SMILE Doula - Supporting a Mother's Intimate Labor Experience

Website

2009-07-16T16:46:00.001-04:00

I now have a domain :)

http://www.smiledoula.com

The site is in the works but you can just see the basic info right now.

I apologize

2009-06-27T10:16:00.002-04:00

I have been really slacking on updating my blog. It has been a crazy 7 months. I am working on getting a website and updating a blog from there.

I gave birth to my daughter on February 10, 2009 and had the most amazing birth!

I have two births coming up in July that I am so excited for! More to come :)

My First Labor and Birth!

2008-11-01T14:44:00.003-04:00

All the studying and anticipation for my first birth was well worth every minute! My first labor and birth spanned over 22 hours.

On 10/23/2008 (Thursday) I recieved a message from client #1 (names are kept private). She took her first dose of Castrol Oil at 9:15am. She decided to go with Castrol Oil because she had been contracting for two weeks but they would not stay continuous. The doctors were talking about inducing her within the next couple of days due to the baby's size so she wanted to get things moving along. I arranged for the boys to go with my father and I got ready for my night.

I arrived at her house at 2:15pm. She had just started contracting at that point but was having a hard time telling what her contractions were. She is one of those lucky moms who you can't tell she is in labor until she is ready to push the baby out. So we sat down and I helped her get in tune with her body to determine what a contractions was and what the baby moving was. She was able to easily start timing her contractions afer that. She took a shower and added nipple stimulation so that these contractions would keep on coming. After the shower, we starting timing the contractions at 4pm for 30 mintues. They were 7 minutes apart and lasted about a minute and a half each.

We then went off to Target and walked many laps around the store. We timed her contractions at 5:30 and they were 5 minutes apart. We continued walking through each one. She was handling her contractions so well I could barely tell when she was having one. At 6pm we decided to sit in my car because she was having a hard time telling when one contraction started and the other started. After timing them for about 15 mintues in the car, we relized they were right on top of eachother. We called the doctors office from my car. We were directed to come to the hospital. We then went to her house and got all her stuff and her husband.

We arrived at the hospital at 7:15pm. They were registering her and the lady behind the desk kept asking if she was being induced. My client told her no that she was contracting every two minutes. She was handling it so well no one could tell she was actually in active labor. Even the nurse that brought her back was assuming she was being induced. They hooked her up to the monitors and got an IV put in. She was checked internally and she was 5cm dilated, -2 station and 60% effaced at 8:02pm

My role was to be her main support person. Her husband expressed that he wanted me to do whatever was needed to keep her comfortable and preferred me taking this role. We started off with a hand massage to help her relax from all the hustle and bustle of admission. We were then given the OK to start walking. We did a couple of laps around the labor and delivery floor. We talked and joked the whole time. She was checked again at 11:40pm and was 6.5cm dilated and 70% effaced. At that time, she sat on the birth ball and I did some counter pressure on her back followed by a full back massage and light touch massage. She was tiring and needed some rest before long. She as checked at 2:07am was progressed to 8cm and 80% effaced.

At that time she chose to get an epidural so that she could rest for a couple of hours to regain her energy. I was able to stay in the room with her while she got her epi and held her hand and talked with her through it to keep her mind off of it. Afterwards, I gave her a head massage because she was starting to get a headache. She was then able to rest on an off up until about 4:50am. They then broke her water but could not get to it because the babies head was in the way. They then tried again at 6:15am with success. She stayed at 8cm until 8am that morning. I really feel strongly that her body needed to rest and that is why she was not progressing.

The doctors administered pitocin at 8:35 that morning. She was starting to get uncomfortable around 9:30 am and it was the first time she felt panicked. I was able to recognize this right away and it was the first time I felt nervous. I took a deep breath and I was able to get her to calm right back down within 30 seconds by getting her to breath and talking her through it. That was the point where she hit transition. She could feel the baby's head coming down. The annesthesiologist gave her another dose of meds to make it a little more comfortable for her. She was checked at was fully complete and ready to push.

She held off just for a little bit because she did not feel ready. The doctor was paged and came in the room about 10:03am. She started pushing at around 10:05am with a resident watching for the baby. She pushed 3 times within a contractions and the resident was holding the babies head in so the doctor could get her gloves on. This really help her not tear at all. The resident released his hand and out came little Gabriel at 10:06am! All 9lbs 4oz of him!

