Most doulas have some sort of bag we bring with us when we go to support a laboring family. Pay attention, and I bet you will notice the big tote bag, purse, or backpack which your doula will bring to your birth. The contents of this magical bag vary with each doula, but there are some common items which many of us bring to help make your labor and birth easier. Some of the things in this bag are specifically for you, the laboring mama working so hard, and some are for the doula, so she can be the best support for you that she can.

1. Food

The importance of food while at a birth can not be overemphasized. . When we head out to a birth, we may be gone for a long time, so it is absolutely essential to bring snacks with us. Perfect snacks for doulas are ones that won't make our breath bad, or that a laboring mama won't be able to smell. Laboring women's' senses are heightened, and so bad breath or smelly food are definitely faux-pas. Trail mix and granola bars are good, onion-flavored potato chips are bad. And chocolate? Chocolate almost always makes things better.

2. Massage Tools

There are all sorts of different tools we like to use to help a mama relax during or in between her contractions. Massage tools in all shapes and sizes, tennis balls, and our hands are what I find myself using time and time again. Many doulas bring massage oil or cornstarch as well, to help give good massages with our hands. Your doula will probably bring scented and unscented oils, just in case you can't stand the smell of the fragrant one. A scent that you usually love can quickly become unbearable when you're in labor. Your doula knows this, hence she comes prepared for whatever will help you best.

3. Heat/cool Packs

It has long been known that heat or cold can greatly help reduce aches and pains. Just think about when you're sore and you get in a nice hot bath. The same concepts apply in labor and birth. Your doula probably has a rice sock that can be popped in the microwave, along with a freezable pack to deliver cold to sore muscles. I've also found that a cool washcloth does just as good as a job of delivering relief.

4. Kneeling Pad

By far, this is the one tool that I use most often. It's a small portable gardening kneeling pad. I will often find myself kneeling behind a mom to rub her back or doing counter pressure when she's having a contraction, and this kneeling pad is a knee saver! I know some people just use a pillow for the same thing, but it comes nowhere near comparing to having a nice piece of foam under your knees especially if you're in that position for a long time. It is essential for your doula that she takes care of her body as she is taking care of you, and this tool does a great job of that.

5. Heart and Hands- or Leaving your Bag in the Car

After many births where I lugged my doula bag out of my car, into the birthing area, never to touch it the whole time, I've learned that sometimes the best tools are the ones I always have and don't need to remember to put in my doula bag- my heart and my hands. These are the tools that can be brought out at a moment's notice, and time and time again, I find myself using these tools solely at a birth.

As a doula gains more experience, she may also find that the tools that she used to lug around to every birth are not as paramount. Often the simplest things lead to the best results.

So ask your doula, what's in your doula bag?

1.      Comfy clothes and shoes- Doulas work long hard hours. We stay with you for the duration of your labor, whether it is 4 hours or 40 hours. We get into uncomfortable positions to help get you more comfortable. We squat, stand, bend over, and are on our feet a lot. Comfy clothes and shoes to wear to a labor are an absolute must. Seasoned doulas know sweatpants and sneakers go a long way to keeping your doula comfy. A comfortable doula is more focusing on helping you have your best birth.  

2.      Taking off comfy clothes- Just as wonderful as it is to wear said comfy clothes, I love coming home from a birth and ripping off my shoes and bra, and collapsing on my bed. There's nothing like it after a long birth.

3.      A long hot shower- No matter how quick or long and difficult the birth was, a long hot shower after coming home from a birth always makes me feel refreshed. Especially if the birth was long, I feel so grimy and love to wash my hair and brush my teeth before passing out in bed.

4.      Food! Your doula probably made sure that you ate before heading to the hospital, and she knows it's just as important for her to eat too. I try to eat something before heading to a birth- I never know how long I will be gone! Snacks in my doula bag are also essential. A granola bar at 4am can sometimes be a life-saver when I'm hitting a wall.

5.      A long nap- After coming home from a long birth,  I usually pick up food on the way home, scarf it down when I walk in the door, peel off my clothes, and then I nap. A long luxurious nap is often needed to reset my sleep-wake cycle if I've been up all hours of the night with parents. If I could have nothing else after a birth, a nap would be my first priority.

