MIDDLEBURY — In Addison County it’s not just doctors who are on call to assist with the delivery of babies — it’s also midwives and doulas.
A doula, also called a birth companion, birth coach or post-birth supporter, is a non-medical person who assists a woman before, during and sometimes after childbirth. They can coach, offer advice, serve as an advocate, offer physical and emotional support and help support a birthing person’s partner through the birth process.
This work requires that they be available at any time or day to coach their clients through a delivery, and many doulas — especially those working in rural communities — are on-call nearly all the time.
According to Dr. Jodi Brown, a physician who specializes in Obstetrics, Gynecology and Midwifery at Porter Medical Center, doulas offer birthing people something that nurses and doctors often can’t in a hospital setting: constant attention.
“We have great nursing care at Porter that is highly individualized, but I think there is always room to have doula care as an important part of the team approach to birth,” Brown said. “There’s great research that’s come up showing how beneficial it is to have doulas be part of the team.”
According to a 2012 survey, 6 percent of birthing people in the U.S. said they used a doula during childbirth. Though that figure might sound low, it’s twice as many as used a doula in 2006.
Part of that is due to doulas becoming increasingly common in hospital birth centers, like the one at Porter. Dr. Brown says some hospitals even keep doulas on staff. At Porter, they provide patients with a list of regional doulas, but sometimes those services fill up. In Addison County most doulas work independently, which limits the number of clients they can take on without being perpetually on-call.
One 2017 study of continuous support for women during childbirth sought to quantify whether having a doula present decreases the likelihood that women will report negative feelings about their childbirth experience. It also aimed to determine whether doulas reduce the frequency of Cesarean sections.
The researchers found that women who gave birth with continuous support in the form of a doula may be less likely to have Cesarean sections and more likely to have shorter labors. Overall, women who used doulas were more likely to report having a positive childbirth experience.
“That’s what’s important,” says Middlebury midwife and doula Chenoa Hamilton. Hamilton runs Jumelles Wellness, where she offers central Vermont families home birth midwifery care, doula services, lactation counseling and childbirth education. Hamilton is a doula, Vermont Licensed Midwife, lactation consultant and EMT and has been attending births since 1997. She’s been a midwife for 15 years.
HAMILTON AND A client get some sunshine. Below, Hamilton poses with another client and her baby. She says that a doulas have different skills they can offer — like massage, for instance — but an important goal all doulas have is to make sure that mothers and their partners feel heard by their doctor during the birth process.
For the last several years, Hamilton has worked out of Riverside Natural Health in Middlebury, a space she shares with her twin sister Nieve Shere, owner of Shere Family Acupuncture. Shere is a licensed acupuncturist and doula who specializes in women’s health. In 2014, the pair joined forces with Stephanie Powers of Cornwall to bring her business, Middlebury Massage, into their integrated practice.
Shere received her doula training through Doulas of North America in 2006. Powers has worked as a licensed massage therapist since 1999 with a specialty in prenatal and postpartum care. She pursued doula training in 2014, after giving birth to her second child with the support of a doula. All three are mothers and have used doulas themselves.
Now, after years of operating independently as doulas, the group is forming a new collective partnership to be able to expand their birth work and take on more clients. By teaming up, they hope to serve more expecting people and to be able to share the duty of being on call for a birth. Their new venture is called Riverside Collective Doulas. They will host an open house at Riverside Natural Health Center in the Star Mill Building in Middlebury on March 13, 5-6:30 p.m.
Hamilton says that each doula brings a different skillset to the table when assisting a birthing person, but that the goal is always to make sure they feel heard by their doctor and that they and their partner (if they have one) feel advocated for as the birth progresses. Often this means making sure that a woman feels that she is making decisions and choices about her body, as opposed to them being made for her.
Hamilton emphasized that doulas are not there to push an agenda or their own ideas about how a birth should go. It’s all about helping the birthing person get what they want, even if that means helping them decide to have a doctor intervene. “People think that the only way to have a ‘good’ birth is if it goes exactly as you wanted and as you planned. In reality, you can have a smooth, textbook-perfect birth but come away feeling unsupported and unheard. Or, you could have a birth where everything you don’t expect happens but you were supported, heard and informed, and come away empowered by that experience,” said Hamilton.
When Amber Jimerson of Bristol was pregnant with her second child, she decided she wanted more personalized attention than she’d received during her first birth. After having her first baby via an unplanned cesarean section, she wanted to try to have her second via a vaginal delivery. Having a doula gave her the added confidence to do so successfully.
A doula, as Shere explains, can instruct a laboring person try a new body position if the labor is not progressing or offer massage. They can identify and explain parts of the process of labor — something a fellow first-time parent may not be able to offer. “It’s about taking care of the whole unit. Labor tests you, and it’s hard to see someone you love go through a normal but very difficult process.”
For Jimerson, the extra support that Hamilton, her doula, offered transformed the process. She’s used Hamilton as her doula for two births. “They’re your personal birthing expert and a resource that’s immediately there, especially if you or your partner get nervous. In the rush of hormones and physical intensity, they can walk you through what each choice will yield.”
This, in conjunction with a general uptick in the demand for doulas in Addison County, is what motivated Powers, Shere and Hamilton to launch a new collaborative out of their shared office space at Riverside Health Center.
To share the burden of being on-call (all three are also parents to you children), they have created a rotating call schedule. Clients will meet and consult with all three doulas and the call schedule determines who will respond and be present during their birth. A range of services are offered, from acupuncture treatments tailored for pregnant women and women recovering from birth, to prenatal and in-labor massage and acupressure and lactation counseling and midwifery services (offered by Hamilton) for in-home births.
The new collaborative will allow them to take on more clients and to individually expand their services within the Middlebury Community. “We are stronger together. It takes a village to raise a child and that support begins at birth,” said Hamilton.