She did not even tear! This was a big fear for mommy as she tore with her first two.

As he was being born I was encouraging mommy, I was telling her how great she was doing and how wonderful her body was for giving birth. When he was born, noone else anounced what the baby was (it was a surprise baby). So I grabbed her as we were both crying and I said "It's a BOY!!" Seeing mommy cry was my biggest accomplishment of the day. She did not cry with her other births and this baby was a surprise to them. I really felt that I help mommy bond with her baby and that was so heartwarming to me.

The experience of going through this labor and birth with my client was more than amazing. I really have not been able to find the words to express how I feel about how wonderful it made me feel. This is my first labor and birth as a doula and it is one that I will remember for the rest of my life! Hearing the mommy say that this was her best labor and birth yet was music to my ears.

My goal is to help a mommy and daddy have the labor and birth they have always wanted. I want them to be confident in the choices they make and to realize that it is their choice and not anyone elses.

Here is what the mother wrote me when she returned from the hospital. This makes being on call 24/7, finding a sitter just in case for my boys every day, finding coverage at work just in case all worth EVERY minute! I have found my passion and it feels so good. I am a doula!!!! Saying that out loud after all that I have worked for is the biggest accomplishment (other than my babies and my husband) that I have made in my life!

"I just wanted to say thank you so much for everything, you were awesome! You helped me so much! You made the whole experience very relaxing. My husband and I truly feel you are apart of our family forever. We can't thank you enough for everything."

More to come....

2008-10-24T19:45:00.002-04:00

I just wanted to update everyone. I attended my first entire labor and birth yesterday until this morning as a Doula. I will update the blog this week with all the details.

The experience was so amazing and moving! Both Momma and Baby are wonderful!

Preeclampsia - more common than we think?

2008-10-21T10:52:00.004-04:00

Pregnancy Induced Hypertension (PIH) can lead to the dreaded Preeclampsia in some pregnancies. Researchers say that Preeclampsia only happens with 5%-8% of pregnancies. However, I am seeing this more and more as I obtain more clients. So far, I have had three clients.

The first client was the first labor that I attended and she had PIH. The second client whose labor can start any day has the beginning signs of Preeclampsia. She is experiencing edema and protein in her urine but no high blood pressure. We will find out on Wednesday if they are going to diagnose her has preeclamptic. My third client has the high blood pressure and is having issues with low platelets in her blood. We will find out on Thursday if she is considered preeclamptic or not.

That is 3 out of 3 clients that have some issues with this nasty disorder in some way. This really concerns me. I found a great article that can help educate us on Preeclampsia from the Mayo Clinic.

I decided to bring out my books and reread what they have to say about this disorder.

In the Ina May's Guide to Childbirth and Spiritual Midwifery by Ina May, she suggests that preeclampsia, eclamsia and HELLP Syndrome can be largely prevented by a good nutritious diet (getting the correct amount of protein is key whether it is from meats, soy or nuts). Reading these books and also attending my Doula Workshop, I learned about Dr. Tom Brewer. Dr. Tom Brewer is a physician that has devoted his life to understanding the cause of this disorder.

For those of you that are interested in reading a great article interviewing Dr. Tom Brewer, click HERE. It is long but worth a read especially if you are going through PIH, Preeclampsia, eclampsia or HELLP.

I have not personally experienced anyone that has been on The Brewer's Diet to prevent or treat PIH, Preeclampsia, eclampsia or HELLP. However, I would be willing to try if I needed to as there does not seem to be any other prevention or treatment for it rather than bed rest and early delivery.

My journey so far...

2008-10-12T13:41:00.002-04:00

I started studying to become a doula about one year ago. I began by researching different organizations where I could become certified. I chose DONA International. Once I made my choice, I began purchasing the required readings for certification and reading them at every chance that I could. I also found my doula trainer and contacted her with some questions and stayed in touch with her periodically. I talked about pregnancy, labor and birth as much as I could with all who were intersted.

My First Labor

In August, I had the honor to be apart of a labor of a friend. She had Pregnancy Induced Hypertension (PIH) and was coming in for an induction. Her cervix was not fully ripe and still very hard so they gave her Cervadil to help soften her cervix. Cervadil is normally left in for 12 hours and then removed before pitocin is started.

