What We Do...
Naturopathy is based on the idea that the body is self-healing. The body wants to return to a state of homeostasis or balance and generally has the means to do so. Naturopathy incorporates natural therapies including herbal and homeopathic remedies, water therapy, massage, acupuncture, nutrition and lifestyle counseling. The Naturopathic Doctor usually chooses an area of specialty and focuses more attention here in his/her practice.
A licensed Naturopathic Doctor (N.D.) attends a four-year graduate level Naturopathic medical school and is educated in all of the same basic sciences as an M.D. In addition, a Naturopathic Doctor incorporates holistic medical practices with an emphasis on disease prevention.
The concept of Homeopathy was developed by Samuel Hahneman in 1790. In determining which remedy to use for a particular condition, Hahneman observed the reaction of a healthy body to a given remedy and deduced that the remedy could then be used to treat the same symptoms experienced. Homeopathy refers to the “Law of Infinitesimals” and the “Law of Similars”. The Law of Infinitesimals is based on the idea of using small amounts of a substance to stimulate the body’s self-healing mechanisms. Because small amounts are used, the medicine is generally considered safe for any segment of the population. The Law of Similars suggests that like heals like. Based on the Law of Similars, one observed the substance- plant or other material and based on what was seen, determined its function.
Traditional Chinese Medicine
Traditional Chinese Medicine has a long and rich history. The first and most authoritative text on acupuncture and Chinese Medicine is the Yellow Emperor’s Classic or Huang Di Nei Jing, Basic Questions of Internal Medicine. The legendary Yellow Emperor was said to have reigned from 2697-2597 B.C. Modern scholarly opinion maintains that the work was written 2000 years later between the Chou and Han dynasties. To this day and throughout history, the Yellow Emperor’s Classic is and has been foundational in the development of theories and applications of Chinese Medicine. Some of the concepts covered in the classic include, the forces of Yin and Yang, Tao, Theory of the 5 Elements, and application of the above theories to medicine.
Tao, means the method of maintaining harmony between heaven, human and earth. Qi- literally means “the flow of something that is the source of vital energy to humans or animals.” Inherent in the human body is a meridian system, which is analogous to a river system or electrical circuit. The meridians flow from one end of the body to the opposite end and then return to their place of origin intercepting and communicating with other meridians and organs on their journey. Qi flows through the meridian system connected to the exterior/interior, upper/lower area of the body. In addition, Qi acts to defend the exterior from outside invasions. The body is considered to be in a healthy state when the energy can flow in the meridian system unimpeded. When obstructions occur due to invading pathogens such as cold, heat, damp, dry, fire, or wind, or through trauma and emotions, the energy can stagnate and disease results. Emotions are a natural component of our lives, however when emotions become too intense one way or the other, or linger for an extended period of time, their effect on the balanced system can be detrimental.
The concepts of Yin and Yang are foundational to Chinese medicine and date back to the “Book of Changes” or the “I Ching” written around 700 B.C. In the I Ching, Yin and Yang correspond to nature’s ebb and flow and are represented by a solid line-Yang, and a broken line-Yin. The combinations of broken and unbroken lines signify all phenomena in nature as represented in states of lesser and greater degrees. The Chinese character for Yin indicates a shady side of a hill, whereas the character for Yang is indicative of the sunny side of the hill. In addition, Yang represents day while Yin represents night. In real life this would translate into daytime being associated with activity and nighttime with rest. Further delineations are noted in the Yin/Yang chart.
Most of us are familiar with the Yin/Yang symbol. You will notice that some aspect of the other is in each half of the symbol; Yin within Yang and Yang within Yin. The two forms are not independent, but are interdependent such that effects felt on one cause effects on the opposite form. All phenomena in the universe result from the interplay of the two opposing forces of Yin and Yang. The sun rises and sets, day becomes night, warm Spring/Summer days are followed by cooler and darker Fall and Winter months.
Choosing the correct acupuncture points and needling them effectively, may correct the imbalances in the body and modify the disease state. In choosing the appropriate acupuncture points, the practitioner often uses a system of balancing which incorporates the 5 Elements:
Each of these elements pertain to certain organs within the body- a yin organ as well as a yang organ. In total there are 6 ‘solid’ yin organs (Heart, Spleen, Lungs, Kidney, and Pericardium) and 6 ‘hollow’ yang organs (Small Intestine, Stomach, Large Intestine, Urinary Bladder, Gall Bladder, and Triple Energizer).
