You pee on a stick and see two lines. Congratulations, you're pregnant!
After telling your partner, and maybe some close family and friends (or maybe you want to tell everyone you know), there are a number of things you begin to do.
You Google “pregnancy due date calculator” and figure out your estimated due date.
You call your doctor or midwife’s office to schedule your first appointment.
You start to look for a doula. What? In the first trimester?!
It’s not as crazy an idea as you may think.
Here's why you may want to hire a doula in your first trimester:
1. The doula you want may not be available later in your pregnancy.
There is no “right” time to book your doula; it’s a very personal decision. Sometimes you don’t even learn what a doula is or how one can help you in birth until later in your pregnancy.
But if you know you are interested in doula support, you may want to start your search earlier rather than later. If you find a doula you really connect with and want to support you, communicating with her before she is booked for your birth month or before she makes vacation plans can ensure that she is available for your estimated due date.
Note that birth work has its ebbs and flows; some months I find myself fully booked with births and other months I have no births booked at all. So even if you are approaching your estimated due date and still want to hire a doula, you will likely find one available for your birth. It just may not be the one you thought you would hire.
2. A doula can help you find the right care provider.
Many people automatically contact the doctor or midwife they see for their yearly pap smear and begin prenatal care with that provider. Sometimes it becomes clear that your current care provider’s philosophy about birth doesn’t quite align with your own. Or you may decide that the hospital or facility where they catch babies doesn’t offer the amenities or experience you want for your birth.
Your doula is familiar with a wide variety of care providers in your area. Want to switch from an OB/GYN to a home birth midwife? Your doula can give you a list of options to investigate. Know you want a hospital birth but aren’t sure which doctor to choose? Or you find out later in pregnancy that you need to transfer care from a midwife to a physician?
Your doula can offer care provider suggestions who may be a good fit for your birth preferences and your personality. She can also outline the features and limitations of the different hospitals in your area, to help you narrow down your decision.
3. Your doula works for you the moment you hire her.
Early pregnancy is fraught with its own unique challenges: morning sickness (that really should be called all-day or any-time-of-day sickness), constipation, feeling bloated, exhaustion, and food aversions to name a few. Your doula can suggest helpful things to try, alternative practitioners who may be of help, or she might suggest that you speak to your care provider if the issue is medical in nature.
Your doula can sympathize with you, listen to your concerns with compassion and understanding, and reassure you that what you are experiencing is normal. Sometimes you just need to vent a little, or get some outside perspective; your doula is there to provide that emotional support.
4. The more established your relationship, the better your doula may be able to help you.
When my clients hire me closer to their estimated due dates, we may have time for only one prenatal visit before their birth. When clients hire me earlier in pregnancy, we have time to have two spaced-out, comprehensive visits.
Not only am I learning about their birth preferences and helping them sort through their options for labor, but I’m also getting to know my clients. I learn how they interact with each other, and identify their chief concerns and wishes. I get to know their sense of humor, what makes them unique, what motivates them, and how they show concern for their partner.
All of this experience and interaction informs how I serve them in labor. And because I get to know them better, I may suggest certain things in labor over others. My support in labor is more tailored to their individual needs.
Getting to know my clients helps me help them, and having more time to do this is a great advantage.
Trigger warning: Miscarriage
Sometimes in early pregnancy, there is a loss. According to ACOG (The American College of Obstetricians and Gynecologists), early pregnancy loss occurs in about 10% of known pregnancies. Approximately 80% of miscarriages occur in the first trimester.
Some clients would prefer to wait until the second trimester, when the chance of miscarriage decreases significantly, or even later, until they begin to think about hiring a doula. This is a valid, understandable choice. The choice to hire a doula in early pregnancy or wait until later on is highly personal and totally up to the expecting couple.
If you do hire your doula in early pregnancy and experience a loss, you can turn to your doula for resources on what to expect and how to cope. The vast majority of doulas will refund to you your deposit, even if your deposit is non-refundable (you can ask your doula before hiring her what is her policy on refunds due to loss). She can offer you support and information on any medical procedures you can expect. She can direct you to resources in your area or refer you to a specially trained bereavement doula who can better support you through this difficult time.
Your doula can give you much more than labor support. She is there for you throughout your pregnancy, helping you navigate your way through a time of great change, uncertainty, and ultimately, of great joy.
