The Ordinary Doula Podcast
Welcome to The Ordinary Doula Podcast with Angie Rosier, hosted by Birth Learning. We help folks prepare for labor and birth with expertise coming from 20 years of experience in a busy doula practice, helping thousands of people prepare for labor, providing essential knowledge and tools for positive and empowering birth experiences.
The Ordinary Doula Podcast
E56: People, Place, and Policy
How can the right combination of people, place, and policy create a birth experience that feels empowering and supportive? Join us on The Ordinary Doula Podcast as we unravel this essential trio that shapes your birthing journey. Discover how assembling the perfect support team of partners, family, friends, and healthcare providers can have a transformative effect on your birth, and learn about the invaluable role a doula plays in bridging any gaps in empathy and experience. I’ll share insights on how the nursing staff's influence can vary and why building rapport with your nurse can make a significant difference.
Also on the agenda is the critical choice of hospital or birth center. We’ll explore the ways that familiarizing yourself with your birthing environment can reduce anxiety and boost comfort. From virtual tours to personalizing your space with sensory items like lighting and floral arrangements, you'll hear tips on setting a positive atmosphere. We’ll also take a closer look at hospital policies, which can differ widely and affect your experience. Armed with knowledge about people, place, and policy, you’ll feel more prepared to navigate your chosen birthing environment.
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Show Credits
Host: Angie Rosier
Music: Michael Hicks
Photographer: Toni Walker
Episode Artwork: Nick Greenwood
Producer: Gillian Rosier Frampton
Voiceover: Ryan Parker
Welcome to the Ordinary Doula Podcast with Angie Rozier, hosted by Birth Learning, where we help prepare folks for labor and birth with expertise coming from 20 years of experience in a busy doula practice Helping thousands of people prepare for labor, providing essential knowledge and tools for positive and empowering birth experiences.
Speaker 2:Hello and welcome to the Ordinary Doula podcast. I am Angie Rozier and I'm your host and I'm so glad to be with you here on today's episode. So today I want to talk about three P's. I'm going to call them People, place and policy. So, in regarding your upcoming birth experience, anyone's upcoming birth experience, those three things the people, the place and the policy are going to have a pretty significant impact on the type of options that are presented to you and the type of experience that you may be having.
Speaker 2:It's, it's interesting to articulate kind of what is missing in some hospital systems and illustrate why people recognize the need to bring in their own dedicated support. That's why I have a job, that's why doulas exist, is because something is missing in systems and there's. There's kind of they've dropped a piece of care that people need to create for their own. Hence we have labor support, professional labor support, as well as family and friends labor support. So, people, place and policy. Your experience will definitely be impacted by people, place and policy. Let's talk first about people. The people involved with your experience, of course, are going to be you and your chosen support person or persons. Maybe that's going to be a partner, a sister, a mom, a friend. Your people will also include a provider, whether you have selected a midwife or a doctor to be your main caregiver, and the people are also going to be the ancillary staff at whatever you've chosen to give birth, whether that's a hospital, um, or a birth center or home. So hopefully you've chosen some good support people. If you know that your inner circle your partner, your sister, your mom, your friend is not going to be good in some aspects of this, maybe you want to consider expanding your team a little bit and getting the support that it that you are looking for.
Speaker 2:Just today I was speaking with a friend and client who's become a dear friend and she her partner has been with her and been involved in all of her deliveries. But just today she said he sucks and he thinks he's doing a great job, but he just you know I need somebody who's been through it. While he's very attentive and very intelligent and very supportive, she finds the need to have somebody who has a little bit broader vision about that. So she that's why she hires doula support. So hopefully, have a good partner and if you don't, how can you enhance that partner's role or kind of accelerate that partner's role, whether by education, by preparation, that's certainly possible. Learn a few things together, take a class, do some preparation, study some apps together, make sure you know what's going on. Read some books together, do some preparation, pull this partner on board. So to their comfort level.