It is important to remember that when your practitioner states that there is an imbalance in a particular meridian, it does not necessarily mean that Western diagnosis will find that organ to be in a diseased state. Remember, Traditional Chinese Medicine utilizes a system of energetics, which can be difficult to measure under standard medical procedures.
Each of the organs is situated in a particular position symbolized by the circle. The organ preceding any one in the circle is the ‘mother of the ‘son’ that follows. Like a good mother, this organ is responsible for providing nourishment and encouragement for growth to the offspring. This cycle is called the ‘generating sequence’. Each of these organs should maintain a balance of energy in order for a healthy state to persist. Your practitioner will feel your pulse and observe your tongue and ask pertinent questions to establish the state of the relationship between the organs.
In addition, a cycle called the ‘Controlling Cycle’, is generated across from one element to the next and its job is to keep the organ in check. At times the response is excessive and this is called ‘Over-Controlling and leads to a situation of disharmony. When the organ being acted upon retaliates, this is called an ‘Insulting Sequence’. Whereas, the first two sequences – Generating and Controlling are efficacious to a balanced system, the Over-Controlling and Insulting provoke and imbalance in the body.
What is a doula?
The word "doula" comes from the ancient Greek meaning "a woman who serves" and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period. Birthing is a transformational process requiring the mother to engage all of her instincts and resources of energy. It is a time of expectation and yet of encountering the unexpected and as such, the birthing process may be a daunting experience for those involved. The doula will provide or direct the parents to information that may help to answer some of their questions. The root of fear is ignorance they say, and birthing is not something to be feared. A little knowledge of what is involved may help to alleviate any fears that may present. Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily.
A Birth Doula
- Recognizes birth as a key experience the mother will remember all her life
- Understands the physiology of birth and the emotional needs of a woman in labor
- Assists the woman in preparing for and carrying out her plans for birth
- Stays with the woman throughout the labor
- Provides emotional support, physical comfort measures and an objective viewpoint, as well as helping the woman get the information she needs to make informed decisions
- Facilitates communication between the laboring woman, her partner and her clinical care providers
- Perceives her role as nurturing and protecting the woman's memory of the birth experience
- Allows the woman's partner to participate at his/her comfort level
- Provides post-partum support with breast-feeding and easing into transitional changes
A birth doula certified by DONA International is designated by the initials CD(DONA).
A Postpartum Doula
- Offers education, companionship and nonjudgmental support during the postpartum fourth trimester
- Assists with newborn care, family adjustment, meal preparation and light household tidying
- Offers evidence-based information on infant feeding, emotional and physical recovery from birth, infant soothing and coping skills for new parents and makes appropriate referrals when necessary
A postpartum doula certified by DONA International is designated by the initials PCD(DONA).
Research evidence shows that the quality services of a postpartum doula can ease the transition that comes with the addition of a baby to a family, improve parental satisfaction and reduce the risk of mood disorders.
Why use a doula?
DONA International doulas mother the mother. Women have complex needs during childbirth and the weeks that follow. In addition to medical care and the love and companionship provided by their partners, women need consistent, continuous reassurance, comfort, encouragement and respect. They need individualized care based on their circumstances and preferences. DONA International doulas are educated and experienced in childbirth and the postpartum period. We are prepared to provide physical (non-medical), emotional and informational support to women and their partners during labor and birth, as well as to families in the weeks following childbirth. We offer a loving touch, positioning and comfort measures that make childbearing women and families feel nurtured and cared for.
Numerous clinical studies have found that a doula’s presence at birth
- tends to result in shorter labors with fewer complications
- reduces negative feelings about one’s childbirth experience
- reduces the need for pitocin (a labor-inducing drug), forceps or vacuum extraction and cesareans
- reduces the mother’s request for pain medication and/or epidurals
Research shows parents who receive support can:
- Feel more secure and cared for
- Are more successful in adapting to new family dynamics
- Have greater success with breastfeeding
- Have greater self-confidence
- Have less postpartum depression
- Have lower incidence of abuse
Birth Doulas Make a Difference
The value of providing laboring women with continuous emotional support, physical comfort, and encouragement has been recognized worldwide.
Given the clear benefits and no known risks associated with intrapartum support, every effort should be made to ensure all laboring women receive support, not only from those close to them but also from specially trained caregivers. This support should include continuous presence, the provision of hands-on comfort, and encouragement.
