Doulas of Iowa City members bring a wide variety of trainings, skills, and experiences to their work with families in Iowa City, Cedar Rapids, and surrounding communities. We're excited to highlight our member doulas through this series.

Today, meet Grace Swartzendruber of All Bodies All Births Doula Services.

With baby number four on the way, my husband and I started reminiscing about our past labors with our other three kiddos.

I was induced at 38 weeks with my oldest for pre-eclampsia, my middle came all on his own at 37 weeks, and my youngest (and at the time, we thought last) decided he wanted to make his own statement coming into this world by arriving at just 35 weeks.

With my third child, my water broke around 1 p.m., and I did not start having contractions until 8 p.m. The OB intended to start Pitocin (a medication to induce contractions) but was pulled away to an emergency, and in that time my body decided to kick start itself.

A mere two hours later my little Elias entered the world. During labor my contractions got more intense than the ones before, but when I was not contracting I felt fine and was even joking with my husband, the nurse, and some friends. Because my labor was progressing quickly, when I was about 7 cm dilated my doctor said, “If you want the epidural you better get it now because if we wait any longer there will not be time. There is just a little lip left on your cervix and when that is gone it will be go time, your body will rev up, and you will completely dilate very fast.”

With my other two kiddos, I got epidurals during labor. But this time I wasn’t in as much pain. Had he not scared me with the “now or never” approach, I  probably would have declined pain medication with that labor. But, I was already in an anxious state of mind knowing my baby was coming too early and may need NICU time so I just gave in.

The story of my third labor still makes me disappointed every time I tell it, because I felt I could have continued to labor unmediated, but out of fear I let my doctor's commentary sway me. Now do not get me wrong, I was absolutely in love with him and would have him again if he didn’t move away. I think he was just giving me a harsh reality check that it was now or not at all for an epidural.

After we found out about baby number four, I did some research. I had never had a doula before but had heard about the benefits and how others had positive labor experiences with them.  Previously, I never wanted a doula because I associated that term with midwife which I associated with home births. While that may be the way to go for some, for me, with my history, it was not an avenue I was willing to take.

But after doing research, I found out they are not the same at all. In fact, a Midwife has medical education while a Doula is a non-medical support person during labor. Doulas have training in understanding labor and its stages along with techniques and positions to help support you during labor, but they do not offer medical advice (whereas midwives are trained medical professionals). During my research I also learned many midwives will work in the hospital and are not exclusively for home births.

After sharing this with my husband and talking about it, we decided to hire a doula for my fourth birth.

As I say to potential clients, make sure you interview several doulas and pick the one you mesh with best. We found a local chiropractor that I ended up going to due to my severe SPD. After talking with her more and more, I learned she was also a doula. We got along so well it wasn’t long before we hired her. With her on my side, I felt that I would have the support I needed to continue to push through this labor and make my dream of a medication-free birth a reality.

My fourth labor with doula support left me convinced that everyone can benefit from a doula. I cannot even begin to describe the amount of support I felt from her. I went into labor at 35 weeks (again!) and due to some unforeseen circumstances, my birth plan went out the window (and that itself was very hard for me to grasp). She was there and helped keep me calm when I wanted to just run home and be done with it all. I was able to labor without pain medication even through Pitocin-induced contractions, and I am extremely proud to say that! I absolutely would not have been able to do it without her. (There were a few moments of despair on my end, and I will admit I did ask for some IV pain meds, but I was too close to delivery to receive them.)

Our interactions with our doula did not end there. She offered support postpartum as well, which I firmly believe is so important, and I preach it to anyone I can. Moms always put themselves last, and we cannot keep doing that. We need to take care of ourselves so we can take care of our family too!

After everything she helped me through, combined with my love for labor and delivery, I chose to become a doula myself! I am beyond excited that I chose this path, and  I just can’t wait to be that person to them that my doula was to me.

What is a birth doula?

A birth doula is a trained professional for who offers informational, emotional and physical support throughout your pregnancy, labor, and birth. Doulas are not medically trained and do not perform any clinical tasks. As such, doulas are also not a replacement for a care provider such as a midwife or obstetrician. Doulas provide knowledge and resources as you explore your options for labor and birth and will assist you in creating a birth plan. Doulas can teach and provide you with comfort measures for pregnancy and labor, such as positioning, relaxation, visualization, and other pain coping techniques. Doulas provide a calm, caring presence and a familiar face during the uncertainties of birth, especially in cases where you do not know who will be on call when you give birth. 

What services does a birth doula provide?

Everyone's birth package looks slightly different, so it's important to talk through the details with the doulas you interview and carefully read through their package description and contract. Typically once hired, birth doulas meet with the birthing person or couple several times throughout pregnancy to get to know them and their wishes for labor and birth. Your doula is available via phone, text and/or email when questions arise and is a great source of emotional and informational support throughout the many changes that take place during pregnancy.

Doulas are also a great referral source for local resources and typically have networked to create relationships with many providers in your area. Once your labor is established at home or the hospital, your doula will join you when you feel like you need additional support. The doula remains with the birthing person/couple throughout labor and birth, and typically until 1-2 hours after baby is born to help the family adjust to the immediate postpartum and assist with breastfeeding if that's one of the family's goals. Usually a birth doula will also have one postpartum follow-up visit in the client's home about 7-10 days after the birth to check in, make sure things are going well, assist with feeding if needed, and refer to any outside resources.

​What are the benefits of a doula?

Doulas serve many purposes, but for me personally, the primary doula purpose is to have that constant support during labor and birth which can be full of unknowns. You typically won't know which nurse, resident, midwife, doctor, etc. will be on call when you give birth, and over the course of a longer labor and birth, these providers will change shifts so you may have multiple different nurses and midwives/doctors. I know, for me, I feel much safer and more secure knowing there will be at least one person beside me who knows me, my partner, and my wishes for birth.

Experienced doulas can also be very helpful since they are usually familiar with your birthing location's staff, procedures, and protocols and can help educate you in advance and also during birth when you have questions. Doulas work together with birth partners as a team to support the birthing person, and can tag in and out to offer continuous support while also taking care of personal needs such as eating, sleeping, and using the bathroom.

Doulas provide a key role of holding space for the birthing person, especially during a long and/or difficult labor and birth. They provide compassion, empathy, and unbiased support when difficult decisions have to be made and when things don't go according to plan. Doulas help remind you of your goals and priorities, but are completely nonjudgmental when things change.

You may see research or statistics that indicates the presence of a doula will lower your chance of having an epidural, cesarean, and/or other interventions, but I personally don't like to make that claim because sometimes those interventions are wanted and/or needed, and that's totally okay. It doesn't mean you have failed or your doula has failed - doulas are there to support you however your birth unfolds.

​Your satisfaction with your birthing experience is usually more related to your involvement in the process and decision making than the outcome. To loosely quote January Harshe of Birth Without Fear, the goal of a doula is to make sure you know your options, that you feel supported, and are respected.

Looking for a birth doula? Join us for our next Meet the Doulas event or reach out to one of our member businesses directly to set up a consultation.