Your Amazing Newborn
by Marshall H. Klaus, M.D., Phyllis H. Klaus, C.S.W., M.F.C.C. Perseus Books, 1998
A brief book review by Constance Williams, Doula and BirthWay's Newborn Care teacher.

All parents should be aware of the states of consciousness of their newborn baby. By recognizing the different states and realizing when they occur and what the expected responses are in each, parents can provide most sensitively for their baby's needs. The new findings which Dr. Klaus, a distinguished neonatologist and his wife Phyllis Klaus, a psychotherapist and educator explore in their fascinating new book, Your Amazing Newborn, provide new parents with valuable insights to help them unlock the secret messages communicated by their newborn baby.

A thorough reading of their book will help new parents appreciate this precious time of bonding, discovery and joy about which early postpartum parents frequently feel so apprehensive. In the interest of satisfying your need to know the nature and characteristics of your newborn, Dr. Klaus has allowed us to set forth some of his ideas here in our BirthWays newsletter.

In an unmedicated birth when healthy babies are allowed the full range of their faculties, your newborn will open up to you in his first few minutes of life in what is called the quiet alert state. During these first minutes, babies have great curiosity. They can see very clearly at a close range of 8-12 inches, approximately the distance between your face and your baby's as you cradle your newborn in your arms. Their vision and hearing are acutely trained to focus on identifying their mother, and they recognize the timbre of her voice as they look around to associate her voice with a face for the first time. An amazing response is also registered when their father speaks because the baby has heard the loving and familiar tones through the uterine wall during pregnancy and seeks to associate that sound with their father's face.

Babies will be in the quiet alert state directly after birth for up to nearly one hour of age and will on their own when dried and placed on the chest, crawl to the breast and will begin to suckle completely on their own. This movement towards the breast has been dubbed the breast crawl. This characteristic is subtly connected to the baby's sense of smell which is associated with the taste of amniotic fluid which the baby has consumed in utero. The smell emanating from the mother's breast attracts the baby and helps the baby identify the mother. Experiments have shown that within a few days babies can select the scent of their own mothers over another mother's scent.

Because the skin is the largest sense organ of the body, the sense of touch is an extremely important characteristic for parents to understand. Infants have been caressed and surrounded by warm fluid and tissues in utero, so it is not hard to understand that they respond to closeness, warmth, and tactile comforting. Gentle massaging and caressing along with cradling, rocking, patting, and stroking of your newborn will deepen your infant's trust and engender smiles, coos and happiness and will be the surest way to calm your baby's cries.

A newborn's ability to seek her mother's face, respond to her voice, smell her scent, taste her skin and feel her touch during this time when babies are highly aware and impressionable state directly after birth is one of the most precious experiences parents can share.

BirthWays highly recommends this wonderful book which will do much to acculturate you to your newborn. You will want to read it to learn about your baby's other states: active awake, drowsy, and the two sleep states: quiet sleep and rapid eye movement (REM) sleep. In addition to this marvelous book, you can call Johnson & Johnson Pediatric Institute at 877.565.5465, to receive the video "Amazing Talents of the Newborn" ($10) which was supervised by the Klauses and a free parent booklet about your amazing newborn.

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"What's a Doula?"
A Brief Discourse on the Latest Innovation in Birth Care
by Constance Williams, Certified Doula

Navigating through unknown waters, sailors need a compass and the stars to find their way to safe harbor. In much the same way, expectant parents need help understanding the changes their families, minds and bodies will go through to arrive at the happy outcome of babe in arms.

Parents are aware of ob/gyn, hospital and nursing care, and many know about midwives, birth center and home birth options. The newest studies on birth show that the continuous care of a Doula will help mothers have a safer, more comfortable birth with fewer obstetrical interventions. The literature documenting this is referenced in the bibliography at the end of this article.

Most couples now are aware of a new care provider for birthing women and their families: it is the Doula. Also known as Labor Support, Labor Assistant or Birth Guide, the Doula is much like a family member, a mother, sister, daughter, aunt or cousin who brings loving comfort to the laboring couple. BirthWays has asked some of the East Bay's most in demand Doulas how they help and why you should consider seeking the support of one for your birthing.

Doulas nowadays are professional women whose stock in trade is a knowledge of normal birth, comfort measures, and a vast knowledge of the spiritual, physical, emotional, psychological and practical issues surrounding the marvel of birth. For the most part, we have ourselves experienced birth in its natural state, at home or in the hospital without interventions. We have come to this work with a passion for the beauty and power of women and with trust in the natural process learned through our own experience.

Doulas hold normal birth sacred in the birthing room. Parents often are not yet aware of all the possibilities and the consistent emotional and physical support which a Doula provides to the mother and her partner. This support can smooth out rough scary spots, calm fears, ease tension and allow the mother's natural production of oxytocin and endorphins to operate at maximum benefit. (Fear and tension in a laboring mother cause production of catecholomines and adrenaline that stop or slow labor... it's the survival instinct in mammals for fight or flight). So, Doulas can shorten labor with their calm, steady and loving presence. They reassure parents about what is normal and promote a positive energy in the labor room.