I am a certified labor (birth) doula and postpartum doula serving clients in Boise, Eagle, Meridian, Nampa, and the Greater Treasure Valley.
Are you newly pregnant and interested in doula support now?
You can use water in labor, even if you don't plan on a having a water birth!
Water is one of my favorite pain management tools in labor. Whether you give birth at home or in the hospital, at some point my clients end up in the tub or in the shower.
Here’s why hydrotherapy can be a wonderful option in labor:
You can relax!
Even for those who aren’t pregnant, a nice, warm bath after a long day of work can make you feel more relaxed and calm. Immersion in water can lessen anxiety and promote relaxation. These same benefits apply when you are in labor.
The calming effects of water can actually help with labor progression. When you are feeling relaxed and calm, your body releases endorphins, which promote the production of another hormone called oxytocin. Oxytocin plays an important role in labor, stimulating contractions. (Known as the "love hormone," oxytocin is also involved in attachment and breastfeeding).
When the oxytocin is flowing, your labor can progress. Conversely, when you are feeling stressed and anxious, adrenaline is produced, which can interfere with oxytocin production. So taking a warm bath, combined with other relaxation tools such as music, meditation, dim lighting, massage, and self-hypnosis, can help your labor keep a nice, active pattern.
Note: In early labor, taking a bath can slow down contractions. This is just fine-- early labor should be a time of rest, since it can take hours or even days to turn into active labor. If active labor is imminent, taking a bath won’t stop it!
It provides pain relief.
Water is sometimes referred to as a “liquid epidural.” While water doesn’t take away all sense of pain (although some clients report that at times it comes pretty close), it definitely helps to make the pain of labor more manageable.
The website Evidence Based Birth gives a review of the evidence behind water immersion as pain relief in labor. In a meta-analysis of several studies, it was reported that people who labored in water were less likely to use epidurals or spinal anesthesia for pain relief.
Submerging your body in water isn’t always necessary. Standing in the shower, with the hot water pointed at the part of your body where you are feeling the most pain or discomfort, is also very effective for pain relief.
You can move.
While submerged in water, it may be easier to move your body into positions that may be more difficult or uncomfortable "on land," like hands and knees, or in a squat. Being in water can help take pressure off of areas of your body that ache. You may feel more buoyant and lighter, contributing to feelings of relaxation.
If you are laboring at home, you can use your own bathtub or shower. (In early labor, I encourage my clients to take a bath and then try to sleep for a while, to reserve their energy for active labor.)
At the birth center, there are tubs and sometimes showers for your use. And more and more hospitals are offering tubs to labor in (although most hospitals still don’t allow pushing or giving birth in the water).
Fortunately for those in the Treasure Valley, both St. Lukes and St. Alphonsus offer labor tubs, either in each room or in a single-use shared space on the labor and floor. Some tubs sport jacuzzi-style vents for additional comfort.
For low-risk pregnancies, you can labor in the tub at just about any time, including after your bag of waters has broken, or if you have been induced. When laboring in the hospital tub, the nurses can monitor you intermittently without you having to get out of the water; if you consent to cervical exams, these can often be done in the water as well. (Note that with narcotic pain medications and epidurals, you won’t be allowed to labor in the tub for safety reasons.)
You can try it again.
At some point, if my clients aren’t planning a water birth, they decide to get out of the tub, either to push out their baby or to continue laboring on land. At this point, I can help them maneuver out of the water and wrap them up in a nice, warm towel so we can try some other comfort measures.
Sometimes, my clients decide to try the tub or shower again, and they easily can.
With some pain medications, you can have only a certain number of doses, and your mobility may be decreased for a while. With hydrotherapy, you can return to the tub or shower at just about any time during labor.
If you are worried about an accidental water birth, your doula and care providers can often get a sense of how close you may be to pushing based on your behavior and sensations you are reporting. We can recommend getting out of the tub to give you enough time to get to the place where you intend to birth your baby.
I am a certified labor (birth) doula and postpartum doula serving clients in Boise, Meridian, Eagle, Nampa, and the Greater Treasure Valley.
Do you have questions about using water in your upcoming birth?
I've worked in the forest, in the lab, and in an office cubicle. My favorite and most passionate work has been alongside clients as they reach inside to find their innermost strength, and give birth to their babies. Each birth is an honor to witness.