6.      Loving family members- Doula work is demanding on families. If often entails wife or mom to be gone for long stretches of time, with no idea when she will return. Coming home to a husband or partner who is supportive of doula work and values what we are doing is priceless. A little wine and chocolate waiting for us never hurts either ;)

7.      Water- When I'm at a birth I try to remember to bring a water bottle with me, but sometimes I forget. It seems the nurse is always very good at making sure the laboring mama has plenty of water, but sometimes the support people get left out of that. When the nurse does ask the partner and I if we want some water, I always enthusiastically say 'yes please!' Even though staying hydrated is such a simple thing, it can really help me stay energized and on top of my doula game. And we're constantly reminding that laboring mama to drink, so it's great if we are treating our own need for hydration just as important.

Have you heard the term 'baby-friendly' hospital? Maybe you've seen the billboards around town which advertise that Feather River Hospital is baby friendly. But what does this term mean? Aren't all hospitals baby friendly? Although many hospitals are friendly to babies, in order for a hospital to declare itself  a Baby Friendly Hospital, specific criteria must be met, including not accepting samples of formula, and making sure all nursing staff are trained in how to help a mother succeed at breastfeeding. Most of the requirements that come with the baby friendly label have to do with breastfeeding. There are only a few hundred hospitals and birth centers in the country which have earned this title.

So specific hospitals can be deemed Baby Friendly, but did you know that they can also be designated Mother Friendly? Two separate organizations give these designations. The Baby Friendly Hospital Initiative was started in part by the World Health Organization (WHO), while the Mother Friendly Childbirth Initiative is backed by the Coalition for Improving Maternity Services, a group of many individuals and organizations.

What makes a hospital mother friendly? Just as there are ten steps which must be completed in order to earn the Baby Friendly label , there are also ten steps to fulfill for a hospital or birth center to be Mother Friendly. To be designated Mother Friendly, hospitals must:

1. Offer all birthing mothers:
Unrestricted access to birth companions including fathers, partners, children, family members, and friends;
Unrestricted access to continuous emotional and physical support from a skilled woman—for example, a doula;
Access to professional midwifery care.

 2. Provide accurate descriptive and statistical information to the public about its practices and procedures for birth care, including measures of interventions and outcomes.

3. Provide culturally competent care—that is, care that is sensitive and responsive to the specific beliefs, values, and customs of the mother’s ethnicity and religion.

4. Provide the birthing woman with the freedom to walk, move about, and assume the positions of her choice during labor and birth (unless restriction is specifically required to correct a complication), and discourages the use of the lithotomy (flat on back) position.

5. Have clearly defined policies and procedures for:
Collaborating and consulting throughout the perinatal period with other maternity services, including communicating with the original caregiver when transfer from one birth site to another is necessary;
Linking the mother and baby to appropriate community resources, including prenatal and breastfeeding support.

6. Not routinely employ practices and procedures that are unsupported by scientific evidence, including but not limited to the following:
shaving, enemas, IVs, withholding nourishment or water, early rupture of membranes, electronic fetal monitoring Other interventions are limited as follows:
Has an induction rate of 10% or less, Has an episiotomy rate of 20% or less with a goal of 5% or less, Has a total cesarean rate of 10% or less in community hospitals, and 15% or less in tertiary care (high-risk) hospitals, Has a VBAC (vaginal birth after cesarean) rate of 60% or more with a goal of 75% or more.

7. Educates staff in non-drug methods of pain relief, and does not promote the use of analgesic or anesthetic drugs not specifically required to correct a complication.

8. Encourages all mothers and families, including those with sick or premature newborns or infants with congenital problems, to touch, hold, breastfeed, and care for their babies to the extent compatible with their conditions.

9. Discourages non-religious circumcision of the newborn.

10. Strives to achieve the WHO-UNICEF “Ten Steps of the Baby-Friendly Hospital Initiative” to promote successful breastfeeding:

Have you heard of Baby Friendly Hospitals? What is your impression of the Mother Friendly Hospital Initiative?