Her blood pressure was very high so the medical staff started administering Magnesium Sulfate (mag). Mag is given to high blood pressure mothers to help prevent seisures. This was my first experience with mag ever so I didn't know what to expect. I remember reading the side effects being a mettalic taste in the mouth and severe hot flashes (flushing). As the nurse was administering the mag through the IV, I would see the mommy starting to tense up. I came to her side and asked her if she tasted the metal taste in her mouth. She said yes and it was making her feel sick. So I asked the nurse if she would be able to chew a peice of gum. The nurse okayed the gum and candy chewing but restricted all of her fluids and food at that point. The nurse then got us a tub of ice water and five rags. I spent the next 45 minutes cooling the mother down as fast as I could with these rags. We had some on her forehead, back of the neck, front of the neck, and two on her stomach. I would just rotate them in the water every minute. Her legs were hot too so I let my hands soak in the ice water for a minute and apply my cold hands and some ice water to her legs. Once the hottness went away, we sat and chatted for a little bit.

Her husband had to leave for a moment and she siad to him jokingly as he left, "Maybe you can rub my feet when you get back!" I then started rubbing her legs and feet to help her relax. She also needed head rubs (because of headache from the PIH) and back rubs (because she was contracting and confined to the bed). I was able to get the nurse to bring in a birthing ball that she sat on for about 45 minutes while I added counter pressure on her back.

Every time a nurse or doctor would come into talk with them, I would pick up where the medical staff left off and explain all they were saying. I answered a lot of questions and left them at about 8pm that night.

At 1am the Cervadil was removed and she started contracting and going into labor on her own. She had a beautiful baby boy at about 5am that morning.

I left the hospital that night on a high. I knew that this is what I needed to be doing and felt like I am right where I need to be. I talked with the mommy the next day and she thanked me for supporting her and informing her on everything. She said it helped her become more relaxed.

At the end of September, is when I attended my Doula Workshop. The information on that is in the previous post.

Doula Training

2008-10-12T11:00:00.003-04:00

At the end of September, I attended my three day workshop for my Doula Training. The whole experience was absolutely empowering. The first day consisted of Childbirth Education and the next two days were Doula Training. We did role playing and really got into the modes we would as if we were at a live birth.

Here I am on the floor acting as the Doula - Comforting the mother and directing the Father (who for the sake of the role play was a women).

I met some really great women at this workshop. We really connected and bonded. Our trainer was absolutely amazing! She has been attending births for over 20 years and has been teaching childbirth education for a while now. She is a humble, intellegent and empowering woman. She is also a HUGE advocate for VBAC's. I feel blessed to be trained by her.

I am now able to attend labor and births to get credit for them towards my DONA certification.

Book Readings

2008-10-12T10:43:00.005-04:00

I know that I have not updated this blog in a long time. I have been very busy with my doula training and will continue to update this as I go through the rest of my training.

I know have 6 books read and I currently reading my last one for training. (5 were required and 2 were optional)

Here are all the books that I have read and how I feel about them.

-The Birth Partner - a must have for every mom-to-be and dad-to-be.
-The Doula Book - has a lot of great stats about doula's - but more for a Doula than a Mom-to-be.

-Ina May's Guide to Childbirth - A GREAT book! She is an amazing writer and it is great for mother's preparing for Natural Childbirth

- Spiritual Midwifery (another Ina May Gaskin book) - has lots of natural birth stories written by the mother's. - A great and empowering read!

- Pregnancy, Childbirth, and the Newborn: The Complete Guide - This was more of a text book to me and it was not fun at all to read. Most of this stuff I skipped over because it was all in The Birth Partner and it was a lot more interesting in that book.

- Hypnobirthing (Mongan Method) - I was disappointed with this book. I really felt that the whole book was based around if you were in a hypnobirthing class rather than focusing on teaching you the methods from the book. We don't have ANY Hypnobirthing classes around here so I can't participate in the classes. It does come with a CD that helps you relax and does show you some breathing techniques.

-The Nursing Mother's Companion: Revised Edition - this is the book I am reading now and so far so good. It is a great reference and gives confidence that you can breast-feed. It goes through stages like "How to get through the first week", "How to get through the first month" and so on. It also goes over possible problems that can occur and how to correct them.