Speaker 2:Some of them are going to be really good about the technical stuff. Others will be really good about you and connecting to you. You know who you're working with. So and hopefully you have an idea of what it is that you want. Other people, providers hopefully you have a provider that you like. Hopefully you have a provider that you trust and can build a relationship with like. Hopefully you have a provider that you trust and can build a relationship with. So many times now we have provider groups where you might cycle through and see different providers throughout a pregnancy and you're not building that connection and having that continuity of care. But hopefully you're able to kind of get a touch points with the people who may be there the provider that might be there to deliver your baby.
Speaker 2:But understand that, know that that that people, that important people that you've chosen a provider might not be the one who is there to manage your labor or to deliver your baby very common and then other people are going to be. Your nurse is going to be your main liaison between you and your labor and your provider, who's going to be kind of watching from afar until the end. So that person is kind of a wild card, because we have no idea who your nurse is going to be until the day you go into labor, the day you get induced, whatever the case may be, until you are actually in process, and that could change, right? Nurse shifts they're generally 12 hours. Sometimes some places have eight hour shifts. So if you're there for very long or you overlap a shift, you'll get a new nurse. You'll have a different people, a different people involved, but the nurse, other than your partner, is going to be the one who spends the most time with you, right, they're going to be taking care of you, they're going to be watching you closely, they're going to be meeting your needs, answering your questions, and you have to build a pretty quick relationship with that person. Our partner we get more time, right, we've chosen them and our nurse, even our provider we hopefully choose and get more time with them. The nurse we get, who we get on the day of, and it can change. So make good friends with your nurse, get to know them, appreciate them for their role.
Speaker 2:Another people that might be involved is other family members, whether you have a mom, a sister, a neighbor, a friend, a child. Maybe you have a child that you want to be there at the delivery. Those are other people and consider how they're going to impact your situation and you want to. Obviously you want people's impact to be positive. And then a doula Hopefully a doula is someone that can be on your team as well. A doula is an incredibly pivotal role to the team because they can bring it together. They can make up for where the partner might be missing some experience or empathy or, you know, in body experience even. Hopefully you're fortunate enough to be able to have a doula on your team. They can be a liaison between what you want and some hospital staff. They can help you articulate what you want, help you understand and know your options. They can involve your other team members as you want them involved. As far as like, if you have a sister, mom, friend who might be there, they can accentuate and enhance their roles as well and then hopefully they can also help you with your staff.
Speaker 2:I always like when I'm at a birth, to make a really friendly space like a really amicable space for the entire team. So we welcome everybody onto the team. That that you know. Of course, we got a mom on the team and her partner, and then when the nurse comes on, we welcome her onto the team and appreciate everyone for their role. You might have like somebody drawing labs who comes in, you might have a housekeeper change the garbage. There's going to be other touch points that might come on. But people are important to your experience. So consider who it is you have around you and what you expect from them and if they can do that. We can't have unrealistic expectations of folks. So sometimes we need to shift or create roles in order for our expectations to be possible with the people we have around us.
Speaker 2:Next P is place. So the place you're going to be when you're in labor and delivering a baby has a lot to do with the experience of it. It definitely impacts what your experience will be like. So if you're at home, you're going to have one type of experience where it's quite autonomous, like people having giving birth at home are very independent. They kind of know what they want. They have a lot of autonomy to make a lot of choices and they invite their team into their home. We also have birth centers. Birth centers, we know, are much more comfortable and home-like than a hospital, but you're still going into another space or traveling somewhere, right, traveling somewhere to go deliver, and usually with birth centers you're not there very long afterwards. They like you to come in an active labor. They don't take you extremely early in labor. In most cases they're not gonna what they call labor sit or labor watch when early labor is happening, and a lot of that can be done at home. And then, of course, we have hospitals is our most common place in the United States that people are delivering to the tune of 95 plus percent. It depends on what state or what region you live in, but anywhere from 99 to about 92% of deliveries are in hospitals, so extremely common.