Hodnett, E.D. Support from caregivers during childbirth (Cochrane Review) in Cochrane Library, Issue 2. Oxford Update Software, 1998. Updated Quarterly.
A doula provides support consisting of praise, reassurance, measures to improve the comfort of the mother, physical contact such as rubbing the mother’s back and holding her hands, explanation of what is going on during labour and delivery and a constant friendly presence. Such tasks can also be fulfilled by a nurse or midwife, but they often need to perform technical/medical procedures that can distract their attention from the mother. Care in Normal Birth: a Practical Guide. Report of a Technical Working Group. World Health Organization, 1996. Facing unprecedented pressures to reduce expenses, many hospitals are targeting the largest single budget item – labor costs… (An) unintended consequence of nursing cutbacks may be an increased cesarean rate; the inability of pared down nursing staff to provide continuous coverage to laboring mothers (has been) shown to increase the chance of a cesarean…Doulas clearly improve clinical and service quality; they provide an absolutely safe way to reduce cesareans and other invasive birthing interventions. Coming to Term: Innovations in Safely Reducing Cesarean Rates. Medical Leadership Council, Washington D.C. 1996
Professionals have paid much attention to innovative technology and the many new options for monitoring and managing labor. While the technology is important, it can become so prominent that clinicians ignore both the natural aspects of labor and the non-technical needs of women in labor. Changes that support the patient in labor and reinforce the natural, physiologic process include providing one-to-one psychological support for patients using nursing staff or doulas. Reducing the Cesarean Section Rates while Maintaining Maternal and Infant Outcomes. Bruce L. Flamm et al. Institute for Healthcare Improvement, Boston, 1997
The continuous availability of a caregiver to provide psychological support and comfort should be a key component of all intrapartum care programs, which should be designed for the effective prevention, and treatment of dystocia (non-progressive labor). Guidelines on Dystocia. Society of Obstetricians and Gynaecologists of Canada, 1995 Birth doulas make a difference
The doula is emerging as a positive contribution to the care of women in labor. By attending to the woman’s emotional needs, some obstetric outcomes are improved. Just as importantly, the early mother-infant relationships and breastfeeding are enhanced. Women’s satisfaction with their birth experiences and even their self-esteem appears to improve when a doula has assisted them through childbirth.
The Birth Doula’s Contribution to Modern Maternity Care
A DONA International Position Paper
The birth of each baby has a long lasting impact on the physical and mental health of mother, baby and family. In the twentieth century, we have witnessed vast improvements in the safety of childbirth, and now efforts to improve psychosocial outcomes are receiving greater attention.
The importance of fostering relationships between parents and infants cannot be overemphasized, since these early relationships largely determine the future of each family, and also of society as a whole. The quality of emotional care received by the mother during labor, birth and immediately afterwards is one vital factor that can strengthen or weaken the emotional ties between mother and child.. Furthermore, when women receive continuous emotional support and physical comfort throughout childbirth, their obstetric outcomes may improve.
Women have complex needs during childbirth. In addition to the safety of modern obstetrical care, and the love and companionship provided by their partners, women need consistent, continuous reassurance, comfort, encouragement and respect. They need individualized care based on their circumstances and preferences. The role of the birth doula encompasses the non-clinical aspects of care during childbirth. This paper presents the position of DONA International on the desirability of the presence of a birth doula at childbirth, with references to the medical and social sciences literature. It also explains the role of the doula in relation to the woman’s partner, the nurse and medical care providers. This paper does not discuss the postpartum doula, who provides practical help, advice and support to families in the weeks following childbirth. The postpartum doula is the subject of another DONA International Position Paper.
Role of the Doula
In nearly every culture throughout history, women have been surrounded and cared for by other women during childbirth. Artistic representations of birth throughout the world usually include at least two other women surrounding and supporting the birthing woman. One of these women is the midwife, who is responsible for the safe passage of the mother and baby; the other woman or women are behind or beside the mother, holding and comforting her. The modern birth doula is a manifestation of the woman beside the mother.
Birth doulas are trained and experienced in childbirth, although they may or may not have given birth themselves. The doula’s role is to provide physical and emotional support and assistance in gathering information for women and their partners during labor and birth. The doula offers help and advice on comfort measures such as breathing, relaxation, movement, and positioning. She also assists the woman and her partner to become informed about the course of her labor and their options. Perhaps the most crucial role of the doula is providing continuous emotional reassurance and comfort.