Early in labor, when a couple are just discovering that labor has started, the Doula will join them at home and help establish the rhythm of labor. She helps the mother yield to the birth process. This is necessary for effective uterine contractions and sets the pace for labor. Helping the mom to stay at home, relax, eat, sleep, and drink while gradually surrendering to labor will accomplish dilation of the cervix in familiar comfortable surroundings and when birth is more active allows easy transition to hospital and delivery of the baby.

When the laboring couple are in hospital, the Doula provides continuity of care. Doctors, nurses, nurse midwives and staff go on and off shift regardless of a mother's status. The Doula is there with her knowledge of the couples' wishes, needs, issues and preferences and can help communicate these to the ever changing staff. Doulas can also explain technical and medical issues, helping a couple to understand their options and the importance of situations which may arise. The Doula is an advocate for the couple in unfamiliar territory, helping to demystify and clarify issues. Doulas never make choices or speak for a mother and partner, but communicate, clarify, advocate and support.

Doulas are also there to help the father and alleviate his fears. One six-foot husband was known to break down in the hospital corridor and sob like a child on a Doula's shoulder at seeing his wife working in labor only to be supported and reminded that this is normal and that birth happens with great effort, the likes of which humble us all. Doulas have a relationship with the family and this matters when the chips are down.

Most importantly, a Doula is an extra pair of hands; willing, loving, wise hands which smooth the way, support the birth and help to facilitate the bonding and welcoming of the baby into the family. Doulas are usually deft with the cameras too!

Some Doulas also provide postpartum care in the home. Postpartum Doulas can reduce chances of breast feeding problems by helping mom with correct breastfeeding techniques. The Doula knows signs to watch for if baby "is getting enough." She supports both breast feeding mothers and mothers who choose to bottle feed, can greatly reduce the chances of needing a lactation consultant, and can identify when one is needed. They perform basic household tasks such as cooking, cleaning and doing laundry and errands as well as caring for other small children in the home. This allows the mother and baby to relax, adjust, recover from the birth and focus on the family.

It is so important that the mother be fed, massaged, comforted and supported through the first days and weeks with her new baby. The Postpartum Doula can answer questions that come up in the night, identify problems, supply corrections, offer suggestions or make referrals as indicated. The mother has a knowledgeable guide who can help her surf the choppy emotional postpartum waves and confidently recover from the birth so that natural bouts of baby blues don't sink into depression.

Many Postpartum Doulas study the wisdom of ancient cultures to learn the customs which aid healing and recovery of the new mother and baby. Enrichments like massage, meditation, "roasting" and visualization which some Postpartum Doulas incorporate into their service honor the mother and the transition she has experienced and ease her into her new role.

The importance of care in the "fourth trimester" cannot be underrated. Mom's true recovery begins when the excitement and high energy intensity of birth is over, Dad has returned to work, when the focus is off of the mother and onto the newborn. This is the time she needs help the most. The care, nurture and support she receives now is critical to her well-being and happiness. The health and happiness of a well-birthed and well-supported woman will then be reflected in her family, the community and the world.

Thanks to the following Doulas for their contributions to this article: Janaki Costello, Carol Egan, Alice Elliott, Patty Lapinska, Treesa McLean, Lisa Moon, Judy Shalev and Carol Shattuck-Rice.

For more about Doulas read the following book:
Mothering the Mother, How a Doula Can Help You Have a Shorter, Easier, and Healthier Birth, Marshall H. Klaus, M.D.; John H. Kennell, M.D.; and Phyllis H. Klaus, M.Ed., C.S.W. Addison Wesley Publishing 1993.

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The New Face of BirthWays

We'd like to announce that we are making some new and exciting changes to make BirthWays more of a resource for the community. BirthWays, along with Waddle and Swaddle, is committed to providing high quality products and services to pregnant women and families. Beginning in May our new home will be 1625 Shattuck Avenue in Berkeley, conveniently located between Waddle and Swaddle and Elephant Pharmacy. Soon you will be able to take your prenatal classes and find a doula at BirthWays, and meet your new baby needs at Waddle and Swaddle all in the same block. This move is part of our new affiliation with Waddle and Swaddle which will allow you to access the BirthWays resources during business hours, get expert advice from people in the know at Waddle and Swaddle and help support local small business and non-profits through your purchases of new baby and lactation products. Housed at Waddle and Swaddle will be our new comprehensive reference database to be arriving soon and our lending library as well as someone available to talk with you 7 days a week.

We are adding new classes and creating economical class packages. Our new location, in a newly renovated building, has a comfortable classroom space. We are close to great food and all your new found needs of pregnancy and parenting.

We are excited about our new look and look forward to serving our community better. If you'd like to be a part of the fun, let us know, we are in the process of actively expanding our volunteer staff to better support pregnant women and families. If you have some free hours available or would like to get involved in something meaningful, please contact us.

Hope to see you soon,
The BirthWays Board

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