Speaker 2:Now you may have different hospitals available to you by insurance or by geographical location and get to know that place, like ask about the people who work there and kind of get to know the place. If you can take a tour, awesome. Sometimes it really helps if you can visualize where you're going to be. If you can envision the labor and delivery unit or the postpartum unit, maybe some hospitals have them combined and it's both. But if you can see in your mind where you're going to be, sometimes that is helpful. Some hospitals have virtual tours where you can get online and kind of do a virtual tour. So again, walking in, you kind of have an idea of where you're going, what it's going to look like.
Speaker 2:But that place has a lot to do with your experience and you want to be comfortable in that place. Some people are much more comfortable at home. Some people are much more comfortable in a hospital. Everyone's a little bit different about that. Some people want to be at home in early labor and then, you know, shift to their birth center or hospital in later labor. And place of course has a lot of physical representation to us and I always encourage my clients to make that space their own, whether they're at a hospital generally, especially in hospitals like home, that is your space, right, you've chosen a lot of the environment of your home and but the birth center. Birth centers are generally quite beautiful. They have a really nice aesthetic component to them. On purpose, they want to feel very comfortable, look very comfortable and have some pretty good amenities, if you will.
Speaker 2:Specific to childbirth and labor, some hospitals do that as well. They might have certain rooms that they reserve for people who are going unmedicated. They might have certain rooms and I've seen that in many different hospitals where they'll have, you know, these awesome tub rooms. We kind of save those for our people going unmedicated, or in those rooms I'll have extra cute aesthetic things which I think they can make everything, every room, kind of cute and aesthetic, but they might have. I have seen hospitals where they have plants or cute pillows or oil diffusers in specific rooms to kind of create a better ambience and give clients more options.
Speaker 2:So kind of be aware the place you're going and what they have available, and then feel free to take with you to that space, that place, anything to make that your own, whether that's think of the five senses, if you want to, you know, put a different blanket on the bed. That changes the room a lot. If you want to bring your own lighting, you have pretty good lighting options in hospitals. But some people just this week I met with a couple who, as we were, creating their comfort measures and their coping plan, they have a gorgeous lamp that they got on their honeymoon in Istanbul and it's blue. Both of their favorite colors are blue and it's this absolutely gorgeous. It's small, it's very travelable. That's what they want to bring to their hospital room to help it be their own space.
Speaker 2:So make that space your own, kind of. Consider the space and how you can personalize it. When you do that, you set the tone for the room you're going to be in. Even in a big hospital system, even in a place where we feel like we don't have much control, where there's a lot of policies around people's behaviors and parameters around which we can practice, and rules, lots and lots of rules. Set the tone for your room. How do you want your room to feel Like. Give some intention to your immediate place and space and how you want that to feel, and you can bring music or scents or colors or items Some people will bring. I had a couple years ago this mom brought floral arrangements. She had four different beautiful floral arrangements that at the end she gave to her nurses, her midwife and to her doula, which was super sweet and it just changed the room. So consider what you want to take to make that place your own.
Speaker 2:And then our next P is policy. So we got the people, we got the place and then we have the policy. Now the place can be very impacted by the policy. The policy can be very impacted by the place. Likewise, policy can be impacted by people and policies impact people. So, depending on who makes decisions at the place you have decided to give birth at will determine policy, and you it's. It's wild to me how policy changes from one hospital to the next. Where they can be, you know, 10 minutes apart from each other driving, but years apart. In policy, some policies are very archaic. Some policies are really up to date and evidence based, but be aware of the policies, of where you give birth and how do you find out policies. So I call this also culture, right? The culture of a place is the people, the place and the policies, how they all intertwine and are going to impact the experience.
