness practice. If you practice throughout your pregnancy, you will have 90 % of it licked before you even reach the labor room. During your labor,your doula can recommend laboring positions, pain management, distraction, relaxation and mindfulness techniques and comfort measures that will assist you to realize the birth you desire.

What if I have a c-section, can I still use a doula?

Even in a surgical setting, the doula is able to calm and support parents, and help facilitate a positive birth. Before the birth she can play soothing music, employ massage techniques, and explain what is happening, so the mother remains calm. She can also assure the father that all is well with his wife and baby. Sometimes the surgery can be scheduled for a particular time, but get pushed back to accommodate emergency patient needs, and cause the mother to have to wait longer than anticipated, which can cause her to become tired, anxious, or fearful. The doula is there to keep her company and keep the mood light, explain things and help the time pass more easily. In some cases, the doula is able to accompany her clients into the OR, with the permission of the OB and anesthesiologist, unless it is an extreme emergency requiring general anesthesia. Birth does not end the minute the baby is delivered, and the doula is also there to help during recovery, and the initiation of breastfeeding.

If an unexpected need for a cesarean arises while a mothering is laboring, her doula can be an invaluable source of information and comfort. She can help with explanations, ask questions of the staff so you have all the information needed about this unexpected intervention, make sure staff answers all mom and dad’s questions, help both mother and father understand what to expect, help the father get ready to attend his wife in the OR, wait with the father helping to keep him calm until he can go into the OR to attend his wife, and once he goes in, the doula can gather and protect your belongings, and wait until you come out of the OR. Once back in your room or in recovery, the doula can assist with warm blankets and other postpartum needs, as well as helping with breastfeeding if the mother feels up to it.

I read somewhere that doulas are the hot thing in maternity care. Why, in this age of information overload, with books on what to expect, and a myriad of internet sites bulging with information, and last, but not least, dear old dad for support, would something as seemingly old-fashioned as the notion of doulas become the high point of birthing fashion?

Yes, doulas have been around for 3000 years, but obstetrical care has moved from low-tech to high-tech in the last 20 years. It is unfair to expect birthing couples to remember and put to proper use at the appropriate times, all the information they have learned. Especially under duress, uncommon circumstances, or being faced with unexpected medical procedures. The doula is objective and able to act as a personable on-site childbirth educator. Trends in obstetrical care have dramatically changed affecting the nurse to patient ratio and the amount of time a nurse and doctor/midwife can spend with each patient. The doula unconditionally offers a continuous presence and continuity of care. A study was also conducted by renowned childbirth lecturer and author, Penny Simkim, the founder of DONA, Doulas of North America. Penny had students from her childbirth education class write their birth experiences down, then after 25 years she had them write it again. The study revealed that woman remembered finite details about their experiences, nurses names, how they were treated, what people were wearing, things that were said, how the laboring mother felt, etc. It concluded that birth is not just about procedures and mode of delivery, but the birth experience as a whole, and how women are treated throughout. A woman’s perception of her birthing experience has also been proven to have profound effects on her ability to bond with and mother her child, on her relationship with her husband/partner, and the healthy start and functioning of their life as a family. Doulas offer loving one-on-one continuous support to help women have a safe and joyous experience which will contribute positively to all aspects of new family life.

How do you feel about parenting?

We believe our world has reached a crisis point, where the future of the environment, and the future of our children, grandchildren, and all sentient beings hangs in the balance. It is your generation and the generation of your children who will become the next stewards of our one and only Mother Earth. I believe those giving birth to, and raising the next generation, and those of us who have the honor of preparing and supporting you to do so, have a responsibility and obligation to educate and develop skills , not only toward successful labor, birth and breastfeeding, but also for the creation of awake parents, children, and families, who will rise up as a more enlightened, peaceful, socially just, environmentally responsible, and loving society, equipped to overcome the challenges the world faces today. Grounding children in principles such as Ubuntu, which says, “ you are, therefore, I am”. Helping them to recognize and embrace the unity and irrevocable interconnectedness of all beings and sentient life. Children who live in a way that considers always the fact that the way each of us moves through the world, impacts all other beings. Children who know that when one suffers or is in want, we all suffer, and so we must always reach out to and care for our brother and sister in need, and as we do so, we care for ourselves too.

As we see the world drowning in the devastating effects of rampant environmental destruction, daily extinctions of multiple irreplaceable species, pollution of our land, air and water by various sources, the toxic take over by corporations of our food supply, poverty, homelessness, hunger, inequality and social injustices, unending wars which will only escalate as resources become more scarce, runaway materialism and over consumption driven by selfish greedy corporations who put profit above human lives, and who are systematically bringing our government, our economy, and our human species to the brink of collapse and extinction -we must ask ourselves, how have I added to the negative state we are in? What part can I play in its healing, and how can I model a better way for my children, so they will grow up to realize their responsibility as part of our global family, committed to caring about and contributing to the welfare of all?

The better world we dream of begins with our children and our commitment to providing the most healthy, stress free, and peaceful environment possible during our pregnancy, to ensure their healthy formation and growth. It continues during our preparation for parenthood as we strive to become more self- aware and enlightened. Once they are in our arms it is a never ending commitment to parenting peacefully, lovingly, compassionately, and mindfully. In this way, we contribute not only to their immediate needs and security, but we also contribute to the creation of a loving, peaceful, socially just and environmentally stable world for their future. In order to do so, we must begin with examining and becoming awake and aware of ourselves first, knowing our own present moment mindfulness will translate into multiple healthy births, that of a baby, a mother, a father, and a family who will grow together to help our children become the lovingly connected members of our One Global Human Family, and in each of their unique ways, change our world for good and for all.