Doulas specialize in non-medical skills and do not perform clinical tasks, such as vaginal exams or fetal heart rate monitoring. Doulas do not diagnose medical conditions, offer second opinions, or give medical advice. Most importantly, doulas do not make decisions for their clients; they do not project their own values and goals onto the laboring woman.
The doula’s goal is to help the woman have a safe and satisfying childbirth as the woman defines it. When a doula is present, some women feel less need for pain medications, or may postpone them until later in labor; however, many women choose or need pharmacological pain relief. It is not the role of the doula to discourage the mother from her choices. The doula helps her become informed about various options, including the risks, benefits and accompanying precautions or interventions for safety. Doulas can help maximize the benefits of pain medications while minimizing their undesirable side effects. The comfort and reassurance offered by the doula are beneficial regardless of the use of pain medications.
The Doula and the Partner Work Together
The woman’s partner (the baby’s father or another loved one) is essential in providing support for the woman. A doula cannot make some of the unique contributions that the partner makes, such as a long-term commitment, intimate knowledge of the woman and love for her and her child. The doula is there in addition to, not instead of, the partner. Ideally, the doula and the partner make the perfect support team for the woman, complementing each other’s strengths. In the 1960s, the earliest days of fathers’ involvement in childbirth, the expectation was that they would be intimately involved as advisors, coaches and decision-makers for women. This turned out to be an unrealistic expectation for most men because they had little prior knowledge of birth or medical procedures and little confidence or desire to ask questions of medical staff. In addition, some men felt helpless and distressed over the women’s pain and were not able to provide the constant reassurance and nurturing that women needed. With a doula present, the pressure on the father is decreased and he can participate at his own comfort level. Fathers often feel relieved when they can rely on a doula for help; they enjoy the experience more. For those fathers who want to play an active support role, the doula assists and guides them in effective ways to help their loved ones in labor. Partners other than fathers (lovers, friends, family members) also appreciate the doula’s support, reassurance and assistance.
Doulas as Members of the Maternity Care Team
Each person involved in the care of the laboring woman contributes to her emotional well-being. However, doctors, nurses and midwives are primarily responsible for the health and well-being of the mother and baby. Medical care providers must assess the condition of the mother and fetus, diagnose and treat complications as they arise, and focus on a safe delivery of the baby. These priorities rightly take precedence over the non-medical psychosocial needs of laboring women. The doula helps ensure that these non-medical needs are met while enhancing communication and understanding between the woman or couple and the staff. Many doctors, midwives and nurses appreciate the extra attention given to their patients and the greater satisfaction expressed by women who were assisted by a doula.(19)
In the late 1970s, when Drs. John Kennell and Marshall Klaus investigated ways to enhance maternal-infant bonding they found, almost accidentally, that introducing a doula into the labor room not only improved the bond between mother and infant, but also seemed to decrease the incidence of complications.(6,7) Since their original studies, published in 1980 and 1986, numerous scientific trials have been conducted in many countries comparing usual care with usual care plus a doula.
Training and Certification
Doula training focuses on the emotional needs of women in labor and non-medical physical and emotional comfort measures. The programs require that participants have some prior knowledge, training and experience relating to childbirth, and consists of an intensive two or three day seminar, including hands-on practice of such skills as relaxation, breathing, positioning and movements to reduce pain and enhance labor progress, touch, and other comfort measures. For certification, the doula must have a background of work and education in the maternity field, or she must observe a series of childbirth classes or equivalent. She must also complete the following: a doula workshop course offered by a DONA Approved Doula Trainer, a breastfeeding requirement, required reading,development of a resource list for her clients, an essay that demonstrates understanding of the integral concepts of labor support and a Basic Knowledge Self Assessment Test. Lastly, she provides positive evaluations from clients, doctors or midwives and nurses along with detailed observations from a minimum number of births.
Summary and Conclusion
In summary, the doula is emerging as a positive contribution to the care of women in labor. By attending to the women’s emotional needs, some obstetric outcomes are improved. Just as importantly, early mother-infant relationships and breastfeeding are enhanced. Women’s satisfaction with their birth experiences and even their self-esteem appears to improve when a doula has assisted them through childbirth. Qigong Exercise Pauline Leung