New Book

2008-06-02T10:48:00.003-04:00

Spiritual Midwifery by Ina May Gaskin

This book is amazing! I am on page 100 and love it! This book is not apart of my required readings but I am very glad I decided to read it. Ina May is such an amazing writer and is so real and isn't afraid to tell it like it is. The first half of the book is women who have delivered on The Farm telling their experiences of natural childbirth. It also goes through how Ina May became a midwife and how she learned from her experiences. I highly recommend this book to all pregnant or wanting to become pregnant women!

I finished my book!

2008-05-19T09:43:00.003-04:00

I just finished my third book "Ina May's Guide to Childbirth" and I highly recommend it! It is amazing...she is amazing. If I had my dream birth, it would be on The Farm in TN with her as my midwife...no drugs! That is my dream...not that it would EVER happen since we can't just pack up and go there. I would love to have a home birth or birth in a birthing center but I can't find any resources to make that happen here where I live.

My long term dream is to make home birth or a birth center birth popular here! I have every intention to go back to school, get my nursing degree and then go on to midwifery school. Birth is an amazing thing and it is often treated as a medical condition. It is not a medical condition! There are exceptions to this rule of course if you have medical issues associated with birth.

Now onto the next book....

Update of me becoming a Doula

2008-05-16T11:03:00.003-04:00

So we have a name, Supporting a Mother's Intimate Labor Experience, we have a logo. We don't have a Doula yet. I am having a hard time finding mother's and father's who want a FREE doula. So I have delayed my workshop until September instead of the end of this month. There is no sense of me taking the three day workshop if I don't have any births lined up. I will still be reading and following my passion and trying to update this blog with interesting stuff. Sorry I have been slacking.

We are still trying for baby #3 and on our third month. We are hoping the third month is a charm! :)

The word Doula is not very known in North East Ohio so the benefits of having one apart of your labor and delivery are not communicated. I hope that one mommy gives me a chance to help her in one of the most important days of her life.

Thank you to all who support me!

We have a name!!!

2008-03-25T11:34:00.003-04:00

Supporting Mother's Intimate Labor Experience

Isn't it lovely? :)

I hope you all like it as much as I do!

Now I have one more question...please comment:

Should it be Supporting Mother's Intimate Labor Experience or Supporting a Mother's Intimate Labor Experience?

Thanks to ALL!

What is a Doula?

2008-03-21T21:11:00.005-04:00

No, it is not a part of your brain like many people think. I have listed some great definitions of a doula below.

"Doulaing - The act of educating, loving, respecting, listening, embracing, advocating for and assisting a woman prenatally, during labor, childbirth and after."

"A doula is an experienced, non-medical assistant who provides physical, emotional and informed choice support in prenatal care, during childbirth and during the postpartum period. A birth doula is a continuous care provider for labor in many settings, also assisting the parturient woman during transport from home to hospital or birth center." wikipedia

" A doula is a professional trained in childbirth who provides emotional, physical and informational support to the woman who is expecting, in labor or has recently given birth. The doula's role is to help women have a safe, memorable and empowering birthing experience. Doulas can also be called labor companions, labor support specialist, labor support professional, birth assistants or labor assistants." American Pregnancy Association

"Doula derives from Greek doula, "servant-woman, slave"

All Pregnant or Looking to Become Pregnant!

2008-03-09T22:09:00.004-04:00

You really need to rent the movie "The Business of Being Born" available through Netflix. It is a must! I was going to go with an OB on my next pregnancy and I am already trying to find a midwife and a doula! I do NOT want a medicated birth ever again!

Click here to see the trailer!

This movie really opens your eyes to the BUSINESS of birth in America compared to other countries and our high infant death rate due to all of the medical interventions. It really is sad that we as Americans do not let the Mother's body do what it was created to do. My goal as a doula is to bring mother's back to their inner strength and be 100% confident in themselves and their abilities. Birth is too beautiful and meaningful to us mothers to have the experience ripped from us!

Birth of Isaac

2008-02-26T00:43:00.004-05:00

Now onto the birth of Isaac. My pregnancy was great with Isaac...I only gained 30 pounds this time :) I had an all around wonderful pregnancy and enjoyed every minute of being pregnant with yet another boy. Since Elias was so big my OB was afraid that Isaac was going to be just as big or even BIGGER! So we had an ultrasound at 38 weeks to see how big he was. The ultrasound can be off my -1 or +1 pound so it really is not accurate at all - He measured in at 7.5 pounds. My OB didn't believe it and wanted to induce me at 39 weeks - July 2nd.