Speaker 2:I was speaking with a same client who's become a dear friend. She is deciding she would love to do a home birth and that's an option she's keeping in her back pocket. But she's deciding between two hospitals and in North Carolina, both of which I've worked at many, many times, and, as we've talked about the nuances between these two hospitals. That's helping her kind of make a decision. She has also done some extra homework. Her baby is going to be born during the winter time so that would be considered flu season for well, most everywhere anywhere has flu season anymore. So this baby will be born during flu season and she's asking about the policy they have around flu season. So she's got two hospitals she's looking at. She has a younger child. She would like the option of this child coming to the delivery. One hospital says during flu season, nobody under 12. The other hospital saying during flu season, nobody under 14 except siblings. During flu season, nobody under 14 except siblings.
Speaker 2:Some hospitals may have a masking policy around flu season. I remember years ago the H1N1 year I don't remember when that was, I don't know 10, 15 years ago something. There was really restrictive policies. We're used to restrictive policies now after COVID, right, like that, got us really used to restrictions. But the H1N1 year of rough flu they restricted visitors like how many people could go in. They and a lot of hospitals created policies, different policies, around that. Um. So this, this client of mine, is deciding which hospital, which hospital policy, am I going to? Um be okay with Same situation.
Speaker 2:We were looking at hospital policies around anesthesia. So there's an anesthesia department in labor and delivery and they have certain policies. One of the hospitals she's looking at has they. They kind of kept this from COVID and haven't let go of it four years ago, but they kept a policy where no one can be in the room while an epidural is being administered. The anesthesia department has set that policy. They're very firm about it. So even the doula gets kicked out of the room, the partner gets kicked out of the room, just the nurse remains in the room while the epidural is being placed. I think that's rough. I think that's a super strict kind of ridiculous policy. That might be the moment or moments that that client needs the most support and when we have a policy that eliminates that support, that's super not cool and people have chosen not to give birth there because of that policy.
Speaker 2:Some hospitals will have widely varying policies around eating and drinking during labor. So do your homework, like where you're going to have a baby, ask. You can call labor and delivery, ask what's your policy on this, what's your policy on that. If you got digging, you'd be surprised what policies really are. You could talk to a nurse manager and get different questions than the receptionist would give you, than a nurse would give you, than infectious control would give you, than the marketing department would give you, than administration would give you. So kind of dig around and ask your provider. That's a good place to start and ask around at the hospital. Ask people who've been there, ask friends or relatives, family, family or neighbors who have delivered at this hospital, what their experience was like surrounding certain things.
Speaker 2:And, honestly, policies are not upheld perfectly. You might have someone enforce a policy very differently in one case and then the next week enforce it, you know, totally opposite. So there's hospital policies around eating and drinking. There's hospital policies around the OR. Can you take one person into the operating room? Can you take two? There's hospital policies around when to break the water, or how long the water can be broken, how to treat that. There's policies around being in the hallway with your baby. There's policies around all kinds of things. You'd be surprised all the policies, the procedural things that happen in labor and delivery. So become familiar with that.
Speaker 2:Ask a doula who's busy and familiar in your area and goes to the hospitals that you're considering. So, considering people, place and policy, we have control over some of those and, considering people, place and policy, we have control over some of those, we have influence on all of those, and so consider for your experience, what it is that you want from your labor. From your experience, how can you best be set up to get that for success, for enjoyment, for empowerment. And go about putting things into place, making shifts, so that you can get the type of birth experience that you are hoping for, considering people, place and policy, because they'll have a big impact. I hope you have the type of birth that you're hoping for. I, for my clients, always hope for a positive birth experience, and a bonus is an empowering birth experience and, of course, a safe birth experience as well, and that can come in.
Speaker 2:So, so, so many different packages. Um, every situation is a little bit different. So consider your situation. What is important to you. That wraps it up today for the ordinary doula podcast. Again, this is angie rosier. Thank you so much for being with us today. Hopefully you can go, reach out and connect with another human being today, find somebody to connect with and share a little piece of joy today. Hope you have a good one and we will hear you, see, you feel you next time. Thanks and bye.
Speaker 1:Thank you for listening to the Ordinary Doula podcast with Angie Rozier, hosted by Birth Learning. Episode credits will be in the show notes Tune in next time as we continue to explore the many aspects of giving birth.