Lamaze more than just a breathing exercise

A Lewes doula is carrying out the mission of Lamaze International, a nonprofit that advocates for safe and healthy pregnancies.

Lamaze International, founded in 1960, is named after Dr. Fernand Lamaze, who popularized labor methods he observed in Russia. Those methods included childbirth education classes, relaxation, breathing techniques, continuous emotional support from the father and a specially trained nurse, often called a doula.

The term “doula” is rooted in ancient Greek and translates to mean “servant-woman.” It was popularized in America by anthropologist Dana Raphael, who used the term in her 1960s dissertation on breastfeeding after an elderly Greek woman used it to refer to the concept of one female helping another in pregnancy, childbirth and postpartum activities.

“Basically, [a doula] is a labor support professional that’s hired by a mom or family and that provides continuous support to the mother throughout labor and birth. That can be hard for people to visualize,” said Kathleen Whittam, who is a Lamaze certified childbirth educator and certified by the Doula Organization of North America. “It’s like a sherpa. If you were going to climb a mountain, you’d do the climbing, but you’d hire a professional to go with you; a professional that knows the mountain, what route to take, when to call for more help, things like that.”

The trauma of childbirth

Whittam is 43 years old and lives in Lewes with her husband and three children. It was her own first childbirth experience that inspired her to become a doula. She was 25, married, healthy and had good health insurance and access to a good hospital, yet the experience was a traumatic one.

“I went into it with the odds in my favor, and my son was born healthy,” she said. “But that’s not all that matters. What matters is your mental and emotional health. My husband and I had this naïve idea that the doctor or nurse would be in the room with us the whole time, and you are monitored, but you’re pretty much left on your own to cope with the labor until it’s time for delivery.”

Whittam felt abandoned, unsure and nervous during her first labor experience.

“How long was it going to take? Was the baby OK? Was I OK? And even though I got an epidural, there was still a lot of pain,” she said.

Whittam thought there had to be a better way. When she became pregnant with her second child, she started researching and found doulas.

“That’s what I needed – someone to encourage me and walk me through it,” she said.

She hired a doula for her daughter’s birth, and even though there were complications during labor, Whittam ultimately felt more comfortable about that birth than her first.

“When the complication came up, it was scary, but we knew what was going on. We went into parenting her in a much better place,” she said.

What doulas do

Doulas and midwives have similar expertise, but they’re not the same thing.

“A midwife actually delivers the baby,” Whittam said. “A doula is there for labor support, more about childbirth education and the physical comfort of the mother throughout the labor, and making sure her birth wishes are followed as closely as possible.”

As a doula, Whittam first visits the mother and/or family in their home for a prenatal meeting in which she tells them what to expect during labor and helps them develop a labor plan. When active labor begins, she joins the mother at her home or at the hospital and provides information and support until a few hours after the baby is born. Finally, she meets with the mother and/or family for a postnatal meeting to review the birth and answer any newborn care questions they may have.

Doula costs can vary, but usually run between $600 and $2,500. A doula can be hired at any point during a pregnancy, but the earlier, the better.

“The earlier you hire me, the more information you get from me, the more time you have to ask questions,” Whittam said.

Lobbying for better birthing

When Whittam attended the Lamaze 2017 Advocacy Summit in Washington, D.C. in October, she visited with Delaware legislators to advocate for public policy in support of safe, healthy and proven birthing practices.

“The cesarean rate, the maternal death rate, the premature [birth] rate – they all continue to rise, and none of that is good for women or babies or our country. It’s expensive. It’s stressful. It’s a problem,” she said.

At the summit, Whittam attended a talk by Dr. Neel Shah of Harvard Medical School. Shah stressed that the best way to address the maternal death rate is to reduce cesarean births.

“Surgically, it’s not that complicated,” Whittam said. “But second or third cesarean … It’s the only surgery in which you have to cut through the same scar repeatedly, and the uterus is very vascular - people lose less blood in a heart operation.”

Lamaze participants have a cesarean rate 13 percent lower than the national rate, according to Lamaze International’s U.S. parent survey.

In addition, Whittam said annual childbirth-related deaths in the United States –  about 700 according to the CDC –  is grossly underreported.

“A lot of women who die from childbirth die within a week from hemorrhage, inadequate care or infection, and their deaths aren’t reported as childbirth-related,” she said.

Whittam said the best thing an expectant mother can do for her health and the health of her baby is to take a childbirth class.

“Women who take formal childbirth classes statistically have better birth outcomes, fewer cesareans and fewer complications,” she said. “I would implore all women to take a childbirth class.”