We went into the hospital at 6am to be prepped (fluids and pitocin started)- now you will have to excuse my memory on the times each event happened with his birth...it was quite traumatic for me so my memory of the details escapes me. By 11am my water broke while sitting on the labor ball and they considered me in active labor, but I did not feel any pain. Being uneducated, I opted for an epidural before I started feeling any pain because when I had Elias it took the anesthesiologist a LONG time to come. Not this time! He was there within 15 minutes of me asking for an epidural. He put the epidural in...the initial dose anyway-almost instantly after the Anesthesiologist left my blood pressure dropped extremely low. The nurses were asking me "do you feel light headed like you are going to pass out?" I felt fine but my blood pressure was telling them other wise. I then began to shake like CRAZY. The anesthesiologist came back in and gave me some type of shot in my but to bring back up my blood pressure...but who knows if it worked because they could not get an accurate reading because I was shaking so bad. After the shaking calmed down and my blood pressure was regulated, I started feeling some cramping in my lower abdomen and my legs. The anesthesiologist came back because he forget to hook me up to the drip of "caine" and I only had the initial dose. So he pumped me with more and then added the drip. This time I was feeling nothing.

As hours went on...I was laying/sitting in the hospital bed the ENTIRE time. I was dilating at a good rate...nothing like I did with Elias. I could not feel my right leg at ALL! I looked down at it and it was sooo swollen and my little toes were about as big as my big toe and I started to freak out! I told them to stop this epidural that I could not take it anymore. They stopped it around 7 I think. I slowly starting feeling the pains of labor on my left side. My right leg and side were still completely numb. I could not move my right leg at all.

Well, Mr. Isaac decided to be stubborn and push himself all the way to my ribs and would not let his head descend down the birth canal. So the had me get on my hands and knees and rock...well I floated. I turned over and rocked but it felt like I was floating because I could not feel my right leg so it felt like it wasn't there. The pains increased and I started feeling sick to my stomach...he was coming soon! I sat up and rocked on the edge of the bed...after a while my doc decided to check me...this was at 10:40pm on July 2nd. I was 9cm and only had a lip of cervix that would not go away. So she pushed it out of the way and I began to push and push and push and push and push. Then Britney comes in at 11pm...she is a friend from highschool and is a nurse that I wanted their with me the entire time because I felt comfortable with her...18 minutes after she came Isaac decided to cooperate and he was born. After 40 min of pushing....here comes my baby boy! I watched him come out in the mirror and he was put right on my chest...all 8 pounds 9 ounces of him! Watching him come out and having him on my chest was the BEST and most indescribable feeling in this world. Tears of joy came running down my face as I witnessed this miracle of birth. And his cry...made me cry even more because he sounded JUST like his brother when he was born.

Isaac did wonderful latching on for breastfeeding and I loved every minute of it. An hour after he was born the nurses tried to get me to go to the recovery rooms and out of Labor and Delivery but I still could not feel my leg nor could I move it. It took about 5 hours after I had him to get me out of that bed and I was still numb. I vowed at that point in time that there had to be a better way and I will not do another epidural again!

Birth of Elias

2008-02-26T00:15:00.002-05:00

It has been over 4 years and I can pretty much remember every detail of my first labor and delivery. Here is his story:

Kris and I just got married and managed to become pregnant right away. I turned 21 while pregnant with Elias. I gained about 60 pounds and ate EVERYTHING I saw! I did not educate myself on labor or delivery at all. I just thought it would happen the way it should and I would be medicated. Boy do I wish I would have known then what I know now! About two weeks before Elias' due date I developed a rash called PUPPPS. This rash covered my body from the tips of my toes to my neck. There is NOTHING you can put on the rash to soothe and stop the itching so the last two weeks I was miserable. It felt like I had poison ivy all over my body. I would not wish this rash on my worst enemy! I was on prednisone and found ice packs helped soothe it a little. On Thursday night, October 2nd, the rash was so intense that I just stayed up all night in and out of the bath and crying. I woke Kris up early in the morning and told him I just could not take this anymore. I called my OB because the rash spread to my face and it is not supposed to do this and she told me to take another prednisone. She called back 2 minutes later and told me to head to the hospital that she was going to induce me. I lost it...I freaked out. I immediately called Kris at work and told him to come home. I had to get some things ready at home and pack my stuff. We were off to the hospital around 2pm.

We got to the hospital and was prepped....pumped with a ton of saline and around 4pm started with small amount of pitocin. At the start of this I was 2cm. By 7pm my water broke on it's own and I was on my way in active labor. At that time I started feeling discomfort from contractions and opted for an epidural. It was wonderful and took my pain away instantly. From 7pm at 2cm to 10cm at 9pm. Needless to say the took me off of pitocin around 8 because I was progressing so fast. I starting pushing at 9pm and all I could do is just pray in between pushes asking God to give me the strength. Everyone thought, including my OB that he was going to be on the bigger side of 7 pounds. I pushed him for over 2 hours and my OB then finally admitted that something was not right. She gave me an episiotomy and reached her hands up and grabbed his head and pulled as I pushed. She saw his head and says "Oh My GOSH." I was like "WHAT?" She said, "We have a BIG baby." After 2 hours and 40 minutes of pushing, Elias Kristian was born at 11:40pm on October 3rd weighing 9lbs 11oz! WHAT!!! My first baby was that big and I was induced 4 days early! I was a mess crying my eyes out at my BIG miracle! I could not believe that I did it and he was here! I was a mommy! I stayed up all night long and just looked at him and admired everything about him. He took to breast feeding right away but I had a hard time with continuing because I was going back to work in 3 months. So I decided to try and formula feed him - again NO education on my part.

When I got home, I was so depressed that I did not stick with breast feeding and thought it was too late. I cried to my mom and told her how much I wanted to breast feed him and she said to me "Just do it then." I put him at the breast and he took right away, I breast fed him for 3 1/2 months! I stopped because he was having major issues with throwing it ALL up but would not with formula.

Looking back I would have only done one thing different. I would have breast feed and stuck with it! His birth was perfect to me and I would not have changed anything about it...I was glad that I had an epidural with him. He was so big and the complications with his head getting stuck would have most likely caused me to pass out from the pain.

How It All Started

2008-02-25T23:11:00.006-05:00

Ever since the birth of my first son Elias, I knew that I wanted to be apart of this beautiful, emotional, crazy experience of labor and birth. I knew that I wanted something to do with it, but just didn't know where I would fit in. I left the hospital thinking that I wanted to go and be a labor and delivery nurse. I really loved how they were so much apart of the labor. After I had my second son, my feelings changed.

My entire labor was rushed and the nurses wanted me to have a c-section after only 10 hours of labor. If it was not for my OB, I probably would have ended up getting one. It is not their fault...they are trained to get the baby out as fast as possible regardless if their are issues or not. In my case, I had no problems at all...the baby was fine...no dips in the HR or anything. I was only dilated to 9 and had a lip and the baby was -2 station. My OB took the time and pushed with me. She moved the lip out of the way and I delivered 40 minutes later. I also had an epidural that went very wrong. As soon as they gave it to me, my blood pressure dropped dangerously low. Then it made my right leg swell so bad that I eventually had to tell them to turn it off. My right leg was the only thing numb when I gave birth to my second son, Isaac.

When I came home after this labor, I felt lost. I had such a rough second labor, and I whole heartedly admit that I did not educate myself on non-medicated natural birth and I did not educate myself on labor besides what I experienced with my first birth. Knowing the let down that I had and wanting it to be different for me and other moms, I started looking in to what I wanted to do. I found the profession of a Doula. It fit me. It is exactly what I want to be. I want to inform mothers, support them on their decisions, help them carry it out, and be their physical, emotional and informational support during labor. I want to help them have the birth THEY want. Doula's are very scarce around this area and I hope that getting my services out there will will change the way women in Cuyahoga Falls and Akron OH birth.

I decided to get my certification through DONA (Doula's of North America). I have a LONG list of items that I must complete before certification is complete. I hope to be done and certified by early 2009. I am soooo excited for this and relieved that I FINALLY found what I want to do. I even have my first birth lined up for August 2008! (I have to complete 3 births before certification).

Kris and I are going to be trying for our third baby in the next couple of months. Going through this certification process allows me to be educated about this whole experience. It is amazing what I didn't know even going through it twice! I plan on finding a doula in my area (few and far between) - I actually hope to help another doula in training. I am also going to do this naturally and have even considered hypnobirthing.